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Anterior locking plate for treatment of severe cervical spine injury


Decompression and fusion surgery of pseudarthrosis rate of up to 5% ~ 26%, multi-segmental fusion of a higher incidence of false joints, and it has led to long-term stability and abnormal cervical knock the possibility of surgery. CSLP can effectively improve the stability of fusion segments chineseJournaloflnicalPracticalM, contribute to bone fusion, and to avoid late complications. We believe that: cervical vertebrae involving partial or subtotal resection and fusion cases required, are indications of anterior fixation, especially for serious cervical spine injury anterior locking plate for the application. [Received 2007-06-29] transurethral resection of anesthesia management experience Qiang Wang Ligang Felix Luo-V-Bi Jinwen CLC: R614.2 +4 Document code: B Article ID :1729 -5386 ( 2007) 09-0062-02 transurethral resection (TURP), has become an important treatment of senile prostatic hyperplasia means, and the advantages of surgical trauma, faster recovery,canada goose norge, easier for the patients, but patients with major surgery part for the elderly, often associated with varying degrees of heart and lung disease, for surgery and postoperative stress tolerance capabilities are relatively low, and intraoperative fluid a large number of 5% mannitol, for a long time in lithotomy position, etc. Anesthesia will be difficult to bring. Our hospital since 2000, in hard and spinal anesthesia,ugg greece, the line of TURP surgery 210 cases, and achieved satisfactory results, are summarized below. 1 Materials and Methods 1.1 General information on elective TURP were 210 cases, aged 60 to 86 years, mean age 70.12 years of age, operative time 55 ~ 160min, the average 75.21min. AI ~ Ⅲ grade, preoperative ECG was normal 107 cases, sT_T change the concurrent sinus bradycardia, premature 89 patients with cerebral vascular disease patients with hemiplegia l4 cases, all patients had no hard and spinal anesthesia contraindicated. 1.2 Anesthesia and monitoring of patients with burglary after an open vein (intravenous Ringer lactate 3-5ml · kg oxygen, take the left bit line hard and spinal anesthesia (CSEA) puncture (L2 ~ 3 or L34) using that method puncture, after the success of subarachnoid injection of 0.5% bupivacaine (8 ~ l0mg) simultaneously by epidural catheter to the head (3 ~ m) reserve, according to the operation time of 2% lidocaine additional medication 5 ~ 8ml / times, to be stable anesthesia (control T10 below), the risk of Huairou District, Beijing Author l First of Anesthesiology (101400) Author: Wang Qiang, male,abercrombie fitch paris, aged 44, deputy chief physician. · Exchange of experience by stable vital signs, take the lithotomy position bladder surgery, at the beginning of surgery before the surgery began 50min, the end of surgery,mulberry outlet, and blood were measured after lh kidney 2, monitoring of blood Na concentration is too low if serum Na replenish saline. Intraoperative MAP 20% below the baseline blood pressure, give ephedrine 5 ~ 10mg, until blood pressure recovered to baseline values. 2 Results All patients with blood pressure in 48 cases, the occurrence rate of 22.85%, of which 5 cases occurred in surgery for bladder lithotomy position or supine position change to move from the operating table flat car. Intraoperative blood Na decreased (120mmol / L ~ <Na ≤ 135mmol / L) 15 cases, the intraoperative blood Na <120mmol / L in 3 cases, surgery Bi Fasheng 8 cases, the overall incidence of 7.14%. Surgery, surgery ECG, SpO2, HR did not change. 3 Discussion TURP patients were elderly, elderly patients showed degenerative changes in the nervous system, reduced functional reserve, the autonomic nervous system also. rough the process of degeneration, neuronal loss, reduce the number of nerve fibers, conduction slowing, receptors and neurotransmitters in the number and function changes, autonomic reflex responses, vasoconstriction response and receptor response to changes in heart rate after are slow start, the reaction to a lesser extent, can not effectively stabilize blood pressure. [J fall in blood pressure occurred in this group 48 cases, the incidence of 22.85%, mainly for intraoperative blood pressure effects of anesthesia. the sympathetic nerve is lagging behind, vasodilation and reduced peripheral vascular resistance, and reduced venous return and decrease cardiac output, J usually can be corrected by rapid expansion, including 5 cases of block level too high (more than T8). rough the expansion and the use of vasoconstrictor be corrected. However, 8 cases occurred in the surgery, the patient from the bladder into a supine lithotomy position causing low blood pressure in 6 patients, from the operating table pushed to the flat car