Purpose: To investigate the clinical effect of percutaneous kyphoplasty (PKP) guided by computed tomography (CT) combined with the three-dimensional coordinate guidance system on the treatment of osteoporotic vertebral compression fracture (OVCF). Methods: 32 cases of OVCF in the elderly admitted to our hospital from October 2019 to March 2021 underwent CT-guided PKP combined with the three-dimensional coordinate guidance system, and 36 vertebrae were treated. The patients’ VAS pain scores (visual analog scale) and ODI (Oswestry disability index) were observed after surgery, and the paired t-test was used to compare these indexes. Results: The 36 vertebrae that were treated with CT-guided PKP combined with the three-dimensional coordinate guidance system underwent unilateral pedicle puncture according to the path planned by CT images. With the ideal position of the puncture needle and a high success rate of puncture, the puncture time was 1.2–2.6 minutes, with an average of about 1.5 minutes; the injected bone cement ranged from 3 to 5.5 mL, with an average of 4.2 mL, and there were no spinal nerve injuries or leakage of the cement in the canal. VAS score decreased from 7.65 ± 0.60 before the operation to 2.59 ± 0.28 one day after the operation (P < 0.01); ODI decreased from 62.3 ± 2.18 before the operation to 27.91 ± 1.32 after the operation (P < 0.01). Conclusion: The application of CT-guided PKP combined with the three-dimensional coordinate guidance system has the advantages of accurate puncture, short operation time, less intraoperative bleeding, and low complications. This treatment is safe, reliable, and satisfactory for patients, and is worthy of clinical promotion.

目的 探讨医用杀菌液体敷料联合湿润烧伤膏治疗Ⅱ～Ⅳ期压疮的临床疗效.方法 选取2016 年10 月至2022 年10 月汉中市铁路中心医院收治的44 例Ⅱ～Ⅳ期压疮患者作为研究对象,按照随机数表法将其随机分为观察组(22 例,47 处压疮创面)和对照组(22 例,46 处压疮创面).观察组患者采用医用杀菌液体敷料联合湿润烧伤膏药纱换药治疗,对照组患者单纯采用医用杀菌液体敷料换药治疗,对比观察两组患者治疗 60d时的临床疗效以及创面愈合时间.结果 治疗60d后,观察组患者临床疗效明显优于对照组(Z =-2·530,P = 0·011),治愈率明显高于对照组(χ2 = 6·286,P = 0·012).观察组患者创面愈合时间明显短于对照组(Z =-3·323,P＜0·001).结论 与单纯应用医用杀菌液体敷料相比,应用医用杀菌液体敷料联合湿润烧伤膏更能明显缩短Ⅱ～Ⅳ期压疮患者创面愈合时间,临床治愈率更高,疗效更显著.

目的 观察骨水泥负压封闭引流联合股后带蒂肌皮瓣移植治疗Ⅳ期坐骨结节压疮的临床疗效.方法 自2016年2月至2020年5月,汉中市铁路中心医院创伤显微骨科对收治的8例坐骨结节Ⅳ期压疮患者,均采用骨水泥股后带蒂肌皮瓣移植联合负压封闭引流技术治疗,分析患者再次感染情况、手术情况及伤口愈合时间.结果 创面经骨水泥负压封闭引流处理1～2次后行股后带蒂肌皮瓣修复,7例皮瓣成活,1例远端部分皮肤表皮坏死,面积为2.0 cm×2.5 cm,创面换药后愈合;伤口愈合时间37～79 d,1例因污染于术后79 d愈合.术后随访1年,8例患者均无再次感染及压疮发生.结论 骨水泥负压封闭引流联合股后带蒂肌皮瓣移植临床疗效可靠,是处理坐骨结节Ⅳ期压疮的有效方法.

Objective To investigate the cortical bone cement strengthening reduction combined with vertebral plasty (PVP) treatment of thoracolumbar osteoporotic fractures in patients with clinical effect.Methods 107 cases of thoracolumbar osteoporotic patients choose our hospital orthopedics 2013 to 2015 surgical treatment were retrospectively analyzed,including 59 cases of patients treated by percutaneous bone cement augmentation therapy reset Joint PVP (PVP group),48 patients taken by percutaneous kyphoplasty (PKP) treatment (PKP group).Results PVP group operative time,blood loss,bone cement,length of hospital stay were significantly higher than PKP patients and the difference was statistically significant;preoperative vertebral PKP and PVP group,middle,Cobbs trailing edge height and angle difference was not statistically significant;immediately after,6 months after the two groups of patients vertebral,middle height compared with preoperative significantly increased,Cobbs angle compared with preoperative significant reduction;vertebral immediate postoperative,6 months after PVP group was significantly higher than the value of intermediate height PKP group,Cobbs angle PVP group significantly less than the PKP group and the difference was statistically significant;preoperative,ODI index difference after 12 months PKP and PVP group between the two groups was not statistically significant;after 12 month index compared two groups of patients ODI preoperative significant reduction.Conclusion Percutaneous bone cement augmentation reset the United PVP treatment of thoracolumbar osteoporotic fractures helps restore vertebral body height,Cobbs angle,reliable outcome.

