Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of...Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May, 2011. Results Surgical excision was successfully performed in 111 cases with 117 tumors. In all those cases, 50 underwent simple tumor resection, 42 underwent resection of tumors and ligation of the external carotid arteries, 7 underwent co-resection of tumors and common carotid arteries, internal carotid arteries, as well as external arteries without vascular reconstruction, and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved. After operation, 3 cases developed cerebral infarction, 30 cases showed cranial nerve palsy, including 15 cases of hypoglossal nerve damage, 10 cases of vagus paralysis, and 5 cases of Horner's syndrome. Conclusion It is essential to make a proper surgical strategy, which can reduce postoperative com- plications.展开更多
To introduce an operation of subscapularis slide from its origin and anterior release from its insertion for treatment of medial rotation contracture, subluxation and dislocation of the shoulder caused by obstetric br...To introduce an operation of subscapularis slide from its origin and anterior release from its insertion for treatment of medial rotation contracture, subluxation and dislocation of the shoulder caused by obstetric brachial plexus palsy (OBPP). Methods: Thirty six cases with medial rotation contracture of the shoulder were diagnosed by measurement of the inferior glenohumeral angle, passive lateral rotation of the shoulder and plain radiographs. Subscapularis slide was performed in 24 cases with simple medial rotation contracture, and anterior release in 12 cases with complex contracture medial rotation contracture combined with subluxation, dislocation, or other deformities of the shoulder joint. Systems of Mallet scoring and Gilbert grading for the shoulder were used to evaluate the postoperative shoulder function. Results: With follow up for a minimum of six months, 32 cases got apparent gains from operations, accounting for 88.8 % of the total operated on. The younger the child was, the better the result. Of 4 cases with no operative effects, 3 had no flexion of the elbow preoperatively, suggesting a poor recovery of the upper trunk of the brachial plexus; the rest one had no repair of the severed subscapularis tendon. Conclusions: Subscapularis slide and anterior release of the shoulder are effective for treatment of medial rotation contracture as well as its consequence of subluxation and dislocation of the shoulder in OBPP. The operative effect is related to childrens age and the recovery extent of the upper trunk of the brachial plexus.展开更多
Objective:: To prospectively compare the clinical outcome of intensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients. Methods: Patients with severe head injury were as...Objective:: To prospectively compare the clinical outcome of intensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients. Methods: Patients with severe head injury were assigned randomly into Group ICT and Group CCT, 100 patients in each group. Patients in Group ICT accepted intensive care therapy in neurosurgical intensive care (NIC) unit for the first 2 weeks after admission, while patients in Group CCT accepted conventional care therapy in ordinary ward. The outcomes were evaluated 3 months after injury. Results: There was a significant increase in good recovery (54%) (χ 2= 4.43 , P< 0.05 ) and significant decrease of death (25%) (χ 2= 4.50 , P< 0.05 ) in Group ICT compared to 39% and 39% in Group CCT respectively. The differences were also confirmed statistically in the following aspects: the patients under 50 years with good recovery pronounced a number increase (χ 2= 7.54 , P< 0.01 ), while the mortality in the same range of age was decreased in Group ICT (χ 2= 5.28 , P< 0.05 ). The mortality was reduced significantly in patients with GCS for 6-8 on admission (χ 2= 8.47 , P< 0.01 ) and in patients with the level of brain stem injured bellow mesencephalon (χ 2= 4.15 , P< 0.05 ). ICT would improve the outcome in patients undergoing conservative therapy only (χ 2= 13.13 , P< 0.01 ). Conclusions: NIC plays an important role in assessing the neurological state, guiding management, evaluating curative effect and estimating the outcome.展开更多
To summarize surgical treatments an d their corresponding curative effects on sciatic nerve injuries. Methods: Surgical treatments on sciatic nerve injury were perfo rmed in 28 patients from January 1990 to July 2000....To summarize surgical treatments an d their corresponding curative effects on sciatic nerve injuries. Methods: Surgical treatments on sciatic nerve injury were perfo rmed in 28 patients from January 1990 to July 2000. The treatments included neur olysis, neurolysis plus partial nerve anastomosis, nerve anastomosis and nerve t ransplantation. The curative effect was evaluated according to Sunderland criter ia. Results: Of 28 cases, 22 patients were followed up with a follo w up period of 13 months to 5 years (average 30 months). Of 22 nerves, 7 were e xcellent, 5 good, 7 fair and 3 poor, with an excellence rate of 54.5 %. Conclusions: The fair results of sciatic nerve injury are relat ed to its structural character. Surgical exploration should be performed if nerv e function does not recover 3 months after primary operation and if Tinels sig n and electromyogram show no signs of nerve regeneration. Electrophysiological m onitoring in the operation is useful in electing surgical methods and predicting the results of nerve anastomosis.展开更多
文摘Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May, 2011. Results Surgical excision was successfully performed in 111 cases with 117 tumors. In all those cases, 50 underwent simple tumor resection, 42 underwent resection of tumors and ligation of the external carotid arteries, 7 underwent co-resection of tumors and common carotid arteries, internal carotid arteries, as well as external arteries without vascular reconstruction, and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved. After operation, 3 cases developed cerebral infarction, 30 cases showed cranial nerve palsy, including 15 cases of hypoglossal nerve damage, 10 cases of vagus paralysis, and 5 cases of Horner's syndrome. Conclusion It is essential to make a proper surgical strategy, which can reduce postoperative com- plications.
