目的:分析锚钉联合空心钉与切开复位钢板内固定治疗肱骨大结节骨折的效果.方法:选取2019年1月至2022年12月漳浦县医院收治的100例肱骨大结节骨折患者,随机分为对照组和观察组,各50例.对照组接受切开复位钢板内固定治疗,观察组接受锚钉联合空心钉治疗.比较两组患者的住院相关指标、肩关节功能疗效、骨折愈合时间、并发症发生情况.结果:观察组患者术中出血量少于对照组,手术时间、住院时间、骨折愈合时间短于对照组,差异具有统计学意义(P＜0.05).观察组患者肩关节功能疗效优良率高于对照组,差异具有统计学意义(P＜0.05).两组患者并发症发生率比较,差异无统计学意义(P＞0.05).结论:在对肱骨大结节骨折患者进行治疗时,相比于切开复位钢板内固定治疗,采用锚钉联合空心钉治疗不仅术中出血量少、手术操作时间短,而且能显著缩短骨折愈合时间,改善肩关节功能.

Objective To compare the effects of different doses of clopidogrel on the clinical treatment of elderly patients with coronary heart disease (CHD) complicated with chronic nephropathy (CHN), and to provide a reference for the choice of therapeutic regimen in the future. Method 60 elderly patients with coronary heart disease complicated with chronic nephropathy were selected. It was divided into 75 mg/d group and 50 mg/d group by convenient sampling. 30 cases of 75 mg/d group were treated with clopidogrel 75 mg/d and 50 mg/d group were treated with imported clopidogrel 50 mg/d. Incidence of adverse cardiovascular events and adverse reactions. Results In the 50 mg/d group, 11 cases were effective, 15 cases were effective, 4 cases were ineffective. In the group of 86. 67;75 mg/d, the total effective rate was 13 cases, 14 cases effective, 3 cases ineffective, and the total effective rate was 90. 0％, there was no significant difference between the two groups in clinical efficacy (P>0. 05). There were no statistically significant differences in MACE 1, rash and thrombocytopenia in the group of 50 mg/d. The incidence of adverse reactions was 10. 0％ MACE 2, rash and thrombocytopenia during the treatment period of 75 mg/d group, 1 case of rashes, 1 case of thrombocytopenia, 1 case of rashes and 1 case of thrombocytopenia. There was no significant difference in the incidence of adverse reactions between the two groups (P>0. 05). Conclusion There is no significant difference in the clinical efficacy and incidence of adverse reactions between clopidogrel and low-subject clopidogrel in the treatment of elderly patients with coronary heart disease and chronic nephropathy.

目的 分析冠心病慢性心力衰竭患者行经皮冠状动脉介入术(PCI)治疗的疗效.方法 123例冠心病慢性心力衰竭手术患者作为观察对象,均接受PCI治疗,根据手术入路方式不同分为经股动脉入路组(65例)和经桡动脉入路组(58例).对比两组患者术后的美国纽约心脏病学会(NYHA)心功能分级、心功能指标[左室射血分数(LVEF),左室短轴缩短分数(FS)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]及并发症发生情况.结果 术后6个月,经股动脉入路组患者的LVEF、FS、LVEDD、LVESD、NYHA心功能分级分别为(53.8±5.9)％、(26.2±2.9)％、(5.0±0.5)mm、(4.1±0.7)mm、(1.4±0.6)级,经桡动脉入路组患者的LVEF、FS、LVEDD、LVESD、NYHA心功能分级分别为(54.1±6.1)％、(26.1±2.8)％、(5.1±0.4)mm、(4.2±0.5)mm、(1.2±0.5)级,两组LVEF、FS、LVEDD、LVESD、NYHA心功能分级比较,差异均无统计学意义(P>0.05).经桡动脉入路组患者的穿刺部位并发症发生率为15.52％、术后并发症发生率为0,均低于经股动脉入路组的30.77％、76.92％,差异均具有统计学意义(P<0.05).结论 经桡动脉入路与经股动脉入路PCI治疗冠心病慢性心力衰竭血管重建效果均较好,但经桡动脉入路并发症更少.

目的:探讨超敏C反应蛋白(hs-CRP)与急性心力衰竭患者预后之间的关系,为今后的临床诊疗工作提供参考.方法:选取阳江市人民医院2016年1月至2016年12月收治的136例急性心力衰竭患者作为观察对象,所有患者入院后均行hs-CRP检测,并根据检测结果将其分为正常组(57例)与异常组(79例),所有患者均给予常规治疗,治疗1个月后比较两组患者的临床总有效率、脑钠肽(BNP)、hs-CRP以及左室舒张末期内径(LVEDD)和左室射血分数(EF).结果:(1)治疗后,正常组中显效21例、有效29例、无效7例,总有效率为87.71％;异常组中显效17例、有效39例、无效23例,总有效率为70.89％;正常组明显高于异常组,差异具有统计学意义(P＜0.05).(2)治疗后,正常组的BNP、EF水平均明显高于异常组,组间比较,差异具有统计学意义(P＜0.05);正常组hs-CRP及LVEED水平均明显低于异常组,组间比较,差异具有统计学意义(P＜0.05).结论:hs-CRP水平异常的急性心力衰竭患者与预后密切相关,其临床治疗效果与预后明显低于正常水平患者.

先天性马蹄内翻足是一种常见的先天畸形.足部畸形包括前足内收、踝关节下垂和跟骨内翻,严重者伴有高弓足或胫骨内旋.