目的 分析股骨近端锁定钢板治疗股骨粗隆间骨折的手术技巧及治疗效果.方法 选择2015年10月至2016年10月我院接收的100例股骨粗隆间骨折患者为研究对象,针对患者实际情况,实施股骨近端锁定钢板治疗,分析治疗效果.结果 患者术中及术后患肢正、侧位X线资料显示骨折位置良好.手术平均时间为(73.48±8.25)min,骨折愈合平均时间为(17.54±3.41)周,患者平均出血量为(97.41±7.41)mL,所有患者均无并发症发生,治疗优良率为95.00％.结论 对股骨粗隆间骨折患者实施股骨近端锁定钢板治疗,有利于患者术后愈合,并发症发生率低,术后恢复时间短,值得在临床中进一步推广.

目的：针对创伤骨科中的骨折患者，讨论固定的方法，为日后的临床治疗提供参考与指导。方法：选择我院创伤骨科于2013年1月～2015年6月收治的骨折患者150例为研究对象，临床应用随机数表法，将150例骨折患者随机划分为3组，分别定义为A1组、A2组、A3组。对比3组患者的临床治疗效果。结果：经过临床治疗，A1组患者的临床总有效率为98．0％，A2组患者的临床总有效率为82．0％，A3组患者的临床总有效率为68．0％，3组患者比较差异有统计学意义，P＜0．05，A1组优于A2组及A3组，A2组优于A3组。结论：创伤骨科中骨折固定的治疗方法较多，临床需根据患者的临床情况，选择有效的方法实施治疗。钢板内固定治疗、髓内针固定治疗、外固定支架（架）治疗，每一种治疗方法都具有自己的特点，需对症实施，才能得到理想的治疗效果。

目的：探讨微创接骨板技术在四肢骨折患者中的临床治疗效果。方法：对照组采用常规方法治疗，观察组采用微创接骨板技术治疗，比较两组治疗效果。结果：观察组手术时间（56.2±5.6）min、手术过程中出血量（60.5±4.8）mL、手术后住院时间（8.9±2.7）d，对照组手术时间（91.2±1.9）min、手术过程中出血量（200.6±4.7）mL、手术后住院时间（8.9±2.7）d，两组比较差异均有统计学意义（ P <0.05）；观察组出现临床并发症低于对照组（ P <0.05）。结论：临床上对于四肢骨折患者治疗方法较多，但是微创接骨技术效果较好，值得推广使用。

目的 比较PFNA与锁定钢板治疗高龄股骨粗隆间骨折的临床疗效.方法 选取我院2012年5月至2014年5月收治的92例股骨粗隆骨折患者,按照随机分配的方法将其分为PFNA组和锁定钢板组,锁定钢板组60例,PFNA组32例,对每组患者的术中出血量、手术时间、术后卧床时间、骨折愈合时间进行回顾性分析,并对髋关节功能进行评分.结果 治疗后随访12～24个月,平均14.7个月,两组患者的骨折愈合时间无明显差异(P＞0.05),PFNA组的术中出血量、术后卧床时间、手术时间均明显少于锁定钢板组,两组对比差异有统计学意义(P＜0.05).对于髋关节评分,PFNA组显著高于锁定钢板组,两组对比差异有统计学意义(P＜0.05).结论 针对股骨粗隆间骨折患者,给予PFNA治疗,具有手术时间短、出血量少、术后恢复快等优点,值得临床推广应用.

目的:总结小网膜囊持续灌洗术在重症急性胰腺炎的应用体会。方法:19例患者在经过积极的ICU复苏,病情无明显减轻后,采用小网膜囊持续灌洗术。患者取半卧位,灌洗速度视引流物多少而定。待引流液清亮,体温、血象、血尿淀粉酶正常,CT复查显示胰腺病变好转可以拔管,平均8.5 d。结果:除1例患者因合并上消化道出血死亡外,其余18例均治愈。结论:应用灌洗术,操作简单、创伤小,为复苏和后期处理争取时间、创造条件,降低了胰周脓肿发生率和病死率。