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find Author "刘学军" 2 results
  • 经椎弓根植骨钉棒固定治疗胸腰椎骨折

    目的  总结经椎弓根植骨、钉棒固定治疗胸腰椎骨折的临床疗效。  方法   2005 年 9 月- 2007 年9  月,采用经后路椎弓根植骨、钉棒固定结合椎管减压治疗胸腰椎骨折 108 例。其中男 68 例,女 40 例;年龄 20 ~ 71 岁,平均 37.5 岁。骨折节段: T11 8 例,T12 44 例,L1 47 例,L2 9 例。按 Magral 分型,A1 型(压缩型)39 例,A2 型(爆裂型)51 例,B 型(骨折脱位)15 例,C 型(旋转脱位、侧方压缩)3 例。合并神经损伤 75 例。受伤至手术时间 8 h ~ 12 d,平均44 h。  结 果  术后切口均Ⅰ期愈合。108 例均获随访,随访时间 24 ~ 48 个月,平均 30 个月。术后 1.5 ~ 2 年,4 例出现断钉、断棒、螺钉松动等并发症,其中 1 例因骨折塌陷达 50% 再次行经后路复位植骨钉棒固定,1 例断钉未取出,2 例螺钉松动取出,均获治愈,无明显椎体再压缩。术后 1 周及末次随访时伤椎前、后缘椎体压缩率、椎管侵占率及后凸Cobb 角均较术前明显改善,差异有统计学意义(P lt; 0.05);术后各时间点间比较差异无统计学意义(P gt; 0.05)。末次随访时按美国脊髓损伤协会分级评价神经功能,均较术前有1~4级提高。参照杨飞等标准对手术效果进行评价,获优58例,良34例,中 10 例,差 6 例,优良率 85.2%。  结论  经椎弓根植骨、钉棒固定治疗胸腰椎骨折可维持椎体高度,促进骨愈合,重建脊柱稳定性,减少远期椎体塌陷及椎弓根钉断裂的发生。

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • Analysis of Pre-hospital First Aid for 51 Cases of Crush Injury

    ObjectiveTo understand the pre-hospital emergency medical staff's knowledge on crush injury and crush syndrome, and the influence of active and effective pre-hospital measures on the prognosis of patients with crush injury. MethodsWe retrospectively analyzed the clinical data of 51 patients with crush injury treated from September 2004 to August 2014, and recorded the number of cases in which pre-hospital emergency medical staff recognized and/or took effective measures to control crush syndrome. Treatment group included those patients who accepted effective prevention and control measures, and the rest of the patients were included in the control group. We compared the two groups of patients in terms of the incidence of serious complications such as crush syndrome and amputation. ResultsTwenty-five cases (49.0%) of crush injury were recognized before the patients were admitted into the hospital, among whom 20 (39.2%) accepted effective preventive and control measures. The mangled extremity severity score between the two groups of patients had no significant difference (6.69±1.96 vs. 7.23±3.54, P>0.05). After being admitted into the hospital, the treatment group had one complication case of crush injury, while the control group had 10 complication cases including 7 of crush injury and 3 of amputation. The complication rate of the treatment group (5.0%) was significantly lower than that of the control group (32.3%, P<0.05). ConclusionActive and effective prehospital preventive and control measures are very important in the treatment of crush syndrome and reduction of morbidity, but the pre-hospital emergency personnel's knowledge of crush injury and crush syndrome is not enough.

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