目的 评价Turbohawk定向斑块切除系统联合药物涂层球囊在下肢动脉硬化闭塞症中临床应用价值。方法 对于术前超声以及下肢动脉CTA检查诊断为下肢动脉硬化闭塞症的8例患者,行Turbohawk斑块旋切以及药物涂层球囊治疗,术后行常规抗凝治疗,定期行彩超复查。结果 8例患者下肢动脉均全部再通成功,技术成功率为100%,术后缺血症状明显改善,术后平均踝肱指数为0.78±0.06,高于术前的0.31±0.12(P<0.05)。住院期间无并发症发生,随访3～18个月,患者保肢均获得成功。结论 Turbohawk定向机械旋切系统联合药物涂层球囊治疗下肢动脉硬化闭塞症,具有创伤小、疗效好以及安全性高等优点,值得临床推广使用。

Objective To evaluate clinical application of using Turbohawk atherectomy device in combination with drug-coated balloon in treatment of atreriosclerosis obliterans in lower extremity. Methods Turbohawk atherectomy device and DCB was performed in 8 patiments with atreriosclerosis obliterans in lower extremity. All patients were diagnosed by ultrasound and CTA. Routine anticoagulation drugs were used after the operation. Follow-up was carried out with color Doppler ultrasound. Results Revascularization was gained in 8 patients. The technically successful rate was 100% and ischemic symptoms relieved significantly immediately after the operation. The post-operative ankle brachinal index(ABI) was 0.78±0.06,which was higher than that of before operation(0.31±0.12). No obvious complications occurred after operation. The follow-up range was 3~18 months and limbs were salvaged successfully. Conclusion With minimal invasive, safe and few complications, Turbohawk atherectomy device in combination with drug-coated balloon is proved to be a very effective treatment atreriosclerosis obliterans in lower extremity and it is worth to popularize.

目的 研究脊柱经皮内镜椎间孔入路和椎板间入路治疗腰椎间盘突出的临床应用效果。方法 本次选取的研究对象为2016年1月—2017年12月期间在我院进行治疗的腰椎间盘突出患者,将60例患者根据红蓝球分组法分为两组,30例/组。将实施脊柱经皮内镜椎间孔入路椎间盘切除术的患者纳入PETD组,将采用椎板间入路椎间盘切除术的患者设为PEID组。将两组腰椎间盘突出患者的手术相关指标、治疗优良率、ODI评分、VAS评分进行比对。结果 观察组腰椎间盘突出患者的手术时间、C型臂透视次数同对照组相比存在差异(P＜0.05);术后卧床时间和住院时间、治疗优良率组间对比无统计学意义;两组术后三个月时的ODI评分、VAS评分均较术前更优(P<0.05)。结论 在腰椎间盘突出治疗中脊柱经皮内镜椎间孔入路、椎板间入路的效果相当,临床上需患者的实际情况和解剖特点选择适合的入路方式和手术方法。

目的 分析基于中医针灸的康复训练对小儿脑瘫的临床疗效。方法 选择我院2016年2月—2017年3月接受治疗的脑瘫患儿88例,根据患儿入院接受疗法不同分为研究组(n=45)和对照组(n=43)。对照组给予康复训练治疗,研究组给予康复训练联合中医针灸治疗。比较两组患者治疗3个月后的临床效果,以及治疗前后粗大运动功能、生活质量评分变化。结果 治疗3个月后,研究组总有效率95.56 %明显高于对照组69.76 %(P<0.05);两组患儿粗大运动功能、生活质量、认知功能及自理动作评分均有提高,但研究组以上指标评分明显高于对照组(P<0.05)。结论 基于康复训练联合针灸干预脑瘫患儿可改善患儿粗大运动功能,提高患儿生活质量,效果显著。

