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find Keyword "陈旧性" 66 results
  • Sequential Anal Dilation and Microwave Treatment of Chronic Anal Fissure

    Objective To analyze and compare the clinical efficacy and advantage between two treatments methods for chronic anal fissure. Methods Divided 96 patients with chronic anal fissure into two groups based on the odd and even numbers of treatment order: 48 patients in study group received sequential anal dilation and microwave treatment, and 48 patients in control group received posterior internal sphincterotomy. The blood loss in operation, wound healing time, wound infection rate, anal infection rate, anal control, postoperative defecation function, anal stenosis rate, and the recurrence rate between the two groups were compared and analyzed. Results Blood loss and wound healing time were less in study group than those in control group (Plt;0.01). Anal control was better in study group than that in control group (Plt;0.05). There were no occurrences of wound infection or anal infection, and the defecation function was improved in both of the two groups. There was no recurrence after one year follow-up in both of the two groups. Anal stenosis rate in study group is lower than that in control group (Plt;0.01). Conclusion The technique of sequential anal dilation and microwave treatment can reduce pain, and is simple, effective, and worthy of promotion.

    Release date:2016-09-08 10:49 Export PDF Favorites Scan
  • DIAGNOSIS AND TREATMENT OF INCONTINENCE BY OUTMODED DEFECT OF NERINEOANUS AND NARTIAL ANUS (REPORT OF 7 CASES)

    目的总结陈旧性会阴肛管缺损肛门不全失禁临床处理经验。方法回顾性分析我院1994年1月至2000年1月收治的7例陈旧性会阴肛管缺损肛门不全失禁患者的临床资料。结果7例患者均行手术治疗,术后全部随访,无一例复发。结论对于陈旧性会阴肛管缺损肛门不全失禁患者,明确找到断裂的外括约肌断端是手术成败的关键。

    Release date:2016-08-28 05:10 Export PDF Favorites Scan
  • 小肠黏膜下层-骨髓间充质干细胞移植-治疗陈旧性心肌梗死

    摘要: 目的 探讨自体骨髓间充质干细胞(MSCs)小肠黏膜下层(SIS)支架复合物移植于陈旧性心肌梗死区域后细胞的存活、支架的降解情况及其对心功能的影响。 方法 将16只黑山羊按随机数字表法分为两组,每组8只。实验组:建立心肌梗死模型,抽取自体骨髓,经体外分离MSCs,进行培养、传代、BrdU标记、与SIS支架复合,并于心肌梗死6周时将MSCs-SIS复合物补片移植至陈旧性心肌梗死区;对照组:建立心肌梗死模型。于移植后6周行超声心动图、HE染色及免疫组织化学检测。 结果 MSCs-SIS植入心肌梗死区2周时在补片区可见大量炎性细胞浸润;6周时淋巴细胞浸润消失,SIS部分降解,移植区见大量移植细胞存活。MSCs-SIS植入体内后6周时,实验组每搏输出量(42.81±4.91 ml vs. 37.06±4.75 ml)、射血分数(59.20%±5.41% vs. 44.56%±4.23%)、室壁增厚率(54.51%±8.60% vs. 43.36%±8.91%)、舒张期E峰 (54.85±6.35 cm/s vs. 43.14±4.81 cm/s)显著高于对照组(Plt;0.05),左心室收缩期末容积(29.75±5.98 ml vs. 46.25±6.68 ml)、舒张期末容积(72.55±8.13 ml vs. 83.31±8.61 ml)显著低于对照组(Plt;0.05)。 结论 SIS作为支架移植MSCs有利于移植细胞存活,对陈旧性心肌梗死后心功能有明显的改善作用。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • TREATMENT OF THORACOLUMBAR KYPHOSIS CAUSED BY OLD FRACTURE USING PEDICAL SCREW AT THE FRACTURE LEVEL, INTERVERTEBRAL DISTRACTION, AND CAGE INSERTION BY POSTERIOR APPROACH

