关节镜监视下有限切开复位、锁定钢板内固定治疗胫骨平台骨折

目的研究系统性红斑狼疮(systemic lupus erythematosus,SLE)患者QT间期离散度(QT-interval dispersion,QTd)的变化与心脏损害及病程、疾病活动、抗心磷脂抗体等临床资料的相关性。方法选取173例SLE患者和70例性别、年龄匹配的健康对照者,回顾性地分析SLE患者的临床资料,测量每份心电图12导联的QT间期计算QTd。结果 (1)SLE患者QTd较健康对照者明显延长(P<0.01),其中有明显心脏损害SLE患者QTd较无明显心脏损害SLE患者和健康对照者明显延长(P<0.01;P<0.01),无明显心脏损害SLE患者QTd较健康对照者明显延长(P<0.01);(2)SLE患者晚期组QTd较早期组和初发组明显延长(P<0.01;P<0.01);(3)SLE重度活动组QTd较轻度活动组和稳定组明显延长(P<0.05;P<0.05);(4)SLE抗心磷脂抗体阳性组QTd较抗心磷脂抗体阴性组明显延长(P<0.05);(5)SLE患者QTd与病程、疾病活动指数(SLEDAI)、抗dsDNA抗体、收缩压、舒张压呈正相关(分别:r=0.176,P<0.05;r=0.178,P<0.05;r=0.172,P<0.05;r=0.393,P<0.01;r=0.355,P<0.01)。结论 SLE患者QTd明显延长并与多种心脏损害的危险因素相关。QTd可能是SLE患者心脏损害的一个有用的评价指标。

Treating tibial plateau factures with arthroscope technology and fixing locking plate with limit incision

Objective To investigate the application and the clinical effect of treating tibial plateau factures with arthroscope technology and fixing locking plate with limit incision.Methods From January 2006 to December 2009,tibial plateau fractures were treated by means of the fracture reposition under the monitoring of arthroscope technology plus fixing locking plate by micro-wound in 35 cases.And the clinical effect was discussed.Results All the cases were followed up for 12 to 32months（12.8months on average）.All the fractures were healed.According to Rassmussen Knee rating system,it was excellent in 24 case,good in 8 cases,medium in 3 cases and the fine rate was 91.4%.Conclusion As for tibial plateau by arthroscope fractures,arthroscopically assisted limit incision in combination with locking plate inner fixation techniques is characterized by minimal invasion,fast fracture healing,sound knee joint function,and all the combined injuries can be treated at the same time.