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两种固定治疗踝关节骨折合并下胫腓联合韧带损伤的疗效比较 被引量:1
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作者 王驭恺 吴升辉 +2 位作者 龚子凌 诸葛英杰 梅炯 《成都医学院学报》 2025年第2期217-220,共4页
目的 对比Endobutton带袢钢板弹性固定与下胫腓螺钉刚性固定治疗踝关节骨折(AF)合并下胫腓联合韧带损伤患者的临床疗效。方法 选择2019年10月至2023年6月上海市第六人民医院收治的AF合并下胫腓联合韧带损伤患者100例为研究对象,根据治... 目的 对比Endobutton带袢钢板弹性固定与下胫腓螺钉刚性固定治疗踝关节骨折(AF)合并下胫腓联合韧带损伤患者的临床疗效。方法 选择2019年10月至2023年6月上海市第六人民医院收治的AF合并下胫腓联合韧带损伤患者100例为研究对象,根据治疗方法不同分为A组(46例)和B组(54例),A组给予下胫腓螺钉刚性固定,B组给予Endobutton带袢钢板弹性固定。比较两组患者手术情况、负重时间、胫腓联合间隙(TBCS)、胫腓骨重叠(TFO)情况、术后6个月临床疗效及并发症发生率。结果 术后B组部分负重时间、完全负重时间较A组短(P<0.05)。术后两组患者TBCS小于术前(P<0.05),TFO大于术前(P<0.05);但术后两组患者TBCS和TFO比较,差异均无统计学意义(P>0.05)。术后6个月B组患者临床疗效优良率83.33%高于A组65.22%(P<0.05),B组患者并发症总发生率1.85%低于A组15.22%(P<0.05)。结论 与下胫腓螺钉刚性固定相较,Endobutton带袢钢板弹性固定能缩短AF合并下胫腓联合韧带损伤患者负重时间,提高术后6个月临床疗效,减少并发症发生率。 展开更多
关键词 踝关节骨折 韧带损伤 Endobutton带袢钢板弹性固定 下胫腓螺钉刚性固定 疗效
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踝上内侧撑开截骨术与弧形截骨术治疗内翻型踝关节炎的疗效比较
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作者 李广翼 杨建义 +5 位作者 龚子凌 缪语 梅国华 薛剑锋 施忠民 马昕 《中华骨科杂志》 北大核心 2025年第22期1448-1455,共8页
目的比较踝上内侧撑开截骨术与弧形截骨术治疗内翻型踝关节炎的临床疗效。方法回顾性分析2018年3月至2024年3月于上海交通大学医学院附属第六人民医院骨科行踝上截骨术治疗的24例内翻型踝关节炎患者资料,男8例、女16例,年龄(60.0±6... 目的比较踝上内侧撑开截骨术与弧形截骨术治疗内翻型踝关节炎的临床疗效。方法回顾性分析2018年3月至2024年3月于上海交通大学医学院附属第六人民医院骨科行踝上截骨术治疗的24例内翻型踝关节炎患者资料,男8例、女16例,年龄(60.0±6.6)岁(范围44~69岁),体质指数(24.3±2.6)kg/m 2(范围20.0~31.9 kg/m 2),左侧8例、右侧16例。根据截骨方式分为内侧撑开截骨组12例和弧形截骨组12例。采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分评价踝关节功能,采用疼痛视觉模拟评分(visual analogue scale,VAS)评估疼痛程度,测量踝关节活动度,影像学评估包括胫骨远端关节面正位角(tibial articular surface angle,TAS)、胫骨远端关节面侧位角(tibial lateral surface angle,TLS)、距骨倾斜角(talar tilt angle,TT)。结果所有患者均顺利完成手术并获得随访,随访时间为(30.5±8.0)个月(范围17~50个月)。内侧撑开截骨组和弧形截骨组术前AOFAS踝与后足评分分别为(53.3±9.8)分和(51.8±10.2)分,末次随访时增至(84.5±5.6)分和(85.1±6.0)分,手术前后的差异均有统计学意义(P<0.05),末次随访时两组间比较差异无统计学意义(P>0.05)。内侧撑开截骨组和弧形截骨组术前踝关节活动度分别为32.5°±6.7°和33.2°±7.1°,末次随访时增至45.7°±5.4°和46.3°±4.8°,手术前后差异均有统计学意义(P<0.05),末次随访时两组间比较差异无统计学意义(P>0.05)。内侧撑开截骨组和弧形截骨组术前TAS角和TLS角分别为77.5°±3.7°、75.2°±4.6°和78.3°±3.9°、76.5°±4.8°,末次随访时增至89.3°±2.6°、82.5°±3.8°和90.1°±2.4°、83.3°±3.5°,手术前后差异均有统计学意义(P<0.05),末次随访时两组间比较差异无统计学意义(P>0.05)。内侧撑开截骨组和弧形截骨组术前TT角分别为6.8°±1.9°和6.7°±2.0°,末次随访时降至2.6°±1.3°和2.5°±1.7°,手术前后差异均有统计学意义(P<0.05),末次随访时两组间比较差异无统计学意义(P>0.05)。内侧撑开截骨组术后1例出现伤口愈合不良,经换药、抗炎治疗后愈合;1例发生术区神经痛,予以营养神经、抗炎对症治疗后好转。两组无一例出现内固定失效、深部感染及重要神经血管损伤等并发性。结论踝上内侧撑开截骨术与弧形截骨术治疗内翻型踝关节炎均可获得满意的早中期功能恢复和影像学改善。 展开更多
关键词 踝关节 骨关节炎 截骨术
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How Snow Leopards Share the Same Landscape with Tibetan Agro-pastoral Communities in the Chinese Himalayas
