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find Keyword "牵引术" 2 results
  • APPLICATION OF MODIFIED TRACTION ARCH OF SKULL IN SKULL TRACTION

    ObjectiveTo investigate the feasibil ity and effectiveness of the modified traction arch of skull (crossbar traction arch) for skull traction in treating cervical spine injury by comparing with traditional traction arch of skull. MethodsBetween June 2009 and June 2013, 90 patients with cervical vertebrae fractures or dislocation were treated with modified skull traction surgery (trial group, n=45) and traditional skull traction surgery (control group, n=45). There was no significant difference in gender, age, injury types, injury level, the interval between injury and admission, and Frankel grading of spinal injury between 2 groups (P>0.05). The cl inical efficacy was evaluated after operation by the indexes such as traction arch sl i ppage times, operation time, the infection incidence of the pin hole, incidence of skull perforation, visual analogue scale (VAS), and reduction status of cervical dislocation. ResultsThe traction arch slippage times, the infection incidence of the pin hole, operation time, blood loss, and postoperative VAS score in trial group were significantly lower than those in control group (P<0.05). There was no significant difference in the incidence of skull perforation caused by clamp crooks of traction arch between 2 groups (P=1.000). At 2 weeks after operation, the patients had no headaches, infections, or other complications in 2 groups. In patients with cervical dislocation, 4 of the trial group and 6 of the control group failed to be reset, the reduction rate was 83.33% (20/24) and 68.42% (13/19) respectively, showing no significant difference (χ2=0.618, P=0.432). ConclusionThe operation with modified traction arch of skull has significant advantages to reduce postoperative complication compared with tradition traction arch of skull.

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  • 手术内固定治疗创伤性连枷胸对患者呼吸功能的影响

    目的观察连枷胸患者胸壁加压包扎、肋骨牵引和手术内固定的治疗效果。 方法纳入2001年1月至2010年6月解放军第一医院心胸外科收治的56例连枷胸患者,分为3组:牵引治疗组,14例,其中男10例、女4例,年龄(39.7±11.6)岁;包扎治疗组,12例,其中男11例、女1例,年龄(40.2±13.2)岁;手术内固定组,30例,其中男26例、女4例,年龄(42.6±12.5)岁。比较3组的治疗效果。 结果手术内固定组与牵引治疗组和包扎治疗组比较,除需呼吸机支持率与牵引治疗组差异无统计学意义(P>0.05)外,呼吸机通气时间、住ICU时间、胸腔引流管拔除时间均缩短(P<0.05),胸部并发症发生率及死亡率降低(P<0.05),动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)显著升高(P<0.01),肺挫伤评分下降明显;而牵引治疗组PaO2、SaO2及肺挫伤评分较入院时改善缓慢,胸壁加压包扎治疗组甚至有加重趋势。 结论大面积浮动胸壁的病理改变以胸腔容积减少为基础,胸壁加压包扎无治疗效果,甚至加重低氧;肋骨巾钳悬吊牵引固定对连枷胸缺氧内环境的改善效果不佳;手术切开复位内固定是改善大面积浮动胸壁呼吸功能障碍的有效方法。

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