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find Author "何嘉" 2 results
  • 锁定钢板微创内固定治疗老年股骨粗隆间骨折

    目的 总结应用锁定钢板微创内固定治疗老年股骨粗隆间骨折的临床疗效。 方法 2005 年3 月-2010 年3 月,采用骨折闭合复位、小切口肌肉下插入股骨近端外侧锁定钢板,以内固定支架方式治疗老年股骨粗隆间骨折65 例。其中男30 例,女35 例;年龄65 ~ 92 岁,平均70.1 岁。顺粗隆间骨折63 例,按Evans 分型:Ⅰ型 13 例,Ⅱ型16 例,Ⅲ型19 例,Ⅳ型15 例;逆粗隆间骨折2 例。均有不同程度骨质疏松。伤后至手术时间3 ~ 10 d,平均5 d。 结果 所有骨折均手法闭合复位成功。手术时间平均60 min,术中失血量平均80 mL。患者切口均Ⅰ期愈合。术后1 个月发生下肢深静脉血栓形成1 例,经溶栓抗凝治疗后治愈。65 例均获随访,随访时间12 ~ 24 个月,平均15 个月。2 例分别于术后9 个月和14 个月并发全身疾病死亡;余63 例骨折均于术后12 ~ 16 周获骨性愈合。无内固定物脱出及断裂、骨折移位、髋内翻、股骨头坏死等与手术相关的并发症发生。存活患者术后1 年髋关节功能按Harris 评分,获优39 例,良17 例,可5例,差2 例,优良率88.9%。 结论 锁定钢板微创内固定治疗老年股骨粗隆间骨折,手术创伤较小,为骨折提供了足够的稳定性并能促进骨折愈合,可获良好临床疗效。

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • Outcomes and prognostic factors of surgically treated thymic carcinoma

    Objective To evaluate the influence of resection status, pathological type, pathological stage and postoperative adjuvant therapy on prognosis of surgically treated thymic carcinoma. Methods In this retrospective study, 56 patients with surgically treated thymic carcinoma in the Department of Thoracic Surgery, Peking Union Medical College Hospital from January 2005 to December 2015 were enrolled. There were 30 males and 26 females aged 52.1±11.5 years ranging from 22 to 81 years. The survival curve was performed by Kaplan-Meier method. The prognostic factors affecting overall survival (OS) and disease-free survival (DFS) were analyzed by one-way analysis of variance (ANOVA). Results R0 resection was performed in 37 patients (67.9%), and other resections in 19 (32.1%); 13 patients suffered thymic carcinoma with Masaoka stage Ⅰ-Ⅱ, 26 Ⅲ, and 17 Ⅳ. Low-grade thymic carcinoma was found in 42 patients, and high-grade in 14. Postoperative radiotherapy, chemotherapy and chemoradiotherapy were performed on 17, 12 and 18 patients respectively and 9 patients were untreated. Forty-one patients was followed up for 1 to 10 years, and the follow-up rate was 73%. The 1-, 3- and 5-year OS rates were 93%, 74% and 61%, respectively. Resection status and pathological stage affected OS. Postoperative radiotherapy after R0 resection affected DFS, but did not affect OS. Conclusion Most patients with thymic carcinoma after surgery can survive for a long period, and R0 resection is the most important prognostic factor of thymic carcinoma. Postoperative radiotherapy after R0 resection in patients with Masaoka stage Ⅱ-Ⅲ is recommended.

    Release date:2018-08-28 02:21 Export PDF Favorites Scan
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