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Resection and reconstruction in high-grade pancreatic head injuries
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作者 Jake Krige Eduard Jonas +1 位作者 Andrew John Nicol Pradeep Harkson Navsaria 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第5期1467-1469,共3页
This study by Chui et al adds further important evidence in the treatment of highgrade pancreatic injuries and endorses the concept of the model of pancreatic trauma care designed to optimize treatment,minimize morbid... This study by Chui et al adds further important evidence in the treatment of highgrade pancreatic injuries and endorses the concept of the model of pancreatic trauma care designed to optimize treatment,minimize morbidity and enhance survival in patients with complex pancreatic injuries.Although the authors have demonstrated favorable outcomes based on their limited experience of 5 patients who underwent a pancreaticoduodenectomy(PD),including 2 patients who were“unstable”and did not have damage control surgery(DCS),we would caution against the general recommendations promoting index PD without DCS in“unstable”grade 5 pancreatic head injuries. 展开更多
关键词 PANCREAS INJURY surgery PANCREATICODUODENECTOMY
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Surgical management of high-grade pancreatic injuries: Insights from a high-volume pancreaticobiliary specialty unit 被引量:3
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作者 Juanita Noeline Chui Krishna Kotecha +2 位作者 Tamara MH Gall Anubhav Mittal Jaswinder S Samra 《World Journal of Gastrointestinal Surgery》 2023年第5期834-846,共13页
BACKGROUND The management of high-grade pancreatic trauma is controversial.AIM To review our single-institution experience on the surgical management of blunt and penetrating pancreatic injuries.METHODS A retrospectiv... BACKGROUND The management of high-grade pancreatic trauma is controversial.AIM To review our single-institution experience on the surgical management of blunt and penetrating pancreatic injuries.METHODS A retrospective review of records was performed on all patients undergoing surgical intervention for high-grade pancreatic injuries [American Association for the Surgery of Trauma(AAST) Grade Ⅲor greater] at the Royal North Shore Hospital in Sydney between January 2001 and December 2022. Morbidity and mortality outcomes were reviewed, and major diagnostic and operative challenges were identified.RESULTS Over a twenty-year period, 14 patients underwent pancreatic resection for highgrade injuries. Seven patients sustained AAST Grade Ⅲinjuries and 7 were classified as Grades Ⅳ or Ⅴ. Nine underwent distal pancreatectomy and 5 underwent pancreaticoduodenectomy(PD). Overall, there was a predominance of blunt aetiologies(11/14). Concomitant intra-abdominal injuries were observed in 11 patients and traumatic haemorrhage in 6 patients. Three patients developed clinically relevant pancreatic fistulas and there was one in-hospital mortality secondary to multi-organ failure. Among stable presentations, pancreatic ductal injuries were missed in two-thirds of cases(7/12) on initial computed tomography imaging and subsequently diagnosed on repeat imaging or endoscopic retrograde cholangiopancreatography. All patients who sustained complex pancreaticoduodenal trauma underwent PD without mortality. The management of pancreatic trauma is evolving. Our experience provides valuable and locally relevant insights into future management strategies.CONCLUSION We advocate that high-grade pancreatic trauma should be managed in high-volume hepatopancreato-biliary specialty surgical units. Pancreatic resections including PD may be indicated and safely performed with appropriate specialist surgical, gastroenterology, and interventional radiology support in tertiary centres. 展开更多
