内镜逆行阑尾炎治疗术与腹腔镜阑尾切除术治疗急性化脓性阑尾炎的疗效对比

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目的 对比内镜逆行阑尾炎治疗术(ERAT)与腹腔镜阑尾切除术(LA)治疗急性化脓性阑尾炎(ASA)的效果。方法 按随机数字表法将2022年7月-2025年12月本院收治的106例SAS患者分为对照组(LA治疗)及观察组(ERAT治疗),各53例。比较两组围手术期指标、术后恢复指标、炎症因子水平[C反应蛋白(CRP)、白介素-6(IL-6)、降钙素原(PCT)]、疼痛介质水平[P物质(SP)、前列腺素E2(PGE2)、5-羟色胺(5-HT)]、免疫功能、胃肠激素[胃泌素(GAS)、血管活性肠肽(VIP)、胃动素(MTL)]、并发症、复发率。结果 观察组较对照组术中出血量更少,手术、住院时间与肛门排气、首次下床活动、体温复常及术后进食时间更短,并发症发生率更低;术后48h的CRP、IL-6、PCT、SP、PGE2、5-HT及VIP水平更低,CD3+、CD4+、CD4+/CD8+与GAS、MTL水平更高,有统计学差异(P<0.05);术后3个月内,两组均无1例复发。结论 与LA治疗ASA相比,ERAT具有创伤小、恢复快、炎症反应轻、并发症少等优势,且对免疫功能、胃肠功能影响小等优势,值得临床借鉴。

活动与固定平台单髁置换早期疗效对比分析

Comparative Analysis of Early Clinical Efficacy Between Mobile-Bearing and Fixed-Bearing Unicompartmental Knee Arthroplasty

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摘要 目的 分析固定(FB)和活动平台(MB)单髁置换术(UKA)在膝关节内侧间室骨关节炎早期阶段的临床效果与影像学差异,以指导临床假体选择。 方法 本研究回顾性纳入41例确诊为单侧膝关节内侧间室骨关节炎的患者,按照假体类型分为两组:FB组(20例,使用春立XG假体)和MB组(21例,使用春立XK假体)。分别在术前、术后及随访终点统计膝关节屈伸活动范围(ROM)、VAS 疼痛评分、美国特种外科医院膝关节评分(HSS );测量并比较股胫角(FTA)、胫骨假体内外翻角(TCVA)、胫骨假体后倾角(TCPSA);记录围手术期指标及并发症情况。 结果 两组患者术后ROM、VAS、HSS 评分均较术前显著改善(P均<0.0001);末次随访时固定平台组 VAS 评分显著低于活动平台组(P<0.05),而两组间的ROM、HSS 评分无统计学差异(均 P>0.05)。两组术后 FTA、TCVA、TCPSA 均恢复至理想范围,组间均无统计学差异(均 P>0.05)。固定平台组手术时间更短(P<0.05),两组均无严重并发症,假体生存率均为 100%。 结论 活动平台与固定平台单髁置换术均可显著改善膝关节内侧间室骨关节炎患者疼痛、活动度及功能,下肢力线恢复效果相当;固定平台假体在疼痛控制与手术便捷性方面更具优势,临床可根据患者情况与术者经验个体化选择。 关键词 单髁置换术;活动平台假体;固定平台假体;骨关节炎;并发症
Abstract Objective To investigate the early clinical outcomes and radiological differences between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA), and to provide evidence for clinical prosthesis selection. Methods Clinical data of 41 patients with unilateral medial compartment knee OA were retrospectively analyzed. The FB group comprised 20 patients (using Chunli XG prosthesis), and the MB group comprised 21 patients (using Chunli XK prosthesis). Knee range of motion (ROM), Visual Analogue Scale (VAS) pain score, and Hospital for Special Surgery (HSS) knee score were compared between the two groups preoperatively, postoperatively, and at the final follow-up. Femorotibial angle (FTA), tibial component valgus angle (TCVA), and tibial component posterior slope angle (TCPSA) were measured and compared. Perioperative indicators and complications were recorded. Results Postoperative ROM, VAS, and HSS scores significantly improved compared with preoperative values in both groups (all P < 0.0001). At the final follow-up, the VAS score in the FB group was significantly lower than that in the MB group (P < 0.05), while no significant differences were observed in ROM or HSS scores between the two groups (all P > 0.05). Postoperative FTA, TCVA, and TCPSA values returned to the ideal range in both groups, with no significant intergroup differences (all P > 0.05). The FB group had a significantly shorter operative time (P < 0.05). No severe complications occurred in either group, and the prosthesis survival rate was 100% in both groups. Conclusion Both FB-UKA and MB-UKA significantly improve pain, range of motion, and function in patients with medial compartment knee OA, with comparable efficacy in restoring lower limb alignment. The FB prosthesis offers advantages in pain control and surgical convenience. Clinical selection may be individualized based on patient characteristics and surgeon experience. Keywords Unicompartmental knee arthroplasty; Mobile-bearing prosthesis; Fixed-bearing prosthesis; Osteoarthritis; Complications

