The clinical outcomes are poor. The patients in this group may have hepatic encephalopathy, hepatorenal syndrome, gastrointestinal bleeding, etc., 3 cases of liver cancer were detected by scanning, and the clinical and image relationship of alpha-fetoprotein+2 was clinically analyzed. Sexual aggravation, changes in patient consciousness, abnormal liver function, separation of enzymes, and 01 did not appear morphological changes. The main flash is the patient's clinical onset, the onset of sputum, and the change of liver sputum morphology 7 is a long-term slow pathological process, and the patient has not formed and showed abnormalities of the smear. Then the symptoms suddenly worsened and died. In this group of cases, the clinical diagnosis is consistent with secondary biliary cirrhosis, and there are 9 reasons for the normal liver morphology. The compensatory function of the human organs is strong, from the appearance of early cirrhosis to the organ function bag. There is a long process to mention the clinical treatment of normal, reasonable liver and enzyme-lowering and yellowing-based treatment, which has guiding significance for preventing liver function deterioration and reducing other organ dysfunction. If you do not support the diagnosis of cirrhosis, you need to combine clinical and symptomatic treatment.
3 clinical comorbidities appear; in the relationship between the wood group data, clinical symptoms in addition to secondary biliary cirrhosis, comorbidities including diabetic cataract hepatic encephalopathy hepatorenal syndrome liver function decompensation and portal pressure, like Can be abnormal liver morphology. The spleen is swollen and the gallbladder is enlarged. spleen. The clinical and imaging findings of the intrathoracic pleural effusion were consistent.
4 secondary biliary cirrhosis with liver cancer and 1 image relationship This group of 3 patients with liver cancer have a history of hepatitis B, in terms of its pathogenesis, secondary biliary cirrhosis based on hepatitis B, combined with liver cancer. 1 like liver cancer 1 cadaveric liver left lobe square right lobe.
1 Liu Zhenchun, Gao Jianwei. , Line 01 only 1 check for application in biliary diseases. Chinese Journal of Practical Internal Medicine, 1998; 18 knives 403 2 Yang Hanqin, Huang Cuiyao. Clinical analysis of 106 cases of cirrhosis with gallstones.
Chinese Journal of Practical Internal Medicine, 1994147401 cannulated screw internal fixation and sartorius musculoskeletal transplantation for the treatment of femoral neck fractures in young and middle-aged Xi'an Red Cross Hospital, Department of Osteoarthritis, Xi'an 70054, Donggonghai, folded, respectively, with cannulated screws and internal fixation The musculoskeletal pedicle bone graft is hand-treated. Results Followed up for 3 years, according to the efficacy criteria, excellent in 37 cases, good in 13 cases, fair in 7 cases, poor in 3 cases, the excellent rate of 83. Conclusion The internal fixation of cannulated screws has strong anti-rotation effect and compression effect. The sartorius muscle graft has the advantages of small trauma and simple operation. It provides the method of osteogenic treatment of femoral cranial fractures in young adults. Surgical hand fixation method was used for autologous adults. In 2000, 60 cases of femoral neck fractures in young adults were treated with cannulated screw internal fixation and sartorius musculoskeletal transplantation. The following are the clinical data of 60 cases of femoral neck fracture. There were 47 males and 13 females; 21 patients with left fracture and 39 patients with right fracture; age 249 years, mean 36 years old; fracture classification, 1. heart type 1 in 5 cases, type 6 in type, type 21 in type, type 28 cases. 54 cases of fresh fractures, 6 cases of old fractures were injured to the shortest time of surgery 3 peaks of the longest 9, 35 cases of car accidents caused by injuries, 1 pair of high-altitude falls, 3 by, type 1 fractures treated with percutaneous hollow nail internal fixation method. Take the supine position, the lower limbs are abducted 3, internal rotation 15 or so, TV, offline positioning, can also be used for percutaneous small cut 1 in the greater trochanter 25., closed at the 12th straight through 28, the end of the page Threaded needle needle round needle reaches 31 stomach, two needles are parallel to the femoral neck and the upper and lower cortical bones. The third needle is below the apex of the greater trochanter 12, at the strong oblique line as far as possible parallel to the femoral moment axis, 3 guide pins The depth of the needle is about 35, 1 to the cartilage surface of the femoral head. After fixation, activity, violent, object, 3 cases; 13 both sacred to the prison joint, check, securely stabilized, insert the protective sputum, insert the cone depth finder through the sleeve to the edge of the bone, determine the required snail cut . Remove the guide pin. Sterile dressings can be used in the osteoporosis area. The phoenix 22 can be used for the treatment of the fractures of the type 1 fractures, the internal fixation of the cannulated screws, and the treatment of the pedicled pedicle flaps. The fascia, dissecting the lateral cutaneous nerve and protecting the thirsty sacral stalk from the anterior side of the iliac crest, retaining the attachment of the sartorius muscle at the anterior superior iliac spine, from the anterior segment of the iliac crest 1 1.52.3, the cannulated screw is fixed by intradermal fixation, and the bamboo trough of 1.51.121.3.1 is cut into the lower part of the bamboo fold line. The designed sartorius tendon is implanted with a root diameter of 2. 1 Kirkner wire fixing block, put into the bow flow tube. The incision was closed by layer-by-layer suture, and the sterile dressing was pressure-wrapped. After treatment, the acetabular acetabular micro-flexion was used to take Dingning shoes, or the lower limb traction belt was tow for 6 weeks. After 6 weeks, the crutches did not carry heavy weight activities. After 9 months, Supporting single-turn activities, 1 year after surgery can be abandoned 4 efficacy judgment and results of excellent hip joint activity, no pain and è·›1 good hip joint activity base is normal. Mild limp, occasional pain. Can rest asymptomatic, pain when walking, limp, life is basically self-sufficient and painful, life can not take care of this group of cases, followed up for 3 years. Excellent in 37 cases, good in 13 cases, fair in 7 cases, and poor in 3 cases. The excellent rate is 83.3.
