椎间盘镜手术系统治疗中老年腰椎间盘突出症的临床效果观察

目的探讨采用椎间盘镜手术系统(MED)对中老年腰椎间盘突出症患者的治疗效果。方法回顾性分析我院骨科2010年2月至2013年4月收治的100例腰椎间盘突出症患者的临床诊治资料。根据手术方式分为经皮内镜下腰椎间盘突出切除术44例(对照组)、采用MED治疗56例(MED组),比较两组患者的术中情况,术前及术后12个月、术后24个月的视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数及Nakia疗效评价情况。结果对照组的手术时间明显短于MED组(P<0.05),而MED组患者的术中出血量、卧床时间、住院时间明显短于对照组(P<0.05)。术前两组患者的VAS、ODI评分差异均无统计学意义(P>0.05),两组患者术后第12个月、24个月的VAS、ODI评分均较术前明显好转(P<0.05),但术后两组患者的ODI评分差异无统计学意义(P>0.05),术后MDE组的VAS评分在第12个月、24个月均显著优于对照组(P<0.01)。术后两组患者的Nakia疗效分布及总有效率比较差异无统计学意义(P>0.05)。结论椎间盘镜手术系统治疗中老年腰椎间盘突出症患者较经皮内镜下腰椎间盘突切除术具有减少患者术中出血量、住院时间、卧床时间、术后疼痛的优势,同时治疗效果良好。     

酒精性肝炎患者肝炎病毒的检验结果探讨

目的：探讨酒精性肝炎患者肝炎病毒检测结果。方法：我院2007年1月至2010年2月收治的390例酒精性肝炎患者临床检测结果进行分析。结果：尚不能认为酒精性肝炎合并肝炎病毒感染的患者病情严重程度与单纯酒精性肝炎患者有统计学差别。酒精性肝炎合并肝炎病毒者与单纯酒精性肝炎者的年龄、饮酒年限、总酒精摄入量差异无统计学意义,但酒精性肝炎合并肝炎患者AST、ALT、AST／ALT值显著较高。结论：ALD合并肝炎感染可使AST、ALT、AST／ALT等灵敏度较高的指标上升,为临床诊断和治疗提供一定依据。但尚有待于进一步的临床流行病学研究调查得以证实。     

羊水过少临床分析

目的探讨羊水过少患者的临床治疗体会。方法回顾性分析2007年7月——2009年12月的93例羊水过少患者临床诊治资料。结果羊水过少组孕周40—42周的患者较多，对照组孕周37—39周的患者较多。羊水过少组的剖宫产率、妊娠并发症和羊水粪染率、不良反应发病率显著较高。结论羊水过少是胎儿危险的重要信号，因此应加强产前检查，做到及早诊断和及早处理。     

经皮椎间孔镜手术治疗腰椎间盘突出症的并发症及应对策略

目的 探讨经皮椎间孔镜腰椎间盘切除术(PELD)治疗腰椎间盘突出症的相关并发症并分析其原因,提出处理对策。方法 回顾性分析接受PELD治疗的138例腰椎间盘突出症患者的临床资料,统计并发症发生情况,分析并发症发生的原因,提出处理对策。结果 本组138例患者,手术时间20～147(58.90±1.95)min;术后VAS评分为(1.04±0.77)分,明显低于术前的(6.67±1.25)分,差异有统计学意义(P<0.05)。根据改良MacNab标准评价优良率,优97例,良27例,可13例,差1例,优良率为89.86%。本组发生并发症共9例(6.52%),其中术中并发症5例(3.62%),包括神经根损伤1例、血管损伤1例、射频刀头脱落1例、类脊髓高压综合征2例;术后并发症4例(2.90%),包括切口感染1例、术后复发1例、感觉异常2例。结论 PELD治疗腰椎间盘突出症可显著改善患者的腰腿痛症状,总体效果较好,具有较高的临床应用价值。PELD的并发症并不少见,需要术者熟悉相关并发症及其产生的原因,规范操作,提高手术技巧,做好应对措施。     

经皮椎体后凸与经皮椎体成形术修复骨质疏松椎体压缩性骨折：随机分组比较

BACKGROUND: Recent literatures have showed that percutaneous kyphoplasty can effectively avoid nerve damage, pulmonary embolism, and insufficient vertebral height and other security risks when bone cement is infused into affected vertebrae in percutaneous vertebroplasty. OBJECTIVE: To compare the effect of percutaneous kyphoplasty and percutaneous vertebroplasty in repair of osteoporotic vertebral compression fractures. METHODS: A total of 106 patients with senile osteoporotic vertebral compression fractures were randomly divided into trial group and control group (n=53 per group). Patients in the trial group were treated with percutaneous kyphoplasty, and those in the control group treated with percutaneous vertebroplasty. All patients were followed up for 6 months after repair. The vertebral compression deformation, bone cement distribution, midline vertebral bone cement condition, vertebral height restoration, bone cement leakage, vertebral kyphosis, progressive spinal collapse, nerve damage, as well as visual analog scale scores and Oswestry disability index scores in these two groups were compared. RESULTS AND CONCLUSION: Compared with the control group, there was less bone cement leakage and vertebral compression deformation in the trial group. Moreouer, in the trial group, bone cement distributed uniformly, vertebral height restoration was good and effective, pain was obviously relieved, and the probability of vertebral kyphosis, progressive spine collapse and nerve damage was significantly reduced (all P < 0.05). These results suggest that percutaneous kyphoplasty can effectively relieve the pain of patients with osteoporotic vertebral compression fractures, restore vertebral body height and reduce the incidence of complications, which effectively guarantees the postoperative restoration of motor function.