背景:先天性髋臼发育不良患者与髋关节翻修患者常存在髋臼上方骨量缺损,使得髋臼侧的处理在髋关节置换术中更为复杂困难。有学者建议髋臼高位放置确保适当的宿主骨接触的同时简化手术,而其作为影响生物力学的手术方式引起很多人的担忧,...背景:先天性髋臼发育不良患者与髋关节翻修患者常存在髋臼上方骨量缺损,使得髋臼侧的处理在髋关节置换术中更为复杂困难。有学者建议髋臼高位放置确保适当的宿主骨接触的同时简化手术,而其作为影响生物力学的手术方式引起很多人的担忧,甚至临床疗效遭到质疑。目的:综述近年国内外髋臼高位放置技术在人工髋关节置换术中的研究进展。方法:第一作者应用计算机检索至2016年12月Pub Med数据库、中国期刊全文数据库的相关文章,以"proximal placement,superior placement,high placement,high hip center,elevated hip center,total hip arthroplasty,revision total hip arthroplasty,dysplasia of developmental hip"为英文检索词,"高旋转中心,髋臼高位技术,髋臼高位放置,全髋关节置换术,髋关节翻修术,先天性髋关节发育不良"为中文检索词。共检索到67篇相关文献,45篇文献符合纳入标准。结果与结论:(1)对于髋关节置换手术中面临的髋臼骨缺损问题,髋臼高位放置是一种选择,尤其对复杂骨缺损患者可以简化手术;(2)尽管违背了恢复解剖旋转中心的原则,通过重建位置的调整、摩擦界面的改善、假体的适当选择,以及手术技术和理念的进步,髋臼高位技术可以在与宿主骨直接接触的范围和强度的基础上获得良好的初始稳定性,进而实现令人满意的长期生物固定效果,同时不会影响髋关节的生物力学;(3)目前中英文文献中髋臼高位放置的定义和名称较为混乱,有待对此进一步规范完善。展开更多
Objectives:Multiple techniques for endoscopic nasojejunal tube(NJT)placement exist.However,poor experience with these techniques has limited more routine practice of NJT placement for many endoscopists.We evaluated en...Objectives:Multiple techniques for endoscopic nasojejunal tube(NJT)placement exist.However,poor experience with these techniques has limited more routine practice of NJT placement for many endoscopists.We evaluated endoscopic NJT placement with a new stiff jejunal(J)tube method(push technique).Methods:The GI Tract database at the Medical University of South Carolina was queried for NJT-placement procedures.Records of 42 patients who had undergone NJT placement by using the push technique between the years 2001 and 2004 at our institution were reviewed for information regarding procedure success and tube-related outcomes.Results:The push technique of NJT placement was successful in 41 of 42 patients(97.6%),with an average procedure time of 11.6 minutes(range,5-50 minutes).Negative outcomes occurred in 61%of properly positioned NJTs and included inadvertent tube removal by the patient or the staff(42.1%),dislodging(10.5%),clogging(5.3%),and kinking(5.3%).The average longevity of the NJT was 7.8 days(range,1-37 days).Most patients were ultimately converted to a percutaneous enteral access device or to oral feedings.Conclusions:Endoscopic placement of NJT by using the push technique is an efficient,reliable method of accessing the small bowel for enteral nutrition.展开更多
文摘背景:先天性髋臼发育不良患者与髋关节翻修患者常存在髋臼上方骨量缺损,使得髋臼侧的处理在髋关节置换术中更为复杂困难。有学者建议髋臼高位放置确保适当的宿主骨接触的同时简化手术,而其作为影响生物力学的手术方式引起很多人的担忧,甚至临床疗效遭到质疑。目的:综述近年国内外髋臼高位放置技术在人工髋关节置换术中的研究进展。方法:第一作者应用计算机检索至2016年12月Pub Med数据库、中国期刊全文数据库的相关文章,以"proximal placement,superior placement,high placement,high hip center,elevated hip center,total hip arthroplasty,revision total hip arthroplasty,dysplasia of developmental hip"为英文检索词,"高旋转中心,髋臼高位技术,髋臼高位放置,全髋关节置换术,髋关节翻修术,先天性髋关节发育不良"为中文检索词。共检索到67篇相关文献,45篇文献符合纳入标准。结果与结论:(1)对于髋关节置换手术中面临的髋臼骨缺损问题,髋臼高位放置是一种选择,尤其对复杂骨缺损患者可以简化手术;(2)尽管违背了恢复解剖旋转中心的原则,通过重建位置的调整、摩擦界面的改善、假体的适当选择,以及手术技术和理念的进步,髋臼高位技术可以在与宿主骨直接接触的范围和强度的基础上获得良好的初始稳定性,进而实现令人满意的长期生物固定效果,同时不会影响髋关节的生物力学;(3)目前中英文文献中髋臼高位放置的定义和名称较为混乱,有待对此进一步规范完善。
文摘Objectives:Multiple techniques for endoscopic nasojejunal tube(NJT)placement exist.However,poor experience with these techniques has limited more routine practice of NJT placement for many endoscopists.We evaluated endoscopic NJT placement with a new stiff jejunal(J)tube method(push technique).Methods:The GI Tract database at the Medical University of South Carolina was queried for NJT-placement procedures.Records of 42 patients who had undergone NJT placement by using the push technique between the years 2001 and 2004 at our institution were reviewed for information regarding procedure success and tube-related outcomes.Results:The push technique of NJT placement was successful in 41 of 42 patients(97.6%),with an average procedure time of 11.6 minutes(range,5-50 minutes).Negative outcomes occurred in 61%of properly positioned NJTs and included inadvertent tube removal by the patient or the staff(42.1%),dislodging(10.5%),clogging(5.3%),and kinking(5.3%).The average longevity of the NJT was 7.8 days(range,1-37 days).Most patients were ultimately converted to a percutaneous enteral access device or to oral feedings.Conclusions:Endoscopic placement of NJT by using the push technique is an efficient,reliable method of accessing the small bowel for enteral nutrition.
