目的:探讨与研究显微内窥镜椎间盘切除术(microendoscopic discectomy,MED)治疗腰椎间盘突出症的特点及易出现的并发症情况.方法:2017年1月到2020年2月选择在空军第九八六医院诊治的椎间盘突出症患者72例,根据治疗方法把患者分为MED组与对照组,各36例,MED组给予MED手术治疗,对照组给予开放手术治疗,记录两组术后并发症发生情况.结果:MED组术后6个月的优良率为97.2％,显著高于对照组的77.8 ％(P＜0.05).两组术后1个月、术后6个月的日本骨科协会(Japanese orthopaedic association,JOA)评分高于术前,MED组高于对照组(P＜0.05).两组术后1个月、术后6个月的视觉模拟评分法(visual analogue scale,VAS)评分低于术前,MED组低于对照组(P＜0.05).MED组术后6个月的髓核组织残留、神经根损伤、硬脊膜破裂、脑脊液漏等并发症发生率为5.6％,显著低于对照组的33.3 ％(P＜0.05).结论:MED治疗腰椎间盘突出症能改善患者的腰椎功能,缓解患者疼痛,提高总体治疗优良率,减少术后并发症的发生.

Objective:To provide anatomic basis for clinical application of island flap pedicled with neurovascular of medial view of the leg.Methods:The origins,courses,branches,distributions,anastomosis and outer diameters of the arteries adjacent to the great saphenous vein and saphenous nerve were investigated on 36 sides of adult lower extremity specimens injected with red latex and 10 sides with ink.Casting specimens of arteries of the leg and foot on 8 sides were obseerved.Results:The accompanying arteries were found going along the great saphenous vein and saphenous nerve to nourish the skin through venocutaneous and neurocutaneous perforators.In each case,either a long artery or a chain linked system of arteries hitchhiked with the nerve and vein.Conclusions:The great saphenous venoadipofascial pedicled with fasciocutaneous flap and the saphenous veno neuroadipofascial pedicled fasciocutaneous flap have been developed for various reconstructions of the leg with proximal and distal bases.

Objective To detect content variety of IL-1 in blood(s erum、supernate) and join t synovial fluid of experimental animals. Methods Thirty animals were randomly divided into Ⅰ experimental group and Ⅱ control group.IL-1 level in blood and jo int synovial fluid from both group animals were determined. Results IL-1 content of both blood (serum supernate) and synovial fluid in group Ⅰ were much higher than that in group Ⅱ.There were obvious differences between two groups. Conclusion The higher IL-1 level indicates more serious OA deve lopment. There exists remarkable positive correlation.

伸膝装置断裂缺损较为少见,常易漏诊,而成为陈旧性,给以后的治疗带来困难.随着工农业及交通运输业的迅速发展,膝部创伤所致的伸膝装置断裂缺损发病率逐渐提高.为提高伸膝装置断裂缺损的修复疗效,自1988年以来,我们在解剖学研究的基础上,设计带血管蒂缝匠肌瓣转位,修复伸膝装置断裂缺损,重建伸膝功能11例[1].经随访2.5～6年,效果满意,报道如下.

目的:报道以膝上内侧血管为蒂大收肌腱转位重建膝关节韧带断裂缺损的应用解剖及术式设计.方法:40侧经动脉灌注红色乳胶成人标本,解剖观测大收肌腱的形态及其血供,2侧新鲜下肢标本模拟手术设计.以膝上内侧血管为蒂大收肌腱转位修复膝关节韧带断裂缺损.结果:应用带血供大收肌腱转位修复胫侧副韧带30例,胫侧副韧带和前交叉韧带8例,胫侧副韧带和后交叉韧带4例,多韧带损伤1例,经随访疗效较为满意.结论:大收肌腱与膝关节毗邻,与膝关节韧带形态近似,以膝上内侧血管为蒂转位修复重建胫侧副韧带尤为理想.