目的:探究改良Stoppa入路联合髂窝入路手术治疗不稳定骨盆前环骨折的疗效,并为这类特殊群体的优质诊疗照护积累循证经验。方法:选取我院于2014年9月-2016年8月收治的且符合纳入标准的38例不稳定骨盆前环骨折患者,在实施髂窝入路复位时,...目的:探究改良Stoppa入路联合髂窝入路手术治疗不稳定骨盆前环骨折的疗效,并为这类特殊群体的优质诊疗照护积累循证经验。方法:选取我院于2014年9月-2016年8月收治的且符合纳入标准的38例不稳定骨盆前环骨折患者,在实施髂窝入路复位时,应妥善固定好骨盆后环,并采取改良Stoppa入路,切口一般是在耻骨联合上方2指处做一横切口,同时也可以采取正中纵切口,并切开皮肤及皮下脂肪,充分暴露腹膜外间隙,借助骨盆复位器械进行辅助复位,利用钢板进行固定塑形重建,待复位满意后再做最后的固定处理,对腹直肌前鞘要进行仔细修复,最后再缝合手术切口。结果:本组患者手术时间为80~150 min,平均时间为(116.7±5.9)min;术中出血量达200~700 m L,平均出血量达(400.8±13.5)m L。手术结束后,通常会选择X线片来确定双侧或单侧骨盆环复位情况,结果显示所有患者复位均满意。对所有患者实施为期7~10个月的随访,平均随访时间为(8.9±1.1)月,骨折愈合时间为8~13周,平均愈合时间为(12.8±2.3)周。除了仅1例发生左下肢深静脉血栓外,均未并发复位不良或切口感染、内固定失效、神经血管损伤等并发症。结论:对于不稳定骨盆前环骨折患者而言,采取改良Stoppa入路联合髂窝入路手术开展治疗,具有操作简便、暴露视野良好、损伤小的优点,能达到较为可观的临床疗效。展开更多
1983～1988年之间收治髂窝脓肿21例,邻近感染病灶的继发感染多见,致病菌以金黄色葡萄球菌多见.初期不易诊断,首先应以 X 线摄影排除骨疾病,主要临床表现有畏寒、发烧、弛张热、髂腰及髋关节部疼痛、髋关节屈曲、腹股沟部肿胀并扪及无波...1983～1988年之间收治髂窝脓肿21例,邻近感染病灶的继发感染多见,致病菌以金黄色葡萄球菌多见.初期不易诊断,首先应以 X 线摄影排除骨疾病,主要临床表现有畏寒、发烧、弛张热、髂腰及髋关节部疼痛、髋关节屈曲、腹股沟部肿胀并扪及无波动性肿块.通过排泄性尿路造影可排除泌尿系疾病,B 超检查有助于肯定诊断,穿刺抽得脓液是诊断的重要依据.经切开排脓和穿刺抽脓获得满意疗效.展开更多
Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance t...Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance to other abdominal processes at imaging, the differential diagnosis may be very difficult. This case report describes a young female adult accessed twice to our Emergency Department with recurrent pain in the right iliac fossa and a clinical picture of abdominal pain and bowel obstruction, who was finally diagnosed with complicated duplication cyst, then resected. The diagnostic tools performed show the simple duplication cyst at the beginning, in the ileocecal region, with the characteristic “gut signature” at Ultrasound and its subsequent inflammatory changing at Computed Tomography, which led to the right diagnostic hypothesis, confirmed by histopathology. An early diagnosis of this condition is needed to undertake the correct surgical approach.展开更多
Introduction: Soft tissue chondroma is a very rare, slow progressing, benign tumor. It has a specific tendency for hands and feet. It can exhibit worrisome radiographic and histologic features mimicking chondrosarcoma...Introduction: Soft tissue chondroma is a very rare, slow progressing, benign tumor. It has a specific tendency for hands and feet. It can exhibit worrisome radiographic and histologic features mimicking chondrosarcomas. Case 1: A 54-year-old man was presented with a big mass in the left thigh. At magnetic resonance imaging (MRI), the lesion exhibited a heterogeneous pattern, localized in muscle without infiltration. Open biopsy was performed showed a soft tissue chondroma. Case 2: A 40 years old man presented with a hard mass on the right iliac fossa. TDM showed a well circumscribed soft tissue mass with a heterogeneous pattern. Histological assessment of the resected specimen confirmed a soft tissue chondroma. Conclusion: Soft tissue chondroma is a very rare benign tumor. In our case, the tumor presented with an unusual location and radiological appearance, suggesting a malignant process. The diagnosis was rectified thanks to pathological examination.展开更多
