目的:研究射频汽化结合髌骨钻孔减压在治疗髌骨软骨病变中的临床效果.方法:利用Arthro Care 2000射频汽化仪对56例髌骨软骨病变患者行损伤的软骨面修整,髌骨周缘滑膜清理;直径2～2.5mm克氏针,自髌骨两侧缘向髌骨内钻孔减压.9例同时行外...目的:研究射频汽化结合髌骨钻孔减压在治疗髌骨软骨病变中的临床效果.方法:利用Arthro Care 2000射频汽化仪对56例髌骨软骨病变患者行损伤的软骨面修整,髌骨周缘滑膜清理;直径2～2.5mm克氏针,自髌骨两侧缘向髌骨内钻孔减压.9例同时行外侧支持带松解.结果:随访6个月～2年10个月,平均1年7个月.术后患者疼痛症状明显缓解.Lysholm评分由术前平均56分提高到术后平均91分.结论:射频汽化仪治疗精确,最大限度地保留了未受损伤的软骨组织;联合髌骨钻孔减压治疗髌骨软骨病变效果良好,术后康复快.展开更多
Purpose： Posterior fossa epidural hematomas （PFEDH） are uncommon in children but usually require timely surgical intervention due to the risk of life-threatening brainstem compression. We attempt to make the surgic...Purpose： Posterior fossa epidural hematomas （PFEDH） are uncommon in children but usually require timely surgical intervention due to the risk of life-threatening brainstem compression. We attempt to make the surgical procedure less invasive by treating selected pediatric patients with trephination minicraniectomy. Methods： We retrospectively reviewed the clinical courses, radiological findings, surgical procedures, and prognoses of the pediatric patients who were treated in our departments for traumatic PFEDH from January 2010 to January 2015. Results： During this period, a total of 17 patients were surgically treated for PFEDH and 7 were managed with trephination mini-craniectomy for hematoma evacuation. The outcomes were good in all 7 patients as evaluated with Glasgow Outcome Score. There was no mortality in this series. The on average 30-month clinical follow-up showed that patients experienced satisfactory recoveries without complications. Conclusion： Our results suggest that trephination mini-craniectomy is a safe surgical technique for selected PFEDH patients with moderate hematoma volume and stabilized neurological functions. However, standard craniectomy is recommend when there are rapid deteriorations in patients＇ neurological functions or the hematomas are large and exerted severe mass effects.展开更多
AIM: To compare long-term postoperative outcomes of manual and femtosecond assisted corneal trephination in deep anterior lamellar keratoplasty(FS-DALK) for keratoconus.METHODS: In the retrospective study, 17 consecut...AIM: To compare long-term postoperative outcomes of manual and femtosecond assisted corneal trephination in deep anterior lamellar keratoplasty(FS-DALK) for keratoconus.METHODS: In the retrospective study, 17 consecutive eyes that underwent vertical side cut incision FS-DALK and 22 eyes that underwent trephine incision DALK were collected over a 2-year period. Main measurements included postoperative uncorrected-visual acuity(UCVA), corrected distance visual acuity(CDVA), refractive sphere and cylinder, manifest refraction spherical equivalent(MRSE), flat and steep corneal keratometry(K1 and K2), endothelial cell density(ECD), and time of epithelium healing and suture removal.RESULTS: Groups were comparable for diagnosis and preoperative visual acuity. Follow-up averaged 23 mo(range, 12-36 mo). At 12 mo, the mean UCVA was better in the manual-DALK group(P=0.039), and the refractive sphere was lower in the FS-DALK group(P=0.040). MRSE between groups differed at 1, 6, and 12 mo postoperatively(P=0.047, 0.025, 0.042, respectively). Mean CDVA, cylinder, K1, K2,corneal astigmatism, ECD, and time of epithelium healing were similar between groups. Stability of MRSE, ECD, and K1 returned sooner after FS-DALK. Initial loosened suture removal time was earlier in the manual-DALK group(P=0.042) while complete suture removal time was similar(P=0.122).CONCLUSION: Manual and femtosecond assisted corneal trephination in DALK are options for advanced keratoconus. FS-DALK do not result in improved visual acuity but it is more stable during the follow-up period. FSDALK in the present form show limited benefit, so surgical design and parameters still need to be optimized and explored.展开更多
文摘目的:研究射频汽化结合髌骨钻孔减压在治疗髌骨软骨病变中的临床效果.方法:利用Arthro Care 2000射频汽化仪对56例髌骨软骨病变患者行损伤的软骨面修整,髌骨周缘滑膜清理;直径2～2.5mm克氏针,自髌骨两侧缘向髌骨内钻孔减压.9例同时行外侧支持带松解.结果:随访6个月～2年10个月,平均1年7个月.术后患者疼痛症状明显缓解.Lysholm评分由术前平均56分提高到术后平均91分.结论:射频汽化仪治疗精确,最大限度地保留了未受损伤的软骨组织;联合髌骨钻孔减压治疗髌骨软骨病变效果良好,术后康复快.