关键词 PANCREAS TRAUMA Injury PANCREATECTOMY PANCREATICODUODENECTOMY Damage control surgery
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Current and future surgery strategies for spinal cord injuries 被引量:7
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作者 Sedat Dalbayrak Onur Yaman Tevfik Y?lmaz 《World Journal of Orthopedics》 2015年第1期34-41,共8页
Spinal cord trauma is a prominent cause of mortality and morbidity. In developed countries a spinal cord injury(SCI) occurs every 16 min. SCI occurs due to tissue destruction, primarily by mechanical and secondarily i... Spinal cord trauma is a prominent cause of mortality and morbidity. In developed countries a spinal cord injury(SCI) occurs every 16 min. SCI occurs due to tissue destruction, primarily by mechanical and secondarily ischemic. Primary damage occurs at the time of the injury. It cannot be improved. Following the primary injury, secondary harm mechanisms gradually result in neuronal death. One of the prominent causesof secondary harm is energy deficit, emerging from ischemia, whose main cause in the early stage, is impaired perfusion. Due to the advanced techniques in spinal surgery, SCI is still challenging for surgeons. Spinal cord doesn't have a self-repair property. The main damage occurs at the time of the injury primarily by mechanical factors that cannot be improved. Secondarily mechanisms take part in the following sections. Spinal compression and neurological deficit are two major factors used to decide on surgery. According to advanced imaging techniques the classifications systems for spinal injury has been changed in time. Aim of the surgery is to decompress the spinal channel and to restore the spinal alinement and mobilize the patient as soon as possible. Use of neuroprotective agents as well as methods to achieve cell regeneration in addition to surgery would contribute to the solution. 展开更多
关键词 SPINAL CORD INJURY surgery Classification Mechanism Management
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Iatrogenic bile duct injuries from biliary tract surgery 被引量:8
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作者 Umar Ali 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2007年第3期326-329,共4页
BACKGROUND:Cholecystectomy is the most commonly performed procedure in general surgery.However,bile duct injury is a rare but still one of the most common complications.These injuries sometimes present variably after ... BACKGROUND:Cholecystectomy is the most commonly performed procedure in general surgery.However,bile duct injury is a rare but still one of the most common complications.These injuries sometimes present variably after primary surgery.Timely detection and appropriate management decrease the morbidity and mortality of the operation. METHODS:Five cases of iatrogenic bile duct injury(IBDI) were managed at the Department of Surgery,First