目的 分析无创产前基因检测(NIPT)在胎儿染色体非整倍体疾病诊断中的检出效率及临床应用价值。方法 选取2016年4月—2018年3月在我院接受无创产前基因检测的3 759例孕妇作为研究对象,利用二代测序AR550平台结合生物信息学进行无创产前基因检测,NIPT 的检测范围包括21、18、13 及性染色体非整倍体。对 NIPT 高风险的孕妇,建议行羊水或脐血穿刺染色体核型分析,比较两者结果的一致性,并随访妊娠结局。结果 3759例孕妇中NIPT提示高风险27例,阳性率为0.71%。其中24例孕妇行染色体核型分析,确诊为 21-三体14例、18-三体1例、13-三体1例和性染色体数目异常4例,阳性预测值分别为100%、50%、100%和66.7%。其中NT增厚中无创孕妇99例,检出高风险为5例,检出率为5.05%（5/99）,明显高于总体检出率。结论 NIPT 对 21-三体和 18-三体具有较高的敏感性和特异性,能提高产前筛查和诊断效率,具有较好的临床应用价值.

Objective To analyze the efficiency and clinical value of noninvasive prenatal gene test (NIPT) in the diagnosis of fetal chromosomal aneuploidy. Methods From April 2016 to March 2018, 3 759 pregnant women who underwent noninvasive prenatal gene testing in our hospital were selected as subjects. The second generation sequencing AR550 platform combined with bioinformatics was used for noninvasive prenatal gene testing. The NIPT detection ranged from 21, 18, 13 to sex chromosome aneuploidy. For pregnant women at high risk of NIPT, amniotic fluid or umbilical cord blood puncture karyotype analysis was recommended to compare the consistency of the two results, and follow-up pregnancy outcomes. Results Among 3 759 pregnant women, NIPT showed 27 cases of high risk, with a positive rate of 0.71%. Twenty-four pregnant women were diagnosed as 21-trisomy in 14 cases, 18-trisomy in 1 case, 13-trisomy in 1 case and abnormal sex chromosome number in 4 cases. The positive predictive values were 100%, 50%, 100% and 66.7% respectively. Among them, 99 cases were non-invasive pregnant women with NT thickening, and 5 cases were at high risk of detection. The detection rate was 5.05% (5/99), which was higher than the overall detection rate. Conclusion NIPT has high sensitivity and specificity to 21-trisomy and 18-trisomy, can improve the efficiency of prenatal screening and diagnosis, and has good clinical application value.

目的 探讨高黏度骨水泥在治疗骨质疏松性椎体压缩性骨折中的临床疗效分析。方法 随机选取本院2012年1月—2016年1月收治的80例骨质疏松椎体压缩性骨折患者。将患者随机分为对照组和观察组,每组各40例,均采用骨水泥联合经皮椎体后凸成形术治疗,对照组采用低黏度骨水泥,观察组采用高黏度骨水泥。采用视觉模拟量表(VAS)评分比较手术前后患者疼痛情况,Oswestry指数(Oswestry disability index,ODI)评分评估患者腰背部功能。观察并比较两组患者VAS、ODI评分,骨水泥渗漏及相关并发症情况。结果 所有患者均顺利完成手术,术后随访1年以上,期间未发生严重并发症。所有患者VAS评分,ODI评分均明显高于术前。两组均出现骨水泥渗漏及其他并发症,低黏度骨水泥组骨水泥渗漏率为66.7%,明显高于高黏度骨水泥组的33.3%,P<0.05,但均无明显神经功能损伤。结论 高黏度骨水泥在骨质疏松椎体压缩性骨折中的应用能显著改善患者临床疗效,明显降低骨水泥渗漏及并发症的发生率。

Objective To investigate the clinical effect of high viscosity bone cement for treatment of osteoporotic vertebral compression fractures. Methods From Jan. 2012 to Jan. 2016, 80 patients with osteoporosis vertebral fractures were enrolled into this study. They were randomly divided into control group and observation group, with 40 cases in each group. They were all adopted PKP methods for treating, while the observation group got the high viscosity bone cement and the control group got the low one. Clinical outcomes were assessed in terms of back pain visual analogue scale (VAS), Oswestry disability index (ODI) after surgery.The outcomes of back pain VAS score, ODI, venous leakage rate, discoidal leak rate, rate of around vertebral body, rate of contiguous vertebral fracture were compared between two groups. Results All patients were successfully completed surgery. We took postoperative follow-up more than one year, there were severe complications occurred. VAS score, ODI score were significantly higher than that of before operation. Two groups had both bone cement leakage and other complications. Low viscosity bone cement group of bone cement leakage rate was 66.7%, significantly higher than the 33.3% of the high viscosity of bone cement group, P<0.05, but no obvious neurologic injury. Conclusion The high-viscosity bone cement for osteoporotic vertebral fractures provides better clinical outcomes. It may reduce bone cement leak rate and complications.

