Objective: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.Methods: Nine cases of posterolateral dislocation of knee joint ,5 cases of fresh injurie...Objective: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.Methods: Nine cases of posterolateral dislocation of knee joint ,5 cases of fresh injuries (the fresh injury group) and 4 cases of old injuries ( the old injury group) were reviewed and analyzed. In the fresh injury group 4 cases failed in close reduction due to "buttonholing" through the medial jo int,among them 3 cases underwent repair of the damaged ligaments. In the old in jury group 2 cases underwent ACL and MCL repair only in acute stage,but re-dis located. Of the rest 2 cases 1 was associated with peroneal nerve injury and the other was not treated in acute stage. One case was associated with comminuted f racture of the tibial condyle and popliteal artery injury. Open reduction was pe rformed in 3 cases. One case was fixed with 2-crossed pin and another was fixe d with one pin through the tibial and femoral condyle and second pin with olecra nization fixation. Plaster immobilization for 6-8 weeks respectively was requir ed. In the old injury group in 1 case ACL and PCL repair (Augustine method) and posterolateral structure were performed and olecranization fixation and plaster immobilization for 6 weeks was needed. Arthrodesis of the knee was done for the patient with comminuted fracture of the tibial condyle and popliteal artery inj ury. Results: All the cases were followed up for 1-23 years (averag e 6 years). Knee stability in 4 cases with repair of the ligaments was improved,although PDT showed (+) with different degrees. The results of the patients tre ated with ligamentous reconstruction were much better than those of the patients without any repair. Conclusions: Well understanding of the traumatic pathological c haracteristics,repair of the damaged ligaments,augmentation of olecranization fixation and postoperative immobilization for 6 weeks are the key points of succ essful treatment.展开更多
目的探讨近端胃切除双通道吻合与全胃切除Roux-en-Y吻合治疗食管胃结合部腺癌的临床疗效,为临床选择提供参考。方法前瞻性对比研究2016年6月至2018年6月赤峰市医院连续收入的食管胃结合部腺癌手术患者,按随机数字表法分为近端胃切除双...目的探讨近端胃切除双通道吻合与全胃切除Roux-en-Y吻合治疗食管胃结合部腺癌的临床疗效,为临床选择提供参考。方法前瞻性对比研究2016年6月至2018年6月赤峰市医院连续收入的食管胃结合部腺癌手术患者,按随机数字表法分为近端胃切除双通道吻合术组(PG组)和全胃切除Roux-en-Y吻合术组(TG组),比较两组的围手术期指标、临床病理、术后早期(≤30 d)及晚期(>30 d)并发症;并比较两组术后3、6、12个月营养状况(BMI、前白蛋白、白蛋白、总蛋白)及贫血指标(Hb、RBC)。结果共收治食管胃结合部腺癌患者83例,符合手术62例,每组各31例,每组各出现1例失访,每组各30例,两组均无肿瘤复发及死亡患者。两组年龄、性别、肿瘤大小、肿瘤分期、术前合并疾病、术前营养状况及贫血指标等差异均无统计学意义(P>0.05)。PG组首次排气时间、开始流食时间及术后住院时间明显短于TG组[(3.0±0.7)d vs (4.2±0.7)d、(7.9±0.9)d vs (9.0±0.9)d、(13.3±1.1)d vs (14.6±0.9)d,P<0.05],而手术时间稍长[(252.0±36.9)min vs (225.8±31.1)min,P<0.05];PG组与TG组术中出血量及淋巴结清扫数目差异均无统计学意义[(241.7±81.0)ml vs (245.8±71.9)ml、(40.5±12.2)个vs (43.2±10.3)个,P>0.05]。术后早期及晚期并发症的发生差异均无统计学意义(P>0.05);PG组术后出现反流食管炎少于TG组(P<0.05)。术后3、6、12个月PG组营养状况明显优于TG组(P<0.05);术后3、6个月两组Hb、RBC均较术前降低,且PG组Hb、RBC高于TG组(P<0.05);而术后12个月PG组与TG组均无贫血。结论近端胃切除双通道吻合术在治疗食管胃结合部腺癌近期临床疗效确切,值得推广。展开更多