Affiliated Hospital,Xi’an Jiaotong University.All the cases who underwent both open and laparoscopic cholecystectomy had persistent injury to the biliary tract and were treated accordingly. RESULTS:Recovery of the patients was uneventful.All patients were followed-up at the surgical outpatient department for six months to three years.So far the patients have shown good recovery. CONCLUSIONS:In cases of IBDI it is necessary to perform the operation under the supervision of an experienced surgeon who is specialized in the repair of bile duct injuries,and it is also necessary to detect and treat the injury as soon as possible to obtain a satisfactory outcome. 展开更多
关键词 biliary tract surgery iatrogenic bile duct injuries HEMORRHAGE bile leakage
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Promoting axonal regeneration following nerve surgery: a perspective on ultrasound treatment for nerve injuries 被引量:3
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作者 Konstantin D. Bergmeister Simeon C. Daeschler +4 位作者 Patrick Rhodius Philipp Schoenle Arne Bocker Ulrich Kneser Leila Harhaus 《Neural Regeneration Research》 SCIE CAS CSCD 2018年第9期1530-1533,共4页
Nerve injury is often associated with limited axonal regeneration and thus leads to delayed or incomplete axonal reinnervation.As a consequence of slow nerve regeneration,target muscle function is often insufficient a... Nerve injury is often associated with limited axonal regeneration and thus leads to delayed or incomplete axonal reinnervation.As a consequence of slow nerve regeneration,target muscle function is often insufficient and leads to a lifelong burden.Recently,the diagnosis of nerve injuries has been improved and likewise surgical reconstruction has undergone significant developments.However,the problem of slow nerve regeneration has not been solved.In a recent meta-analysis,we have shown that the application of low-intensity ultrasound promotes nerve regeneration experimentally and thereby can improve functional outcomes.Here we want to demonstrate the experimental effect of low intensity ultrasound on nerve regeneration,the current state of investigations and its possible future clinical applications. 展开更多
关键词 peripheral nerve injuries nerve regeneration REINNERVATION experimental studies low-intensityultrasound adjunct treatment nerve reconstruction nerve surgery axonal injury
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Exploring the Role of Serum Cystatin C in Early Detection of Acute Kidney Injury among On-Pump Cardiac Surgery Patients: A Single-Center Investigation in Bangladesh
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作者 Md. Ahaduzzaman Md. Abir Tazim Chowdhury +8 位作者 Munama Magdum Md. Saiful Islam Khan Satyajit Sharma Monoj Tiwari Md. Abul Bashar Maruf Md. Alauddin Omar Sadeque Khan Md. Mostafizur Rahman Mirza Md. Nazmus Saquib 《World Journal of Cardiovascular Diseases》 CAS 2024年第6期363-373,共11页
Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria ... Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cystatin C, with an Area under the ROC Curve of 0.864 and a cut-off value of 0.55 (p Conclusion: This study supports the superior utility of serum Cystatin C as an early detector of AKI in on-pump cardiac surgery patients compared to serum creatinine. Its ability to identify AKI several hours earlier may contribute to reduced morbidity, mortality, and healthcare costs. The findings underscore the significance of exploring novel biomarkers for improved post-cardiac surgery renal function assessment. 展开更多