活动与固定平台单髁置换早期疗效对比分析

Comparative Analysis of Early Clinical Efficacy Between Mobile-Bearing and Fixed-Bearing Unicompartmental Knee Arthroplasty

:-
 
目的 探讨固定平台(FB)与活动平台(MB)单髁置换术(UKA)治疗膝关节内侧间室骨关节炎(OA)的早期临床疗效及影像学差异,为临床假体选择提供依据。 方法 回顾性分析41 例单侧膝关节内侧间室骨关节炎患者临床资料,其中 FB 组 20例(采用春立XG假体),MB 组 21 例(采用春立XK假体)。比较两组患者术前、术后和末次随访的膝关节活动度(ROM)、疼痛视觉模拟评分(VAS)、美国特种外科医院膝关节评分(HSS);测量并比较股胫角(FTA)、胫骨假体内外翻角(TCVA)、胫骨假体后倾角(TCPSA);记录围手术期指标及并发症情况。 结果 两组患者术后ROM、VAS、HSS 评分均较术前显著改善(P均<0.0001);末次随访时固定平台组 VAS 评分显著低于活动平台组(P<0.05),ROM、HSS 评分两组差异无统计学意义(均 P>0.05)。两组术后 FTA、TCVA、TCPSA 均恢复至理想范围,组间差异均无统计学意义(均 P>0.05)。固定平台组手术时间更短(P<0.05),两组均无严重并发症,假体生存率均为 100%。 结论 固定平台与活动平台单髁置换术均可显著改善膝关节内侧间室骨关节炎患者疼痛、活动度及功能,下肢力线恢复效果相当;固定平台假体在疼痛控制与手术便捷性方面更具优势,临床可根据患者情况与术者经验个体化选择。 关键词 单髁置换术;活动平台假体;固定平台假体;骨关节炎;并发症
Abstract Objective To investigate the early clinical outcomes and radiological differences between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA), and to provide evidence for clinical prosthesis selection. Methods Clinical data of 41 patients with unilateral medial compartment knee OA were retrospectively analyzed. The FB group comprised 20 patients (using Chunli XG prosthesis), and the MB group comprised 21 patients (using Chunli XK prosthesis). Knee range of motion (ROM), Visual Analogue Scale (VAS) pain score, and Hospital for Special Surgery (HSS) knee score were compared between the two groups preoperatively, postoperatively, and at the final follow-up. Femorotibial angle (FTA), tibial component valgus angle (TCVA), and tibial component posterior slope angle (TCPSA) were measured and compared. Perioperative indicators and complications were recorded. Results Postoperative ROM, VAS, and HSS scores significantly improved compared with preoperative values in both groups (all P < 0.0001). At the final follow-up, the VAS score in the FB group was significantly lower than that in the MB group (P < 0.05), while no significant differences were observed in ROM or HSS scores between the two groups (all P > 0.05). Postoperative FTA, TCVA, and TCPSA values returned to the ideal range in both groups, with no significant intergroup differences (all P > 0.05). The FB group had a significantly shorter operative time (P < 0.05). No severe complications occurred in either group, and the prosthesis survival rate was 100% in both groups. Conclusion Both FB-UKA and MB-UKA significantly improve pain, range of motion, and function in patients with medial compartment knee OA, with comparable efficacy in restoring lower limb alignment. The FB prosthesis offers advantages in pain control and surgical convenience. Clinical selection may be individualized based on patient characteristics and surgeon experience. Keywords Unicompartmental knee arthroplasty; Mobile-bearing prosthesis; Fixed-bearing prosthesis; Osteoarthritis; Complications
论著

