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find Author "高毅" 2 results
  • 改良双侧Glenn手术后早期处理

    目的 总结功能性单心室患者行改良双侧Glenn 术后早期处理经验,为临床提供借鉴。 方法 回顾性分析2009 年1 月至2010 年6 月济南军区总医院共19 例功能性单心室患者行改良双侧Glenn 术的临床资料,其中男10 例,女9 例;年龄3.5 ~ 18.0(7.4±3.3)岁,体重11.5 ~ 70.0( 21.5±12.3) kg;术前经超声心动图和心血管造影检查诊断为功能性单心室19 例,其中合并三尖瓣闭锁4 例,二尖瓣闭锁1 例。术后患者均取半卧位,留置桡动脉、上腔静脉测压管,常规建立下腔静脉输液通路。给予多巴胺、米力农等正性肌力药物,依据上腔静脉压力情况予以吸入伊洛前列环素,后续口服西地那非,并强调联合序贯治疗。控制红细胞积压(HCT)在0.40 左右,血浆白蛋白> 30 g/L。撤离呼吸机后予以抗凝治疗。 结果 全组无死亡,无严重并发症。手术时间(119.0±41.8) min,机械通气时间(6.5±1.9) h,监护室滞留时间( 3.6 ±1.5) d,纵隔心包引流量(13.9±4.2) ml/kg。全组患者动脉血氧饱和度(SaO2)较术前上升28.3%(t=5.13,P=0.000),术后平均肺动脉压(13.6±3.6) mm Hg。 结论 改良双侧Glenn 术对于难以解剖根治及不能Ⅰ期生理矫治的紫绀型复杂先天性心脏病患者效果良好。术后应结合新的手术方式及病理生理特点采取有针对性处理。

    Release date:2016-08-30 05:48 Export PDF Favorites Scan
  • Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures

    Objective To evaluate the effectiveness of Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures. MethodsA retrospective analysis was conducted on 20 patients with bone defects complicating distal radius fractures who met the selection criteria and were treated between June 2022 and June 2024. The cohort comprised 2 males and 18 females, aged 54-87 years (mean, 63.3 years). Etiologies included falls in 17 cases, traffic accidents in 2 cases, and crush injury in 1 case. According to AO classification, there were 5 cases of type A, 8 cases of type B, and 7 cases of type C. The interval from injury to operation ranged from 2 to 10 days (mean, 5.8 days). All patients underwent volar plate fixation augmented with Poster Fusion Cage and demineralized xenogeneic bone matrix grafting. The operation time, intraoperative blood loss, fracture healing time, and postoperative complications were recorded. Radiographic parameters, including radial height, volar tilt, and ulnar deviation, were measured on standardized X-ray films obtained immediately postoperatively and at last follow-up, and whether secondary reduction loss occurred was judged. At last follow-up, wrist range of motion (extension, flexion, radial deviation, ulnar deviation, pronation, and supination) and grip strength (expressed as a percentage of the contralateral side) were measured. Wrist function was assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and Patient-Rated Wrist Evaluation (PRWE) score. Results The operation time was 70-200 minutes (mean, 116.4 minutes), and the intraoperative blood loss was 10-80 mL (mean, 36.5 mL). All surgical incisions healed by first intention, with no neurovascular complications documented. All patients were followed up 9-12 months (mean, 11.6 months). All fractures healed normally, with a healing time of 8-14 weeks (mean, 9.95 weeks). No significant difference was observed in radial height, volar tilt, or ulnar deviation between immediate postoperative and last follow-up (P>0.05). All fractures achieved satisfactory reduction, with no secondary loss of reduction or implant failure occurring during follow-up. At last follow-up, the range of motion of the affected wrist joint was 60°-65° (mean, 62.5°) in extension, 67°-75° (mean, 71.1°) in flexion, 18°-23° (mean, 20.4°) in radial deviation, 28°-33° (mean, 30.1°) in ulnar deviation, 69°-80° (mean, 74.7°) in pronation, and 69°-82° (mean, 75.6°) in supination. Grip strength recovered to 75%-85% (mean, 80%) of the contralateral side. Functional scores showed a DASH score of 5-15 (mean, 9.4) and PRWE score of 8.0-12.5 (mean, 10.2). Conclusion The combination of Poster Fusion Cage and xenogeneic bone graft augmentation provides a safe and effective treatment for bone defects in distal radius fractures.

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