目的探讨寰枢椎椎弓根螺钉技术在2~5岁学龄前儿童寰枢概位手术治疗中的应用效果。方法2008年9月一2015年8月采用颈椎后路椎弓麵钉钉棒系统治疗寰枢椎脱位学龄前患儿15例，男10例，女5例；年龄24~60个月，平均39.8个月。患儿主要表现为...目的探讨寰枢椎椎弓根螺钉技术在2~5岁学龄前儿童寰枢概位手术治疗中的应用效果。方法2008年9月一2015年8月采用颈椎后路椎弓麵钉钉棒系统治疗寰枢椎脱位学龄前患儿15例，男10例，女5例；年龄24~60个月，平均39.8个月。患儿主要表现为颈部疼痛、活动受限，5例患儿有颈髓压迫症状，美国脊髓损伤协会(ASIA)分级C级2例，D级3例。术前常规行张口位和伸屈动力侧位X线、CT三维重建及MRI检查。麻醉后行颇骨牵引手法复位，对于可完全复位及部分复位的13例患儿，行俯卧位后路手术；对不能复位的2例患儿，先前路松解再翻身行后路手术。直视下置人寰枢椎螺钉，并完成复位及固定植骨融合。早期5例患儿行自体體骨块植骨，后期8例患儿行异体骨植骨，另2例患儿未植骨。结果15例患儿手术过程顺利，共置人54枚螺钉，其中寰枢椎椎弓麵钉49枚，寰椎侧块螺钉3枚，枢椎棘突椎板螺钉2枚，未发生脊髓、神经根及椎动脉损伤。术中出血量30~ 150 m L,平均80 m L ;手术时间80-200 rain,平均110 min。所有患儿随访6~60个月，平均32.6个月。患JL ^ 后3个月随访时均无明显颈部疼痛症状，无明显活动受限。5例术前神经功能异常患儿在术后6个月随访时均恢复至E级。自体體骨植骨患儿寰枢椎融合时间为3~6个月，平均4.2个月；异体骨植骨患儿寰枢椎融合时间为6~9个月，平均7.3个月。结论对寰枢椎明显脱位的学龄前儿童可以考虑施行后路寰枢椎复位、固定植骨融合术，常规直径3.5腿的椎弓擁钉钉棒系统可以用于大多数2~5岁学龄前患儿寰枢椎固定。展开更多
Objective. To examine the association between sweet drink consumption and overweight among preschool children. Methods. A retrospective cohort design was used to examine the association between sweet drink consumption...Objective. To examine the association between sweet drink consumption and overweight among preschool children. Methods. A retrospective cohort design was used to examine the association between sweet drink consumption and overweight at follow-up among 10 904 children who were aged 2 and 3 years and had height, weight, and Harvard Service Food Frequency Questionnaire data collected between January 1999 and December 2001 and height and weight data collected 1 year later. Sweet drinks included vitamin C-containing juices, other juices, fruit drinks, and sodas as listed on the Harvard Service Food Frequency Questionnaire. Logistic regression was used to adjust for age; gender; raceethnicity; birth weight; and intake of high-fat foods, sweet foods, and total calories. Results were stratified by baseline BMI. Results. Among children who were normal or underweight at baseline (BMI < 85th percentile), the association between sweet drink consumption and development of overweight was positive but not statistically significant. Children who were at risk for overweight at baseline (BMI 85th-< 95th percentile) and consumed 1 to < 2 drinksday, 2 to < 3 drinksday, and ≥3 drinksday were, respectively, 2.0 (95%confidence interval CI : 1.3-3.2), 2.0 (95%CI: 1.2-3.2), and 1.8 (95%CI: 1.1-2.8) times as likely to become overweight as the referent ( < 1 drink day). Children who were overweight at baseline (BMI ≥95th percentile) and consumed 1 to < 2 drinksday, 2 to < 3 drinksday, and ≥3 drinksday were, respectively, 2.1, 2.2, and 1.8 times as likely to remain overweight as the referent. Conclusions. Reducing sweet drink consumption might be 1 strategy to manage the weight of preschool children. Additional studies are needed to understand the mechanism by which such consumption contributes to overweight.展开更多
