简介:摘要目的分析股骨粗隆间骨折治疗失败的原因,以及失败后进行翻修治疗的对策。方法通过对我院近十年来收治的29例股骨粗隆间骨折既往治疗失败的病例进行分析,总结分析治疗失败的原因及探索补救措施。结果本组6例患者采取保守治疗均并发髋内翻畸形,其中4例畸形愈合,2例骨折不愈合。使用DHS固定失败5例,均伴发DHS主钉的后上方穿凿。空心钉内固定治疗10例均伴发不同程度的髋内翻畸形、内固定松动,其中畸形愈合3例,不愈合4例,后期并发反粗隆间骨折3例。股骨上段勺型接骨板治疗6例均伴发髋内翻畸形,其中3例不愈合。DCS内固定治疗1例伴发钢板断裂骨折不愈合。90度角型接骨板内固定治疗1例伴发髋内翻畸形。结论内固定方式选择不当、内固定植入不当、康复训练方式不当等是股骨粗隆间骨折治疗失败的原因,正确的病例选择和精确的手术操作是治疗成功的关键。
简介:Triglyceride-richhpoprotein(TRL)remnantshavebeenimphcatedbybothclinicalandlaboratorystudiesinthepathogenesisofatheroselerosisandthrombosis.Weuseannewimmunoseparationmethod,providedbyJapanImmunoresearchLaboratories,todeterminetheremnant-hkeparticles(RLP)ofhpeproteins.IsolationofRLPfromserumisachievedusinganimmunoaffmitygelcontainingspecificanti-humanapoA-IandapoB-100(JI-H)monoelonalantibodies,wheretheformerrecognizesHDLandnewlysecretedapoA-I-containingchylomicrons,thelatterrecognizesLDLandmajorityofVLDL.AsaresultofthespecificityoftheJI-Hantibody,themajorityoftheapoB-48-containingchylomicrons,andcertainapoE-enrichedapoB-100-containingVLDLaxenotrecognized.TheselipoproteinsarenotcapturedbytheimmunoaffinitygelandarethusisolatedintheunboundRLPfraction,whichispredominantlymadeupofTRLhavingremnant-hkeproperties.ThecomponentsoftheunboundedfractionaxetheremnantsofCMandVLDLs,verifiedbyultracentrifugationandlipoproteinselectrophoresisinagarosegels.WeestablishedaconvenientapproachtomeasureRLP-cholesterolontheHitachi7150biochemicalanalyser.Thewithin-runandrun-to-runimprecision(CV)oftheassaywas2.75%and11.48%respectively.ThelinearoftheRLP-cinourassaywas0-180mg/dl.Wechose30normallipidslevelforthecontrolgroup(15male&15female),themedianfastingserumRLP-cconcentrationwas8.12±4.88mg/dl.WefredthatRLP-cconcentrationweresignficantlycorrelatedwithTG,VLDL-c,HDL-c&apoE(r=0.765,0.511,-0.378,0.241respectively,P<0.01);andnosignficantcorrelationwassubsequentlyobservedbetweenRLP-candLDL-c.Inourstudy,themedianfastingRLP-cconcentrationweresignificantlyhigherin91patientswithcoronaryarterydisease(CAD),in15patientswithnon-insulindependentdiabetesmeUitus(DM),andin45patientsundergoinghemodialysiswithend-stageretinaldisease
简介:摘要目的研究内固定法治疗老年性股骨粗隆及周围严重粉碎性骨折。方法对60例患者加压髂螺钉、Gamma钉及单臂外固定架固定治疗。结果经过手术治疗后,优良率达到96.3%,恢复状况良好。结论内固定法治疗老年性股骨粗隆及周围严重粉碎性骨折的方法值得推荐。
简介:自体皮源不足一直是治疗大面积深度烧伤的一大难题,微粒皮移植技术的运用可大大节省自体皮源,是烧伤创面修复的有效方法之一。2000年9月~2002年6月,笔者采用喷洒法皮粒播植术[1,2]治疗大面积深度烧伤患者,取得良好效果,现报告如下。临床资料:本组6例,其中男4例,女2例,年龄11~58岁,平均39岁。烧伤总面积均>70%TBSA,其中烧伤总面积>90%TBSA3例,Ⅲ度烧伤面积>50%TBSA4例。6例患者四肢创面均为深Ⅱ~Ⅲ度烧伤。异种皮的准备:(1)新鲜条状猪皮的制备:选用120kg左右健康纯白猪,处死后,用肥皂水刷洗冲净污垢,剃毛,以0.1%新洁尔灭溶液淋洗猪身,用辊轴刀切取7~10cm宽、尽可能长的条状刃厚或薄中厚猪皮。将切取的猪皮用等渗盐水冲净血迹,再以0.1%新洁尔灭溶液浸泡20min,等渗盐水漂洗,如此反复3次,最后将条状猪皮反裹(真皮面向外)在消毒绷带上,置于无菌盘中,喷以含抗生素的等渗盐水保护剂,置0~4℃普通冰箱保存,2周内使用。(2)辐照猪皮:...