左肺巨大错构瘤1例

巨大肺错构瘤少见,今报告经手术后病理证实1例。患者女性,28岁。因咳嗽痰中带血丝于1991年2月18日入院。既往史在15年前无诱因咳数口鲜血后自止。曾在外院摄片发现左胸阴影,因咳血自愈后未经治疗和复查。尚能参加体育运动。生育两胎均健康。 查体:体温36.7℃,脉搏74次/分,呼吸21次/分、     

腓骨长肌腱及动力腱联合治疗严重膝关节不稳

目的：探讨腓骨长肌腱及动力腱联合治疗膝关节交叉韧带等损伤所致严重膝关节不稳的疗效。方法：将腓骨长肌腱止点切断后游离并翻折肌腱,经膝关节损伤韧带附着处骨孔,沿损伤韧带行走方向,重建膝关节韧带。对包含胫侧副韧带损伤者,加鹅足成形术;对包含后交叉韧带损伤者,加髌韧带中１／３止点切断、经胫骨平台中央骨孔固定术。结果：本组随访１～５年,根据改良的Ｌｙｓｈｏｌｍ评分表,７０～９０分６例,５０～６９分５例,平均     

不同方法治疗老年性股骨粗隆间骨折的临床分析

Objective Probe into different method safe and effective fixation method,clinical result and cliniical to indications of different treatments in intertrochanter fracture of femur in the old elderly.Methods Adopting the femur near end dissecting type to lock the stencil plate fixation 14 of 58 cases of old intertrochanter fracture of femur separately.the hip screw of motive force(DHS) fixation was used in 24,femur near end stencil plate fixation in 20,and the blood loss,operation time,ossicle split off situation and fracture heal time were compared among the three groups.Sanders grade results and complications were followed up.Results Postoperative follow up Was done in all patients,from 8 months to 3 years,averaged 1.5 years.three groups of skill type fine rate of the three groups being 92.9%,92%,90%respectively.Conclusions Different methods showed good clinical results in treating the old intertrochanter fracture of femur,each having its indications.Operation should be done should follow based on fracture type,age,physique factors and patient's osteoporosis intensity,choosing the best healing solution by characteristics of intermal flxation while each combining.The hook board(ALHP)is suitable for old patients with serious osteoporosis,DHS for Evans Ⅰ,Ⅱ types and some Evans Ⅲ type,and femur near end dissecting type stencil plate for Ⅳ and Ⅴ types fractures.     

颈项肌锻炼操治疗退行性下颈椎不稳症

目的探讨自编颈项肌锻炼操治疗退行性下颈椎不稳症的临床效果。方法对129例退行性下颈椎不稳症患者发放自编颈项肌锻炼操手册,指导患者进行系统性颈项肌功能锻炼,并坚持锻炼0.5 a以上。结果本组随访0.5~2 a,治愈率68.2%,总有效率96.9%。颈椎过伸、过屈位动力性侧位片显示角位移和水平位移锻炼后比锻炼前有明显改善(P均<0.05)。结论自编颈项肌锻炼操不仅增加退行性下颈椎不稳症患者的颈椎动态性稳定,同时也增加颈椎静态性稳定,是保守治疗退行性下颈椎不稳症的有效方法。     

不同方法治疗老年性股骨粗隆间骨折的临床分析

Objective Probe into different method safe and effective fixation method,clinical result and cliniical to indications of different treatments in intertrochanter fracture of femur in the old elderly.Methods Adopting the femur near end dissecting type to lock the stencil plate fixation 14 of 58 cases of old intertrochanter fracture of femur separately.the hip screw of motive force(DHS) fixation was used in 24,femur near end stencil plate fixation in 20,and the blood loss,operation time,ossicle split off situation and fracture heal time were compared among the three groups.Sanders grade results and complications were followed up.Results Postoperative follow up Was done in all patients,from 8 months to 3 years,averaged 1.5 years.three groups of skill type fine rate of the three groups being 92.9%,92%,90%respectively.Conclusions Different methods showed good clinical results in treating the old intertrochanter fracture of femur,each having its indications.Operation should be done should follow based on fracture type,age,physique factors and patient's osteoporosis intensity,choosing the best healing solution by characteristics of intermal flxation while each combining.The hook board(ALHP)is suitable for old patients with serious osteoporosis,DHS for Evans Ⅰ,Ⅱ types and some Evans Ⅲ type,and femur near end dissecting type stencil plate for Ⅳ and Ⅴ types fractures.     

