目的：研究创伤性胸腰椎压缩骨折（Traumatic thoracolumbar compression fracture，TTCF）患者在手术治疗期间接受经皮微创椎弓根钉内固定治疗后的效果。方法：选择我院2018年2月至2021年5月治疗的80例TTCF患者进行研究分析，将TTCF患者分为甲组（40例，开放手术治疗）与乙组（40例，经皮微创椎弓根钉内固定治疗），观察指标为手术情况、并发症情况、Cobb角、腰椎功能、疼痛指数。结果：治疗后，乙组TTCF患者手术情况优于甲组TTCF患者，P＜0.05；治疗后，乙组TTCF患者并发症发生率低于甲组TTCF患者，P＜0.05；治疗后，乙组TTCF患者Cobb角优于甲组TTCF患者，P＜0.05；治疗后，乙组TTCF患者腰椎功能优于甲组TTCF患者，P＜0.05；治疗后，乙组TTCF患者疼痛指数低于甲组TTCF患者，P＜0.05。结论：TTCF患者接受经皮微创椎弓根钉内固定治疗手术后效果十分明显，对胸腰椎组织创伤性低、安全性高，有效降低其疼痛指数，并发症发生率低，患者骨组织恢复情况更好。

目的 探讨改良"蛋壳"技术在骨质疏松性椎体压缩性骨折经皮椎体后凸成形术(PKP)患者中的应用效果.方法 将86例骨质疏松性椎体压缩骨折患者随机分为对照组(n=43)和观察组(n=43).对照组采用PKP治疗方案,观察组采用改良"蛋壳"技术的PKP治疗方案.术后7d时,比较2组手术指标、视觉模拟疼痛表(VAS)评分、Oswestry功能障碍指数问卷表(ODI)、Cobb角、椎体前缘百分比及并发症发生率.结果 2组术中出血量、手术时间及下床活动时间的差异无统计学意义(P＞0.05),但观察组骨水泥灌注量高于对照组,差异有统计学意义(P＜0.05).观察组术后7d的VAS、ODI、Cobb角均低于对照组,椎体前缘百分比高于对照组,差异有统计学意义(P＜0.05).观察组术后渗漏、感染、下肢放射痛、下肢麻木及肌力下降等并发症总发生率均低于对照组,差异有统计学意义(P＜0.05).结论 改良"蛋壳"技术具有创伤较小、疼痛较轻、并发症较少等优势,可改善骨质疏松性椎体压缩骨折行PKP患者的椎体功能.

Objective:To investigate the specific types of lateral meniscus injury in Schatzker type II tibial plateau fractures and its potential correlation with CT features of the lateral plateau.Methods:The data of 213 patients with Schatzker II tibial plateau fractures from August 2014 to June 2021 were retrospectively analyzed, including 132 males and 81 females, aged from 29 to 61 years, with an average of 44.9 years. All patients underwent arthroscopic evaluation of fracture reduction immediately after open reduction and internal fixation (ORIF). According to the actual situation during the operation, the types and locations of lateral meniscus injury were determined and the patients were divided into the meniscus injury group and non-injury group. By measuring lateral plateau depression (LPD) and lateral plateau widening (LPW) of the lateral tibial plateau on CT images, the correlation of which and lateral meniscus injury was analyzed. The optimal critical values of LPD and LPW for predicting lateral meniscus injury were obtained by drawing the relevant receiver operating characteristic (ROC) curves.Results:The meniscus injury group (109 patients) mainly showed injuries involving the mid-body and posterior horn of lateral meniscus (98.2%, 107/109) and LPD was 13.1±3.2 mm; while the LPD of 104 patients without meniscus injury was 9.1±3.0 mm with a statistical difference ( t=3.98, P<0.001). The LPW of meniscus injury group and non-injury groups was 8.0±1.3 mm and 6.7±1.6 mm, respectively, and the difference was statistically significant ( t=2.68, P=0.011). The optimal predictive critical point of LPD and LPW was 7.6 mm (sensitivity 90.3%, specificity 64.7%, area under the curve 0.834) and 7.3 mm (sensitivity 80.5%, specificity 58.8%, area under the curve 0.722). Conclusion:Schatzker II tibial plateau fractures combined with lateral meniscus injury is usually characterized by meniscus-joint capsule separation, rupture and longitudinal fracture. The mid-body and posterior horn of lateral meniscus injury is more likely to occur when LPD> 7.6 mm and/or LPW> 7.3 mm on coronal CT images.

