经皮椎体成形术治疗骨质疏松性椎体压缩骨折的护理体会

目的探讨经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的护理体会。方法对116例接受经皮椎体成形术治疗的老年骨质疏松性椎体压缩性骨折患者,术前进行基本护理、心理护理和俯卧位训练,术中术后给予监测生命体征,预防并发症,并进行康复锻炼指导等护理方法。结果所有患者的疼痛症状均明显缓解,出院时均恢复行走,无一例发生并发症。术后随访1～3年,对手术效果均满意。结论围手术期对患者整体的身心护理保障了经皮椎体成形术的顺利进行,是确保手术成功的关键。     

高黏度骨水泥治疗骨质疏松性锥体压缩骨折患者围手术期护理

目的 探讨高黏度骨水泥椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折患者围手术期护理.方法 30例患者采用高黏度骨水泥PVP治疗骨质疏松性椎体压缩骨折,通过术前常规护理及心理、饮食干预,术后指导四肢康复锻炼和严密观察骨水泥渗漏,及时给予相应的护理措施.结果 30例患者在护理干预下积极配合PVP治疗,术后疼痛明显减轻.结论 术前充分地准备,术后正确的指导和精心的观察、护理,能够帮助患者尽快地恢复日常生活活动能力,减轻疼痛,提高生活质量.     

体位复位结合经皮椎体后凸成形术治疗Kummell s病的临床研究

Kummell s病是骨质疏松椎体压缩性骨折(osteoporotic vertebral body compression fracture,OVCF)一种严重并发症[1],引起长期慢性腰背痛,如不及时干预,椎体会进一步压缩、塌陷,压迫脊髓,甚至导致瘫痪[2]。Kummell’s病非手术治疗往往无效,对于Ⅰ、Ⅱ期患者,目前多采用经皮椎体成形术(percutaneous vertebro plasty,PVP)或经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗,以缓解疼痛、稳定椎体,但同时存在骨水泥渗漏风险[1]。     

腹腔镜下子宫肌瘤剔除术的围手术期护理框架构建探索

目的：对腹腔镜下子宫肌瘤剔除术的围手术期护理方框架构建予以探讨。方法随机选取我院2013年1月～2013年12月间收治的腹腔镜下子宫肌瘤剔除术患者30例,在患者围手术期为患者实施全面的综合护理干预。结果30例患者都顺利出院,没有死亡病例,并且没有发生护理并发症。结论将综合护理干预应用于腹腔镜下子宫肌瘤剔除术的围手术期护理工作中,对于提升其手术成功率,降低术后并发症的发生具有积极的作用。     

单双侧经皮椎体成形术治疗骨质疏松性椎体压缩性骨折疗效对比

【摘要】 目的 对比分析单双侧经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的临床效果。方法 选取2018 年 5 月至 2020 年 6 月河南省洛阳正骨医院收治的 104 例骨质疏松性椎体压缩性骨折患者作为研究对象, 并按照治疗方法将其分为单侧组与双侧组, 每组 52 例。单侧组患者采用单侧经皮椎体成形术治疗, 双侧组患者采用双侧经皮椎体成形术治疗, 对比两组患者手术时间、视觉模拟评分法 (VAS) 评分、椎体前缘高度、Cobb 角以及并发症发生情况。 结果 单侧组患者手术时间明显短于双侧组 (t = 29.664, P < 0.001); 术后 1 个月, 单侧组患者VAS评分、椎体前缘高度及 Cobb 角与双侧组无明显差异 ( t = 0.312、0.487、0.657, P = 0.756、0.627?0.513); 单侧组患者并发症发生率与双侧组无明显差异 (χ2= 0.343, P = 0.558)。结论 单双侧经皮椎体成形术治疗骨质疏松性椎体压缩性骨折均可取得满意的治疗效果, 但单侧经皮椎体成形术手术时间较短, 操作更简便。     

经皮肾镜穿刺取石术治疗25例肾结石患者的护理

目的 探讨护理干预对经皮肾镜穿刺取石术治疗肾结石疗效的影响.方法 选取2008年8月至2009年8月来我院行经皮肾镜穿刺取石术的50例肾结石患者,随机分为常规手术组(常规手术)和护理干预组(常规手术+围术期护理干预),每组各25例.记录患者术前焦虑程度、术后满意度及并发症发生情况.结果 经护理干预后其焦虑例数仅为6例,与术前常规手术组(13例)比较,差异有统计学意义(P<0.05);常规手术组患者对护理干预的满意率为80%,护理干预组患者满意率为100%,两组比较,差异有统计学意义(P<0.05),且护理干预组患者术后出血、尿路感染发生率较低.结论 对经皮肾镜穿刺取石术治疗肾结石行护理干预,可有效降低患者术前的焦虑,增加患者的满意度,以促进患者康复.     