Discussion 1 Characteristics of femoral neck fracture in young and middle-aged adults There is no osteoporosis in young adults. The bone structure of the proximal femur is very strong. Only a large amount of violence can cause femoral neck fractures, such as traffic injuries or high-altitude falls, and fractures. More dislocations, blood damage is also more serious, and sometimes a component of multiple body damage. The treatment of 2 femoral neck fractures is to improve the rate of fracture healing and reduce the rate of avascular necrosis of the femoral head. For the factory; 1 type and basal type of femoral neck fractures, we routinely use 3 hollow screws percutaneous fixation to form a spatial angular structure, which has strong anti-rotation effect; hollow screws have deeper screws. This is done, which reduces the treatment of femoral neck and 3 inch femoral neck fractures. We have realized in clinical practice that the upper and lower cortical culverts as close as possible to the femoral neck are close to the cortical bone and the needle is tight. After strong force, you must wear T-shirts or maintain traction. The depth of the needle is up to the end of the femoral head cartilage surface 35 close to the femoral cortex. If the needle is too long, the needle tip can pierce the cartilage surface of the femoral head and affect the joint activity; if the needle tail cannot be close to the femoral cortex, the pressure will not be applied if the needle is too short. The needle + can pass through the fracture line, and it does not have the advantage of being pressurized as a cannulated screw. In the factory, the fracture is pre-compressed. Therefore, the tensile stress stress stimulating effect of separating the fracture surface can be offset, the fracture healing can be accelerated, and the nail is threaded, and it is not easy to loosen or quit, thereby avoiding the complications of the sclerosing muscle. With the blood supply, the blood supply of the bone flap across the fracture end, inserted into the femoral head, can stabilize the relationship between the head and neck, communicate the formation and activity of the fracture ends, and provide the ischemic femoral head and fracture end. A new source of blood supply, to promote the repair of fractures, Xiao Yongan 2; compared with the transplantation of bamboo pedicles of the pedicles, it is found that the effect of the pedicled musculoskeletal flap or the deep vascular pedicled bone flap is superior to the sartorius muscle. Muscle pedicle flap transplantation However, the posterior approach of the femoral muscle musculoskeletal graft is difficult to perform, and it will destroy the posterior blood supply of the hip capsule. The femoral neck fracture often has a large defect in the posterior part of the fracture end. Obviously, posterior incision is not conducive to the repair of bone defects. For example, the use of circumflex deep vascular pedicle bone graft is more time-consuming, because the separation of blood vessels is more time-consuming, the bone graft needs to leave more soft tissue, and the bone flap is too small to damage the blood. Supply, too big to insert nine reasons Considering the difficulty of operation, this procedure is unsatisfactory and the sartorius muscle pedicle flap surgery is anterior incision. Compared with the first two procedures, the operation is small, and the bone flap has reliable blood supply. The muscle pedicle is long and fixed, and the same incision is completed next time. The operation is simple, the trauma is small, and it is easy to promote. More importantly, the anterior incision does not destroy the blood supply behind the hip capsule. It is beneficial to the repair of the posterior bone of the fracture to minimize the possibility of avascular necrosis of the femoral head. Only one of the 60 patients in this group has avascular necrosis of the femoral head. Bone and joint damage. Beijing People's Medical Publishing House, 2 Xiao Yongan. The sartorius muscle pedicle flap grafting for the treatment of old femoral neck fractures. Journal of Bone and Joint Injury, 1993; 4255
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