文摘To introduce an operation of subscapularis slide from its origin and anterior release from its insertion for treatment of medial rotation contracture, subluxation and dislocation of the shoulder caused by obstetric brachial plexus palsy (OBPP). Methods: Thirty six cases with medial rotation contracture of the shoulder were diagnosed by measurement of the inferior glenohumeral angle, passive lateral rotation of the shoulder and plain radiographs. Subscapularis slide was performed in 24 cases with simple medial rotation contracture, and anterior release in 12 cases with complex contracture medial rotation contracture combined with subluxation, dislocation, or other deformities of the shoulder joint. Systems of Mallet scoring and Gilbert grading for the shoulder were used to evaluate the postoperative shoulder function. Results: With follow up for a minimum of six months, 32 cases got apparent gains from operations, accounting for 88.8 % of the total operated on. The younger the child was, the better the result. Of 4 cases with no operative effects, 3 had no flexion of the elbow preoperatively, suggesting a poor recovery of the upper trunk of the brachial plexus; the rest one had no repair of the severed subscapularis tendon. Conclusions: Subscapularis slide and anterior release of the shoulder are effective for treatment of medial rotation contracture as well as its consequence of subluxation and dislocation of the shoulder in OBPP. The operative effect is related to childrens age and the recovery extent of the upper trunk of the brachial plexus.
文摘Objective:: To prospectively compare the clinical outcome of intensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients. Methods: Patients with severe head injury were assigned randomly into Group ICT and Group CCT, 100 patients in each group. Patients in Group ICT accepted intensive care therapy in neurosurgical intensive care (NIC) unit for the first 2 weeks after admission, while patients in Group CCT accepted conventional care therapy in ordinary ward. The outcomes were evaluated 3 months after injury. Results: There was a significant increase in good recovery (54%) (χ 2= 4.43 , P< 0.05 ) and significant decrease of death (25%) (χ 2= 4.50 , P< 0.05 ) in Group ICT compared to 39% and 39% in Group CCT respectively. The differences were also confirmed statistically in the following aspects: the patients under 50 years with good recovery pronounced a number increase (χ 2= 7.54 , P< 0.01 ), while the mortality in the same range of age was decreased in Group ICT (χ 2= 5.28 , P< 0.05 ). The mortality was reduced significantly in patients with GCS for 6-8 on admission (χ 2= 8.47 , P< 0.01 ) and in patients with the level of brain stem injured bellow mesencephalon (χ 2= 4.15 , P< 0.05 ). ICT would improve the outcome in patients undergoing conservative therapy only (χ 2= 13.13 , P< 0.01 ). Conclusions: NIC plays an important role in assessing the neurological state, guiding management, evaluating curative effect and estimating the outcome.
文摘To summarize surgical treatments an d their corresponding curative effects on sciatic nerve injuries. Methods: Surgical treatments on sciatic nerve injury were perfo rmed in 28 patients from January 1990 to July 2000. The treatments included neur olysis, neurolysis plus partial nerve anastomosis, nerve anastomosis and nerve t ransplantation. The curative effect was evaluated according to Sunderland criter ia. Results: Of 28 cases, 22 patients were followed up with a follo w up period of 13 months to 5 years (average 30 months). Of 22 nerves, 7 were e xcellent, 5 good, 7 fair and 3 poor, with an excellence rate of 54.5 %. Conclusions: The fair results of sciatic nerve injury are relat ed to its structural character. Surgical exploration should be performed if nerv e function does not recover 3 months after primary operation and if Tinels sig n and electromyogram show no signs of nerve regeneration. Electrophysiological m onitoring in the operation is useful in electing surgical methods and predicting the results of nerve anastomosis.