微波消融联合泡沫硬化术与射频消融联合泡沫硬化术治疗下肢静脉曲张的疗效对比

Clinical effects comparison between microwave ablation combined with foam sclerosis and radiofrequency ablation combined with foam sclerosis in treating varicose veins of lower extremity

:33-37
 
目的 探究腔内微波消融(EMA)联合泡沫硬化剂治疗与腔内射频消融(RFA)联合泡沫硬化剂治疗下肢静脉曲张的临床疗效和并发症情况。方法 回顾性选择收集106例下肢静脉曲张患者的临床资料,其中54例患者(观察组)接受EMA联合泡沫硬化剂治疗,52例患者(对照组)接受RFA联合泡沫硬化剂治疗。比较2组患者相关临床指标及并发症发生情况。结果 观察组手术时间(34.92±2.35)min,对照组手术时间(46.33±2.71)min,观察组手术时间较短,差异有统计学意义(P<0.05),其余手术参数差异不明显(P>0.05)。观察组的住院费用(21 063.74±850.47)元,对照组住院费用(23 312.40±1 035.86)元,观察组住院费用较低,有统计学差异(P<0.05)。2组间并发症发生率、总有效率和总满意度均无显著差异。对比2组患者手术前和手术治疗后1年的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分,组间对比没有统计学差异(P>0.05);而在患者手术1年之后的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分均呈现出明显的下降趋势(P<0.05)。结论 微波消融是有效治疗下肢静脉曲张的术式,与射频消融比较,具有同样良好的短期效果;微波消融所需的手术时间较短且费用较低。
Objective To compare the clinical efficacy and complications between endovascular microwave ablation (EMA) combined with foam sclerotherapy and radiofrequency ablation (RFA) combined with foam sclerotherapy in patients with varicose veins of lower extremity. Methods A total of 106 patients with varicose veins of lower extremity were included in the retrospective study.Among them, 54 patients (observation group) were treated with EMA combined with foam sclerotherapy, and 52 patients (control group) were treated with RFA combined with foam sclerotherapy.The related clinical indexes and complications between the two groups were compared. Results The observation group had a shorter procedure time than the control group (34.92±2.35 minutes vs 46.33±2.71 minutes, P<0.05), and no significant differences were observed in the other procedure parameters.The hospitalization cost was (21063.74±850.47) yuan for the observation group and (23312.40±1035.86) yuan for the control group, and the hospitalization cost of the observation group was lower(P<0.05).No significant differences were found in the total effective rate,total satisfaction and complication rate between the two groups.Comparison of venous clinical severity score (VCSS) and Aberdeen varicose vein questionnaire (AVVQ) scores before and one year after operation between the two groups showed no statistical differences (P>0.05). While the VCSS and AVVQ scores of the patients showed a significant downward trend one year after operation (P<0.05). Conclusions Microwave ablation is an effective treatment for varicose veins in the lower extremity, which has the same good short-term effect as radiofrequency ablation. Microwave ablation requires a shorter operation time and less cost.
临床诊疗

iRoot BP Plus和氢氧化钙用于年轻恒前牙活髓切断术的疗效对比

:92-95
 
目的 分析年轻恒前牙活髓切断术中iRoot BP Plus和氢氧化钙的应用价值。方法 分析我院收治的年轻恒前牙活髓切断术治疗患者临床数据,对60例患者分组治疗,对照组使用氢氧化钙作为盖髓剂,研究组使用iRoot BP Plus作为盖髓剂,对比治疗相关数据。结果 研究组患者手术时间、术后肿胀时间以及疼痛时间较对照组更短(P<0.05);两组患者语言功能、咀嚼功能评分比较差异无统计学意义(P>0.05),而研究组患者固定、舒适以及美观程度评分较对照组更高(P<0.05);研究组治疗成功率为95.12%,略高于对照组成功率的79.55%(P<0.05)。结论 对接受年轻恒前牙活髓切断术治疗的患者采用iRoot BP Plus作为盖髓剂能够取得更为理想的效果,不仅可以有效改善患者牙齿功能,提升美观度,还能够减少操作时间,且成功率更高,可作为主要治疗方案纳入考量。
临床诊疗