关键词 Acute Kidney Injury (AKI) On-Pump Cardiac surgery Serum Cystatin C Serum Creatinine Diagnostic Biomarkers Early Detection Cardiopulmonary Bypass Single-Center Study BANGLADESH
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Injuries Requiring Surgery in Folk Dancers: A Retrospective Cohort Study of 9 Years
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作者 Neslihan Aksu Vefa Atansay +3 位作者 Taner Aksu Safiye Koculu Sukriye Damla Kara Isik Karalok 《Journal of Sports Science》 2018年第2期108-117,共10页
关键词 DANCER injuries folk DANCERS KNEE injuries ARTHROSCOPY return to dance KNEE surgery
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A 2-year follow-up survey of 523 cases with peripheral nerve injuries caused by the earthquake in Wenchuan, China 被引量:1
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作者 Chun-qing He Li-hai Zhang +1 位作者 Xian-fei Liu Pei-fu Tang 《Neural Regeneration Research》 SCIE CAS CSCD 2015年第2期252-259,共8页
We performed a 2-year follow-up survey of 523 patients with peripheral nerve injuries caused by the earthquake in Wenchuan, Sichuan Province, China. Nerve injuries were classiifed into three types: type I injuries we... We performed a 2-year follow-up survey of 523 patients with peripheral nerve injuries caused by the earthquake in Wenchuan, Sichuan Province, China. Nerve injuries were classiifed into three types: type I injuries were nerve transection injuries, type II injuries were nerve compression injuries, and type III injuries displayed no direct neurological dysfunction due to trauma. In this study, 31 patients had type I injuries involving 41 nerves, 419 had type II injuries involving 823 nerves, and 73 had type III injuries involving 150 nerves. Twenty-two patients had open tran-section nerve injury. The restoration of peripheral nerve function after different treatments was evaluated. Surgical decompression favorably affected nerve recovery. Physiotherapy was effective for type I and type II nerve injuries, but not substantially for type III nerve injury. Pharmaco-therapy had little effect on type II or type III nerve injuries. Targeted decompression surgery and physiotherapy contributed to the effective treatment of nerve transection and compression injuries. The Louisiana State University Health Sciences Center score for nerve injury severity de-clined with increasing duration of being trapped. In the ifrst year after treatment, the Louisiana State University Health Sciences Center score for grades 3 to 5 nerve injury increased by 28.2% to 81.8%. If scores were still poor (0 or 1) after a 1-year period of treatment, further treatment was not effective. 展开更多
关键词 nerve regeneration EARTHQUAKE peripheral nerve injury LSUHSC score compartment syndrome surgery therapy PHYSIOTHERAPY nerve decompression neural regeneration
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Intraoperative Blood Glucose Levels and Postoperative Acute Kidney Injury in Pediatric Patients Having Congenital Heart Surgery under Cardiopulmonary Bypass
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作者 Dongyun Bie Hongbai Wang +7 位作者 Chaobin Zhang Chunrong Wang Yuan Jia Su Yuan Sheng Shi Jiangshan Huang Jianhui Wang Fuxia Yan 《Congenital Heart Disease》 SCIE 2023年第4期475-488,共14页