目的 探究一次性带冲洗球囊胃管的临床应用。方法 收集来我院进行腹部外科手术的患者共200例,随机分为研究组与对照组,每组100例,其中研究组患者采用一次性带球囊胃管治疗,对照组则应用传统胃管进行治疗。观察对比2组患者进行引流的通畅情况、治愈时间、胃管滑脱及胃管相关并发症等情况。结果 研究组患者的一次置管成功率高于对照组(P＜0.05),置管停顿率和自行拔管率均低于对照组(P＜0.05);研究组低于对照组(P＜0.05);研究组患者的不良反应发生率低于对照组(P＜0.05),差异均有统计学意义。结论 一次性带冲洗球囊胃管治疗可持续冲洗胃腔及灌注药物,保证引流通畅,明显提高胃肠减压效果,促进胃黏膜的炎症水肿、糜烂出血等病症的修复愈合,并且能够提高置管效果,减少置管时间,同时避免不良反应的发生,值得临床进一步推广。

Objective To investigate the clinical value of disposable balloon catheter with irrigation. Methods In our hospital for abdominal surgery patients with a total of 200 cases were randomly divided into study group and control group, 100 cases in each group. The study group was treated by disposable balloon intubation, the control group used conventional gastric tube. Observation and comparison of two groups were taken with drainage patency, cure time, gastric tube slippage and gastric tube related complications. Results The study group of patients with a success rate of catheterization was higher than that of the control group (P<0.05), catheter pause rate and self extubation rate were lower than that of the control group (P<0.05); the study group was significantly lower than that of the control group (P<0.05); the adverse reaction of patients in the study group was significantly lower than that of the control group (P<0.05), the differences were statistically significant. Conclusion Disposable flushing balloon intubation treatment of gastric cavity perfusion and sustainable irrigation, to ensure smooth drainage, may improve the effect of gastrointestinal decompression, promote the repair of gastric mucosal inflammation and edema, erosion, bleeding and other symptoms and improve the effect of catheterization, reduce the intubation time, and avoid the occurrence of adverse reactions. It is worthy of further promotion.

目的 探讨心理干预联合补佳乐在绝经后妇女宫内节育器(IUD)取出术中的临床效果。方法 选取2012年10月—2015年9月在本站施行IUD取出术的绝经后妇女200例,随机分为观察组和对照组各100例,对照组在手术前给予口服补佳乐1 mg 每日1次 连服7天,第8天施行取出术,观察组在对照组的基础上配合心理干预,观察两组在手术过程中的疼痛程度、宫颈松弛度、心理紧张度的差异。结果 IUD取出术中疼痛程度,观察组:0级 53%,1级40.0%, 2级7.0%,3级0%;对照组:0级14.0%,1级27.00%,2级44.0%,3级15.0%。观察组患者IUD取出术中成功率、满意度分别为87%、96%,与对照组比较,两者差异均有统计学意义(P<0.05)。结论 心理干预联合补佳乐应用于绝经后IUD取出术,可有效改善生殖器的施术条件,减少受术者痛苦,安全、有效,效果满意。