    Objective To evaluate the effectiveness of using pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach to treat thoracolumbar kyphosis caused by old fracture. Methods Between June 2008 and June 2010, 15 cases of thoracolumbar kyphosis caused by old fracture were treated with pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach. There were 9 males and 6 females with a mean age of 54.6 years (range, 39-65 years). The disease duration was 5 months to 3 years with an average of 1.5 years. Fractured segments included T11 in 1 case, T12 in 4 cases, L1 in 5 cases, and L2 in 5 cases. Ten patients had nerve symptom, according to American Spinal Injury Association (ASIA) grading, 3 cases were classified as grade B, 4 cases as grade C, and 3 cases as grade D, of which 3 cases had sexual and sphincter dysfunction. At preoperation, the Cobb angle was (47.4 ± 10.2)°; the Oswestry disability index (ODI) score was 67.9% ± 6.9%; and the visual analogue scale (VSA) was 8.6 ± 1.4. Results The wounds obtained primary healing. The mean follow-up time was 28 months (range, 13-60 months). X-ray films showed intervertebral bone fusion was obtained within 6-11 months (mean, 10.2 months). No fixation loosening or breaking occurred during follow-up. Kyphosis was corrected, and lumbar back pain was relieved. At 1 year after operation, Cobb angle was significantly corrected to (13.3 ± 7.7)° (t=72.80, P=0.00); ODI score was significantly improved to 25.2% ± 4.6% (t=48.04, P=0.00); VAS score was significantly decreased to 2.3 ± 0.6 (t=26.52, P=0.00). According to ASIA grading in 10 patients with spinal cord injury, the spinal cord function was improved by 1 grade in 8 cases (3 cases from grade B to C, 3 cases from grade C to D, and 2 cases from grade D to E); 3 patients with sexual and sphincter dysfunction recovered in different degrees. Conclusion Using pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach is an effective method to treat thoracolumbar kyphosis caused by old fracture.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • PALMARIS LONGUS TENDON GRAFT FOR TREATMENT OF OLD MALLET FINGER DEFORMITY

    Objective To investigate the effectiveness of the terminal extensor tendon reconstrution by palmaris longus tendon graft for the treatment of old mallet finger deformity. Methods Between February 2009 and February 2011, 32 patients with old mallet finger deformity were treated with palmaris longus tendon graft. There were 28 males and 4 females with an average age of 32.5 years (range, 22-58 years). The injury causes included sports injury in 26 cases and punctured injury in 6 cases. The index finger was involved in 8 cases, the middle finger in 3 cases, the ring finger in 16 cases, and the little finger in 5 cases. According to the Rockwell’s classification, all patients were classified as type I. The time from injury to operation was 4-16 weeks (mean, 6 weeks). Results Primary healing was obtained in all incisions; no necrosis, infection, or nail bed injury occurred. All patients were followed up 12-20 months (mean, 14 months). The patients had no pain or paresthesia of volar finger. According to Patel’s functional assessment system, the results were excellent in 8 cases, good in 21 cases, fair in 2 cases, and poor in 1 case at last follow-up, with an excellent and good rate of 90.6%. Conclusion Reconstruction of the terminal extensor tendon by palmaris longus tendon graft is a reliable method to treat old mallet finger deformity.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • SPINAL CANAL DECOMPRESSION WITH MICROENDOSCOPIC DISECTOMY AND PILLAR VERTEBRAL SPACE INSERTION FOR THORACOLUMBAR NEGLECTED FRACTURE