Purpose:This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury(AKI)in children undergoing congenital cardiac surgery.Methods:We conduct... Purpose:This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury(AKI)in children undergoing congenital cardiac surgery.Methods:We conducted a prospective nested case-control study in children(age<18 years)undergoing congenital heart surgery with cardiopulmonary bypass(CPB)at the Fuwai Hospital between April 01,2022 and July 30,2022.Cases were individuals who developed AKI within the first postoperative 7 days(AKI group)and controls were those without AKI(Non-AKI group)according to KDIGO criteria.AKI and Non-AKI groups unmatched and 1:1 matched by age,sex,and baseline serum creatinine were separately analyzed.Multivariate logistic and conditional logistic regressions were used to assess the associations between blood glucose variables and AKI.Results:688 consecutively approached patients were included in the final analysis.On multivariate analysis,intra-CPB(adjusted odds ratio[OR]0.802;95%confidence interval[CI],0.706 to 0.912;p=0.001)and post-CPB(adjusted OR 0.830;95%CI,0.744 to 0.925;p=0.001)blood glucose levels were associated with postoperative AKI.There were no significant differences in pre-CPB blood glucose(adjusted OR 0.926;95%CI,0.759 to 1.129;p=0.446)or intraoperative glycemic fluctuations(adjusted OR 0.905;95%CI,0.723 to 1.132;p=0.382)between AKI and Non-AKI groups.Results based on matched cases and controls were consistent with those from the unmatched analyses.Conclusion:Higher intraoperative blood glucose levels during and after CPB were protective factors against postoperative AKI in pediatric patients after congenital heart surgery. 展开更多
关键词 Blood glucose CHILDREN congenital heart surgery cardiopulmonary bypass acute kidney injury
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Incidence and peri-operative risk factors for development of acute kidney injury in patients after cardiac surgery:A prospective observational study
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作者 Stavros Dimopoulos Georgios Zagkotsis +9 位作者 Charalambia Kinti Niki Rouvali Magda Georgopoulou Mariantzela Mavraki Androniki Tasouli Efterpi Lyberopoulou Antonios Roussakis Ioannis Vasileiadis Serafim Nanas Andreas Karabinis 《World Journal of Clinical Cases》 SCIE 2023年第16期3791-3801,共11页
BACKGROUND Patients admitted to intensive care unit(ICU) after cardiac surgery develop acute kidney injury(AKI) immediately post-operation. We hypothesized that AKI occurs mainly due to perioperative risk factors and ... BACKGROUND Patients admitted to intensive care unit(ICU) after cardiac surgery develop acute kidney injury(AKI) immediately post-operation. We hypothesized that AKI occurs mainly due to perioperative risk factors and may affect outcome.AIM To assess peri-operative risk factors for AKI post cardiac surgery and its relationship with clinical outcome.METHODS This was an observational single center, tertiary care setting study, which enrolled 206 consecutive patients, admitted to ICU after cardiac surgery. Patients were followed-up until ICU discharge or death, in order to determine the incidence of AKI, perioperative risk factors for AKI and its association with outcome.Univariate and