显微外科技术针头支架法输精管吻合术42例分析

目的探讨输精管吻合术的新方法及复育效果。方法通过显微外科技术针头I临时支架固定法，行输精管吻合术42例。结果42例输精管吻合术，术后随访，检查精液有精子36例，术后再通率85．7％；配偶受孕25例，复孕率59．5％。结论应用显微外科技术针头临时支架法行输精管吻合术，可有助于提高输精管再通率复育率。     

Surgical strategy of one stage surgery of anterior release combined with posterior correction in treatment of severe scoliosis

Objective: Severe scoliosis refers to scoliosis with serious and stiff curve. It always combins with trunk imbalance in coronal and sagittal contour. Besides complex pathological changes, cardiopulmonary deficits and other concomitant diseases increase treatmental difficulties. So the treatment of severe scoliosis is always a great challenge to spine surgeon. Methods :Thirty-six patients with severe scoliosis received one stage posterior correction followed by anterior release during July 1997 to January 2003, including 9 males and 27 females. Mean age was 17.2 years. Of them, 33 was idiopathic scoliosis and 3 was neurofibromatosis scoliosis( Cobb angle: 85-116 degree); 20 cases were abnormal in sagital plane. Three-dimensional devised instrumentation were applied such as CD, CD-Horizon, TSRH or Isola in posterior procedure followed by anterior release during the same anesthesia. 31 cases of this group received thorac icplasty. Results: The correction in the frontal plane achieved an average of 48.5%. In the sagittal plane, the pathological shape of the spine was reduced and distinctly ameliorated. 80. 6% of the patients maintained or achieved balance of sagittal plane. There were no complications of severe neurological deficit, hook displacement, rod broken, and deep infection at follow-up. One case occurred traumatic pleurisy after operation and another appeared pseudarthrosis 2 years later. One case demonstrated imbalance 11 months after operation. One patient was presented loss of correction more than 10 degree at one year follow-up and 5.2 degree in average. Conclusion:The study indicates that the one stage posterior correction combined with anterior release in treatment of severe scoliosis can achieve satisfactory correction. Appropriate choice of cases, preoperational detailed assessment and application of SEP and wake-up test during operation can possibly reduce severe complication. The long-term outcomes still need further observation.     

利用喙肩韧带重建喙锁韧带治疗陈旧性肩锁关节脱位

对陈旧性肩锁关节脱位或半脱位的手术治疗有许多方法，一般常以重建喙锁韧带为主，对新鲜脱位也有用螺丝钉经锁骨外端固定于喙突等手术［１，２］，但效果尚不甚理想，容易发生畸形、复发等并发症。我们自１９８８年以来采用喙肩韧带重建喙锁韧带治疗陈旧性肩锁关节脱位１...     

181例病毒性心肌炎临床特点及心律失常类型

小儿病毒性心肌炎１８１例，其中暴发性及心源性休克型８例。其主要特点是：心脏增大（４３．４％），心律失常（９３．９％），其中早搏最多见（５９．９％）；传导阻滞（１５．５％）。作者认为应强调对Ⅱ°－Ⅱ型以上传导阻滞病情严重应给激素及临时起搏器抢救治疗；心电轴异常（３５．７％），亦是心肌炎的重要心电图改变之一。     

癌胚抗原尼龙固相免疫放射分析及其临床应用

为建立癌胚抗原尼龙微球固相免疫放射分析法并应用于临床，采用Ｌｏｄｏｇｅｎ法＾１２５Ｉ标记ＣＥＡ单克隆抗体Ｃ－１７，用单克隆抗体Ｃ－５０、Ｃ－６化学包被尼龙微球制成固相抗体，建立一步法的ＣＥＡＮ－ＳＰＩＲＭＡ，灵敏度２μｇ／Ｌ，工作范围为５－８０μｇ／Ｌ，批内和批间ＣＶ分别为４．６３％和８．３４％，回收率９３．８６－１０４．７３％。结果：６５例正常人ＥＣＡ值为５．２±３．８μｇ；Ｌ，７８例良性病人为     

动脉灌注灭活再植治疗骨肉瘤的体会

本组１２例骨肉瘤均采用动脉区域灌注灭活再植及术后化疗方法，术后２年存活率平均为７５％，１例因经验不足致局部复发，仅占８．３％，表明在化疗保障下，采用此种方法即能保肢，又能获得与截肢治疗相同的手术效果，优于单纯行灭活再植术后中方法。     

头皮皮脂腺癌一例

头皮皮脂腺癌一例李相龙１申哲范２李哲浩２１延边大学医学院附属医院脑外科２延边脑科医院脑外科关健词癌；皮脂腺；颅骨中图法分类号Ｒ７３０２６１；Ｒ６５１患者，女，７６岁．因发现头部包块４０ｄ入院．患者４０ｄ前无意中发现左侧头顶有２～３个黄豆粒大小的包块...     

平板运动试验Q-Tc、Q-Tr和△Q-Tc对冠心病的诊断价值:与冠脉造影结果对照

78例病人接受冠脉造影和次极量平板运动试验,探讨Q-Tc、Q-Tr和△Q-Tc预测冠脉病变的准确性。Q-Tc与Q-Tr的敏感度,特异度,阳性预测值及诊断准确率分别为84,76,83,81％与69,88,89,77％,与ST段降低的相比无明显差别,提示其诊断价值相似。与心血管造影资料对照,上述指标能反映冠脉病变的程度。△Q-Tc的敏感度低(58％)而特异性高(94％),其诊断准确性(73％)与其他指标相比无显著差异,故有应用价值。