    Objective To investigate the effectiveness of spinal canal decompression with microendoscopic disectomy (MED) and pillar vertebral space insertion through pedicle of vertebral arch for thoracolumbar neglected fracture. Methods Between February 2006 and November 2009, 30 patients with thoracolumbar neglected fracture were treated by spinal canal decompression with MED and pillar vertebral space insertion through pedicle of vertebral arch. There were 22 males and 8 females with an average age of 36.2 years (range, 17-58 years). The disease duration was 6 weeks to 14 months with an average of 5.3 months. All patients had single vertebral compression fracture, including T9 in 1 case, T11 in 2 cases, T12 in 5 cases, L1 in 11 cases, L2 in 5 cases, L3 in 5 cases, and L4 in 1 case. The preoperative Cobb angle was (27.5 ± 7.5) ° . The preoperative height of vertebrae was (26.67 ± 5.34) mm. The visual analogue score (VAS) was 5.8 ± 1.4. According to Wolter classification for spinal canal stenosis, there were 17 cases of grade 1, 10 cases of grade 2, and 3 cases of grade 3. According to Frankel grade, 3 cases were in grade A, 8 cases in grade B, 13 cases in grade C, and 6 cases in grade D. Results The average operation time was 70 minutes (range, 40-120 minutes) and the average blood loss was 180 mL (range, 100-400 mL). The hematoma occurred in 1 case, and other incisions healed by first intension. No deep vein thrombosis of the lower extremity occurred. All patients were followed up 26 months on average (range, 24-46 months). The Cobb angle and vertebral height at 3 days and last follow-up were significantly improved when compared with ones before operation (P lt; 0.01). At last follow-up, the spinal canal stenosis was grade 0 in 27 cases and grade 1 in 3 cases according to Wolter classification. At 24 months after operation, the spinal function was obviously improved; 1 case was in grade A, 1 case in grade B, 3 cases in grade C, 9 cases in grade D, and 16 cases in grade E according to Frankle grade, showing significant differences when compared with preoperative ones (P lt; 0.05). The VAS score at 1 month after operation was significantly higher than that before operation (P lt; 0.01), then the score showed downtrend along with time, and it was significantly lower at 24 months after operation than before operation (P lt; 0.01). Conclusion Spinal canal decompression with MED and pillar vertebral space insertion for thoracolumbar neglected fracture has short surgical time, less blood loss, and satisfactory reduction, but higher technical requirement is necessary for MED.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • REPAIR OF OLD INJURY OF KNEE MEDIAL COLLATERAL LIGAMENT BY A COMBINATION OF DYNAMIC AND STATIC STABILITY

    Objective To observe the effectiveness of the combination of dynamic and static stabil ity in the treatment of old knee medial collateral l igament injury. Methods Between March 2004 and June 2008, 26 cases of old knee medial collateral l igament injury were treated, including 19 males and 7 females with a mean age of 38 years (range, 21-48 years). Injury was caused by traffic accident in 6 cases, by sprains in 12 cases, by fall ing from height in 8 cases. The location was left knee in 15 cases and right knee in 11 cases. Of them, 24 patients showed the positive result of knee valgus test, 2 cases showed sl ightly relaxed knee tendon. The knee X-ray films of valgus stress position showed that the medial joint space differences between both knees were 3-5 mm in 2 cases and 5-12 mm in 24 cases. The injuries included avulsion of the medial femoral condyle starting point in 19 cases, central laceration in 6 cases, and tibial point laceration concomitant meniscus injury in 1 case. The time from injury to hospital ization was 3-14 months (mean, 6.4 months). Gracil is muscle was used to repair knee medial collateral l igament and the sartorius muscle transfer to reconstruct the medial rotation of knee stabil ity function. Results All incisions healed by first intention. No joint infection, deep vein thrombosis, or other postoperative compl ications occurred. Twentysix cases were followed up 12-58 months with an average of 30 months. The results of knee valgus stress test were negative with no joint tenderness. At 3 months after operation, the knee X-ray films of valgus stress position showed the medial joint space differences between both knees were less than 1 mm. According to the modified Lysholm-Scale score, the results were excellent in 18 cases, good in 7 cases, and fair in 1 case with an excellent and good rate of 96% at last follow-up. Conclusion A combination of dynamic and static stabil ity in repairing old knee medial collateral l igament injury is easy-to-operate and has the advantages to perform the operation in the same incision, so it can avoid the shortcomings of single repair method and achieve better effectiveness.

