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损伤预防措施
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The experienses of two cases supra- condylar osteotomy complicated with injuries of peroneus communis are rep- orted.The causes of injuries are related with anatomical factors in the peroneus communis course.In addition, they are also related with the cha- racters of the nerve structure,namely, less vessels more nerve fibers and less connective tissue.The prevention mea- sures are also presented.

本文根据我院发生的2例股骨髁上截骨术并发腓总神经损伤的教训。从腓总神经自坐骨神经的出口到腓总神经进入腓骨颈部骨—筋膜管中,在行程上的解剖因素和该神经在结构上血管少,神经纤维多,结缔组织少的特点与易致伤的原因进行分析,并提出股骨髁上截骨术中并发腓总神经损伤的预防措施。

AbstractTwelve patients with iatrogenic bile duct injuriesoccurred during laparoscopic cholecystectomy(LC)were treated from June 1992 to May 1994.All the pa-tients underwent re-operation and were cured. Thecauses and characteristics of the inlurieswere:(1)per-foration of the common hepatic or common bile ductcaused by dissecting hook(3 cases );( 2 ) necrosis andperforation of the common hepatic duct due to diather-mic injury(1 case);(3)clamping of the common hep-atic duct by Ti clip(1 case);(4)secondary high...

AbstractTwelve patients with iatrogenic bile duct injuriesoccurred during laparoscopic cholecystectomy(LC)were treated from June 1992 to May 1994.All the pa-tients underwent re-operation and were cured. Thecauses and characteristics of the inlurieswere:(1)per-foration of the common hepatic or common bile ductcaused by dissecting hook(3 cases );( 2 ) necrosis andperforation of the common hepatic duct due to diather-mic injury(1 case);(3)clamping of the common hep-atic duct by Ti clip(1 case);(4)secondary high bileduct stricture following a failed end-to-end anastornosisor hepatico-cholangio-jejunostcmy of the amputatedcommon hepatic duct(5 cases );(5)delayed high bileduct stricture( 2 cases ).It is emphasized that theseveritv of bile duct inluries bv LC be should not over-looked,and more experience in this field be accumulat-ed to avoid this serious complication.

作者自1992年6月~1994年5月治疗腹腔镜胆囊切除术(LC)并发的胆管损伤及高位胆管狭窄12例,均经手术治愈。根据其损伤原因及特征分为以下六种类型:(1)LC术中因电凝切割钩引起肝总管或胆总管穿孔(3例);(2)LC术中胆囊管残瑞钛夹导电致胆囊肝总管坏死穿孔(1例);(3)钛夹止血时钳夹肝总管致高位狭窄(1例);(4)胆总管损伤后行胆管吻合继发肝总管高位狭窄(2例);(5)LC中胆总管横断后,行肝总管空肠吻合术后吻合口狭窄(3例),再次手术切开左右肝管,行肝胆管空肠再吻合;(6)LC术后延迟性高位胆管狭窄(2例)。作者对胆管损伤的预防措施及治疗方法进行了讨论,并强调LC胆管损伤严重性和进一步提高认识并积累经验的必要性。

It is reported 52 cases of tibia fatigue fracture. All of the patients were recruits and 17 to 20 year old. The fracture took the place during training in three months, in their joining up army Most of injuries occured in supermedial and anterointeral tibia (84. 6%). The anatomic stuhure and biomechanics of this fracture are discussed. It is considered that tibia fatigue fracture is relative to the " muscle blank" region in anterointernal tibia and conex in supermedial tibia. They result in unbanlance stress...

It is reported 52 cases of tibia fatigue fracture. All of the patients were recruits and 17 to 20 year old. The fracture took the place during training in three months, in their joining up army Most of injuries occured in supermedial and anterointeral tibia (84. 6%). The anatomic stuhure and biomechanics of this fracture are discussed. It is considered that tibia fatigue fracture is relative to the " muscle blank" region in anterointernal tibia and conex in supermedial tibia. They result in unbanlance stress on tibia during training, i, e. high compression on posterolateral region and high tension on anterointernal region. The unbanlance leads to tibia fatigue fracture. The mechanis, of this injury is discussed and the preventive methods are put forward.

本组52例胫骨疲劳骨折,均为男性新战士,年龄17~20岁(平均19.2%岁)。所有病例发生在3个月的新兵训练期间,部位以胫骨中上段前面或前内侧为主(84.6%)。通过对胫骨应力骨折发生的解剖基础和生物力学分析,提示该类骨折的发生与胫骨前内侧的“肌肉空白区”和其中上段凸向内的解剖结构有关,训练中胫骨受的应力不平衡,即后外侧压应力大而前内侧张应力大。张力是骨折的外在因素。分析了军训中跑、跳、蹬等动作导致胫骨疲劳骨折的机理,从而提出对这类损伤的预防措施。

 
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