简介:目的探讨以自体砧骨重建听骨链的开放式IIIa型鼓室成形术的听力改善疗效。方法回顾性收集16例(16耳)因慢性化脓性中耳炎或胆脂瘤中耳炎接受开放式Ⅲa型鼓室成形术患者的临床资料,所有病例均采用自体砧骨进行听骨链重建。术后随访3-6个月,评估患者手术后听力改善情况,分析指标为手术前后言语频率的纯音听阈及气骨导差。结果所有均达到干耳。纯音气导听阈从术前的45.2到干耳。降至术后的30.6的干耳。纯音气导听阈(P〈0.05)。术前、术后气骨导差分别为33.1、术后7dB及19.8、术后7dB分别为从术前的析,其中气骨导差小于20dB者占62.5%(10/16)。结论在本组病例中,以自体砧骨行听骨链重建开放式Ⅲa型鼓室成形术,获得了较好的近期听力改善效果,其远期疗效有待于进一步观察。
简介:目的探讨烟雾病合并Graves病的临床特征和颅内外血管重建术的效果。方法回顾性分析4例成人烟雾病合并Graves病患者的临床资料,女3例,男1例,平均年龄(32±7)岁。对4例患者在经药物治疗甲状腺功能正常后,均行颞浅动脉-大脑中动脉旁路移植术,观察手术疗效及随访结果。结果(1)3例表现为脑梗死,1例表现为频繁短暂性脑缺血发作。DSA证实2例为单侧烟雾病,2例为双侧烟雾病;头部MRI均可见脑梗死灶。(2)药物治疗甲状腺功能正常后,3例烟雾病症状稳定,1例在术后1周内有高热、心率快等高代谢症状;血管重建术后随访6~18个月症状改善,1例良好,3例优秀,Graves病均无复发。复查头部MRI提示4例患者均无新发脑梗死灶,MR血管成像可见缺血灶区域脑沟内动脉充盈较术前明显改善,有2例可见患侧大脑中动脉M2~M3段逆行充盈。术后单光子发射计算机体层扫描脑灌注成像提示,手术侧缺血灶灌注较手术前明显改善。结论合并Graves病时烟雾病症状加重,表现为急性或慢性脑缺血症状。控制甲状腺功能亢进症状后,脑缺血症状多数能缓解。颞浅动脉-大脑中动脉旁路移植术能够建立有效的侧支循环,改善临床症状。
简介:摘要总结盆腔器官脱垂合并压力性尿失禁患者应用Prolife网片进行女性前盆底重建的围手术期护理方法。方法选择年龄40岁以上,诊断为阴道前壁脱垂III-IV°(POP-Q分类)伴或不伴子宫脱垂患者共70例采用改良的Prolife网片进行前盆修补和结构重建手术,系阴道内通过前后路螺旋穿刺引导器放置不可吸收的聚丙烯网片的微创手术。术前做好护理评估及心理护理,术后注意病情观察,加强会阴创口护理,做好并发症的预防与护理,重视出院指导,建立随访。结果70例患者均顺利完成手术并治愈出院。术后5~18个月随访,患者的盆底结构基本正常,相关症状消失或明显改善。结论全面、专业、细致的护理提高了手术成功率,保障了手术效果。
简介: 【摘 要】目的:探讨膝关节镜下交叉韧带重建术患者围手术期的护理方案及康复训练方法。方法:将 76例患者随机分为观察组及对照组。对照组患者接受常规围手术期护理措施及一般性的康复指导,观察组患者接受针对性围手术期护理措施及康复训练。比较两组患者护理前后膝关节 HHS评分、 Lysholm评分及疗效。结果:护理后,观察组患者 HHS评分及 Lysholm评分均高于对照组患者( P<0.01) ;观察组患者总有效率( 89.5%)高于对照组患者( 71.1%)( P<0.05)。结论:针对性围手术期护理措施及康复训练在膝关节镜下交叉韧带重建术患者中的应用效果显著,能够明显改善患者的膝关节功能,促进患者的康复。 【关键词】交叉韧带重建术 ;康复训练 ;膝关节功能 [Abstract] Objective: To explore the perioperative nursing plan and rehabilitation training method of patients with cruciate ligament reconstruction under knee arthroscope. Methods: 76 patients were randomly divided into observation group and control group. Patients in the control group received routine perioperative nursing measures and general rehabilitation guidance, while patients in the observation group received targeted perioperative nursing measures and rehabilitation training. The HHS score, Lysholm score and curative effect of the two groups were compared before and after nursing. Results: after nursing, the HHS score and Lysholm score of the observation group were higher than those of the control group (P < 0.01); the total effective rate of the observation group (89.5%) was higher than that of the control group (71.1%) (P < 0.05). Conclusion: targeted perioperative nursing measures and rehabilitation training in the knee arthroscopic cruciate ligament reconstruction of patients with significant effect, can significantly improve the knee joint function of patients, promote the rehabilitation of patients.
简介:Background:Preventinganteriorcruciateligament(ACL)injuriesisimportanttoavoidlong-termadversehealthconsequences.Identifyingbarrierstoimplementationofthesepreventionprogramsiscrucialtoreducingtheincidenceoftheseinjuries.OurpurposewastoidentifybarriersofimplementationforACLinjurypreventionprogramsandsuggestmechanismsforreducingthebarriersthroughapplicationofaSocioEcologicalModel(SEM).Methods:StudiesinvestigatingACLpreventionprogrameffectivenessweresearchedinMedlineviaPubMedandtheCochraneLibrary,andasubsequentreviewofthereferencesoftheidentifiedarticles,yielded15articlestotal.Inclusioncriteriaencompassedprospectivecontrolledtrials,publishedinEnglish,withACLinjuriesastheprimaryoutcome.Studieswereindependentlyappraisedby2reviewersformethodologicalqualityusingthePEDroscale.Barrierstoimplementationwereidentifiedwhenreportedinatleast2separatestudies.ASEMwasusedtosuggestwaystoreducetheidentifiedbarriers.Results:Fivebarrierswereidentified:motivation,timerequirements,skillrequirementsforprogramfacilitators,compliance,andcost.TheSEMsuggestedwaystominimizethebarriersatalllevelsofthemodelfromtheindividualthroughpolicylevels.Conclusion:IdentificationofbarrierstoprogramimplementationandsuggestinghowtoreducethemthroughtheSEMisacriticalfirststeptowardenablingACLpreventionprogramstobemoreeffectiveandultimatelyreducingtheincidenceoftheseinjuries.