multivariate logistic regression analysis was performed to assess predictor variables for AKI development.RESULTS After ICU admission, 55 patients(26.7%) developed AKI within 48 h. From the logistic regression analysis performed, high EuroScore Ⅱ(OR: 1.18;95%CI: 1.06-1.31, P = 0.003), white blood cells(WBC) pre-operatively(OR: 1.0;95%CI: 1.0-1.0, P = 0.002) and history of chronic kidney disease(OR: 2.82;95%CI: 1.195-6.65, P = 0.018) emerged as independent predictors of AKI among univariate predictors. AKI that developed AKI had longer duration of mechanical ventilation [1113(777–2195) vs 714(511–1020) min, P = 0.0001] and ICU length of stay [70(28–129) vs 26(21–51) h, P = 0.0001], higher rate of ICU-acquired weakness(16.4% vs 5.3%, P =0.015), reintubation(10.9% vs 1.3%, P = 0.005), dialysis(7% vs 0%, P = 0.005), delirium(36.4% vs 23.8%, P = 0.001) and mortality(3.6% vs 0.7%, P = 0.046).CONCLUSION Patients present frequently with AKI after cardiac surgery. EuroScore Ⅱ, WBC count and chronic kidney disease are independent predictors of AKI development. The occurrence of AKI is associated with poor outcome. 展开更多
关键词 Acute kidney injury Renal failure Cardiac surgery Predisposing factors PROGNOSIS OUTCOME
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血流限制训练对肩袖损伤术后患者康复效果观察
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作者 张峥 郭立芬 +2 位作者 潘冰晶 陈安忠 朱红霞 《安徽医学》 2024年第3期354-359,共6页
目的探讨血流限制训练在肩袖损伤术后患者中的应用效果。方法选取2021年6至2023年6月聊城市第二人民医院收治的140例肩袖损伤术后的患者为研究对象,采用随机数字表法将其分为对照组和观察组,每组70例。对照组患者接受骨科术后常规护理,... 目的探讨血流限制训练在肩袖损伤术后患者中的应用效果。方法选取2021年6至2023年6月聊城市第二人民医院收治的140例肩袖损伤术后的患者为研究对象,采用随机数字表法将其分为对照组和观察组,每组70例。对照组患者接受骨科术后常规护理,观察组患者在对照组基础上实施血流限制训练,采用UCLA肩关节功能评分、肩关节活动度、视觉模拟疼痛评分(VAS)评分和SF-36健康状况量表比较两组干预4周和8周后的康复效果。结果重复测量方差分析结果显示,两组患者干预前的各项评价指标均有所改善。干预结束后,观察组患者UCLA肩关节功能评分、肩关节前屈、外展、外旋和内旋活动度和生活质量评分均较干预前明显增加(P<0.05),且观察组均高于对照组(P<0.001);两组患者VAS得分均低于干预前,观察组患者VAS得分均低于对照组(P<0.001)。结论血流限制训练可提高肩袖损伤患者术后关节活动度,减轻术后疼痛,并改善其生活质量,为此类患者的康复治疗提供新的思路。 展开更多
关键词 血流限制训练 肩袖损伤术后 术后康复
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透明质酸钠关节腔内注射联合关节镜手术治疗水平撕裂型半月板损伤的效果
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作者 李群 傅明辉 +3 位作者 成昌桂 曾四宝 陈诚 丁祖运 《中国医药导报》 CAS 2024年第1期104-107,共4页
目的分析透明质酸钠关节腔内注射联合关节镜手术治疗水平撕裂型半月板损伤的效果。方法选择2020年1月至2021年12月南京市溧水区人民医院收治的72例水平撕裂型半月板损伤患者,按照随机数字表法将其分为对照组(36例)与研究组(36例)。对照... 目的分析透明质酸钠关节腔内注射联合关节镜手术治疗水平撕裂型半月板损伤的效果。方法选择2020年1月至2021年12月南京市溧水区人民医院收治的72例水平撕裂型半月板损伤患者,按照随机数字表法将其分为对照组(36例)与研究组(36例)。对照组接受关节镜手术治疗,研究组在对照组的基础上采用透明质酸钠关节腔内注射,持续治疗5周。比较两组治疗前后膝关节Lysholm评分、国际膝关节评分委员会(IKDC)评分;比较两组临床疗效;比较两组治疗前后膝关节活动度;比较两组治疗前后血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平;记录两组治疗过程中并发症的发生情况。结果治疗后,两组Lysholm评分、IKDC评分、膝关节活动度高于治疗前,且研究组高于对照组(P<0.05)。研究组临床疗效优于对照组(P<0.05)。治疗后两组IL-1β、TNF-α水平低于治疗前,且研究组低于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论透明质酸钠关节腔内注射联合关节镜手术治疗水平撕裂型半月板损伤效果显著,可减轻炎症反应,改善膝关节活动度与膝关节功能,且安全性良好。 展开更多
关键词 透明质酸钠 水平撕裂型 半月板损伤 临床疗效 关节镜手术
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全肩关节镜和关节镜辅助小切口手术治疗肩袖损伤的对比研究
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作者 孙羽 孙保安 宁睿 《中国处方药》 2024年第2期186-189,共4页
目的探讨应用全肩关节镜手术与关节镜辅助下小切口手术治疗肩袖损伤的疗效差异及对术后关节功能的影响。方法选取2020年1月~2022年12月收治的肩袖损伤并接受手术治疗的患者93例,随机分A组和B组,A组47例、B组46例。A组接受关节镜辅助下... 目的探讨应用全肩关节镜手术与关节镜辅助下小切口手术治疗肩袖损伤的疗效差异及对术后关节功能的影响。方法选取2020年1月~2022年12月收治的肩袖损伤并接受手术治疗的患者93例,随机分A组和B组,A组47例、B组46例。A组接受关节镜辅助下小切口手术,B组接受全肩关节镜手术。比较两组手术失血量、手术用时、住院用时、视觉模拟疼痛评分(VAS)、美国加州大学肩关节功能评分(UCLA)及整体疗效差异。结果术前两组VAS评分、UCLA评分比较,差异无统计学意义(P>0.05),术后1月、3月、6月B组各时间点VAS评分均低于A组(P<0.05),B组UCLA评分均高于A组(P<0.05);B组手术失血量、住院时间少于A组,手术用时高于A组(P<0.05);两组治疗总优良率比较,差异无统计学意义(P>0.05)。结论两种手术整体疗效相近;关节镜下小切口手术创伤性低,手术用时短;全肩关节镜手术失血量少、住院用时短,且术后疼痛与关节功能恢复效率更高。 展开更多
