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find Author "秦桂兰" 3 results
  • Therapeutic Effect on Radial Nerve Injuries in Plateau Area

    【摘要】 目的 探讨高原地区桡神经损伤的治疗效果,并总结影响疗效的因素。 方法 回顾性分析2005年6月-2010年6月收治的桡神经损伤并有完整随访资料的54例患者,其中男40例,女14例;年龄8~69岁,平均32.6岁。开放性损伤5例,闭合性损伤49例;左侧26例,右侧28例。受伤原因:刀伤5例,医源性损伤(手术牵拉伤、被钢板挤压伤)10例,肱骨干骨折合并桡神经损伤39例。神经损伤类型:桡神经完全断裂12例;大部分断裂15例;挫伤27例,挫伤长度1.5~4.5 cm。所有患者均有典型的感觉及运动功能障。采用神经吻合修复27 例,神经松解减压27例。骨折均用钢板内固定。 结果 所有患者手术均顺利,术后切口均I期愈合,无手术相关并发症发生。54例均获随访16~24个月,平均18个月。骨折于术后8~14个月达临床愈合。末次随访时根据中华医学会手外科上肢周围神经功能评定标准,神经吻合的27例中,获优14例,良8例,差5例;神经松解减压术治疗的27例均获优。总优良率为91%。 结论 上臂桡神经损伤宜早期手术修复,神经吻合的疗效较神经松解减压术差。【Abstract】 Objective To explore the therapeutic effect on radial nerve injuries in plateau area, and to analyze the influencing factors. Methods The clinical data of 54 patients with radial nerve injuries who were treated between June 2005 and June 2010 were retrospectively analyzed. The patients included 40 males and 14 females and aged 8-69 years (averaged 32.6 years old). Of these 54 patients, 5 were open injuries, 49 were closed injuries; 26 were on the left side, and 28 were on the right sides. Causes of injuries included: 5 direct cut injuries, 10 iatrogenic injuries (including traction injuries and crush injuries by steel plates), and 39 humeral shaft fracture and radial nerve injuries. Types of nerve injuries included: 12 complete radial neurotmesis, 15 partial radial neurotmesis, and 27 radial contusions (with contusion length ranged 1.5-4.5 cm). All patients had radial nerve injuries experienced significant motor dysfunctions. Among these patients, 27 underwent nerve anastomosis, the remaining 27 were treated by nerve decompression; all fractures were treated with internal fixation with steel plates. Results During the average follow-up of 18 months (16-24 months), all 54 patients completely recovered from radial nerve injuries without any complications. The time for fracture healing ranged 8-14 months. According to the evaluation standards for radial nerve functional recovery, developed by the Chinese Medical Association, among the 27 cases treated by nerve anastomosis, 14 were “optimal”, 8 were “fair”, and 5 were “bad”; and all 27 cases treated by nerve decompression were “optimal”. Conclusion It is suggested to have early surgical treatment for the upper arm radical nerve injuries. The nerve decompression had better curative effects than the nerve anastomosis does.

    Release date:2016-08-26 02:18 Export PDF Favorites Scan
  • 高原腕关节结核的诊断与治疗

    目的 总结高原地区腕关节结核的诊断及治疗方法。 方法 回顾分析2007 年10 月- 2009 年10月25 例腕关节结核患者临床资料。男12 例,女13 例;年龄25 ~ 65 岁,平均34.6 岁。左腕15 例,右腕 10 例。其中15例有肺结核或既往有肺结核病史。腕关节结核发病至入院时间为2 ~ 8 个月,平均6 个月。单纯腕关节滑膜结核10 例行保守治疗;全腕关节结核12 例、腕部屈肌腱腱鞘结核3 例采用化疗联合手术病灶清除治疗。 结果 治疗后除2 例全腕关节结核及1 例腕部屈肌腱腱鞘结核患者切口Ⅱ期愈合外,其余患者切口均Ⅰ期愈合。患者均获1 年6 个月随访。随访期间无结核复发,切口周围均无再次窦道形成。10 例单纯腕关节滑膜结核者及3 例腕部屈肌腱腱鞘结核者腕关节、掌指关节及指间关节活动自如,均于治疗后2 个月完全恢复劳动。12 例全腕关节结核者前臂旋前平均70°、旋后70°,较术前明显改善,术后4 个月完全恢复劳动。 结论 早期诊断、手术前后联合化疗、及时手术清除病灶、术后腕关节石膏固定、同时加强各掌指及指间关节活动,是治疗腕关节结核的有效方法。

    Release date:2016-08-31 05:43 Export PDF Favorites Scan
  • 小指固有伸肌重建拇指对掌功能一例

    Release date:2016-09-01 10:15 Export PDF Favorites Scan
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