目的 评估双Endobutton联合带线铆钉治疗RockwoodⅢ～Ⅴ型肩锁关节脱位的临床效果.方法 回顾性分析南京中医药大学附属常熟医院2015年4月至2017年12月经双Endobutton联合带线铆钉方法治疗的48例RockwoodⅢ～Ⅴ型新鲜肩锁关节脱位患者的临床资料.分别于术前及术后1、3、6、12、24个月行疼痛视觉模拟量表(VAS)评分,肩关节功能Constant评分及美国肩肘外科协会(ASES)评分.通过复查肩关节正位X射线片以测量喙锁间距(CCD)、锁骨长度(CL)、锁骨隧道距离(CTD)、双隧道夹角(CCα),并由此计算锁骨隧道比例(CTR)和喙锁间距复位率(CCD ratio).结果 本研究48例患者随访24～30个月,平均26.6个月.VAS评分从术前(5.4±1.6)分降至术后24个月的(0.3±0.2)分,差异有统计学意义(P<0.05).Constant评分和ASES评分从术前(43.6±12.4)分和(44.8±10.6)分提高至术后24个月的(96.3±3.4)分和(97.1±3.8)分,差异有统计学意义(P<0.05).CCD从术前(15.3±5.9)mm缩短至术后24个月的(8.0±0.9)mm,CCD ratio由术前的90.1％降至术后24个月的2.4％,差异均有统计学意义(P<0.05).锁骨隧道钻孔位置基本位于锁骨外侧1/5处,锁骨隧道与喙突隧道夹角平均值约为8.2°.结论 双Endobutton联合带线铆钉治疗RockwoodⅢ～Ⅴ型肩锁关节脱位能够对喙锁韧带、肩锁韧带进行解剖重建,能有效促进关节早期稳定,患者可早期活动,无需手术取出内固定物,并发症少,临床疗效良好.

目的:通过回顾性研究因肩锁关节脱位而手术治疗的43位患者,比较其在采取不同手术方式干预后的肩关节功能情况.方法:收集2015年3月至2018年3月肩锁关节脱位患者43例,根据患者手术意愿分为A组(带袢钢板加锚钉技术组)与B组(锁骨钩钢板组),其中A组患者28例,B组患者15例.比较两组性别、年龄、住院时间等一般资料,以及两组患者术前、术后6个月及术后1年B组取掉锁骨钩钢板之后的VAS评分、Constant-Murley功能评分与ASES(American Shoulder and Elbow Surgeons)功能评分.结果:两组患者术前的一般资料及术前VAS评分,Constant-Murley评分与ASES评分差异均无统计学意义(P＞0.05),术后6个月带袢钢板加锚钉技术组的VAS评分低于锁骨钩钢板组(P=0.031),Constant-Murley评分与ASES功能评分优于锁骨钩钢板组(P=0.029,0.018),而术后1年时上述评分差异均无统计学意义(P＞0.05).结论:采取带袢钢板加锚钉技术的患者术后早期肩关节功能及疼痛比采取锁骨钩钢板治疗的患者有明显好转,但在锁骨钩钢板拆除之后,两者之间的功能差异不大.锁骨钩钢板治疗的患者在拆除内固定之后,肩关节功能有较明显的改善.

跟骨骨折是最常见的跗骨骨折,多由高处跌落或挤压所致.跟骨骨折的分型方法有多种,目前临床常用的分型方式为Essex-Lopresti分型和Sanders分型.跟骨解剖结构复杂,局部软组织覆盖差,治疗比较困难且容易出现并发症,现阶段跟骨骨折的治疗仍具有一定的挑战性.传统的手术治疗方法效果较差,并发症较多.随着技术的发展,微创手术疗法已成为外科手术的发展方向.微创手术治疗跟骨骨折,既能使关节很好的复位,又可以减少并发症的发生.本文就跟骨骨折的分型和微创治疗进展进行综述,以期为临床跟骨骨折微创手术的选择提供一定的参考.

