Objectives : A systematic review was undertaken to evaluate the effectiveness of incision retention available to surgeons conducting open abdominal or pelvic surgeries. Both the ability of the retractor to retain the ...Objectives : A systematic review was undertaken to evaluate the effectiveness of incision retention available to surgeons conducting open abdominal or pelvic surgeries. Both the ability of the retractor to retain the wound and harm to the patient due to the retractor were reviewed. Methods : A search was conducted using the following databases: EMBASE, PubMed, BIOSIS, Engineering Village, Web of Science, Best practice, Science Direct, CRCnet BASE, Proquest, Wiley Online Library, and Comprehensive Biomaterial. Results : What the articles found were then narrowed down to those which matched the objective of the review. This resulted in ten articles to review. Two reviewers reviewed and summarized the articles. Femoral neuropathy was found to be a common complication due to Retractors. Other outcomes analysed or studied were found to be infected, postoperative pain and exposure provided. Femoral neuropathy can be estimated to occur at a rate between 2.6% and 7.5% in open pelvic and abdominal surgeries. The Alexis O-ring retractor was found to lower the required morphine intake following surgery when compared to the Belfour retractor. Conclusions : There is a lack of high quality/high levels of evidence studies that have been conducted on Retractors. Femoral neuropathy is the outcome most commonly documented in relation to Retractors. Surgeons need to be aware about the use and implementations of the retractors. Care should be taken in protecting the blades and during long surgery relocating retractors should be considered.展开更多
目的:探讨眶隔筋膜瓣结合额肌瓣悬吊术对重度上睑下垂的远期疗效及屈光状态的影响。方法:选取2016年8月-2017年8月笔者医院收治的重度上睑下垂患者84例(128眼),随机分为两组,对照组应用单切口额肌筋膜瓣悬吊术治疗,研究组应用眶隔筋膜...目的:探讨眶隔筋膜瓣结合额肌瓣悬吊术对重度上睑下垂的远期疗效及屈光状态的影响。方法:选取2016年8月-2017年8月笔者医院收治的重度上睑下垂患者84例(128眼),随机分为两组,对照组应用单切口额肌筋膜瓣悬吊术治疗,研究组应用眶隔筋膜瓣联合额肌瓣悬吊术治疗。比较两组矫正率、上睑回缩量及双侧眼睑对称程度。结果:两组总矫正率比较(100.0%vs98.4%),差异无统计学意义(P>0.05),但研究组完全矫正率为75.0%明显多于对照组的56.3%,差异有统计学意义(P<0.05)。术后6个月,研究组患者的上睑回缩量明显低于对照组[(0.16±0.02)mm vs (0.41±0.03)mm,P<0.05];研究组患者的上睑缘恢复对称程度、上睑缘形态及眼睑闭合程度均优于对照组,差异有统计学意义(P<0.05)。两组患者的角膜屈光度和角膜散光度比较,差异无统计学意义(P>0.05)。结论:在针对重度上睑下垂的治疗过程当中,应用眶隔筋膜瓣联合额肌瓣悬吊术的治疗效果理想,临床上应当进一步推广应用。展开更多
目的观察不同腭平面倾斜度的骨性Ⅱ类错[牙合]畸形成年女性患者切牙管与上颌中切牙牙根的位置、切牙管唇侧骨皮质厚度,探讨腭平面倾斜度对上前牙内收正畸治疗效果的影响。方法60例骨性Ⅱ类错[牙合]畸形成年女性患者均行口腔颌面锥形束C...目的观察不同腭平面倾斜度的骨性Ⅱ类错[牙合]畸形成年女性患者切牙管与上颌中切牙牙根的位置、切牙管唇侧骨皮质厚度,探讨腭平面倾斜度对上前牙内收正畸治疗效果的影响。方法60例骨性Ⅱ类错[牙合]畸形成年女性患者均行口腔颌面锥形束CT扫描,测量腭平面倾斜度,计算腭平面与眼耳平面夹角度数,分为顺时针组30例(腭平面与眼耳平面夹角<—2.5°)和平行组30例(腭平面与眼耳平面夹角—2.5°~4.5°)。以腭平面为参考平面,应用软件建立与腭平面平行的鼻腭孔高度水平面(N水平面)、上颌中切牙牙根根尖高度水平面(R水平面)、切牙孔高度水平面(I水平面),测量矢状面影像上切牙管长度、N水平面切牙管唇侧牙槽骨板厚度(the thickness on the N plane,NT)、R水平面切牙管唇侧牙槽骨板厚度(the thickness on the R plane,RT)、I水平面切牙管唇侧牙槽骨板厚度(the thickness on the I plane,IT)及各水平面影像上切牙管宽度、切牙根尖间距、切牙与切牙管距离等参数。比较2组切牙管长度、NT、RT、IT及各水平面影像上切牙管宽度、切牙管与上颌中切牙牙根之间的位置关系。结果顺时针组NT[(10.68±2.12)mm]、RT[(8.55±1.59)mm]、IT[(8.64±1.39)mm]均大于平行组[(8.74±2.42)、(7.22±1.85)、(7.56±1.43)mm](t=3.32,P=0.002;t=3.00,P=0.004;t=2.97,P=0.004),切牙管长度、N水平面切牙管宽度、R水平面中切牙根尖间距、R水平面切牙管宽度、R水平面切牙管与右侧中切牙根尖距离、R水平面切牙管与左侧中切牙根尖最短距离、I水平面切牙管宽度、I水平面切牙管与右侧中切牙间最短距离、I水平面切牙管与左侧中切牙间最短距离与平行组比较差异均无统计学意义(P>0.05)。结论腭平面顺时针方向倾斜的成年女性骨性Ⅱ类错[牙合]畸形患者上切牙唇侧牙槽骨较厚,在正畸治疗中可较大程度内收上前牙;腭平面倾斜度较小者上切牙唇侧牙槽骨较薄,内收上前牙程度受限;测量骨性Ⅱ类错[牙合]畸形患者腭平面与眼耳平面角度,评估腭平面倾斜度可为制订正畸方案提供参考。展开更多