电视胸腔镜手术与传统开胸手术在胸腺瘤治疗中的临床疗效对比

:114-116
 
目的 对比分析电视胸腔镜手术与传统开胸手术在胸腺瘤治疗中的临床疗效。方法 将我院2018年11月—2020年11月间收治的92例胸腺瘤患者作为本次实验案例,根据随机双盲原则进行分组,其中对照组46例患者采用传统开胸手术治疗,观察组46例患者采用电视胸腔镜手术治疗,对于2组患者治疗中的临床疗效进行对比分析。结果 观察组术后的肺功能指标下降幅度小于对照组,且观察组的手术时间、胸管引流时间、下床活动时间、住院时间均短于对照组,出血量、引流量低于对照组,切口长度小于对照组,组间指标数据存在统计学差异(P<0.05)。结论 电视胸腔镜手术与传统开胸手术在胸腺瘤治疗中的临床疗效相比,前者创伤小、恢复快、对于患者肺功能的影响更小,具有明显的优势。
临床诊疗

电视胸腔镜手术与传统开胸手术在胸腺瘤治疗中的临床疗效对比分析

Comparative analysis of the clinical efficacy of video-assisted thoracoscopic surgery and traditional thoracotomy for thymoma

:131-133
 
目的 对比分析电视胸腔镜手术与传统开胸手术在胸腺瘤治疗中的临床疗效。方法 将我院2018年11月—2020年11月间收治的92例胸腺瘤患者作为本次实验案例,根据随机双盲原则进行分组,其中对照组46例患者采用传统开胸手术治疗,观察组46例患者采用电视胸腔镜手术治疗,对于2组患者治疗中的临床疗效进行对比分析。结果 观察组术后的肺功能指标下降幅度小于对照组,且观察组的手术时间、胸管引流时间、下床活动时间、住院时间均短于对照组,出血量、引流量低于对照组,切口长度小于对照组,P<0.05,组间指标数据存在统计学差异。结论 电视胸腔镜手术与传统开胸手术在胸腺瘤治疗中的临床疗效相比,前者具有明显的优势,创伤小、恢复快、对于患者肺功能的影响更小。
论著

镇痛活络酊和外用非甾体抗炎药治疗肱骨外上髁炎的短期疗效对比研究

Short-term effects comparison between analgesic tincture and topical nonsteroidal anti-inflammatory drugs in the treatment of lateral epicondylitis