目的:探讨带线铆钉结合空心螺钉治疗后交叉韧带胫骨止点撕脱骨折的手术方法及临床疗效.方法:对18例后交叉韧带胫骨止点撕脱骨折采用取膝关节后方切口,直视下复位骨折,使用空心螺钉固定骨折块、带线铆钉重建后交叉韧带.术后使用Lysholm评分、膝关节活动度、Lachman试验及后抽屉试验评价膝关节功能恢复情况.结果:18例均获得随访,随访8～24个月,平均(14.2±3.2)个月.术后复查X线片显示所有患者骨折复位满意,骨折均顺利愈合,平均愈合时间2.5个月.Lysholm评分术前与术后分别为(52.56±7.82)分、(90.32±3.47)分,差异有统计学意义(P＜0.05);膝关节活动度术前与术后分别为(41.73±7.92)°及(125.52±3.51)°,差异有统计学意义(P＜0.05);术后Lachman试验及后抽屉试验均为阴性.结论:带线铆钉结合空心螺钉治疗后交叉韧带胫骨止点撕脱骨折的手术创伤小,固定牢固可靠,利于早期康复锻炼及功能恢复,值得临床推广.

目的:观察“三步八法”推拿术治疗腰椎间盘突出症的临床疗效.方法:自2013年1月～2016年12月,选取腰椎间盘突出症患者40例,采用数字表法随机分为两组,治疗组20例,对照组20例.治疗组采用“三步八法”推拿术治疗,对照组采用骨盆牵引治疗.记录治疗前后两组VAS评分、JOA评分及疗效评定.结果:两组治疗前后的VAS评分及JOA评分相比差异有统计学意义(P＜0.05);两组治疗后组间VAS评分、JOA评分相比差异有统计学意义(P＜0.05),治疗组优于对照组,差异有统计学意义(P＜0.05).结论:对于腰椎间盘突出症,“三步八法”推拿术比骨盆牵引能够更好地缓解疼痛等症状、改善生活质量.

Objective:To explore the clinical effect of the "eight-shaped" double incision steel plate internal fixation in the treatment of calcaneal fracture.Methods:From December 2014 to June 2016,calcaneal fractures of the proper type were treated by the "eight-shaped" double incision including calcaneal lateral longitudinal incision and anterior oblique incision,and anatomical locking steel plate internal fixation after fracture reduction.The healing of the incision was observed,and the function of the ankle was evaluated by AOFAS ankle and foot function scoring system.Results:Surgery was successfully completed in 27 cases of calcaneal fractures involving the joint surface,fracture reduction and internal fixation positions were good in all cases,and there were no postoperative incision infection,flap necrosis or other complications.26 patients were followed up for 6 months to 2 years.The AOFAS ankle and foot function scores were excellent in 15 cases,good in 9 cases,and fair in 2 cases,with a total excellent and good rate of 92.3％.Conclusions..The "eight-shaped" double incision steel plate internal fixation in the treatment of calcaneal fracture can reduce the incidence of soft tissue complications,and the clinical curative effect is satisfactory.It is especially suitable for intra-articular fractures,and is worthy of clinical promotion.

