<正>颈髓损伤患者急性期即早期常合并腹胀和便秘,应激性溃疡、晚期发生便失禁等消化系统并发症[1]。严重腹胀使膈肌升高,更加重了颈髓损伤患者的呼吸困难,便秘影响患者的食欲,不利于患者康复。应激性溃疡是颈髓损伤患者一种严重并发症,护理不当,造成病情加重,甚至死亡。对急性颈髓损伤患者,我院采用亚低温治疗,效果满意,为进一步推进优质化护理,我们借鉴临床护理路径应用原则,为急性颈髓损伤患者建立了临床护理路径,为患者的早日恢复起到了保障作用。
AIM To analyze the difference of different treatment methods and stuff for plerosis and curative effect of acetabular defects in revision total hip arthroplasty. METHODS Twenty hips of 18 hip revision cases with acetabular defects who were treated at the Department of Orthopaedics General Hospital of Chinese PLA from March 2002 to April 2003 were analyzed. The patients included 10 males and 8 females with the age of 38 to 72 years with and average of 54.3 years. Sixteen cases 18 hips underwent revision for the first time 2 cases 2 hips for the second time. The severity of acetabular component loosening was classified into five types according to AAOS Type Ⅰin 10 segment bone defect cases 11 hips type Ⅱ in 3 lacuna bone defect cases 3 hips type Ⅲ in 5 mixed defect cases 6 hips. Porous surface acetabular component was use in 9 hips Titanium mesh with allografts was used in 11 hips. Allografts with size 4-6 mm were used in all cases. RESULTS Eighteen patients were followed up for 3 years and 2 months averagely and all involved in the result analysis. ①All of the bone grafts was healed well and the post-operation wounds were all primary healing. ②X-ray test containing of acetabular component was good no translucent line between prothesis and donor bone bed and the bone defect had been repaired. ③The Harris score was 15-43 points before revision and 62-89 points after revision. CONCLUSION Using allografts to repair the contained acetabular defects or using Titanium mesh and compaction allograft to repair the uncontained acetabular defects provide stable condition to the allograft healing. It is verified that the morselised bone healed well the Titanium mesh is labile and the position of prosthesis is good which reaches the aim of repairing bone defect and fixing prosthesis.
患者,女,58岁,左侧下颌无痛性肿物3个月.临床检查:面部两侧不对称,左下颌体区轻度隆起,局部皮肤无潮红,皮温不高,|7牙己拔除,相应|67牙槽嵴及其颊侧前庭隆起,颊侧骨皮质压有"乒乓球"样感,压痛(+),同侧颌下颈部未触及肿大淋巴结.曲面断层片示:左下颌体区3cm×2cm边界清楚低密度影.血常规:
