目的 總結腹部閉合性損傷的診治體會。方法 回顧性分析我院78例腹部閉合性損傷患者的臨床資料。結果 78例中67例手術治療，4例行腎動脈栓塞術，7例保守治療； 除1例死亡外，余均治愈。結論 及時診斷和治療是救治腹部閉合性損傷患者的關鍵，腹腔穿刺、B超、CT及X線檢查的合理應用對診斷有重要價值。
Six patients with moderate to advanced primary carcinoma of the liver were treated in this hospital with perfusion chemotherapy and embolization through the regional portal vein under the guidance of B-ultrasongraph rather than (with) operatie catheteization of the portal vein. The results show that all the tumor masses were reduced in size after the treatment (1.2-3.2cm, average value 1.9cm). It might be a new way for treating the primary carcinom of liver. The detailed procedure is descibed and the effects are also discussed in this article.
ObjectiveTo evaluate the feasibility and short-term effectiveness of bilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach for osteoporotic vertebral compression fracture (OVCF) of lumbar.MethodsA retrospective analysis was made on the clinical data of 93 patients with OVCF of lumbar who met the selection criteria between January 2018 and June 2019. According to the different surgical methods, they were divided into group A (44 cases, treated with bilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach) and group B [49 cases, treated with percutaneous kyphoplasty (PKP) via bilateral transpedicle approach]. There was no significant difference in gender, age, body mass index, T value of bone mineral density, injury cause, fractured level, time from injury to operation, comorbidities, and preoperative Cobb angle of injured vertebra, visual analogue scale (VAS) score, and Oswestry disability index (ODI) between the two groups (P>0.05). The operation time, intraoperative fluoroscopy times, bone cement injection amount, and incidence of bone cement leakage were recorded and compared between the two groups; Cobb angle of the injured vertebrae, VAS score, and ODI were measured before operation, at 2 days and 1 year after operation. The contralateral distribution ratio of bone cement was calculated according to the anteroposterior X-ray film at 2 days after operation.ResultsThe operation time and the intraoperative fluoroscopy times in group A were significantly less than those in group B (P<0.05). There was no bone cement adverse reactions, cardiac and cerebrovascular adverse events, and no complications such as puncture needles erroneously inserted into the spinal canal and nerve injuries occurred in the two groups. Bone cement leakage occurred in 6 cases and 8 cases in groups A and B, respectively, all of which were asymptomatic paravertebral or intervertebral leakage, and no intraspinal leakage occurred; the bone cement injection amount and incidence of bone cement leakage between the two groups showed no significant differences (P>0.05). The contralateral distribution ratio of bone cement in group A was significantly lower than that in group B (t=2.685, P=0.009). Patients in both groups were followed up 12-20 months, with an average of 15.3 months. The Cobb angle of the injured vertebrae, VAS score, and ODI in the two groups were significantly improved at 2 days after operation, however, the Cobb angle of the injured vertebra at 1 year after operation was significantly lost when compared with the 2 days after operation, the VAS score and ODI at 1 year after operation were significantly further improved when compared with the 2 days after operation, the differences were all significant (P<0.05). There was no significant difference in the Cobb angle of the injured vertebrae, VAS score, and ODI between the two groups at each time point after operation (P>0.05).ConclusionBilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach is comparable to bilateral PKP in short-term effectiveness with regard to fracture reduction, reduction maintenance, pain relief, and functional improvement. It has great advantages in reducing operation time and radiation exposure, although it is inferior in bone cement distribution.