文摘Purpose： Posterior fossa epidural hematomas （PFEDH） are uncommon in children but usually require timely surgical intervention due to the risk of life-threatening brainstem compression. We attempt to make the surgical procedure less invasive by treating selected pediatric patients with trephination minicraniectomy. Methods： We retrospectively reviewed the clinical courses, radiological findings, surgical procedures, and prognoses of the pediatric patients who were treated in our departments for traumatic PFEDH from January 2010 to January 2015. Results： During this period, a total of 17 patients were surgically treated for PFEDH and 7 were managed with trephination mini-craniectomy for hematoma evacuation. The outcomes were good in all 7 patients as evaluated with Glasgow Outcome Score. There was no mortality in this series. The on average 30-month clinical follow-up showed that patients experienced satisfactory recoveries without complications. Conclusion： Our results suggest that trephination mini-craniectomy is a safe surgical technique for selected PFEDH patients with moderate hematoma volume and stabilized neurological functions. However, standard craniectomy is recommend when there are rapid deteriorations in patients＇ neurological functions or the hematomas are large and exerted severe mass effects.
基金Supported by the Innovation Project of Shandong Academy of Medical Sciences。
文摘AIM: To compare long-term postoperative outcomes of manual and femtosecond assisted corneal trephination in deep anterior lamellar keratoplasty(FS-DALK) for keratoconus.METHODS: In the retrospective study, 17 consecutive eyes that underwent vertical side cut incision FS-DALK and 22 eyes that underwent trephine incision DALK were collected over a 2-year period. Main measurements included postoperative uncorrected-visual acuity(UCVA), corrected distance visual acuity(CDVA), refractive sphere and cylinder, manifest refraction spherical equivalent(MRSE), flat and steep corneal keratometry(K1 and K2), endothelial cell density(ECD), and time of epithelium healing and suture removal.RESULTS: Groups were comparable for diagnosis and preoperative visual acuity. Follow-up averaged 23 mo(range, 12-36 mo). At 12 mo, the mean UCVA was better in the manual-DALK group(P=0.039), and the refractive sphere was lower in the FS-DALK group(P=0.040). MRSE between groups differed at 1, 6, and 12 mo postoperatively(P=0.047, 0.025, 0.042, respectively). Mean CDVA, cylinder, K1, K2,corneal astigmatism, ECD, and time of epithelium healing were similar between groups. Stability of MRSE, ECD, and K1 returned sooner after FS-DALK. Initial loosened suture removal time was earlier in the manual-DALK group(P=0.042) while complete suture removal time was similar(P=0.122).CONCLUSION: Manual and femtosecond assisted corneal trephination in DALK are options for advanced keratoconus. FS-DALK do not result in improved visual acuity but it is more stable during the follow-up period. FSDALK in the present form show limited benefit, so surgical design and parameters still need to be optimized and explored.