Objective To design a locking compression plate ( LCP) for fixation of periprosthetic proximal femur fractures ( PPFF ) in Chinese. Methods ( 1 ) The imaging data of 90 patients that had primary total hip arthroplasty ( THA) in Department of Orthopaedics, the Traditional Chinese Medicine of Changzhou, the Affiliated Hospital of Nanjing University of Chinese Medicine from September 2012 to December 2013 were retrospectively analyzed. The vertical distance between the edge of femur prosthesis and anterior or posterior femoral outer cortex was measured on the postoperative lateral X-rays films of hip of all cases. ( 2 ) Twenty cadaver femoral specimens were selected and their length and circumference were measured. Next to it, these specimens were implanted with femoral prosthesis stem, established the cadaveric femoral prosthesis model. Then 5 femoral prosthesis models underwent gemstone CT spectral scan and three-dimensional reconstruction. The vertical distance between the edge of femoral prosthesis stem and anterior or posterior femoral outer cortex and the length of femur for the vertical distance greater than 6 mm between the femoral prosthesis stem and femoral outer cortex were measured. The sagittal curve of femur was also assessed. ( 3 ) The LCP was digital customized according to the measured data of 90 patients and 5 femoral prosthesis models. After that, they were used to fix 5 cadaveric femur prosthesis models, and the relation of the locking screws on the LCP and the femoral prosthesis stem were observed by general view and image. The angle of locking screw which maybe contacted the femoral prosthesis was adjusted again. Then the improved LCP were used for fixing 10 cadaveric femur prosthesis models, the relation between the locking screws and the femoral prosthesis stem was evaluated. Finally, the design of the LCP was determined. Results (1)The measured data from the postoperative lateral X-rays films of hip of 90 cases were shown as follows:the average minimum and maximum vertical distance were ( 11. 26 ± 3. 58 ) mm and ( 17. 97 ± 6. 94)mm between the proximal half of the prosthesis and the outer posterior cortex of the femur, and they were (9. 18 ± 2. 32)mm and (14. 22 ± 3. 10)mm between the distal half of the prosthesis stem and the outer anterior femoral cortex respectively. ( 2 ) The average length and circumference of 20 cadaver femoral specimens were (41.67 ±0.24)cm and(9.19 ±0.74)cm respectively. The measured data from gemstone CT of femoral prosthesis models were showed as below: the average vertical distance between the proximal half of the prosthesis and the outer posterior cortex of the femur was ( 12. 36 ± 3. 24 ) mm, and it was (8. 14 ± 1. 21 )mm between the distal half of the prosthesis stem and the outer anterior femoral cortex. The length of femur was ( 69. 20 ± 4. 53 ) mm corresponding with the vertical distance over 6mm between proximal half prosthesis and femoral cortex, and that was (57. 31 ± 3. 82)mm between distal half prosthesis and femur cortex. (3)The length of the LCP corresponding to proximal half femur prosthesis was designed with 3 locking holes which can be angulated in a specific angle in posterior of the prosthesis stem, and the length corresponding to distal half femur prosthesis was designed with 3 locking holes that can be angulated in a specific angle in anterior of the prosthesis stem. The curve of LCP was consistent with the curve of the femur. All locking screws achieved double cortical fixation by appropriate angle posterior or anterior the femoral prosthesis. Conclusions Although the LCP designed according to the anatomical data of Chinese femur can obtain adequate fixed space for femoral prosthesis models, and provide a new solution for treatment of PPFF, it still needs further clinical verification.

Objective To explore the mid-term curative effect of different re-constructional ways of polyeth-ylene terephthalate ( PET) artificial ligament in treating the distal tibiofibular syndesmosis injury .Methods From Mar.2013 to Dec.2014,data of 27 cases of distal tibiofibular syndesmosis injury who were treated by re-construc-tional therapy with PET artificial ligament were retrospectively analyzed .There were 16 males and 11 females,with an average age of 35.5(22 to 47) years.Among these cases were 26 cases associated with ankle fracture and 1 case of simple tibiofibular syndesmosis injury . The bilateral suspension technique or unilateral suspension technique combined with absorbable screw fixation was adopted .Results The patients were followed up for 18-23(20.4 ± 1.3)months.After operations,X-ray films showed that the distal tibiofibular syndesmosis interspace and ankle mor-tise anatomy were normal .There was no loss of reduction within 18 months after operation .AOFAS ankle function scale was used to evaluate the curative effect ,indicating excellent in 18 cases,good in 8 cases,and fair in 1 case. Conclusion PET artificial ligament reconstruction can supply high tenacity which is needed in short -time functional recovery,and it can also recover the ankle activity earlier .The unilateral suspension technique combined with ab-sorbable screw fixation can shorten the time of surgery .

Objective To explore the effect of polyethylene terephthalate artificial ligament revascularization on the treatment of distal tibiofibular syndesmosis injury .Methods The data of 18 patients with distal tibiofibular syndesmosis injury in our hospital from March 2013 to March 2014 were retrospectively analyzed .Fourteen patients received the bilateral suspension fixed technology ,and 4 cases were fixed with unilateral suspension fixation by extrusion screw which could be absorbed .The ankle joint mobility was measured during the follow-up,which were evaluated by American orthopedic foot and ankle society ( AOFAS) .Results Eighteen patients with distal tibiofibular syndesmosis in-jury were followed up for 12~17 months,with an average of 13.5 months.Imagings showed that the tibiofibular space was normal on postop-erative X-ray films,and there was no lost in 1 year.The PET of artificial ligaments were taken out ,and the artificial ligament and bone tissue were combined with a good ligament toughness .The pathological examination revealed the fibrous tissue grew in the artificial ligaments .Ac-cording to AOFAS ankle function grading evaluation of curative effect ,11 cases were excellent ,6 cases were good ,and 1 case was not obvious . Conclusion PET artificial ligament revascularization can recover the hinge functions of tibiofibular syndesmosis for patients with early recov -ery of ankle plantar flexion range in a short time .Different ways of fixed ligament had no obvious effect on functional recovery ,however,the extrusion screw technology can shorten the time of surgery .