目的 探讨针灸治疗在体外受精—胚胎移植技术的临床效果。方法 以2013年8月—2015年8月在顺德妇幼保健院生殖科,因不孕进入IVF/ICSI周期的108例患者为研究对象,按照随机自愿原则将其分为三组,针刺组、安慰针刺组、对照组各36例,针刺组:在移植前24小时、移植后30分钟进行相关的针刺治疗,安慰针刺组:针刺穴位与妊娠无关,对照组:不使用针刺疗法,比较三组临床效果。结果 治疗后针刺组Ⅰ型内膜血流类型及PI、RI、S/D低于治疗前,Ⅱ+Ⅲ型内膜下血流类型高于治疗前,差异有统计学意义(P＜0.05)。针刺组总有效率高于安慰针刺组、对照组,三组差异有统计学意义(P＜0.05)。针刺组种植成功率、妊娠成功率及活产率均高于安慰针刺组、对照组,三组差异有统计学意义(P＜0.05)。结论 在体外受精—胚胎移植技术中为患者实施针灸治疗可改善子宫内膜下血流情况,提高临床疗效、改善妊娠结局。

Objective To investigate clinical results of acupuncture treatment in vitro fertilization-embryo transfer technology. Methods August 2013-August 2015 reproductive and child health hospital in Shunde branch,due to infertility entering IVF/ICSI cycles of 108 patients for the study,in accordance with the principle of voluntary they were randomly divided into three groups,the acupuncture group,placebo group and control group 36 cases,respectively.Acupuncture group:24 hours before transplantation,30 minutes post-transplant treatment of infertility acupuncture.Placebo group:acupuncture and were unrelated to infertility.The control group:acupuncture was not used.We compared three groups of clinical effect. Results In the treatment of type Ⅰ endometrial blood flow in the acupuncture group type and PI,RI,S/D were significantly lower than before treatment,Ⅱ+Ⅲ,endometrial blood type under were significantly higher than before treatment.the difference was significance(P<0.05). The acupuncture group was more efficient than placebo group and the control group,the three groups was significant(P<0.05). The success rate of acupuncture group planting,the success rate of pregnancy and live birth rates were higher than placebo group and the control group,the three groups was significant differences(P<0.05). Conclusion In vitro fertilization-embryo transfer technology into the implementation of acupuncture treatment for patients can improve blood flow under the endometrium,improve clinical outcomes and improve pregnancy outcomes.

目的 探讨锥形纤维桩核与金属铸造桩核在残冠残根修复治疗中的临床效果。方法 65例患者共计69颗残冠残根经完善的根管治疗后采用锥形玻璃纤维桩树脂核和全冠修复,另外32例41颗牙经铸造桩核冠修复,观察疗效对比。结果 所有病例每年复查一次,平均随访期为2年,69颗纤维桩修复患牙未发现牙根折裂,其中66颗全冠与桩核固位稳定,无主诉不适、牙周健康、患者对修复体美学效果与咀嚼功能均感满意。3例失败病例分别为全冠、纤维桩核松动脱落各1颗,有1颗纤维桩折断,成功率为95.6%。金属铸造桩核组41颗患牙失败4例,其中根折2例,均已拔除,牙龈炎伴牙龈及修复体颈缘变色1例,改用纤维桩修复,继发龋1例,成功率为90.2%。结论 纤维桩树脂核具有美学效果好,机械性能好,无腐蚀,耐疲劳,易拆除,不易根折等优点,可替代铸造桩核作为理想的冠、残根桩核修复材料。

目的 探讨二维超声联合三维超声检测不同孕期胎儿肢体畸形的临床价值。方法 回顾性分析我科2013年1月—2015年1月超声筛查的1352名孕15~34周的孕妇,运用二维及三维超声,采用连续顺序追踪超声法检测胎儿四肢,将产前诊断结果与引产或引产结果对照。结果 1352名孕妇胎儿畸形46例(3.40%,46/1352),总涉及肢体73处(近端肢体畸形65处,远端肢体畸形8处),其中四肢短小9例(骨发育不全2例,单纯四肢短小畸形5例,成骨发育不全2例),漏诊2例;足畸形16例34处,漏诊1例,残肢畸形15例;手畸形6例,漏诊1例。结论 孕中期二维连续顺序追踪超声法联合三维超声胎儿肢体畸形检出率高,对及早发现胎儿肢体畸形有一定的诊断价值。