postoperative correction

  • 文章类型: Journal Article
    评估了乳腺癌根治术后女性的心理情绪状况。采用国际问卷FACT-G和模块FACT-B模块,对186名接受I-II期乳腺癌药房监测的妇女的生活质量进行了调查。受访者的年龄分别为30-40岁、41-50岁、51-60岁、61-70岁和71岁及以上。在接受乳腺癌根治术的女性中,与术后其他观念相比,心理情绪状态表现得最生动,并降低了生活质量。绝大多数切除乳房的女性会感到自卑和沮丧,绝望,对健康恶化和死亡的恐惧随着年龄的增长而增加。在30-41岁的妇女中,对疾病的应对满意的比例为64.8%,51-60岁占45.8%,70岁及以上占4.2%。压力对疾病的影响在51-60岁(63,6%)和61-70岁(58,8%)的女性中最为明显。没有建立城乡受访者情绪状况水平的可靠差异。妇女对通过乳房丢失形成的术后矫正方法的态度取决于她们的年龄,居住地,教育水平。超过60%的50岁以下的受访者认为解决植入物内假体置换中的美学问题。在51-60岁的受访者中,25.0%的人首选同时进行乳房切除术和乳房再造,而10.1%的人首选乳房整形手术。内假体置换更常由60岁以上的女性和农村居民使用。乳房矫正模式的选择通常取决于患者的经济可能性。对乳房切除术后综合征妇女的生活质量的研究是个性化康复措施的药房监测综合方法的宝贵组成部分。妇女心理康复的有效性需要临床心理学家和医疗社会服务的参与。
    The psycho-emotional status of women after radical surgery for breast cancer was assessed. The international questionnaire FACT-G and module FACT-B module were applied to investigate life quality of 186 women under dispensary monitoring concerning breast cancer of stage I-II. The respondents were aged 30-40, 41-50, 51-60, 61-70 and 71 years and older. In women who underwent radical surgery for breast cancer, psycho-emotional status is manifested most vividly as compared with other perceptions in the postoperative period and decreases quality of life. The overwhelming majority of women with breast removal experiences feeling of inferiority and depression, despair, fear of health deterioration and death that increase with age. The percentage of women satisfied with their coping with illness is 64.8% among 30-41 years old, 45.8% among 51-60 years old and 4.2% among 70 years and older. The impact of stress on disease is most felt in women of 51-60 years old (63,6%) and 61-70 years old (58,8%). No reliable differences in level of emotional condition of urban and rural respondents was established. The attitude of women to methods of postoperative correction through formation of breast lost depends on their age, place of residence, level of education. More than 60% of respondents under age of 50 years consider solution of aesthetic problem in endoprosthesis replacement with implants. Among respondents aged 51-60 years, 25.0% preferred simultaneous mastectomy and breast reconstruction and 10.1% - breast plastic surgery. The endoprosthesis replacement is more often resorted by women older 60 years and rural residents. The choice of mode of breast correction often depends on financial possibilities of patients. The study of quality of life of women with post-mastectomy syndrome is valuable component of integrated approach to dispensary monitoring that individualizes rehabilitation measures. The effectiveness of psychological rehabilitation of women requires involvement of clinical psychologists and medical social services.
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  • 文章类型: Journal Article
    背景:脊柱侧凸的术前灵活性是手术计划的关键方面,因为它提供了曲线刚度的信息,结构变化的程度,要融合的水平和校正量。这项研究的目的是通过确定这两个特征之间的相关性来评估仰卧灵活性是否可用于预测青少年特发性脊柱侧凸(AIS)患者的术后矫正。
    方法:对2018年至2020年间接受手术治疗的41例AIS患者进行回顾性分析。收集术前,术后站立X线片和整个脊柱的术前CT图像,并用于测量仰卧柔韧性和术后矫正率。采用T检验分析两组仰卧灵活性和术后矫正率的差异。进行了皮尔逊积矩相关分析,并建立回归模型来确定仰卧位灵活性与术后矫正之间的相关性。独立分析胸曲线和腰曲线。
    结果:发现仰卧柔韧性明显低于矫正率,但与术后矫正率具有很强的相关性,胸曲组r值为0.68,腰曲组r值为0.76。仰卧位灵活性与术后矫正率之间的关系可用线性回归模型表示。
    结论:仰卧位灵活性可用于预测AIS患者术后矫正。在临床实践中,仰卧射线照片可以用来代替现有的灵活性测试技术。
    BACKGROUND: The preoperative flexibility of the scoliotic spine is a key aspect of surgical planning, as it provides information on the rigidity of the curve, the extent of structural changes, the levels to be fused and the amount of correction. The purpose of this study was to assess whether supine flexibility can be used to predict postoperative correction in patients with adolescent idiopathic scoliosis (AIS) by determining the correlation between these two characteristics.