Objective To evaluate the relationship between the loss of kyphosis correction degree of thora-columbar fracture and injured vertebra morphology scale .Methods From Jun.2011 to Jun.2013,56 patients with thoracolumbar fracture received treatment of posterior cross segment pedicle fixation .Before and after surgery and at follow-up,Cobb angle ,vertebral compression rate and disc space height next to the injured vertebra were evaluated . All the patients were divided into 3 groups according to the scale .The loss of kyphosis correction degree and disc space height were compared among the 3 groups, and the relationship between the loss of kyphosis correction degree and injured vertebra morphology scale was analyzed . Results All the patients were followed up for 13 to 19 months,with an average of 15.5 months.The loss of kyphosis correction degree and injured vertebra morphology scale were obviously related .The correction degree loss was significantly different within the 3 groups ( P<0.05 );the loss of Cobb angle was 0.5°and the loss of vertebral compression rate was 0.6% in the mild group;the loss of Cobb angle was 2.7°and the loss of vertebral compression rate was 4.4% in the moderate group;the loss of Cobb angle was 4.1°and the loss of vertebral compression rate was 8.4% in the severe group with internal fixation bro-ken.The results indicated that patients with higher scale were more likely to develop complications with obvious loss of vetebral compression rate .Conclusion The loss of kyphosis correction degree and injured vertebra morphology scale are obviously associated ,and the scale has a great guiding significance in the treatment of thoracolumbar frac-tures.

Objective To observe the clinical effect of bridging plate fixation for the treatment of unstable acetabulum fractures. Methods The data of 12 patients with unstable acetabulum fracture who were treated by bridging plate fixation in our hospital from March 2014 to March 2015 were retrospectively analyzed.According to the OTA/AO type,8 cases were type B fracture,4 cases were type C fracture. Five patients were treated by ilioinguinal approach,4 patients recieved Stoppa approach.Through follow-up,the acetabulum fracture was eval-uated according to Matta evaluation standards,and the results was observed.Results All of 12 cases were followed up from 12 months to 16 months,with the average time of (14.1 ±2.2)months.The imaging showed that the postoperative femoral head-acetabulum matching was good,and there was no reset lost in a year.According to Matta evaluation standards,10 cases was excellent,1 case was good,1 case was in general.Conclusion The clinical curative effect of bridging plate fixation for instability of acetabulum fracture is excellent.Different approa-ches can not influence the way of functional recovery,but the time of the operation through Stoppa approach is shorter.

输尿管开口囊肿是输尿管末端先天囊性扩张性病变，临床上既往以开放手术治疗为主〔1〕。本研究旨在探讨经尿道膀胱镜下钬激光治疗老年输尿管囊肿患者的疗效。

目的:评价带袢钢板(Endobutton)联合带线锚钉(TwinFix)技术“双束”解剖重建喙锁韧带治疗RockwoodⅣ-Ⅵ型肩锁关节脱位的临床疗效.方法:回顾性分析2009年4月-2012年12月治疗的RockwoodⅣ-Ⅵ型的肩锁关节脱位72例的患者资料,其中RockwoodⅣ型38例,RockwoodⅤ型18例,RockwoodⅥ型16例;左侧57例、右侧14例,双侧1例.运用带袢钢板联合带线锚钉技术“双束”解剖重建喙锁韧带.结果:手术时间为40～65min,平均55min;术后摄片提示肩锁关节脱位复位良好;70例患者在术后获得了23～44个月的随访,平均(31.5±9)个月.Constant-Murley肩关节功能评分:术后第1周末分值平均为89.3,术后1年末分值平均为96.4,至术后3年末评分略高于术后1年末的分值,平均为98.1.67例日常活动、工作及运动正常,患肩无不适症状;5例体力劳动及上举患肢时轻度不适.无再脱位、术后肩痛、肩峰撞击等严重并发症发生.结论:采用带袢钢板联合带线锚钉技术“双束”解剖重建了锥状韧带和斜方韧带,允许患者术后早期功能锻炼,是治疗RockwoodⅣⅥ型肩锁关节脱位的多平面固定快速恢复生物学稳定性的弹性固定方法.