缝匠肌蒂髂骨膜骨瓣移植治疗青壮年股骨颈骨折

目的探讨缝匠肌蒂骼骨膜骨瓣治疗青壮年股骨颈骨折的疗效。方法采用3枚空心拉力螺钉内固定,带缝匠肌蒂髂骨膜骨瓣移植于骨折端治疗21例青壮年股骨颈骨折患者。结果术后随访2~5 a,骨折愈合良好,股骨头坏死2例。按Bramback标准,优15例,良4例,差2例,优良率90%。结论空心拉力螺钉内固定及缝匠肌蒂髂骨膜骨瓣移植治疗青壮年股骨颈骨折操作简单,骨折固定牢固,创伤小,骨折愈合率高,股骨头坏死率低。     

不同方法治疗老年性股骨粗隆间骨折的临床分析

目的 探讨不同方法治疗老年性股骨粗隆问骨折安全有效的内固定方法、临床效果及其临床适应证.方法 对58例老年性股骨粗隆间骨折分别采用股骨近端解剖型锁定钢板固定14例,动力髋螺钉(DHS)固定24例,股骨近端解剖型钢板固定20例,比较3组术中失血量、手术时间、骨质劈裂情况及骨折愈合时间,随访Sanders评分结果和并发症发生情况,并进行临床和统计学分析.结果 术后全部得到随访,随访8个月～3年,平均1.5年,3组术式的优良率分别为92.9%、92%和90%.结论 不同方法治疗老年性股骨粗隆间骨折的临床效果都很满意,但各有其适应证,手术方式应根据骨折类型、年龄、体质因素及患者骨质疏松程度,结合各内固定特点选择最佳治疗方案,对伴有严重骨质疏松的高龄患者适合选用应用解剖型锁定钩板(ALHP)固定,对Evans Ⅰ、Ⅱ型和部分EvansⅢ型适合选用DHS固定,对Ⅳ、Ⅴ型适合选用股骨近端解剖型钢板固定.     

四肢非主要血管皮瓣的临床应用

目的 :探讨四肢非主要血管蒂皮瓣移位修复皮肤缺损的效果。方法 :采用四肢主要血管分支或 (和 )皮神经营养血管为蒂的 12种皮瓣修复皮肤软组织缺损 2 6例。皮瓣面积 2 3 0cm× 12cm～ 2 0cm× 3 0cm。结果 :2 4例皮瓣完全成活 ,2例皮瓣远端部分坏死 ,经换药、植皮而愈。经随访临床效果满意。结论 :根据四肢皮肤缺损部位、大小、功能要求等 ,选择主要血管分支或 (和 )皮神经营养血管蒂的皮瓣 ,能较好的修复部分创面。     

静脉桥接配合神经生长因子治疗周围混合神经损伤

目的 :探讨神经断端自体静脉桥接及应用神经生长因子 (NGF)联合治疗周围混合神经损伤的临床疗效。方法 :用倒置的自体静脉段将完全断裂的周围混合神经远近端套接 ,神经断端间保留 3mm的小间隙形成神经再生室 ,术中将NGF1 0 0 0 u 一次注入再生室内 ,术后于损伤神经支配的肌肉 (靶肌肉 )内连续每天注射NGF1 0 0 0 u 共 2周。结果 :本组 6例均获得随访 ,最短 3个月 ,最长 1 8个月 ,根据周围混合神经综合评定标准 ,所有 7条神经均达到优良 ,靶肌肉肌力≥M3。结论 :该法对提高周围混合神经 (尤其运动神经 )损伤后功能恢复效果显著