文摘Objective: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.Methods: Nine cases of posterolateral dislocation of knee joint ,5 cases of fresh injuries (the fresh injury group) and 4 cases of old injuries ( the old injury group) were reviewed and analyzed. In the fresh injury group 4 cases failed in close reduction due to "buttonholing" through the medial jo int,among them 3 cases underwent repair of the damaged ligaments. In the old in jury group 2 cases underwent ACL and MCL repair only in acute stage,but re-dis located. Of the rest 2 cases 1 was associated with peroneal nerve injury and the other was not treated in acute stage. One case was associated with comminuted f racture of the tibial condyle and popliteal artery injury. Open reduction was pe rformed in 3 cases. One case was fixed with 2-crossed pin and another was fixe d with one pin through the tibial and femoral condyle and second pin with olecra nization fixation. Plaster immobilization for 6-8 weeks respectively was requir ed. In the old injury group in 1 case ACL and PCL repair (Augustine method) and posterolateral structure were performed and olecranization fixation and plaster immobilization for 6 weeks was needed. Arthrodesis of the knee was done for the patient with comminuted fracture of the tibial condyle and popliteal artery inj ury. Results: All the cases were followed up for 1-23 years (averag e 6 years). Knee stability in 4 cases with repair of the ligaments was improved,although PDT showed (+) with different degrees. The results of the patients tre ated with ligamentous reconstruction were much better than those of the patients without any repair. Conclusions: Well understanding of the traumatic pathological c haracteristics,repair of the damaged ligaments,augmentation of olecranization fixation and postoperative immobilization for 6 weeks are the key points of succ essful treatment.
文摘目的探讨近端胃切除双通道吻合与全胃切除Roux-en-Y吻合治疗食管胃结合部腺癌的临床疗效,为临床选择提供参考。方法前瞻性对比研究2016年6月至2018年6月赤峰市医院连续收入的食管胃结合部腺癌手术患者,按随机数字表法分为近端胃切除双通道吻合术组(PG组)和全胃切除Roux-en-Y吻合术组(TG组),比较两组的围手术期指标、临床病理、术后早期(≤30 d)及晚期(>30 d)并发症;并比较两组术后3、6、12个月营养状况(BMI、前白蛋白、白蛋白、总蛋白)及贫血指标(Hb、RBC)。结果共收治食管胃结合部腺癌患者83例,符合手术62例,每组各31例,每组各出现1例失访,每组各30例,两组均无肿瘤复发及死亡患者。两组年龄、性别、肿瘤大小、肿瘤分期、术前合并疾病、术前营养状况及贫血指标等差异均无统计学意义(P>0.05)。PG组首次排气时间、开始流食时间及术后住院时间明显短于TG组[(3.0±0.7)d vs (4.2±0.7)d、(7.9±0.9)d vs (9.0±0.9)d、(13.3±1.1)d vs (14.6±0.9)d,P<0.05],而手术时间稍长[(252.0±36.9)min vs (225.8±31.1)min,P<0.05];PG组与TG组术中出血量及淋巴结清扫数目差异均无统计学意义[(241.7±81.0)ml vs (245.8±71.9)ml、(40.5±12.2)个vs (43.2±10.3)个,P>0.05]。术后早期及晚期并发症的发生差异均无统计学意义(P>0.05);PG组术后出现反流食管炎少于TG组(P<0.05)。术后3、6、12个月PG组营养状况明显优于TG组(P<0.05);术后3、6个月两组Hb、RBC均较术前降低,且PG组Hb、RBC高于TG组(P<0.05);而术后12个月PG组与TG组均无贫血。结论近端胃切除双通道吻合术在治疗食管胃结合部腺癌近期临床疗效确切,值得推广。