    METHODS: A total of 41 AIS patients who underwent surgical treatment between 2018 and 2020 were retrospectively enrolled for analysis. Preoperative and postoperative standing radiographs and preoperative CT images of the entire spine were collected and used to measure supine flexibility and the postoperative correction rate. T tests were used to analyse the differences in supine flexibility and postoperative correction rate between groups. Pearson\'s product-moment correlation analysis was performed, and regression models were established to determine the correlation between supine flexibility and postoperative correction. Thoracic curves and lumbar curves were analysed independently.
    RESULTS: Supine flexibility was found to be significantly lower than the correction rate but showed a strong correlation with the postoperative correction rate, with r values of 0.68 for the thoracic curve group and 0.76 for the lumbar curve group. The relationship between supine flexibility and postoperative correction rate could be expressed by linear regression models.
    CONCLUSIONS: Supine flexibility can be used to predict postoperative correction in AIS patients. In clinical practice, supine radiographs may be used in place of existing flexibility test techniques.
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  • 文章类型: Journal Article
    OBJECTIVE The study aimed to determine if the intraoperative segmental lordosis (as calculated on a cross-table lateral radiograph following a single-level transforaminal lumbar interbody fusion [TLIF] for degenerative spondylolisthesis/low-grade isthmic spondylolisthesis) is maintained at discharge and at 6 months postsurgery. METHODS The authors reviewed images and medical records of patients ≥ 16 years of age with a diagnosis of an isolated single-level, low-grade spondylolisthesis (degenerative or isthmic) with symptomatic spinal stenosis treated between January 2008 and April 2014. Age, sex, surgical level, surgical approach, and facetectomy (unilateral vs bilateral) were recorded. Upright standardized preoperative, early, and 6-month postoperative radiographs, as well as intraoperative lateral radiographs, were analyzed for the pelvic incidence, segmental lumbar lordosis (SLL) at the TILF level, and total LL (TLL). In addition, the anteroposterior position of the cage in the disc space was documented. Data are presented as the mean ± SD; a p value < 0.05 was considered significant. RESULTS Eighty-four patients were included in the study. The mean age of patients was 56.8 ± 13.7 years, and 46 patients (55%) were men. The mean pelvic incidence was 59.7° ± 11.9°, and a posterior midline approach was used in 47 cases (56%). All TLIF procedures were single level using a bullet-shaped cage. A bilateral facetectomy was performed in 17 patients (20.2%), and 89.3% of procedures were done at the L4-5 and L5-S1 segments. SLL significantly improved intraoperatively from 15.8° ± 7.5° to 20.9° ± 7.7°, but the correction was lost after ambulation. Compared with preoperative values, at 6 months the change in SLL was modest at 1.8° ± 6.7° (p = 0.025), whereas TLL increased by 4.3° ± 9.6° (p < 0.001). The anteroposterior position of the cage, approach, level of surgery, and use of a bilateral facetectomy did not significantly affect postoperative LL. CONCLUSIONS Following a single-level TLIF procedure using a bullet-shaped cage, the intraoperative improvement in SLL is largely lost after ambulation. The improvement in TLL over time is probably due to the decompression part of the procedure. The approach, level of surgery, bilateral facetectomy, and position of the cage do not seem to have a significant effect on LL achieved postoperatively.
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