关键词 肩袖损伤 关节镜下小切口手术 全肩关节镜手术 关节功能
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房颤射频消融术对心脏搭桥合并心脏瓣膜手术患者心功能、心肌损伤及预后的影响
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作者 李忠辉 刘秀燕 曹瑞芳 《四川医学》 CAS 2024年第2期118-122,共5页
目的探究房颤射频消融术(RA)对心脏搭桥合并心脏瓣膜手术患者心功能、心肌损伤及预后的影响。方法选取我院2022年2月至2023年3月接受心脏搭桥合并心脏瓣膜手术患者50例,随机数字表法将其分为观察组25例(房颤RA治疗)与对照组25例(保守药... 目的探究房颤射频消融术(RA)对心脏搭桥合并心脏瓣膜手术患者心功能、心肌损伤及预后的影响。方法选取我院2022年2月至2023年3月接受心脏搭桥合并心脏瓣膜手术患者50例,随机数字表法将其分为观察组25例(房颤RA治疗)与对照组25例(保守药物治疗)。对比两组手术相关指标、不同时间点心肌损伤[肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)]及心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]指标,术后随访3个月,统计患者窦性心律转复及心脑血管不良事件(MACCE)发生率。结果观察组体外循环时间比对照组长,总住院时间比对照组短,差异均有统计学意义(P<0.05)。两组术后血清CK-MB、cTnI、NT-proBNP水平均呈现先上升、后下降趋势(P<0.05);观察组术后2 h血清CK-MB、cTnI、NT-proBNP水平均显著高于对照组(P<0.05),但两组间术后48 h上述指标差异均无统计学意义(P>0.05)。术后3个月,观察组比对照组LVEF[(49.78±2.35)%vs.(45.03±2.17)%]显著上升,LVEDD[(54.93±4.30)mm vs.(57.38±4.16)mm]、LVESD[(39.62±4.37)mm vs.(46.15±5.23)mm]显著下降(P<0.05)。观察组术后第1天、出院时及术后3个月窦性心律转复率均显著高于对照组(P<0.05),术后3个月内MACCE两组对比差异无统计学意义(P>0.05)。结论房颤RA能有效改善心脏搭桥合并心脏瓣膜手术患者心功能,提高窦性心律转复率,短期预后好,但可能引发一过性心肌酶上升。 展开更多
关键词 心脏搭桥 心脏瓣膜手术 房颤射频消融术 心功能 心肌损伤
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脊柱后路手术患者压力性损伤预防管理的研究进展
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作者 邓瑞春 蒋维连 《中国卫生标准管理》 2024年第2期195-198,共4页
后路手术是胸椎腰椎疾病患者的主要手术治疗方式,对减轻损伤以及恢复脊神经功能有较好的效果。但该手术治疗的患者在手术过程中需要采取强制俯卧位,而且有较长的手术时间,发生术中获得性压力性损伤的概率较高。发生后不仅给患者带来疼... 后路手术是胸椎腰椎疾病患者的主要手术治疗方式,对减轻损伤以及恢复脊神经功能有较好的效果。但该手术治疗的患者在手术过程中需要采取强制俯卧位,而且有较长的手术时间,发生术中获得性压力性损伤的概率较高。发生后不仅给患者带来疼痛甚至病死,而且延长患者住院时间,增加其经济负担。术中获得性压力性损伤(intraoperation-acquired pressure injury,IAPI)越来越受护士的重视,其中关键在于预防。文章综述预防管理脊柱后路手术患者压力性损伤,涵盖了原因、风险评估、预防策略及管理模式。旨在为手术室护士的早期风险识别、有效护理干预、及时采取针对性措施及管理方式提供依据,有利于降低手术患者压力性损伤发生。 展开更多
关键词 脊柱 手术 俯卧位 压力性损伤 护理 手术中预防 综述
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针对性康复护理对肩袖损伤行关节镜手术患者术后肩关节功能恢复及护理满意度的影响
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作者 张阿勤 《中国医药指南》 2024年第10期37-40,共4页
目的 分析针对性康复护理对肩袖损伤行关节镜手术患者术后肩关节功能恢复及护理满意度的影响。方法 选取2020年6月至2023年6月于厦门大学附属中山医院接受关节镜手术治疗的肩袖损伤患者100例,根据随机数字表法分为两组,对照组(50例)采... 目的 分析针对性康复护理对肩袖损伤行关节镜手术患者术后肩关节功能恢复及护理满意度的影响。方法 选取2020年6月至2023年6月于厦门大学附属中山医院接受关节镜手术治疗的肩袖损伤患者100例,根据随机数字表法分为两组,对照组(50例)采取常规护理方法,观察组(50例)在此基础上施以针对性康复护理干预,对比两组的肩关节功能(欧美肩关节评分系统C-M)、生活质量(SF-36)、并发症发生率及护理满意度。结果 术后5个月时,观察组的C-M评分、SF-36评分均较对照组高(P <0.05);观察组并发症发生率较对照组更低(4.00%vs. 16.00%,P <0.05);观察组护理满意度较对照组更高(98.00%vs. 82.00%,P <0.05)。结论 将针对性康复护理用于肩袖损伤行关节镜手术患者,能使其肩关节功能得到更好恢复,减少并发症发生,提高生活质量与护理满意度。 展开更多
关键词 肩袖损伤 关节镜手术 针对性康复护理 肩关节功能 护理满意度
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扩大翼点入路逐步控制性减压手术治疗重型颅脑损伤的效果分析
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作者 丁帅 利文倩 +1 位作者 韦立广 邹瑜珑 《中外医药研究》 2024年第9期9-11,共3页
目的:分析扩大翼点入路逐步控制性减压手术治疗重型颅脑损伤的效果。方法:选取2021年1月—2023年1月钦州市第二人民医院神经外科收治的重型颅脑损伤患者86例作为研究对象,随机分为对照组和观察组,各43例。对照组采用大骨瓣减压术联合传... 目的:分析扩大翼点入路逐步控制性减压手术治疗重型颅脑损伤的效果。方法:选取2021年1月—2023年1月钦州市第二人民医院神经外科收治的重型颅脑损伤患者86例作为研究对象,随机分为对照组和观察组,各43例。对照组采用大骨瓣减压术联合传统快速减压术治疗,观察组采用扩大翼点入路逐步控制性减压术治疗。比较两组颅内压、美国国立卫生研究院脑卒中量表(NIHSS)评分、格拉斯哥昏迷指数(GCS)评分及预后情况。结果:开颅前,两组颅内压水平比较,差异无统计学意义(P>0.05);术后24、72 h,两组颅内压水平降低,观察组低于对照组,差异有统计学意义(P<0.05)。术前,两组NIHSS、GCS评分比较,差异无统计学意义(P>0.05);术后72 h,两组NIHSS评分降低,观察组低于对照组,两组GCS评分升高,观察组高于对照组,差异有统计学意义(P<0.05)。观察组预后良好率高于对照组,差异有统计学意义(P=0.030)。结论:扩大翼点入路逐步控制性减压手术治疗重型颅脑损伤的效果显著,可降低颅内压水平,改善患者神经功能、昏迷程度及预后。 展开更多