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作者 XIAO Changxi BAI Defeng +5 位作者 Joseph PLAMBERT LI Yibin Lhaba CERING gong ziling Philip RIORDAN SHI Kun 《Journal of Resources and Ecology》 CSCD 2022年第3期483-500,共18页
The snow leopard(Panthera uncia)inhabits a human-altered alpine landscape and is often tolerated by residents in regions where the dominant religion is Tibetan Buddhism,including in Qomolangma NNR on the northern side... The snow leopard(Panthera uncia)inhabits a human-altered alpine landscape and is often tolerated by residents in regions where the dominant religion is Tibetan Buddhism,including in Qomolangma NNR on the northern side of the Chinese Himalayas.Despite these positive attitudes,many decades of rapid economic development and population growth can cause increasing disturbance to the snow leopards,altering their habitat use patterns and ultimately impacting their conservation.We adopted a dynamic landscape ecology perspective and used multiscale technique and occupancy model to better understand snow leopard habitat use and coexistence with humans in an 825 km^(2)communal landscape.We ranked eight hypothetical models containing potential natural and anthropogenic drivers of habitat use and compared them between summer and winter seasons within a year.HABITAT was the optimal model in winter,whereas ANTHROPOGENIC INFLUENCE was the top ranking in summer(AICc_(w)≤2).Overall,model performance was better in the winter than in the summer,suggesting that perhaps some latent summer covariates were not measured.Among the individual variables,terrain ruggedness strongly affected snow leopard habitat use in the winter,but not in the summer.Univariate modeling suggested snow leopards prefer to use rugged land in winter with a broad scale(4000 m focal radius)but with a lesser scale in summer(30 m);Snow leopards preferred habitat with a slope of 22°at a scale of 1000 m throughout both seasons,which is possibly correlated with prey occurrence.Furthermore,all covariates mentioned above showed inextricable ties with human activities(presence of settlements and grazing intensity).Our findings show that multiple sources of anthropogenic activity have complex connections with snow leopard habitat use,even under low human density when anthropogenic activities are sparsely distributed across a vast landscape.This study is also valuable for habitat use research in the future,especially regarding covariate selection for finite sample sizes in inaccessible terrain. 展开更多
关键词 habitat use landscape ecology occupancy model Qomolangma Panthera uncia
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