【摘要】 目的 探讨左炔诺孕酮宫内释放系统联合桂枝茯苓胶囊治疗子宫腺肌病的疗效。 方法 2006年2月-2010年2月108例子宫腺肌病患者随机分为观察组（n=56）与对照组（n=52），观察组患者宫内放置左炔诺孕酮宫内释放系统，同时口服中成药桂枝茯苓胶囊，3粒/次，3次/d，连服6个月。对照组单放置左炔诺孕酮宫内释放系统进行治疗，观察月经量、痛经程度、子宫体积及血清CA125水平变化。 结果 6个月后，观察组患者痛经明显缓解，月经量显著减少，子宫体积缩小，血清CA125水平明显降低，治疗前后比较，差异均有统计学意义（Plt;0.05）；与对照组比较，痛经评级、子宫体积缩小、血清CA125水平差异均有统计学意义（Plt;0.05）。 结论 左炔诺孕酮宫内释放系统与桂枝茯苓胶囊联合治疗子宫腺肌病安全有效，满意度高，值得临床推广应用。【Abstract】 Objective To evaluate the therapeutic effect of levonorgestrel-releasing intrauterine system (LNG-IUS) combined with Guizhi Fulin capsules treating adenomyosis. Methods A total of 108 patients with adenomyosis diagnosed in our hospital from February 2006 to February 2010 were randomly divided into the observation group (n=56) and the control group (n=52). The patients in the observation group were treated with LNG-IUS and simultaneously administrated orally with the Guizhi Fulin capsules (three capsules per time, three times per day for six continuous months). The patients in the control group were treated with LNG -IUS only. The changes of the menstrual blood volume, severity of dysmenorrhea, uterine volume and the level of serum CA125 were observed and evaluated. Results After six months’ treatment, dysmenorrhea of all the patients was obviously alleviated, the menstrual blood volume reduced significantly, the uterine volume shrank, and the level of serum CA125 decreased significantly; the results after the treatment differed much from that before the treatment (Plt;0.05). Compared with those in the control group, the differences in the grades of the dysmenorrheal, shrinkage of the uterine volume and the level of serum CA125 were statistically significant (Plt;0.05). Conclusion Combined usage of LNG-IUS and Guizhi Fulin capsules is an effective and safe way treating adenomyosis.
Objective To assess the effectiveness of the new anterolateral approach of the distal femur for the treatment of distal femoral fractures. Methods Between July 2007 and December 2009, 58 patients with distal femoral fractures were treated by new anterolateral approach of the distal femur in 28 patients (new approach group) and by conventional approach in 30 patients (conventional approach group). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, disease duration, complication, or preoperative intervention (P gt; 0.05). The operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, hospitalization days, and Hospital for Special Surgery (HSS) score of knee were recorded. Results Operation was successfully completed in all patients of 2 groups, and healing of incision by first intention was obtained; no vascular and nerves injuries occurred. The operation time and intraoperative fluoroscopy frequency of new approach group were significantly less than those of conventional approach group (P lt; 0.05). But the intraoperative blood loss and the hospitalization days showed no significant difference between 2 groups (P gt; 0.05). All patients were followed up 12-36 months (mean, 19.8 months). Bone union was shown on X-ray films; the fracture healing time was (12.62 ± 2.34) weeks in the new approach group and was (13.78 ± 1.94) weeks in the conventional approach group, showing no significant difference (t=2.78, P=0.10). The knee HSS score at last follow-up was 94.4 ± 4.2 in the new approach group, and was 89.2 ± 6.0 in the conventional approach group, showing significant difference between 2 groups (t=3.85, P=0.00). Conclusion New anterolateral approach of the distal femur for distal femoral fractures has the advantages of exposure plenitude, minimal tissue trauma, and early function rehabilitation training so as to enhance the function recovery of knee joint.
Objective To study the effectiveness of anterolateral C-shaped approach in the treatment of intertrochanteric fracture of the femur in elderly patient by comparing with traditional anterolateral approach. Methods Between April 2010 and November 2011, 66 patients with intertrochanteric fracture of the femur were analyzed retrospectively. Of 66 patients, 37 underwent improved anterolateral C-shaped approach combined with fixation of dynamic hip screw (DHS) (improved group), and 29 underwent traditional anterolateral approach combined with fixation of DHS (conventional group). There was no significant difference in gender, age, injury cause, side, disease duration, fracture type, and complication between 2 groups (P gt; 0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospitalization time were recorded; and X-ray films were taken to observe the fracture healing. The hip function was evaluated according to self-established criterion. Results The operation was successfully completed in all patients, and primary healing of incision was achieved. All patients were followed up 12-24 months (mean, 17.8 months). Bone union was achieved in both groups; the fracture healing time was 3-6 months (mean, 4.8 months). No loosening or breaking of internal fixation was observed during follow-up period. The operation time and postoperative drainage volume of improved group were significantly less than those of conventional group (P lt; 0.05); no significant difference was found in intraoperative blood loss and hospitalization days between 2 groups (P gt; 0.05). According to self-established criterion, improved group was significantly better than conventional group in recovery of hip joint motion and function at 6 and 12 months after operation (P lt; 0.05). Conclusion Anterolateral C-shaped approach combined with DHS could minimize muscle injury and scar formation, which is beneficial to surgical exposure and early postoperative rehabilitation.