目的交流肝脏外伤非手术治疗的病例选择与治疗体会。方法对该院57例非手术治疗的肝脏外伤病例资料进行回顾性分析。结果57例肝脏外伤患者中55例经非手术治疗后痊愈出院，另2例在治疗过程中经中转手术治愈，全组病例无一例死亡。结论对经过严格选择的肝脏外伤病例进行非手术治疗，疗效肯定，也是安全可行的。CT检查在病例选择中具有非常重要的作用。
Based on the guidelines of the diagnostic test systematic review, this study elaborated the statistical processing of the pooling of data detailed in the systematic review of diagnostic test, discussed the methods for identification and handling of the heterogeneity, evaluated the advantages and disadvantages of the index of the accuracy in diagnostic tests, and proposed the identification method of the publication bias. It also took the data from the published article entitled “Diagnostic Value of ProGRP and NSE for Small Cell Lung Cancer: A Meta-Analysis” as an example for analysis and illustration, which presented clearly the data processing and interpretation of the systematic review of diagnostic test, in order to provide references for clinical researchers to study and conduct the systematic review of diagnostic test.
Objective To investigate the effectiveness of double-needle suture for mixed meniscus tear repair under arthroscope. Methods Between April 2006 and January 2011, 22 patients with mixed meniscus tear were treated with double-needle suture under arthroscope. There were 14 males and 8 females, aged 18-41 years (mean, 31.3 years). All injuries were caused by sports. The time between injury and admission ranged from 2 days to 4 years (median, 11 months). International Knee Documentation Committee (IKDC) score was 42.5 ± 15.2, Lysholm score was 45.5 ± 13.5, and Tegner score was 2.9 ± 1.6. Seventeen cases complicated with anterior cruciate ligament injury. Results Healing of incision by first intention was achieved in all patients. No injury of nerve and blood occurred. The patients were followed up 12-48 months with an average of 27.6 months. According to Barrett et al. standard, 19 cases (86%) got clinical healing. The IKDC, Lysholm, and Tegner scores were improved to 77.1 ± 8.9, 79.8 ± 9.9, and 6.8 ± 1.6 respectively at last follow-up, showing significant differences when compared with preoperative scores (P lt; 0.05). Conclusion Arthroscopic meniscus repair using double-needle suture can provide good effectiveness because it has high firmness.
Objective To analyze the effectiveness of volar locking compression plate (LCP) and radial styloid process plate for the treatment of type C fractures of the distal radius. Methods Between May 2010 and May 2011, 24 cases of type C fractures of the distal radius were treated, including 8 males and 16 females with an average age of 52 years (range, 23-73 years). Injury was caused by falling in 20 cases and by traffic accident in 4 cases. All were fresh closed fractures. The locations were the left side in 15 cases and the right side in 9 cases. According to AO typing, there were 16 cases of type C2 and 8 cases of type C3. The preoperative palmar tilt angle ranged from — 60 to 25° (mean, — 45.3°); the preoperative ulnar inclination angle ranged from — 16 to 13° (mean, 8.2°); and the preoperative radial length shortening was 8-18 mm (mean, 12 mm). The time from injury to operation was 3-10 days (mean, 5.2 days). Results All operation incisions healed primarily. All patients were followed up 9-16 months (mean, 13.5 months). The healing time of fracture was 8-12 weeks (mean, 10.2 weeks). The articular surface was smooth and the radial length was recovered. The postoperative palmar tilt angle ranged from 8 to 15° (mean, 12.3°); the postoperative ulnar inclination angle ranged from 18 to 26° (mean, 22.3°). No loss of reduction, refracture, or carpal tunnel syndrome occurred during follow-up. The average range of motion of the wrist was 45.3° (range, 30-70°) in dorsal extension, was 50.2° (range, 26-78°) in palmar flexion, was 13.5° (range, 8-25°) in radial inclination, was 23.6° (range, 15-32°) in ulnar inclination, was 65.7° (range, 35-90°) in pronation, and was 72.5° (range, 20-90°) in supination at last follow-up. According to the wrist function by Gartland-Werley scoring, the results were excellent in 12 cases, good in 8 cases, and fair in 4 cases; and the excellent and good rate was 83.3%. Conclusion Treatment of type C fractures of the distal radius with volar LCP and radial styloid process plate can reconstruct normal anatomic structures and get good functional recovery.
【Abstract】 Objective To investigate the cl inical outcomes of the treatment of knee dislocation with multiplel igaments injuries by anterior cruciate l igament (ACL) and posterior cruciate l igament (PCL) reconstruction underarthroscopy and repair of the injured structures of the knee joint. Methods From July 2003 to August 2006, there were24 patients with knee dislocation (19 males and 5 females), with the average age of 42 years (ranging from 20 years to 69years), whose ACL and PCL were reconstructed under arthroscopy and whose collateral l igaments and other structures of the knee were repaired [8 with injuries of ACL, PCL, medial collateral l igament (MCL) and lateral collateral l igament (LCL); 12 with injuries of ACL, PCL and MCL; 4 with injuries of ACL, PCL and LCL]. There were 1 case with common peroneal nerve injury, 3 with medial meniscus injury and 7 with lateral meniscus injury. Every patient had single knee dislocation. The outcome was measured from the following aspects: range of the knee, compl ication, cl inical improvement and Lysholm scoring. Results Twenty-four patients were followed up for 11 months to 36 months, with the average time of 25 months.Eleven patients (45.8%) recovered to the normal sports level and 13 (54.2%) patients’ knee function improved significantly so that they could walk by themselves. Lachman test, anterior drawer test and posterior drawer test were negative in 24 patients. The side-to-side difference was less than 5 mm in 24 patients. There were 4 patients who had sl ight knee stiffness. One patient’ s feel ing and sports function of the general peroneal nerve improved to the normal level. Lysholm scale of the knee function was 41.8 ± 4.3 preoperatively and 87.0 ± 6.0 postoperatively (P lt; 0.05). The movement ranges of the knee were (87.5 ± 12.5)° preoperatively and (125.0 ± 9.2)° postoperatively (P lt; 0.05). Conclusion Reconstructing the ACL and PCL and repairing other structures of the knee is an effective method to treat dislocation of the knee.