文摘目的探讨寰枢椎椎弓根螺钉技术在2~5岁学龄前儿童寰枢概位手术治疗中的应用效果。方法2008年9月一2015年8月采用颈椎后路椎弓麵钉钉棒系统治疗寰枢椎脱位学龄前患儿15例，男10例，女5例；年龄24~60个月，平均39.8个月。患儿主要表现为颈部疼痛、活动受限，5例患儿有颈髓压迫症状，美国脊髓损伤协会(ASIA)分级C级2例，D级3例。术前常规行张口位和伸屈动力侧位X线、CT三维重建及MRI检查。麻醉后行颇骨牵引手法复位，对于可完全复位及部分复位的13例患儿，行俯卧位后路手术；对不能复位的2例患儿，先前路松解再翻身行后路手术。直视下置人寰枢椎螺钉，并完成复位及固定植骨融合。早期5例患儿行自体體骨块植骨，后期8例患儿行异体骨植骨，另2例患儿未植骨。结果15例患儿手术过程顺利，共置人54枚螺钉，其中寰枢椎椎弓麵钉49枚，寰椎侧块螺钉3枚，枢椎棘突椎板螺钉2枚，未发生脊髓、神经根及椎动脉损伤。术中出血量30~ 150 m L,平均80 m L ;手术时间80-200 rain,平均110 min。所有患儿随访6~60个月，平均32.6个月。患JL ^ 后3个月随访时均无明显颈部疼痛症状，无明显活动受限。5例术前神经功能异常患儿在术后6个月随访时均恢复至E级。自体體骨植骨患儿寰枢椎融合时间为3~6个月，平均4.2个月；异体骨植骨患儿寰枢椎融合时间为6~9个月，平均7.3个月。结论对寰枢椎明显脱位的学龄前儿童可以考虑施行后路寰枢椎复位、固定植骨融合术，常规直径3.5腿的椎弓擁钉钉棒系统可以用于大多数2~5岁学龄前患儿寰枢椎固定。
文摘Objective. To examine the association between sweet drink consumption and overweight among preschool children. Methods. A retrospective cohort design was used to examine the association between sweet drink consumption and overweight at follow-up among 10 904 children who were aged 2 and 3 years and had height, weight, and Harvard Service Food Frequency Questionnaire data collected between January 1999 and December 2001 and height and weight data collected 1 year later. Sweet drinks included vitamin C-containing juices, other juices, fruit drinks, and sodas as listed on the Harvard Service Food Frequency Questionnaire. Logistic regression was used to adjust for age; gender; raceethnicity; birth weight; and intake of high-fat foods, sweet foods, and total calories. Results were stratified by baseline BMI. Results. Among children who were normal or underweight at baseline (BMI < 85th percentile), the association between sweet drink consumption and development of overweight was positive but not statistically significant. Children who were at risk for overweight at baseline (BMI 85th-< 95th percentile) and consumed 1 to < 2 drinksday, 2 to < 3 drinksday, and ≥3 drinksday were, respectively, 2.0 (95%confidence interval CI : 1.3-3.2), 2.0 (95%CI: 1.2-3.2), and 1.8 (95%CI: 1.1-2.8) times as likely to become overweight as the referent ( < 1 drink day). Children who were overweight at baseline (BMI ≥95th percentile) and consumed 1 to < 2 drinksday, 2 to < 3 drinksday, and ≥3 drinksday were, respectively, 2.1, 2.2, and 1.8 times as likely to remain overweight as the referent. Conclusions. Reducing sweet drink consumption might be 1 strategy to manage the weight of preschool children. Additional studies are needed to understand the mechanism by which such consumption contributes to overweight.
