目的 探讨心理干预措施对改善妇科恶性肿瘤患者的生命质量的作用及有效性。 方法 对2008年11月－2010年11月收治的87例妇科恶性肿瘤患者，随机分为试验组与对照组，试验组43例，实施心理干预及常规治疗；对照组44例，采取常规治疗；并对两组患者入院后及出院前生存质量、心理状况以问卷调查方式进行资料收集，用以比较、评价心理干预对改善妇科恶性肿瘤患者生命质量的作用及效果。 结果 妇科恶性肿瘤患者抑郁发生率为56.3%（49/87），焦虑发生率为62.1%（54/87）； 心理干预后两组患者组间各指标比较，试验组患者的总体健康状况、生存质量、角色功能、情绪功能、认知功能得分比对照组增高（P＜0.05）；试验组患者疲倦、恶心呕吐、失眠、食欲下降、便秘症状、抑郁、焦虑得分比对照组得分下降（P＜0.05）。 结论 心理干预可改变妇科肿瘤患者的负性心理倾向，缓解抑郁、焦虑等情绪，减轻化疗药物所引起的系列副作用，能有效提高其生活质量。
Objective To investigate the effectiveness in the treatment of single segment thoracic vertebra tuberculosis by limited decompression combined with epidural absorbable haemostat covering and vertebral plate reconstruction based on one-stage posterior approach, debridement, bone fusion, and internal fixation. Methods Between September 2005 and March 2010, 90 cases of single segment thoracic vertebra tuberculosis were treated by using limited decompression combined with epidural absorbable haemostat covering and vertebral plate reconstruction based on one-stage posterior approach, debridement, bone fusion, and internal fixation in 44 patients (treatment group) and by one-stage posterior approach, bone fusion, and internal fixation in 46 patients (control group). There was no significant difference in gender, age, disease duration, affected segment, Cobb angle, Frankle grade, erythrocyte sedimentation rate (ESR), and Oswestry disability index (ODI) between 2 groups (P gt; 0.05). Results All incisions healed by first intension. All 90 cases were followed up 24-44 months (mean, 38 months). There was no significant difference in ESR between 2 groups at 1 week and 3 months after operation (P gt; 0.05). Postoperative iconography indicated that the bone fusion rate of the treatment group was 100% and no epidural cicatricial tissue or failure of internal fixation was observed, showing significant difference when compared with control group (3 cases having failure of internal fixation) (P=0.032). The Cobb angles were significantly corrected after operation when compared with preoperative angles in 2 groups (P lt; 0.05). At 2 years after operation and at last follow-up, the Cobb angle and correction loss in treatment group were significantly better than those in control group (P lt; 0.05). The ODI and Frankel grade were significantly improved at last follow-up when compared with preoperative ones in 2 groups (P lt; 0.05); the treatment group was significantly better than the control group in the ODI, improvement rate of ODI (P lt; 0.05), and in Frankel grade (Uc=4.368, P=0.000). Conclusion Compared with conventional operation method, it is an ideal operation method to use limited decompression combined with epidural absorbable haemostat covering and vertebral plate reconstruction based on one-stage posterior approach, debridement, bone fusion, and internal fixation for treatment of single segment thoracic vertebra tuberculosis, with minimal wound, less complications, and good function recovery.
Objective To assess the effectivness of different bone graft fusion ways in the treatment of thoracolumbar burst fractures. Methods Between June 2000 and June 2009, 126 cases of thoracolumbar burst fractures were treated by onestageposterior short segment internal fixation combined with bone graft fusion. All patients had acute spine and spinal injuryat the levels of T11-L2, who were with different degrees of neural function injury (below Frankel grade D). The patients were randomly divided into 3 groups and were treated respectively by centrum combined with interbody bone graft fusion (group A), posterolateral bone graft fusion (group B), and ring bone graft fusion (group C) combined with posterior short segment pedicle instrumentation. The changes of the Cobb angle, correction loss of Cobb angle, bone fusion rate, internal fixation failure rate, Oswestry Disabil ity Index (ODI), and Frankel grade of the fracture vertebral were observed after operation to evaluate the effectiveness of different bone graft fusion ways. Results All 126 cases were followed up 24-32 months (mean, 28 months). The operation time and bleeding volume in group C were significantly larger than those in groups A and B (P lt; 0.05), but no significant difference was found between groups A and B (P gt; 0.05). At 2 years after operation and last follow-up, the Cobb angle and correction loss in group B were significantly larger than those in groups A and C (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). At last follow-up, the bone fusion rate and internal fixation failure rate were 100% and 0 in group A, 78.6% and 21.4% in group B, and 97.5% and 0 in group C; there were significant differences between group B and groups A, C (P lt; 0.05), but no significant difference was found between groups A and C (P gt; 0.05). ODI and Frankel grade were obviously improved after operation, showing significant differences between preoperation and last follow-up (P lt; 0.05) in 3 groups, between group B and groups A, C (P lt; 0.05), but no significant difference was found between groups A and C (P gt; 0.05). Conclusion The centrum combined with interbody bone graft fusion is best in 3 bone graft fusion ways because of its optimum bone fusion and according with human body biomechanics mechanism. Back outboard bone graft fusion may not a appropriate bone fusion way because of its high internal fixation failure rate and not according with human body biomechanics mechanism. The ring bone graft fusion may not be an indispensable bone fusion way because of its common bone fusion ratio and lower cost-performance ratio.