经皮椎体成形术的护理

经皮椎体成形术(percutaneous verterbroplasty，PVP)应用于椎体转移性肿瘤和骨质疏松症所致的椎体压缩性骨折的治疗，获得了良好的镇痛效果。目前，PVP已被广泛地应用于治疗上述疾病所致的顽固性疼痛和加固椎体。我院于2001年7月开展此项手术，取得了良好的效果，现将10例患者的护理报道如下。     

围术期精细化护理干预对甲状腺瘤手术患者疼痛及应激反应的影响

目的 分析围术期精细化护理干预在甲状腺瘤手术患者中的干预效果。方法 收取2020年05月-2022年10月的60例甲状腺瘤手术患者,按随机数字分配法分参照组(常规护理)、干预组(常规护理+围术期精细化护理干预),各30例,对比组间相关情况。结果 相比参照组,干预组疗后VAS评分、心理情况评分、血压、心率均更低,生理应激指标和生活质量评分更高(P<0.05)。结论 对甲状腺瘤患者实行围术期精细化护理能缓解患者疼痛,改善应激反应,是一种良好的干预策略。     

CT引导经皮穿刺微波消融治疗原发性肝癌的护理

目的：总结CT引导经皮穿刺微波消融(MWA)治疗原发性肝癌的护理要点。方法对77例原发性肝癌患者行CT引导经皮穿刺MWA治疗,应用优质护理方法实施围手术期护理,并对围手术期患者出现的不良反应进行分析、总结。结果77例接受CT引导经皮穿刺MWA治疗的患者均顺利完成手术治疗,术后出现不同程度疼痛29例,肝功能损害6例,气胸1例。所有患者经过积极的治疗和护理后,病情均得到有效控制,本组未出现围手术期死亡案例。结论充分的术前准备、密切的术中配合以及术后有效的治疗和护理有利于病情恢复,对有效预防和减少并发症的发生,提高患者生存质量均有重要意义。     

经皮穿刺球囊扩张椎体后凸成形术的围手术期护理

中老年人由于骨质疏松的缘故,胸腰椎压缩性骨折成为了临床常见的脊柱致残疾病。传统的治疗措施为卧床休息、药物促进骨质吸收,减少骨溶解及镇痛等处理,但疗程长,疗效不确切。经皮球囊扩张成形（PKP）是治疗骨质疏松胸腰椎压缩性骨折（VCF）的一种有效方法,具有复位效果好、畸形矫形效果明显、疼痛缓解好的优点。此方法简单有效,为保证手术预期效果,围手术期护理亦非常重要,随着微创技术的不断发展,这类手术的护理也在不断发展与完善。笔者就经皮穿刺球囊扩张椎体后凸成形术的护理,报告如下。     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme     

改进的定位技术在胸部肿瘤穿刺活检中的应用

目的：探索CT-SIM三维定位系统、体模固定技术和PET-CT融合影像导引定位技术在胸部肿瘤经皮穿刺活检中的应用价值。方法：对380例胸部肿瘤患者行改进的CT定位技术下的经皮穿刺活检术。根据肿瘤的大小、深度、毗邻关系、活动度以及患者的心肺功能状态,综合运用CT-SIM系统、体模固定技术和PET-CT融合影像导引技术,为患者进行穿刺前定位。统计穿刺定位时间长度、成功率、确诊率、并发症发生情况,并与210例采用传统铅栅定位下胸部肿瘤穿刺活检的相应资料进行比较。结果：采用改进的CT定位技术的380例患者穿刺定位精确,平均定位时间（9.5 min）较传统方法（16.8 min）缩短7.3 min,活检成功率和确诊率分别是98.7%和95.3%,高于传统定位方法的93.3%和83.3%,两者差异均具有统计学意义（P〈0.05）。穿刺并发症发生率相似,气胸发生率分别为2.8%和2.9%,咯血发生率分别为11%和12.8%。结论：根据患者状态及肿瘤特点,在CT-SIM系统快速精确定位技术的基础上,综合运用体模固定技术和PET-CT融合影像导引技术,能显著缩短经皮穿刺活检的定位时间,提高活检成功率。