为了探讨颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)的临床分型及其手术方式的选择,回顾性分析了2006年4月～2011年3月收治颈椎OPLL患者46例。根据患者后纵韧带骨化的范围,将OPLL分为:I型累及下颈椎,...为了探讨颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)的临床分型及其手术方式的选择,回顾性分析了2006年4月～2011年3月收治颈椎OPLL患者46例。根据患者后纵韧带骨化的范围,将OPLL分为:I型累及下颈椎,病变范围≤2个椎体,II型累及下颈椎,病变范围≥3个椎体,III型累及下颈椎,狭窄率≥50%且合并发育性椎管狭窄,IV型累及上颈椎。手术方式的选择:颈后路椎管减压术或后路减压内固定术。以此选择颈后路、颈前路及颈椎前后路手术方式,计算JOA改善率。经过随访后,患者从术前JOA评分平均8.72分(4分～11分)提高至13.11分(8分～15分),JOA平均改善率为53.56%。据此分型可十分明确的选择手术方式,并取得较好临床效果。此分型可为手术治疗OPLL提供一个客观的临床标准。展开更多
Since existing selection methods of surgical treatment schemes of renal cancer patients mainly depend on physicians’clinical experience and judgments,the surgical treatment options of renal cancer patients lack their...Since existing selection methods of surgical treatment schemes of renal cancer patients mainly depend on physicians’clinical experience and judgments,the surgical treatment options of renal cancer patients lack their scientifical and reasonable information expression and group decision-making model for renal cancer patients.Fuzzy multi-sets(FMSs)have a number of properties,which make them suitable for expressing the uncertain information of medical diagnoses and treatments in group decision-making(GDM)problems.To choose the most appropriate surgical treatment scheme for a patient with localized renal cell carcinoma(RCC)(T1 stage kidney tumor),this article needs to develop an effective GDM model based on the fuzzy multivalued evaluation information of the renal cancer patients.First,we propose a conversionmethod of transforming FMSs into entropy fuzzy sets(EFSs)based on the mean and Shannon entropy of a fuzzy sequence in FMS to reasonably simplify the information expression and operations of FMSs and define the score function of an entropy fuzzy element(EFE)for ranking EFEs.Second,we present the Aczel-Alsina t-norm and t-conorm operations of EFEs and the EFE Aczel-Alsina weighted arithmetic averaging(EFEAAWAA)and EFE Aczel-Alsina weighted geometric averaging(EFEAAWGA)operators.Third,we develop a multicriteria GDM model of renal cancer surgery options in the setting of FMSs.Finally,the proposed GDM model is applied to two clinical cases of renal cancer patients to choose the best surgical treatment scheme for a renal cancer patient in the setting of FMSs.The selected results of two clinical cases verify the efficiency and rationality of the proposed GDM model in the setting of FMSs.展开更多
文摘为了探讨颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)的临床分型及其手术方式的选择,回顾性分析了2006年4月～2011年3月收治颈椎OPLL患者46例。根据患者后纵韧带骨化的范围,将OPLL分为:I型累及下颈椎,病变范围≤2个椎体,II型累及下颈椎,病变范围≥3个椎体,III型累及下颈椎,狭窄率≥50%且合并发育性椎管狭窄,IV型累及上颈椎。手术方式的选择:颈后路椎管减压术或后路减压内固定术。以此选择颈后路、颈前路及颈椎前后路手术方式,计算JOA改善率。经过随访后,患者从术前JOA评分平均8.72分(4分～11分)提高至13.11分(8分～15分),JOA平均改善率为53.56%。据此分型可十分明确的选择手术方式,并取得较好临床效果。此分型可为手术治疗OPLL提供一个客观的临床标准。
基金This study has received funding by the Science and Technology Plan Project of Keqiao District(No.2020KZ58).
文摘Since existing selection methods of surgical treatment schemes of renal cancer patients mainly depend on physicians’clinical experience and judgments,the surgical treatment options of renal cancer patients lack their scientifical and reasonable information expression and group decision-making model for renal cancer patients.Fuzzy multi-sets(FMSs)have a number of properties,which make them suitable for expressing the uncertain information of medical diagnoses and treatments in group decision-making(GDM)problems.To choose the most appropriate surgical treatment scheme for a patient with localized renal cell carcinoma(RCC)(T1 stage kidney tumor),this article needs to develop an effective GDM model based on the fuzzy multivalued evaluation information of the renal cancer patients.First,we propose a conversionmethod of transforming FMSs into entropy fuzzy sets(EFSs)based on the mean and Shannon entropy of a fuzzy sequence in FMS to reasonably simplify the information expression and operations of FMSs and define the score function of an entropy fuzzy element(EFE)for ranking EFEs.Second,we present the Aczel-Alsina t-norm and t-conorm operations of EFEs and the EFE Aczel-Alsina weighted arithmetic averaging(EFEAAWAA)and EFE Aczel-Alsina weighted geometric averaging(EFEAAWGA)operators.Third,we develop a multicriteria GDM model of renal cancer surgery options in the setting of FMSs.Finally,the proposed GDM model is applied to two clinical cases of renal cancer patients to choose the best surgical treatment scheme for a renal cancer patient in the setting of FMSs.The selected results of two clinical cases verify the efficiency and rationality of the proposed GDM model in the setting of FMSs.