:123-129
 
目的 对比中成药镇痛活络酊和非甾体抗炎药(Nonsteroidal Anti-inflammatory Drugs,NSAIDs)治疗肱骨外上髁炎(lateral epicondylitis,LE)的短期临床疗效差异。方法 筛选后符合纳入标准的LE患者60例,随机分为镇痛活络酊组(n=30)和NSAIDs组(n=30)。镇痛活络酊组外用镇痛活络酊,NSAIDs组外用法斯通凝胶(酮洛芬),两组均连续用药3周,3次/d。用药后3 周、6 周和12 周连续随访,主要观测指标包括视觉模拟评分(visual analog scale,VAS);肩、肘和手的功能评分(Disabilities of the arm, Shoulder And Hand,DASH);无痛握力(Pain-free grip strength,PFGS)。VAS评分分别测量患者1周前用力活动时的VAS评分和正常休息时的VAS评分,记为VAS(活动时)和VAS(休息时)。运用统计学方法对比分析两组患者在VAS评分(活动时)、VAS评分(休息时)、DASH评分和PFGS上的差异。结果 两组患者在VAS评分(活动时)、VAS评分(休息时)和DASH评分上均未见组间差异(P>0.05)。两组患者在用药前、用药后3周、用药后6周的PGFS对比同样无组间差异(P=0.91,P=0.42,P=0.13)。但是,在用药后12周,镇痛活络酊组的PFGS高于NSAIDs组(P=0.02)。结论 镇痛活络酊缓解LE疼痛的效果与外用NSAIDs相当,对提升伸肌力效果则更优。
Objective To compare the short-term clinical effects difference between analgesic tincture and topical nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of lateral epicondylitis (LE). Methods 60 cases of LE patients were randomly divided into an analgesic tincture group (n=30) and a NSAIDs group (n=30). Analgesic tincture was chosen for the analgesic tincture group and topical ketoprofen gel for the NSAIDs group to treat LE. Two groups were treated continuously for 3w, 3 times/day. Clinical results of each drug were followed-up at the time point of 3w, 6w and 12w after usage. Observational indexes included the visual analogue scale (VAS), disabilities of the arm, shoulder and hand questionnaire (DASH) and pain-free grip strength (PFGS). The inter-group difference of VAS (at activity), VAS (at rest), DASH score and PFGS were compared subsequently. Results No difference of the VAS (at activity), VAS (at rest), DASH score were ascertained (P> 0.05) between groups. Inter-group difference of PGFS was also not discerned at the time points of pre-treatment and 3 weeks and 6 weeks (P=0.91, P=0.42, P=0.13) post-treatment. However, PFGS of the analgesic tincture group was found to be higher than that of the NSAIDs group (P=0.02) after 12 weeks post-treatment. Conclusion Effect of analgesic tincture in releasing pain is almost the same to that of tropical NSAIDs, but a better effect in improving muscle strength.
临床诊疗

不同血运重建策略对急性心肌梗死合并多支血管病变患者的疗效对比

Comparison of the effects of different revascularization strategies on patients with acute myocardial infarction complicated with multi-vessel disease

:80-83
 
目的 分析与比较不同血运重建策略对急性心肌梗死合并多支血管病变患者的疗效,以探讨其临床价值。方法 选取本院在2012年8月—2015年8月期间收治的急性心肌梗死合并多支血管病变患者,对每个患者均成功行PCI后,按随机数字表法分为实验组与对照组,实验组于发病后7~10天行预防性急诊PCI,并对非梗死相关血管病变进行干预;对照组则根据患者的缺血情况对非梗死相关血管病变行急诊PCI。随访2年,并记录2组患者主要心脏不良事件、其它心血管事件以及再次急诊PCI情况。结果 共有450例患者完成2年的随访,实验组患者有226例,对照组患者有224例。2组患者的全因病死率(χ2=7.040,P=0.008)、心脏不良事件(P均>0.05)以及心力衰竭发生率(χ2=1. 527,P=0.217)均无统计学差异。与对照组相比,实验组再发心绞痛(χ2=21.092,P<0.001)、心因性再住院(χ2=22.893,P<0.001)和再次支架治疗(χ2=17.835,P<0.001)的发生率均明显较低,而其相关血管血运重建率较高。且实验组随访2年时,β受体阻滞剂(χ2=7.040,P=0.008)和硝酸酯类药物(χ2=63.889,P<0.001)服用率均明显较高。结论 急性心肌梗死合并多支血管病变患者在成功行急诊干预梗死相关血管后,且预防性干预非梗死相关血管,可使再发心绞痛、再次支架治疗以及心因性再住院的发生率显著降低。
Objective By analyzing and comparing the effects of different revascularization strategies on patients with acute myocardial infarction complicated with multi-vessel disease, to explore its clinical value.Methods Selecting the patients with acute myocardial infarction complicated with multi-vessel disease from August, 2012 to August, 2015 in our hospital (Zhaoqing No.2 People's Hospital), after each patient was successfully treated with PCI, divided them into experimental group and control group by random number table method, the experimental groups were treated with preventive emergency PCI after the onset 7-10 days, and the intervention of non-infarct-related vascular diseases were done;the control groups were treated with emergency PCI for the non-infarct-related vascular diseases according to the patient's lack of blood. Visiting them randomly for 2 years, the main cardiac adverse events, other cardiovascular events and one more emergency PCI situation in the two groups were recorded.Results A total of 450 patients completed two years of follow-up, with 226 patients in the experimental group and 224 patients in the control group. All-cause mortality (χ2=7.040,P=0.008), cardiac adverse events (P> 0.05)and incidence of heart failure (χ2=1. 527,P=0.217) were no statistically significant difference between the two groups. Compared with the control group, the incidence of angina pectoris (χ2=21.092,P<0.001), cardiologic rehospitalization (χ2=22.893,P<0.001)and one more stent treatment (χ2=17.835,P<0.001) of the experimental group was significantly lower, but the revascularization rate was higher of their related blood vessels. And when the experimental group was followed up for 2 years, the taking rate of β-blockers (χ2=7.040,P=0.008) and nitrates (χ2=63.889,P<0.001) was significantly higher.Conclusion After the patients with acute myocardial infarction complicated with multi-vessel disease were successfully treated with emergency PCI to intervene the infarct-related blood vessels, and at the same time the intervention of the non-infarct-related blood vessels were done, the recurrence of angina pectoris, stent treatment and cardiopulmonary rehospitalization was significantly reduced.
论著