文摘目的:探究改良Stoppa入路联合髂窝入路手术治疗不稳定骨盆前环骨折的疗效,并为这类特殊群体的优质诊疗照护积累循证经验。方法:选取我院于2014年9月-2016年8月收治的且符合纳入标准的38例不稳定骨盆前环骨折患者,在实施髂窝入路复位时,应妥善固定好骨盆后环,并采取改良Stoppa入路,切口一般是在耻骨联合上方2指处做一横切口,同时也可以采取正中纵切口,并切开皮肤及皮下脂肪,充分暴露腹膜外间隙,借助骨盆复位器械进行辅助复位,利用钢板进行固定塑形重建,待复位满意后再做最后的固定处理,对腹直肌前鞘要进行仔细修复,最后再缝合手术切口。结果:本组患者手术时间为80~150 min,平均时间为(116.7±5.9)min;术中出血量达200~700 m L,平均出血量达(400.8±13.5)m L。手术结束后,通常会选择X线片来确定双侧或单侧骨盆环复位情况,结果显示所有患者复位均满意。对所有患者实施为期7~10个月的随访,平均随访时间为(8.9±1.1)月,骨折愈合时间为8~13周,平均愈合时间为(12.8±2.3)周。除了仅1例发生左下肢深静脉血栓外,均未并发复位不良或切口感染、内固定失效、神经血管损伤等并发症。结论:对于不稳定骨盆前环骨折患者而言,采取改良Stoppa入路联合髂窝入路手术开展治疗,具有操作简便、暴露视野良好、损伤小的优点,能达到较为可观的临床疗效。
文摘1983～1988年之间收治髂窝脓肿21例,邻近感染病灶的继发感染多见,致病菌以金黄色葡萄球菌多见.初期不易诊断,首先应以 X 线摄影排除骨疾病,主要临床表现有畏寒、发烧、弛张热、髂腰及髋关节部疼痛、髋关节屈曲、腹股沟部肿胀并扪及无波动性肿块.通过排泄性尿路造影可排除泌尿系疾病,B 超检查有助于肯定诊断,穿刺抽得脓液是诊断的重要依据.经切开排脓和穿刺抽脓获得满意疗效.
文摘Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance to other abdominal processes at imaging, the differential diagnosis may be very difficult. This case report describes a young female adult accessed twice to our Emergency Department with recurrent pain in the right iliac fossa and a clinical picture of abdominal pain and bowel obstruction, who was finally diagnosed with complicated duplication cyst, then resected. The diagnostic tools performed show the simple duplication cyst at the beginning, in the ileocecal region, with the characteristic “gut signature” at Ultrasound and its subsequent inflammatory changing at Computed Tomography, which led to the right diagnostic hypothesis, confirmed by histopathology. An early diagnosis of this condition is needed to undertake the correct surgical approach.
文摘Introduction: Soft tissue chondroma is a very rare, slow progressing, benign tumor. It has a specific tendency for hands and feet. It can exhibit worrisome radiographic and histologic features mimicking chondrosarcomas. Case 1: A 54-year-old man was presented with a big mass in the left thigh. At magnetic resonance imaging (MRI), the lesion exhibited a heterogeneous pattern, localized in muscle without infiltration. Open biopsy was performed showed a soft tissue chondroma. Case 2: A 40 years old man presented with a hard mass on the right iliac fossa. TDM showed a well circumscribed soft tissue mass with a heterogeneous pattern. Histological assessment of the resected specimen confirmed a soft tissue chondroma. Conclusion: Soft tissue chondroma is a very rare benign tumor. In our case, the tumor presented with an unusual location and radiological appearance, suggesting a malignant process. The diagnosis was rectified thanks to pathological examination.
