纤支镜肺泡灌洗术防治亚低温治疗患者肺部并发症的疗效

目的]探讨锁定钢板治疗肱骨上段复杂骨折的疗效.方法]回顾性分析本院2005～2009年经切开复位钢板内固定术治疗的肱骨上端复杂骨折患者52例,均为Neer三部或四部骨折,其中肱骨近端锁定钢板（ LPHP ）治疗25例,传统T型钢板及普通肱骨近端解剖钢板治疗27例.通过从手术时间,骨折临床愈合时间、术后功能Constant-Murley 绝对值评分优良率等方面进行评估,对两种内固定疗效进行分析比较.结果]LPHP组手术时间为（ 89.0±15.6 ） min,传统钢板组为（ 120.6±21.9 ） min,两组比较有统计学意义（P〈0.05）;LPHP组骨折临床愈合时间（ 13.0±2.10 ）周,传统钢板组为（ 15.5±2.67 ）周,两组比较有统计学意义（P〈0.05）;Constant-Murley 绝对值评分LPHP组优良率为92.0%,传统钢板组为66.7%,两组比较差异有统计学意义（ P 〈0.05）.结论]LPHP治疗肱骨上段复杂骨折较传统钢板内固定手术时间短,骨折愈合快,骨折固定牢固,术后功能恢复良好,值得临床推广应用.

Bronchoscopic Bronchoalveolar Lavage for Preventing the Lung Complications in Patients Treated by Mild Hypothermia

Objective]To explore the value and safety of early and regular bronchoseopic bronchoalveolar lavage for the prevention of pulmonary infection or atelectasis in patients treated by mild hypothermia. Methods]A total of 108 cases of severe head injury receiving mild hypothermia therapy were randomly divided into control group and treatment group. The treatment group performed bronchoscopic bronchoalveolar lavage based on conventional treatment. The imaging changes of the incidence of pulmonary infection or atelectasis were compared between two groups. Results] The incidence of pulmonary infection or atelectasis in the con trol group was higher than that in the treatment group, and there was significant difference between two groups（ P 〈0.01）. Conclusion]Early and regular bronehoscopic bronchoalveolar lavage can significantly reduce the incidence of pulmonary infection or atelectasis in severe head injury patients during mild hypothermia treatment.