双柏散与喜疗妥软膏治疗PICC相关性静脉炎的临床疗效对比

Comparision of clinical efficacy in the treatment of phlebitis correlation with peripherally inserted central catheter(PICC) between Shuangbai Powder and Hirudoid cream

:42-44
 
目的 探讨双柏散与喜疗妥软膏治疗经外周静脉穿刺置入中心静脉导管(PICC)相关性静脉炎的临床疗效对比。方法 选取PICC相关性静脉炎患者80例,随机分为观察组和对照组各40例,观察组采用双柏散水蜜制剂外敷,对照组采用喜疗妥软膏外涂,观察2组临床疗效。结果 观察组显效率87.5%,总有效率97.5%;对照组显效率65%,总有效率80%。观察组显效率和总有效率均高于对照组(P<0.05)。两组在治疗后各时点疼痛评分均低于治疗前(P<0.01);对照组在治疗24h后各治疗时点疼痛评分均低于治疗前,差异有显著性意义(P<0.01),但在12 h治疗时点疼痛评分虽亦低于治疗前,但差异无显著性意义(P>0.05)。观察组患者在治疗后12 h、24 h、36 h和48 h时点的静脉炎疼痛评分均低于对照组,差异有显著性意义(P<0.01或P<0.05),而在72 h时点两组疼痛评分差异无显著性意义(P>0.05)。结论 本研究结果表明双柏散外敷治疗PICC相关性静脉炎效果优于喜疗妥组,且疼痛症状改善时间更早。
Objective To compare clinical efficacy in the treatment of phlebitis correlation with peripherally inserted central catheter (PICC) between Shuangbai Powder and Hirudoid cream. Methods 80 patients with PICC correlation phlebitis were randomly divided into observation group and control group. There were 40 cases in the observation group treated with Shuangbai Powder and 40 cases in the control group treated with Hirudoid cream. We observed clinical curative effect of two groups. Results The efficiency rate was 87.5% and total effective rate was 97.5% in the observation group. The efficiency rate was 65% and total effective rate was 80% in the control group. The difference of the efficiency rate and total effective rate between observation group and control group was significance (P<0.05). The pain scores were lower in observation group after treatment than it was before(P<0.01);The pain scores were lower in control group after 24 hours treatment than it was before(P<0.01);The pain scores after 12 hours of treatment lower than before, but there was no significant difference(P>0.05). The pain scores after 12 hours,24 hours,36 hours and 48 hours of treatment in observation group were lower than control group(P<0.01 or P<0.05),but there was no significant difference in the pain score of both groups after 72 hours of treatment(P>0.05). Conclusion The clinical efficacy in the treatment of phlebitis correlation with peripherally inserted central catheter (PICC) by Shuangbai Powder is better than Hirudoid cream, and the time of pain relief in the group treated by Shuangbai Power is earlier than it treated by Hirudoid cream.
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