目的:研究微創側腦室穿刺聯合置管外引流術治療腦室出血的療效。方法:將我院48例腦室出血患者隨機分為治療組及對照組,對照組采用常規內科藥物治療,治療組在對照組基礎上采用微創側腦室穿刺聯合置管外引流術。結果:治療組的總有效率為83.33%,顯著高于對照組的50.0%,死亡率顯著低于對照組,以上差異有統計學意義(Plt;0.05)。結論:微創側腦室穿刺聯合置管外引流術治療腦室出血效果好,損傷小、操作簡便易行,縮短了病程,顯著降低了患者致殘率及死亡率,及早手術,可提高治愈率和生存質量,值得推廣。
ObjectiveTo evaluate the clinical effect of ultrasound guided puncture irrigation and traditional incision and drainage in the treatment of breast abscess. MethodsCNKI, Wanfang Database, CBM, PubMed, Cochrane Library, Web of Science, and EMbase were searched, at the same time complementary with other retrieval in any language to collect the randomized controlled trials (RCTs) about comparison ultrasound guided needle aspiration with incision and drainage to treat the breast abscesses published by late August, 2015. Data related to clinical outcomes were extracted by two reviewers independently. Statistical analyses were carried out using RevMan5.3 software. ResultsEight studies were included, which involving 373 participants according to the inclusion criteria. The differences were statistically significant about the cure rate [OR=2.51, 95% CI (1.47, 4.28), P=0.000 8〕, effective rate [OR=7.45, 95% CI (2.29, 24.27), P=0.000 9〕, the heeling time [SMD=-1.77, 95%CI (-2.09, -1.44), P < 0.000 01〕, the length of the scar [MD=-2.88, 95% CI (-3.43, -2.33), P < 0.000 01〕, and the complications [OR=0.18, 95% CI (0.05, 0.62), P=0.007〕. Conciusions Compared with traditional methods of incision and drainage, ultrasound guided needle aspiration and wash has the more cure rate, the more effective rate, the less heeling time and scars as well as complications.
Objective To analyse the correlative factors of secondary vertebral fracture after percutaneous kyphoplasty (PKP) in treatment of osteoporotic vertebral compression fracture (OVCF) at different levels (adjacent and/or nonadjacent levels). Methods Between December 2002 and May 2008, 84 patients with OVCF were treated with PKP, and the cl inical data were analysed retrospectively. There were 11 males and 73 females with an average age of 70.1 years (range, 55-90 years). All patients were followed up 24-96 months (mean, 38 months). Secondary vertebral fracture occurred in 12 cases at 3-52 months after PKP (secondary fracture group), no secondary fracture in 72 cases (control group) at over 24months. The preoperative bone mineral density, postoperative vertebral height compression rate, postoperative Cobb angle, amount of injected bone cement per vertebra, puncture pathway (uni- or bilateral puncture), age, gender, number of fracture segment, and cement intradiscal leakage were compared between 2 groups to find correlative factors of secondary vertebral fractures. Results There was no significant difference in preoperative bone mineral density, postoperative vertebral height compression rate, postoperative Cobb angle, amount of injected bone cement per vertebra, puncture pathway, age, gender, and number of fracture segment between 2 groups (P gt; 0.05). But the incidence of cement intradiscal leakage was much higher in secondary fracture group than in control group (χ2=5.294, P=0.032). Conclusion Cement intradiscal leakage may be the correlative factor of secondary vertebral fracture after PKP in OVCF.
目的 總結超聲引導下經皮經肝穿刺膽管引流術(PTCD)的優、缺點,為臨床治療重癥急性膽管炎（SAC）提供參考。方法 回顧性分析我院1994年8月至2008年7月期間對156例老年SAC患者行在超聲引導下的PTCD治療的臨床資料。結果 156例行PTCD均獲成功,1次穿刺成功140例，其成功率達89.7%（140/156）; 16例首次穿刺失敗后再次穿刺均成功。無一例發生腹腔出血、膽汁性腹膜炎等并發癥。本組引流效果較好,中毒危象緩解，黃疸減退，肝功能改善。結論 PTCD較外科手術創傷小、操作簡單、快速,具有微創的特點,對老年、有嚴重合并癥及復雜疾病不能耐受手術及麻醉的SAC患者，其作為緊急搶救措施切實可行,并為后期施行根治性手術爭取了時間。