目的 探讨关节镜下Ethibond缝线联合Endobutton钢板固定治疗前交叉韧带下止点撕脱性骨折的可行性及近期疗效.方法 2010年7月～2012年8月对23例膝前交叉韧带下止点撕脱骨折患者行关节镜下Ethibond韧带缝线联合Endobutton带袢钢板止点重建术,男性16例,女性7例;年龄25 ～ 66岁,平均38.5岁.术中使用Ethibond缝线,横穿撕脱骨折腱骨联合区,经韧带两侧胫骨骨隧道拉到胫骨内下方,固定在胫骨前方Endobutton钢板上.结果 手术时间45～70min,平均55min.23例均随访11 ～24个月,平均17.5个月.术后6个月,所有骨折均获愈合,未出现骨折移位及膝关节不稳;Lysholm膝关节功能评分86 ～ 97分.结论 关节镜下韧带缝线联合Endobutton带袢钢板治疗膝前交叉韧带下止点撕脱骨折,操作简便,效果可靠.

目的探讨在关节镜辅助下治疗Ⅴ、Ⅵ型胫骨平台骨折并前交叉韧带(ACL)撕脱骨折的临床疗效。方法选择Ⅴ、Ⅵ型胫骨平台骨折并ACL损伤患者12例,Schatzker分型为Ⅴ型9例、Ⅵ型3例。在关节镜辅助下行胫骨平台骨折锁定钢板有限切开复位内固定术,用Ethibond聚乙烯缝线固定ACL下止点撕脱骨折。术后进行随访,并行Rasmussen膝关节功能评分。结果术后随访10～24个月,12例患者行X线复查均示骨性愈合,未出现塌陷、移位、膝关节畸形等;Rasmussen膝关节功能评分显示优4例,良6例,可2例,优良率为83.3%。结论关节镜辅助下治疗Ⅴ、Ⅵ型胫骨平台骨折并ACL下止点撕脱骨折,具有创伤小、可同时处理关节内合并伤、获得良好复位及术后功能恢复快、效果好、并发症少等优点。

Objective To explore the clinical method and efficacy of arthroscopy-assisted surgery for Schatzker type V tibial plateau fractures with double plate technique.Methods Totally 12 cases of Schatzker type V tibial plateau fractures were admitted from Dec.2010 to Jul.2011,who were treated by limited open reduction and internal fixation with double locking plate.Of the patients,there were 10 cases of traffic accidents injury and 2 cases of falling injury.The curative effectiveness was evaluated with the Rasmussen knee score.Results The follow-up period was 12-24 months,with an average of 16 months.The operation time was 90-160 minutes(mean 120 minutes).All fractures were healed after 3-5 postoperative months.No infection,deep venous thrombosis or ankylosis occurred except 1 case suffered from osteoarthritis.According to the Rasmussen knee score,6 cases had excellent results,4 good,and 2 fair.The excellent and good rate was 83.3%.Conclusion Arthroscopy-assisted double plate technique for treating Schatzker type V tibial plateau fractures has advantages of satisfactory reduction,limited operative invasion,convenience in dealing with intra-articular knee injuries,early postoperative functional exercise, quick recovery and little complications.

目的 总结右腋下小切口二尖瓣成形术的疗效,探讨微创瓣膜手术方法及相关技术.方法 回顾性分析行右腋下小切口二尖瓣成形术42例患者的临床资料,其中重度二尖瓣关闭不全38例,中度二尖瓣关闭不全4例,合并中度以上三尖瓣关闭不全24例.结果 所有患者手术均顺利完成,同期行三尖瓣成形术24例,手术切口长7.8 ～ 11.8(8.5±2.0) cm,体外循环时间42～ 105(52.5±25.8) min,主动脉阻断时间35～ 95(42.5±17.6) min,术后呼吸机辅助时间1.6～ 12.0(4.5±5.2)h,术后24 h胸腔引流量105～860(265±67) ml.术后残余轻度二尖瓣关闭不全4例,右膈神经麻痹3例,二次开胸止血5例,切口感染4例.随访2个月至5年,患者临床症状消失,活动能力明显改善,晚期死亡1例,死于心脏外原因,再发重度二尖瓣关闭不全3例,再次行换瓣手术.结论 综合应用各种二尖瓣成形术,右腋下小切口二尖瓣成形术能够取得良好的早、中期临床疗效.