文摘Objectives : A systematic review was undertaken to evaluate the effectiveness of incision retention available to surgeons conducting open abdominal or pelvic surgeries. Both the ability of the retractor to retain the wound and harm to the patient due to the retractor were reviewed. Methods : A search was conducted using the following databases: EMBASE, PubMed, BIOSIS, Engineering Village, Web of Science, Best practice, Science Direct, CRCnet BASE, Proquest, Wiley Online Library, and Comprehensive Biomaterial. Results : What the articles found were then narrowed down to those which matched the objective of the review. This resulted in ten articles to review. Two reviewers reviewed and summarized the articles. Femoral neuropathy was found to be a common complication due to Retractors. Other outcomes analysed or studied were found to be infected, postoperative pain and exposure provided. Femoral neuropathy can be estimated to occur at a rate between 2.6% and 7.5% in open pelvic and abdominal surgeries. The Alexis O-ring retractor was found to lower the required morphine intake following surgery when compared to the Belfour retractor. Conclusions : There is a lack of high quality/high levels of evidence studies that have been conducted on Retractors. Femoral neuropathy is the outcome most commonly documented in relation to Retractors. Surgeons need to be aware about the use and implementations of the retractors. Care should be taken in protecting the blades and during long surgery relocating retractors should be considered.
文摘目的:探讨眶隔筋膜瓣结合额肌瓣悬吊术对重度上睑下垂的远期疗效及屈光状态的影响。方法:选取2016年8月-2017年8月笔者医院收治的重度上睑下垂患者84例(128眼),随机分为两组,对照组应用单切口额肌筋膜瓣悬吊术治疗,研究组应用眶隔筋膜瓣联合额肌瓣悬吊术治疗。比较两组矫正率、上睑回缩量及双侧眼睑对称程度。结果:两组总矫正率比较(100.0%vs98.4%),差异无统计学意义(P>0.05),但研究组完全矫正率为75.0%明显多于对照组的56.3%,差异有统计学意义(P<0.05)。术后6个月,研究组患者的上睑回缩量明显低于对照组[(0.16±0.02)mm vs (0.41±0.03)mm,P<0.05];研究组患者的上睑缘恢复对称程度、上睑缘形态及眼睑闭合程度均优于对照组,差异有统计学意义(P<0.05)。两组患者的角膜屈光度和角膜散光度比较,差异无统计学意义(P>0.05)。结论:在针对重度上睑下垂的治疗过程当中,应用眶隔筋膜瓣联合额肌瓣悬吊术的治疗效果理想,临床上应当进一步推广应用。
文摘目的观察不同腭平面倾斜度的骨性Ⅱ类错[牙合]畸形成年女性患者切牙管与上颌中切牙牙根的位置、切牙管唇侧骨皮质厚度,探讨腭平面倾斜度对上前牙内收正畸治疗效果的影响。方法60例骨性Ⅱ类错[牙合]畸形成年女性患者均行口腔颌面锥形束CT扫描,测量腭平面倾斜度,计算腭平面与眼耳平面夹角度数,分为顺时针组30例(腭平面与眼耳平面夹角<—2.5°)和平行组30例(腭平面与眼耳平面夹角—2.5°~4.5°)。以腭平面为参考平面,应用软件建立与腭平面平行的鼻腭孔高度水平面(N水平面)、上颌中切牙牙根根尖高度水平面(R水平面)、切牙孔高度水平面(I水平面),测量矢状面影像上切牙管长度、N水平面切牙管唇侧牙槽骨板厚度(the thickness on the N plane,NT)、R水平面切牙管唇侧牙槽骨板厚度(the thickness on the R plane,RT)、I水平面切牙管唇侧牙槽骨板厚度(the thickness on the I plane,IT)及各水平面影像上切牙管宽度、切牙根尖间距、切牙与切牙管距离等参数。比较2组切牙管长度、NT、RT、IT及各水平面影像上切牙管宽度、切牙管与上颌中切牙牙根之间的位置关系。结果顺时针组NT[(10.68±2.12)mm]、RT[(8.55±1.59)mm]、IT[(8.64±1.39)mm]均大于平行组[(8.74±2.42)、(7.22±1.85)、(7.56±1.43)mm](t=3.32,P=0.002;t=3.00,P=0.004;t=2.97,P=0.004),切牙管长度、N水平面切牙管宽度、R水平面中切牙根尖间距、R水平面切牙管宽度、R水平面切牙管与右侧中切牙根尖距离、R水平面切牙管与左侧中切牙根尖最短距离、I水平面切牙管宽度、I水平面切牙管与右侧中切牙间最短距离、I水平面切牙管与左侧中切牙间最短距离与平行组比较差异均无统计学意义(P>0.05)。结论腭平面顺时针方向倾斜的成年女性骨性Ⅱ类错[牙合]畸形患者上切牙唇侧牙槽骨较厚,在正畸治疗中可较大程度内收上前牙;腭平面倾斜度较小者上切牙唇侧牙槽骨较薄,内收上前牙程度受限;测量骨性Ⅱ类错[牙合]畸形患者腭平面与眼耳平面角度,评估腭平面倾斜度可为制订正畸方案提供参考。
