目的 探讨腔镜下双平面假体植入乳房重建术在乳腺癌患者乳房重建中的临床价值。方法 回顾性分析2023年1月至2025年1月于我院行手术治疗的126例乳腺癌患者病例资料，根据术中乳房重建方式分为两组，将采用胸肌前假体植入乳房重建的63例患者纳入对照组，采用腔镜下双平面假体植入乳房重建的63例患者纳入研究组。比较两组围手术期指标、患侧乳房体积、创面瘢痕[温哥华瘢痕量表（VSS）评分]、乳房美观度、生活质量[中文版乳腺癌患者生命质量测定量表（FACT-B）评分]及并发症情况。结果 研究组手术时间长于对照组，术中出血量高于对照组（P＜0.05）。两组术后引流量、住院天数比较无显著差异（P＞0.05）；术后3个月研究组患侧乳房体积大于对照组，VSS评分低于对照组（P＜0.05）；研究组乳房美观度优良率95.24%高于对照组80.95%（P＜0.05）；术后3个月，研究组FACT-B总评分高于对照组（P＜0.05）；两组并发症总发生率比较无显著差异（P＞0.05）。结论 乳腺癌患者采用腔镜下双平面假体植入乳房重建术虽在一定程度增加手术时间及术中出血量，但能改善乳房形态，提升美观满意度，改善患者生活质量，且不增加并发症风险。

目的 分析烟雾病患者在血管重建术并发脑高灌注综合征的危险因素,为指导预防血管重建术后并发症提供参考依据。方法 选择2022年9月—2023年9月期间医院接收的148例烟雾病患者为研究对象,采用血管重建术治疗,统计术后高灌注综合征发生率,单因素分析术后并发高灌注综合征与性别、年龄、既往史、类型、铃木分期、灌注分期、手术侧别、入院改良Rankin 量表（mRS）评分、术后脑血流量（CBF）等因素的关系,并采取非条件Logistic多因素回归分析烟雾病患者血管重建术后并发高灌注综合征的危险因素。结果 148例患者血管重建术后,共42例并发脑高灌注综合征,发生率为28.38%。其中术后并发脑高灌注综合征与无并发脑高灌注综合征患者的性别、总胆固醇、甘油三酯、空腹血糖、入院mRS评分及基础疾病类型、手术侧别和手术时间比较差异无统计学意义（P>0.05）。烟雾病血管重建术后并发脑高灌注综合征患者年龄、是否合并高血压、铃木分期、灌注分期、收缩压、舒张压、术后CBF与无脑高灌注综合征患者比较差异有统计学意义（P<0.05）。年龄、收缩压、舒张压、铃木分期、灌注分期、CBF为烟雾病血管重建术后并发脑高灌注综合征的影响因素（P<0.05）。结论 烟雾病患者血管重建术后并发高灌注综合征的危险因素主要为高龄、收缩压升高、舒张压升高、铃木分期中晚期、灌注分期高、CBF降低,对此类患者需引起重视,做好针对性干预。

目的 探索冰袋冷敷对膝关节前交叉韧带重建术后关节疼痛肿胀和活动度的影响。方法 回顾性分析自2021年1月—2021年7月在我院因前交叉韧带损伤行前交叉韧带重建术的患者资料,将符合标准的71例行单侧前交叉韧带重建术的患者按住院号的单双号分成2组。其中,对照组38名患者,试验组33名患者。对照组38名患者术后不用冰袋冷敷;试验组33名患者术后采用冰袋冷敷。用视觉模拟评分表评估对照组和试验组患者术前、术后的疼痛,并测量患者的膝关节肿胀程度和活动度。结果 对照组和试验组患者术前视觉模拟评分比较,差异无统计学意义(P>0.05),试验组在术后6、24、48、72小时四个不同的时间点时疼痛视觉模拟评分均明显低于对照组,差异有统计学意义(P<0.001);对照组和试验组患者术前关节活动度比较,差异无统计学意义(P>0.05),试验组在术后4、5、6、7天四个不同的时间点时关节活动度优于对照组,差异有统计学意义(P<0.001);对照组和试验组患者术前膝关节肿胀程度比较,差异无统计学意义(P>0.05),试验组在术后1、2、3天三个不同的时间点时膝关节肿胀程度低于对照组,差异有统计学意义(P<0.001)。结论 冰袋冷敷能够有效减轻前交叉韧带重建术后膝关节疼痛肿胀并改善关节活动度。