关键词 颅脑损伤 扩大翼点入路 逐步控制性减压手术
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体感模拟训练结合功能性电刺激在脑外伤术后患者上肢功能康复治疗中的作用
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作者 方芳 戴志强 +3 位作者 张社敏 曹宁 谢亚丽 谢佳芯 《中国实用神经疾病杂志》 2024年第8期1013-1017,共5页
目的探讨体感模拟训练结合功能性电刺激在脑外伤术后患者上肢功能康复治疗中的应用效果。方法选取中国人民解放军联勤保障部队第920医院2020-01—2022-12行手术治疗的103例脑外伤患者为研究对象,分为对照组(51例)和观察组(52例)。对照... 目的探讨体感模拟训练结合功能性电刺激在脑外伤术后患者上肢功能康复治疗中的应用效果。方法选取中国人民解放军联勤保障部队第920医院2020-01—2022-12行手术治疗的103例脑外伤患者为研究对象,分为对照组(51例)和观察组(52例)。对照组患者采取功能性电刺激,观察组患者采取体感模拟训练+功能性电刺激,治疗周期为8周。比较2组治疗前后的上肢运动功能[Fugl-Meyer运动功能评定量表(FMA)评分、简易上肢功能检查量表(STEE)评分]、日常生活活动能力[改良Barthel指数(MBI)评分]、体感诱发电位检测。结果治疗前,观察组FMA评分、STEE评分分别为(29.83±4.16)分、(62.48±8.74)分,对照组分别为(30.27±5.03)分、(63.14±9.24)分,组间比较差异无统计学意义(P>0.05);治疗后,观察组FMA评分、STEE评分分别为(42.69±5.56)分、(78.15±7.36)分,对照组分别为(36.47±4.69)分、(70.24±8.56)分;治疗后,2组FMA评分、STEE评分均较治疗前升高,且观察组上述两项指标均优于对照组(P<0.05)。治疗前,观察组MBI评分为(59.67±8.09)分,对照组为(60.25±9.26)分,组间比较差异无统计学意义(P>0.05);治疗后,观察组MBI评分为(75.17±7.65)分,对照组为(68.24±7.23)分;治疗后2组MBI评分各项及总分均较治疗前升高,观察组优于对照组(P<0.05)。治疗前,观察组N9波幅和潜伏时间分别为(3.21±1.02)μV、(8.88±1.23)ms,N20波幅和潜伏时间分别为(1.43±0.26)μV、(22.54±2.23)ms,对照组N9波幅、潜伏时间分别为(3.11±1.13)μV、(10.16±0.90)ms,N20波幅和潜伏时间分别为(1.48±0.29)μV、(22.61±2.28)ms,组间比较差异无统计学意义(P>0.05);治疗后,观察组N9波幅、潜伏时间分别为(4.28±1.12)μV、(10.21±0.96)ms,N20波幅和潜伏时间分别为(2.38±0.41)μV、(19.87±2.36)ms,对照组N9波幅、潜伏时间分别为(3.65±1.08)μV、(9.65±1.29)ms,N20波幅、潜伏时间分别为(1.82±0.30)μV、(21.02±2.49)ms;2组N9和N20的波幅均较治疗前升高,N9和N20的潜伏时间均较治疗前降低,且观察组优于对照组(P<0.05)。结论体感模拟训练结合功能性电刺激可更有效加强脑外伤术后患者的上肢功能,改善中枢神经运动传导功能,提高其日常生活活动能力。 展开更多
关键词 脑外伤 血肿清除术 上肢功能 功能性电刺激 体感模拟训练
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去骨瓣减压术治疗颅脑损伤后血肿增大的风险因素分析
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作者 张锦贤 《浙江临床医学》 2024年第5期703-705,共3页
目的研究去骨瓣减压术治疗颅脑损伤后血肿增大的风险因素。方法回顾性分析2022年1月至2023年8月本院收治的颅脑损伤117例,所有患者均行去骨瓣减压术,根据术后CT检查血肿是否增大分为发生组(n=62)与未发生组(n=55)。比较两组一般资料及... 目的研究去骨瓣减压术治疗颅脑损伤后血肿增大的风险因素。方法回顾性分析2022年1月至2023年8月本院收治的颅脑损伤117例,所有患者均行去骨瓣减压术,根据术后CT检查血肿是否增大分为发生组(n=62)与未发生组(n=55)。比较两组一般资料及鹿特丹CT评分(Rotterdam CT)、格拉斯哥昏迷评分(GCS)间的差异,经多因素Logistic回归分析去骨瓣减压术治疗颅脑损伤后血肿增大的危险因素。结果两组患者性别、合并高血压、高脂血症、冠心病比较差异无统计学意义(P>0.05),发生组年龄≥65岁、瞳孔散大、发病至开颅时间<4h占比及RotterdamCT评分、血糖、骨瓣最大径明显高于非血肿增大组,GCS评分低于未发生组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄、Rotterdam CT评分、GCS评分、瞳孔状态、发病至开颅时间、血糖、骨瓣最大径是颅脑损伤患者术后血肿增大的危险因素(P<0.05)。结论颅脑损伤患者术后血肿增大受诸多因素影响,其中年龄、瞳孔状态、GCS评分、Rotterdam CT评分、发病至开颅时间、血糖、骨瓣最大径可预测患者术后血肿情况,应予以密切关注。 展开更多
关键词 去骨瓣减压术 颅脑损伤 血肿增大 瞳孔状态 骨瓣最大径
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多元化干预联合零缺陷护理模式在颅脑损伤急诊手术患者中的应用效果
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作者 陈敏 《中外医药研究》 2024年第20期109-111,共3页
目的:分析多元化干预联合零缺陷护理模式在颅脑损伤急诊手术患者中的应用效果。方法:选取2022年1月—2023年6月于赣南医学院第一附属医院接受急诊颅脑损伤手术治疗的患者78例作为研究对象,随机分为对照组与观察组,各39例。对照组给予常... 目的:分析多元化干预联合零缺陷护理模式在颅脑损伤急诊手术患者中的应用效果。方法:选取2022年1月—2023年6月于赣南医学院第一附属医院接受急诊颅脑损伤手术治疗的患者78例作为研究对象,随机分为对照组与观察组,各39例。对照组给予常规护理,观察组给予多元化干预联合零缺陷护理模式。比较两组Barthel指数、健康调查简表评分、并发症发生情况及护理满意度。结果:干预后,两组Barthel指数高于干预前,观察组高于对照组,差异有统计学意义(P<0.05);干预后,两组心理健康、社会功能、精力和躯体健康评分高于干预前,观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P=0.042);观察组护理满意度高于对照组,差异有统计学意义(P=0.025)。结论:多元化干预联合零缺陷护理模式能提高患者的生活活动能力及生活质量,降低并发症发生率,提高满意度。 展开更多
关键词 多元化干预 零缺陷护理模式 颅脑损伤 急诊手术 护理满意度 生活质量
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