目的比较internal brace(IB)与带线锚钉通过改良Broström术治疗慢性踝关节不稳的临床疗效。方法回顾性分析2019年5月至2022年2月在桂林市人民医院本院关节骨科行手术治疗的42例慢性踝关节外侧不稳患者资料,根据距腓前韧带修补所用...目的比较internal brace(IB)与带线锚钉通过改良Broström术治疗慢性踝关节不稳的临床疗效。方法回顾性分析2019年5月至2022年2月在桂林市人民医院本院关节骨科行手术治疗的42例慢性踝关节外侧不稳患者资料,根据距腓前韧带修补所用材料的不同将患者分为IB组(19例)和带线锚钉组(23例)。比较两组患者一般资料、手术时间、并发症发生率、术后完全负重行走时间、术后恢复跑步的时间、美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分、视觉模拟评分法(visual analog scale,VAS)评分。结果所有患者术后均获得随访,随访时间12~18个月,平均(13.8±5.3)个月。两组患者基线资料差异无统计学意义(P>0.05);两组各有1例术口拆线后再出现渗液,换药后愈合;两组各有2例术口区域感觉障碍,除IB组有1例术后半年仍未完全恢复外,其余3例术后2~3个月恢复;IB组患者术后6周随访时AOFAS评分优于带线锚钉组,差异有统计学意义(t=2.239,P=0.025),但术后6周时VAS评分比较差异无统计学意义(t=0.308,P=0.760);末次随访时AOFAS评分和VAS评分比较,两组之间差异无统计学意义(t=0.045,P=0.965;t=0.203,P=0.840);IB组术后完全负重行走时间、术后恢复跑步的时间显著早于带线锚钉组,差异有统计学意义(t=26.566,P<0.01;t=4.838,P<0.01)。结论IB与带线锚钉通过改良Broström术开放治疗慢性踝关节不稳的临床疗效满意,且使用IB在早期康复和重返运动方面优于带线锚钉。展开更多
[目的]比较内支架纤维带与半腱肌重建内侧髌股韧带治疗髌骨脱位的临床疗效。[方法]回顾性分析2021年7月—2022年9月68例髌骨脱位患者的临床资料,根据医患沟通结果,其中35例采用内支架纤维带固定(纤维带组),33例采用半腱肌固定(肌腱组)...[目的]比较内支架纤维带与半腱肌重建内侧髌股韧带治疗髌骨脱位的临床疗效。[方法]回顾性分析2021年7月—2022年9月68例髌骨脱位患者的临床资料,根据医患沟通结果,其中35例采用内支架纤维带固定(纤维带组),33例采用半腱肌固定(肌腱组)。比较两组围手术期、随访及影像学资料。[结果]纤维带组手术时间[(63.5±6.0) min vs(88.9±6.6) min,P<0.001]、切口长度[(3.7±0.7) cm vs(10.0±1.4) cm, P<0.001]、术中失血量[(22.9±3.9) m L vs(53.2±13.3) mL, P<0.001]、下地行走时间[(1.2±0.4) d vs(1.9±0.9) d, P<0.001]、住院时间[(2.4±1.0) d vs(4.9±2.1) d, P<0.001]均显著少于肌腱组。两组患者术后均完成随访。随访时间平均(28.9±3.8)个月。纤维带组术后完全负重活动时间[(10.8±1.1)周vs(12.9±1.5)周, P<0.001]显著早于肌腱组。随时间推移,两组Kujala、Lysholm、Tegner评分及ROM均显著增加(P<0.05), VAS评分显著减少(P<0.05)。相应时间点,两组间上述指标的差异均无统计学意义(P>0.05)。影像学方面,术后两组髌骨适合角(patellar congruence angle, PCA)、髌骨倾斜角(patellar tilt angle, PTA)、髌骨外移距离(patellar displacement, PD)均显著改善(P<0.05)。相应时间点,两组间上述影像指标的差异均无统计学意义(P>0.05)。[结论]两种手术均能有效恢复髌骨解剖位置和膝关节功能。纤维带组仅使用带线锚钉,无骨质丢失,无需获取自体肌腱,对软组织干扰小,早期临床疗效更佳。展开更多
BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MO...BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.AIM To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement,complication rates,and long-term patient outcomes.METHODS The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed.According to the treatment method,the patients were divided into an observation group(29 patients)and a control group(30 patients).General data,liver function indices,complications,adverse effects,and 3-year survival rates after different surgical treatments were recorded for the two groups.RESULTS There were no significant differences in baseline information(sex,age,tumor type,or tumor diameter)between the two groups(P>0.05).Alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels were significantly better in both groups after surgery than before surgery(P<0.05).The overall incidence of biliary bleeding,gastrointestinal bleeding,pancreatitis,and cholangitis was 6.9%in the observation group and 30%in the control group(P<0.05).No significant differences in the rates of blood transfusion,intensive care unit admission,or death within 3 years were observed between the two groups at the 1-month follow-up(P>0.05).The 3-year survival rates were 46.06%and 39.71%in the observation and control groups,respectively.CONCLUSION Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function,with minimal complications.This technique is a promising palliative approach for patients ineligible for radical surgery.However,further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.展开更多