Objective To explore the effect of ice pack cold compress on joint pain,swelling and motion after anterior cruciate ligament reconstruction. Methods The data of patients undergoing anterior cruciate ligament reconstruction due to anterior cruciate ligament injury in our hospital from January 2021 to July 2021 were retrospectively analyzed,and 71 patients who received unilateral anterior cruciate ligament reconstruction meeting the standards were divided into two groups according to the odd and even numbers of hospital admission. There were 38 patients in the control group and 33 patients in the experimental group. Thirty-eight patients in the control group did not use ice packs after surgery. Thirty-three patients in experimental group were treated with ice pack after operation. Visual analogue scale was used to evaluate the preoperative and postoperative pain of the control group and experimental group,and the degree of knee swelling and range of motion were measured. Results There was no significant difference in preoperative visual analogue scale between control group and experimental group (P>0.05). The scores of pain in the experimental group were significantly lower than that in the control group at 6,24,48 and 72 hours after surgery,with statistical significance (P<0.001). There was no significant difference in preoperative range of motion between control group and experimental group(P>0.05), the range of motion of the experimental group was significantly better than that of the control group at four different time points of 4,5,6 and 7 days after operation,with statistical significance(P<0.001). There was no significant difference in the degree of preoperative knee joint swelling between the control group and the experimental group(P>0.05),and the degree of knee joint swelling in the experimental group was lower than that in the control group on,1,2 and 3 days after surgery,three different time points, with statistically significant difference(P<0.001). Conclusions Ice pack cold compress can effectively reduce the pain and swelling of the knee joint after anterior cruciate ligament reconstruction and improve the range of motion of the joint.

目的 探讨在关节镜下膝关节前交叉韧带损伤重建术治疗的临床效果。方法 选取2018年3月—2020年3月之间我院接受住院治疗的80名膝关节前交叉韧带损伤患者作为研究对象。根据手术方式的不同,常规手术进行交叉韧带损伤的重建术治疗为常规组,关节镜下膝关节前交叉韧带损伤重建术治疗为研究组,每组各40名患者,比对两组的治疗效果。结果 通过数据得出常规组的膝功能评分(71.8±12.6)及膝功能不稳评分(13.2±1.6)要低于研究组膝功能评分(83.9±12.9)及膝功能不稳评分(19.3±2.3),差异有统计学意义(P＜0.05)。在术后疼痛评分上研究组(3.35±0.23)各项数据均优于常规组(4.35±1.69),差异有统计学意义(P＜0.05)。研究组并发症发生率仅为5%,常规组并发症发生率有17.5%,研究组数据远要低于常规组,差异有统计学意义(χ^<sup>2=5.178,P=0.023)。结论 在膝关节镜下前交叉韧带损伤重建术治疗可有效改善膝关节活动性、稳定性、有效减轻患者的疼痛感,减少并发症的发生,促进膝关节功能的康复。关节镜下进行膝关节前交叉韧带损伤重建术治疗具有临床推广和采纳的价值。

Objective To investigate the clinical effect of arthroscopic anterior cruciate ligament (ACL) reconstruction. Methods 80 patients with ACL injury in our hospital from March 2018 to March 2020 were selected as the research objects. According to the different surgical methods, patients underwent the traditional open surgery for cruciate ligament injury reconstruction treatment were selected as the control group,patients underwent arthroscopic anterior cruciate ligament injury reconstruction treatment were as the study group, 40 patients in each group, the treatment effect of the two groups were compared. Results The Lysholm score (71.8±12.6) and and Lysholm instability score (13.2±1.6) of the control group were lower than those of the study group (83.9±12.9 and 19.3±2.3), the differences were statistically significant (P <0.05). In the postoperative pain score, the study group (3.35±0.23) data was better than the control group (4.35±1.69), the difference was statistically significant (P <0.05). The incidence of complications in the study group was only 2.5%, and that in the control group was 17.5%, which was significantly lower than the control group, and the difference was statistically significant (χ²= 5.178, P= 0.023). Conclusion Arthroscopic anterior cruciate ligament reconstruction can effectively improve the activity and stability of knee joint, effectively reduce the pain of patients, reduce the occurrence of complications, and promote the rehabilitation of knee joint function. Arthroscopic anterior cruciate ligament reconstruction has the value of clinical promotion and adoption.

目的 研究早、晚期关节镜下前交叉韧带重建术治疗前交叉韧带损伤(ACL)的临床效果。方法 选取我院2017年12月—2019年12月收治的100例ACL损伤患者,根据不同手术治疗时间分为早期重建组(≤3周,54例)和晚期重建组(4～12周,46例)。比较两组术前及术后14周膝关节功能Lysholm及国际膝关节文献委员会(IKDC)评分,分析两组术前及术后14周膝关节活动度及肌力情况,对比两组术后2、4、8周的患膝屈曲角度,比较两组围术期临床指标。结果 两组患者术后均无早期并发症发生,手术切口均Ⅰ期愈合。两组术后14周Lysholm及IKDC评分较治疗前升高(P＜0.05);早期重建组术后14周Lysholm及IKDC评分与晚期重建组比较差异无统计学意义(P＞0.05)。两组术后14周屈曲受限角度、伸膝受限角度及萎缩指数较治疗前降低(P＜0.05);早期重建组术后14周屈曲受限角度、伸膝受限角度及萎缩指数与晚期重建组比较差异无统计学意义(P＞0.05)。早期重建组术前及术后2、4、8周的患膝屈曲角度与晚期重建组比较差异无统计学意义(P＞0.05)。早期重建组疼痛消除时间、肿胀消除时间及关节恢复正常时间显著长于晚期重建组(P＜0.05)。结论 行早、晚期关节镜下前交叉韧带重建术治疗ACL损伤患者的疗效相近,但晚期重建患者术后恢复效果显著,利于改善预后。