脊柱术后脑脊液漏的处理

脑脊液漏为脊柱手术后的一种并发症，有学者统计其发生率约为2．3％～9．4％。其发生与多种因素有关，除椎管条件、粘连等本身因素外，不适当的手术操作也是造成脑脊液漏的重要原因。脑脊液漏处理不当可导致伤口感染不愈、硬脊膜囊肿甚至椎管内感染等严重并发症。我院自1998—05／2006—07月共有57例患者脊柱术后出现脑脊液漏，经过适当的处理无一例出现感染，现报告如下。     

Clinical application of anterior cervical decompression and fusion under METRx system

Objective: To explore the feasibility and effect of anterior cervical decompression and fusion under METRx system. Methods: Between Nov. 2001 and Nov. 2003, totally 23 consecutive patients were performed anterior cervical decompression and fusion under METRx system. The clinical outcome was evaluated by Odom standard. Results: Decompression and fusion along with internal fixation was obtained in all the 23 patients with minimal tissue damage and operation-caused scar. There were no wound infection, neurological injuries, throat discomfort and other complications. The total rate of excellent and good outcome in patients with degenerative cervical diseases was 94%. Conclusion: Cervical decompression and fusion can be performed under METRx system with its own advantages, such as minimal tissue damage and operation-caused scar, less throat discomfort.     

关节镜下缝合术治疗半月板前角损伤的疗效

目的:探讨关节镜下使用MenderⅡ缝合器修复半月板损伤的临床疗效。方法:半月板前角损伤47例,其中男29例(29膝),女18例(18膝);年龄12～31岁,平均(20.53±4.12)岁;病程3～35 d,平均(12.43±5.74) d.应用MenderⅡ缝合器在膝关节镜下行由外向内缝合术,并对患者术前、术后疼痛、跛行等采用Lysholm膝关节评分系统进行评估分析。结果:46例均获随访,时间12～48个月,平均(31.84±8.34)个月。所有患者手术切口Ⅰ期愈合,未出现重要血管、神经损伤等并发症,患膝关节交锁症状均消失,其疼痛、跛行、肿胀、活动受限等症状明显好转,Lysholm膝关节评分由术前52.33±7.31提高至术后86.74±6.92.结论:应用MenderⅡ缝合器对半月板前角损伤患者行由外向内缝合术,术后症状改善明显,近期疗效满意。     

膝关节镜下经皮改良张力带钢丝治疗髌骨骨折20例报道

目的评价膝关节镜下经皮穿刺张力带钢丝固定术治疗髌骨骨折的方法和疗效.方法2002年2月～2003年10月间我科收治的20例髌骨骨折患者,采用膝关节镜和C臂辅助下闭合复位,经皮穿刺张力带钢丝固定术治疗.对该20例病例资料进行分析和总结.结果所有病例术后膝关节功能良好,根据胥少汀[1]评分法,优16例(80%),良4例(20%).结论膝关节镜下经皮穿刺张力带钢丝固定术治疗髌骨骨折具备以下优点:固定牢固,创伤小,恢复快,复位确切,能同时探查和处理膝关节其他损伤.