文摘目的比较internal brace(IB)与带线锚钉通过改良Broström术治疗慢性踝关节不稳的临床疗效。方法回顾性分析2019年5月至2022年2月在桂林市人民医院本院关节骨科行手术治疗的42例慢性踝关节外侧不稳患者资料,根据距腓前韧带修补所用材料的不同将患者分为IB组(19例)和带线锚钉组(23例)。比较两组患者一般资料、手术时间、并发症发生率、术后完全负重行走时间、术后恢复跑步的时间、美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分、视觉模拟评分法(visual analog scale,VAS)评分。结果所有患者术后均获得随访,随访时间12~18个月,平均(13.8±5.3)个月。两组患者基线资料差异无统计学意义(P>0.05);两组各有1例术口拆线后再出现渗液,换药后愈合;两组各有2例术口区域感觉障碍,除IB组有1例术后半年仍未完全恢复外,其余3例术后2~3个月恢复;IB组患者术后6周随访时AOFAS评分优于带线锚钉组,差异有统计学意义(t=2.239,P=0.025),但术后6周时VAS评分比较差异无统计学意义(t=0.308,P=0.760);末次随访时AOFAS评分和VAS评分比较,两组之间差异无统计学意义(t=0.045,P=0.965;t=0.203,P=0.840);IB组术后完全负重行走时间、术后恢复跑步的时间显著早于带线锚钉组,差异有统计学意义(t=26.566,P<0.01;t=4.838,P<0.01)。结论IB与带线锚钉通过改良Broström术开放治疗慢性踝关节不稳的临床疗效满意,且使用IB在早期康复和重返运动方面优于带线锚钉。
文摘[目的]比较内支架纤维带与半腱肌重建内侧髌股韧带治疗髌骨脱位的临床疗效。[方法]回顾性分析2021年7月—2022年9月68例髌骨脱位患者的临床资料,根据医患沟通结果,其中35例采用内支架纤维带固定(纤维带组),33例采用半腱肌固定(肌腱组)。比较两组围手术期、随访及影像学资料。[结果]纤维带组手术时间[(63.5±6.0) min vs(88.9±6.6) min,P<0.001]、切口长度[(3.7±0.7) cm vs(10.0±1.4) cm, P<0.001]、术中失血量[(22.9±3.9) m L vs(53.2±13.3) mL, P<0.001]、下地行走时间[(1.2±0.4) d vs(1.9±0.9) d, P<0.001]、住院时间[(2.4±1.0) d vs(4.9±2.1) d, P<0.001]均显著少于肌腱组。两组患者术后均完成随访。随访时间平均(28.9±3.8)个月。纤维带组术后完全负重活动时间[(10.8±1.1)周vs(12.9±1.5)周, P<0.001]显著早于肌腱组。随时间推移,两组Kujala、Lysholm、Tegner评分及ROM均显著增加(P<0.05), VAS评分显著减少(P<0.05)。相应时间点,两组间上述指标的差异均无统计学意义(P>0.05)。影像学方面,术后两组髌骨适合角(patellar congruence angle, PCA)、髌骨倾斜角(patellar tilt angle, PTA)、髌骨外移距离(patellar displacement, PD)均显著改善(P<0.05)。相应时间点,两组间上述影像指标的差异均无统计学意义(P>0.05)。[结论]两种手术均能有效恢复髌骨解剖位置和膝关节功能。纤维带组仅使用带线锚钉,无骨质丢失,无需获取自体肌腱,对软组织干扰小,早期临床疗效更佳。
文摘BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.AIM To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement,complication rates,and long-term patient outcomes.METHODS The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed.According to the treatment method,the patients were divided into an observation group(29 patients)and a control group(30 patients).General data,liver function indices,complications,adverse effects,and 3-year survival rates after different surgical treatments were recorded for the two groups.RESULTS There were no significant differences in baseline information(sex,age,tumor type,or tumor diameter)between the two groups(P>0.05).Alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels were significantly better in both groups after surgery than before surgery(P<0.05).The overall incidence of biliary bleeding,gastrointestinal bleeding,pancreatitis,and cholangitis was 6.9%in the observation group and 30%in the control group(P<0.05).No significant differences in the rates of blood transfusion,intensive care unit admission,or death within 3 years were observed between the two groups at the 1-month follow-up(P>0.05).The 3-year survival rates were 46.06%and 39.71%in the observation and control groups,respectively.CONCLUSION Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function,with minimal complications.This technique is a promising palliative approach for patients ineligible for radical surgery.However,further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.