    Release date:2016-08-31 05:41 Export PDF Favorites Scan
  • MINIPLATE INTERNAL FIXATION AND AUTOGENOUS ILIAC BONE GRAFT IN SURGICAL TREATMENT OF OLD METATARSAL FRACTURES

    Objective To summarize the experience of treating old metatarsal fractures with surgery methods of miniplate internal fixation and autogenous il iac bone. Methods Between May 2009 and July 2010, 7 patients with old metatarsal fractures were treated surgically, including 5 multi-metatarsal fractures and 2 single metatarsal fractures. There were 5 males and 2 females aged from 25 to 43 years (mean, 33 years). The time from fracture to operation was 4-12 weeks. The X-rayfilms showed that a small amount of callus formed at both broken ends with shortening, angulation, or rotation displacement. The surgical treatments included open reduction, internal fixation by miniplate, and autogenous il iac bone graft (1.5-2.5 cm3). The external plaster fixation was used in all patients for 4 to 6 weeks postoperatively (mean, 5 weeks). Results All incisions healed by first intention. The 7 patients were followed up 8-18 months (mean, 13.5 months). The cl inical fracture heal ing time was 6 to 12 weeks postoperatively (mean, 8.4 weeks). No pain of planta pedis occurred while standing and walking. The American Orthopaedic Foot and Ankle Society (AOFAS) mesopedes and propodium score was 75-96 (mean, 86.4). Conclusion It has the advantages of rel iable internal fixation, high fracture heal ing rate, less compl ications to treat old metatarsal fractures with surgery methods of miniplate internal fixation and autogenous il iac bone graft, so it is an effective treatment method.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • 锁骨钩钢板固定结合喙锁韧带重建治疗陈旧性肩锁关节脱位

    目的 总结锁骨钩钢板固定结合喙锁韧带重建治疗陈旧性肩锁关节脱位的临床疗效。 方法 2003 年6 月- 2008 年12 月,采用锁骨钩钢板固定结合喙锁韧带重建治疗17 例陈旧性肩锁关节脱位。男11 例,女6 例;年龄16 ~ 53 岁,平均39 岁。均为直接暴力致伤。左侧7 例,右侧10 例。Rockwood 分型:Ⅲ型14 例,Ⅳ型2 例,Ⅴ型1 例。受伤至手术时间为14 ~ 55 d,平均23 d。 结果 术后切口均Ⅰ期愈合。肩锁关节脱位均纠正,无神经、血管损伤等并发症发生。术后患者均获随访,随访时间6 ~ 15 个月,平均12 个月。术后3 ~ 6 个月取出锁骨钩钢板,无再脱位发生。术后6 个月按Karlsson 疗效评价标准:优12 例,良4 例,差1 例,优良率94.1%。 结论 锁骨钩钢板固定结合喙锁韧带重建具有操作简便、创伤小、固定可靠、可早期功能锻炼等优点,是治疗陈旧性肩锁关节脱位的一种有效方法。

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • 经皮穿刺后凸成形术治疗老年陈旧性椎体压缩骨折

    目的 总结经皮穿刺后凸成形术治疗老年陈旧性椎体压缩骨折的疗效。 方法 2002 年4 月-2005 年6 月采用经皮穿刺后凸成形术治疗老年陈旧性椎体压缩骨折25 例。男11 例,女14 例;年龄62 ~ 83 岁,平均68 岁。腰痛持续时间3 ~ 12 个月。影像学检查显示,1 个椎体骨折14 例,2 个椎体骨折7 例,3 个椎体骨折4 例。经体格及影像学检查确定28 个“责任椎”:T11 1 个,T12 10 个,L1 13 个,L2 3 个,L4 1 个;按照AO 骨折分型,A1.2 型5 个,A1.3 型13 个,A2.3 型10 个。 结 果 术后患者无不良反应,切口均Ⅰ期愈合,3 d 后出院。22 例获随访,随访时间48 ~ 84 个月,平均60 个月。术后2 d、3 个月及末次随访时疼痛视觉模拟评分(VAS)、Oswestry 评分及侧位X 线片椎体中点高度与术前比较,差异均有统计学意义(P lt; 0.05);术后各时间点间比较,差异均无统计学意义(P gt; 0.05)。 结论 经皮穿刺后凸成形术治疗老年陈旧性椎体压缩骨折,可迅速缓解患者长期慢性腰背痛症状,减少卧床时间,提高患者生活质量。

    Release date:2016-09-01 09:04 Export PDF Favorites Scan
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