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Objective To investigate periprosthetic femoral shaft remodeling with tapered femoral stems after total hip arthroplasty (THA) for elderly patients and evaluate the mid-term clinical outcomes.Methods The study involved 30 elderly (70-90 years) patients (34 hips) treated with femoral shaft remodeling with tapered stems after THA from January 2003 to January 2005. The postoperative X-ray images were collected and perioperative periprosthetic bone mineral density was analyzed by dual-energy X-ray absorptiometry (DEXA). The Harris score was applied in follow-up observation, and Kaplan-Meier method was used to evaluate the working life of the femoral prosthesis. Results Four patients were died of lung cancer. The remaining 26 patients ( 30 hips) were followed up for 5-7 years ( mean, six years). The postoperative X-ray measurements showed that total hip prosthesis subsidences were less than 1.5 mm within one year in 12 hips, with no prosthesis loosening observed. Bone proliferations were seen in Gruen zones 2, 3, 4, 5, 6, 11 and 12, and bone resorptions were seen in zones l and 7. DEXA showed that bone mineral density was increased in Gruen zones 2,3,4 and 5, but decreased mainly in Gruen zones 1,6 and 7. The increase of bone mineral density in zones 2 and 5 was faster compared to other sites six months after the operation ( P < 0.05 ) and the change of bone mineral density was prone to be stable in two years ( P > 0.05 ). Within one year after initial implantation, periprosthetic bone mineral density was significantly decreased ( P < 0.05 ). Two years after the operation, rare changes of periprosthetic bone mineral density were found ( P > 0.05 ), with only regional redistribution of bone mass from the proximal to the distal femur. The Harris score of hip joint function was increased from preoperative 38.56 ± 8.21 to 86.32 ± 6. 01 at the final follow-up. The 6-year survival rate of the prosthesis was 100%. Conclusion Femoral shaft remodeling with tapered stems after total hip arthroplasty for the elderly patients shows good periprosthetic bone remodeling and satisfactory mid-term clinical results. 相似文献
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目前,重症急性胰腺炎(severe acute pancreatitis,SAP)的引流方式主要有前腹壁切开引流、经腹腔镜前入路引流、B超引导下穿刺置管引流等. 相似文献
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目的应用Oswestry功能障碍指数(Oswestry disability index,ODI)评定成人腰椎峡部裂椎体滑脱(isthmic spondylolisthesis,ISS)的手术疗效。方法用ODI问卷表和综合评分表对手术治疗的成人腰椎(ISS)患者52例进行评分,手术一年以后再次评分,完成随访46例,平均随访时间15个月,分别计算优良率,并进行相关分析。结果ODI指数与综合评分表评定的优良率相比,无显著性差异。结论用ODI评定成人腰椎ISS患者的手术疗效稳定、可靠,可作为一项重要的参考指标。 相似文献
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患者 ,女 ,73岁 ,因反复上腹疼痛 2年 ,复发、加重伴恶心、呕吐 2周入院。近 1月体重减轻约 4kg。查体 :腹膨隆 ,剑突下及右上腹压痛 ,胃振水音阳性 ,肠鸣音弱 ,未闻及高调肠鸣及气过水声 ,余阴性。化验 :血、尿、便常规无异常 ;肝肾功示 :白蛋白 30 g/L ,球蛋白 31 2 8g/L ,白球比 0 96 ,Na+ 132 70mmol/L ,CO2 CP15 10mmol/L ,HBsAg(- )。B超示 :(1)胆囊肿大、积液 ,胆囊结石伴胆囊炎 ;(2 )胃潴留 (原因待查 )。上消化道钡餐示 :十二指肠内肿块 (十二指肠降部有一圆弧形压迫 ,钡剂通而不畅 )。胸片、心电… 相似文献
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刘宏鸣 《第三军医大学学报》2001,23(8):930-930
患者男,45岁,农民。反复上腹隐痛3年,食欲下降,进食脂肪餐后腹泻,2000年5月5日入院。查体剑突下轻压痛,未扪及腹部包块。既往有饮酒史,饮酒量 150-250ml/d,饮酒时间约20年。肝肾功能均正常,血、尿淀粉酶分别为250、1260 U苏氏单位,血清脂肪酶195 U(国际单位)。B超、CT、ERCP均示“胰管结石伴慢性胰腺炎”。术中见胰腺萎缩,主胰管扩张,可扪及胰管内多发结石。沿主胰管走向切开主胰管6 cm,取出胰管内多发性、灰白色结石数10粒。胰腺尾部结石较多且严重纤维化,决定行胰尾切除,由… 相似文献
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目的:观察盐酸甲氯芬酯对脑梗死患者心率变异性(heart rate variability,HRV)的影响,探讨其对脑梗死患者心脏自主神经功能损伤的疗效.方法:选择91例脑梗死患者,随机分为2组(甲氯芬酯治疗组46例、吡拉西坦对照组45例),选取同期50例健康体检者作为正常对照;甲氯芬酯治疗组静滴盐酸甲氯芬酯,吡拉西坦对照组静滴吡拉西坦,共15 d;比较各组HRV各项参数的变化.结果:与健康人群相比,脑梗死患者SDNN、SDANN、SDNN Index、RMSSD、PNN50、HRVTI各项指标均显著降低(P<0.05).甲氯芬酯治疗后HRV各项指标均明显高于治疗前(P<0.05);吡拉西坦治疗后SDNN、SDANN、SDNN Index较治疗前增高(P<0.05),而RMSSD、PNN50、HRVTI无显著变化.治疗前2组各项指标无统计学差异,治疗后甲氯芬酯治疗组各项指标高于吡拉西坦对照组(P<0.05).结论:脑梗死后心脏自主神经活动受到抑制,甲氯芬酯能改善脑梗死后心脏的自主神经功能,对预防心血管事件有一定价值. 相似文献