切除神经

From January 2000 to December 2001, 69 patients with breast cancer were reservation intercostobrachial nerve and 34 patients were not.

对天津医科大学附属肿瘤医院 20001~200112月间69例保留肋间臂神经和34例切除肋间臂神经的乳腺癌患者进行随访。

The intercostobrachial nerves were reserved and resected in 39 and 7 cases respectively. The sensory function of internal upper arm was been studied by follow-up after operation.

在46例乳癌根治术中完整保留肋间臂神经39例，切除肋间臂神经7例，术后对46例上臂内侧皮肤感觉随访观察。

Results: In the group of reservating intercostobrachial nerve, 48 patients have no change in sensation, 11 patients have anesthesia, one has burning sensation, and 9 patients have hypoaesthesia.

结果：肋间臂神经保留组术后48例无感觉方面上的变化，11例发生感觉麻木，1例上肢出现烧灼感，9例上肢出现感觉减退；而肋间臂神经切除组术后3例出现腋窝无汗，18例发生感觉麻木，4例上肢出现烧灼感，9例上肢出现感觉减退。

Methods 46 patients with breast cancer were underwent radical resection. The intercostobrachial nerves were reserved and resected in 39 and 7 cases respectively. The sensory function of internal upper arm was been studied by follow-up after operation.

在46例乳癌根治术中完整保留肋间臂神经39例，切除肋间臂神经7例，术后对46例上臂内侧皮肤感觉随访观察。

Results: In the group of reservating intercostobrachial nerve, 48 patients have no change in sensation, 11 patients have anesthesia, one has burning sensation, and 9 patients have hypoaesthesia.

两组之间在统计学上有显著性差异（χ2=481570；P＜005）；肋间臂神经保留组58例术后未发生患肢疼痛，11例发生患肢疼痛；而肋间臂神经切除组5例术后未发生患肢疼痛，29例术后发生患肢疼痛。

Skin sensory function of internal upper arm and armpit was normal in 39 cases of intercostobrachial nerve reservation, but abnormal in 7 cases of intercostobraehial nerve resection.

保留肋间臂神经39例中术后患侧上臂内侧和腋窝皮肤感觉均正常，而切除肋间臂神经的7例患者均有不同程度的感觉异常。

Skin sensory function of internal upper arm and armpit was normal in 39 cases of intercostobrachial nerve reservation, but abnormal in 7 cases of intercostobraehial nerve resection.

结果 46例患者在随访第1～3年局部均未发现癌肿复发。保留肋间臂神经39例中术后患侧上臂内侧和腋窝皮肤感觉均正常，而切除肋间臂神经的7例患者均有不同程度的感觉异常。

But in the group of resecting intercostobrachial nerve, 3 patients have axillary absent sweating, 18 patients have anesthesia, 4 patients have burning sensation, and 9 patients have hypoaesthesia.

两组之间在统计学上有显著性差异（χ2=481570；P＜005）；肋间臂神经保留组58例术后未发生患肢疼痛，11例发生患肢疼痛；而肋间臂神经切除组5例术后未发生患肢疼痛，29例术后发生患肢疼痛。

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

objective to investigate the effect of radiography and method of operation on the surgical indication as well as the operation treatment of lumbar disc herniation and lumbar canal stenosis.methods the data of 300 cases with lumbar disc herniation and lumbar canal stenosis were reviewed from jan 1999 to dec 2004.all cases were treated by the method of minimal invasive open operation.the nucleus was resected through an 3.5～4.5cm in length.the sacrospinalis muscle between laminae was stripped partly and the part of upper lamina and the part of medial facet was resected.

目的 探讨影像学检查和手术方法对腰椎间盘突出症和椎管狭窄症手术方式和适应证的影响。方法自1999年1月～2004年12月，为300例腰椎间盘突出症和椎管狭窄症患者实施微创开放式手术，做3.5～4.5cm长的皮肤切口，剥离椎间的部分骶棘肌，咬除部分椎板上缘及小关节内侧缘后，摘除髓核，并根据需要做半椎板或全椎板手术或扩大神经根管和切除肥厚的黄韧带及神经管内的骨性增生。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。