Prospective trials of minor surgical procedures and high-fibre diet for haemorrhoids.

Two hundred and sixteen consecutive patients seen for the first time with symptomatic haemorrhoids entered trials of conservative and minor surgical treatment. They were divided into two groups according to their pretreatment maximal anal pressure. Patients with pressures of 100 cm H2O (73.7 mm Hg) or more (108 patients) were treated by anal dilatation (37), sphincterotomy (34), or high-fibre diet (37). Four and 12 months later anal dilatation had produced significantly better results than sphincterotomy or diet. Furthermore, anal dilatation was the only treatment associated with a significant reduction in anal pressure at four and 12 months. Patients with pressures under 100 cm H2O (108 patients) were treated by rubber-band ligation (35), cryosurgery (36), or diet (37). Four and 12 months later significantly more patients were improved by rubber-band ligation than by cryosurgery or diet. These results suggest that haemorrhoids in patients with excessive activity of the internal anal sphincter are best treated by anal dilatation and that in all other patients rubber-band ligation is the treatment of choice.     

Lateral Subcutaneous Internal Sphincterotomy in Treatment of Anal Fissure

One hundred and three patients with anal fissures have been treated by lateral internal sphincterotomy performed by a subcutaneous myotomy technique, and 99 have been successfully followed up for from 3 to 24 months (mean 11 months). The operation was free from significant complications, apart from slight reactionary bleeding in one case and a perianal abscess in another. The fissure persisted or recurred in three cases, in one of which a further lateral sphincterotomy was performed, with cure. Various minor defects of anal continence were noted in 12 cases. These results have been found to be superior to those obtained previously in the same surgical unit with open posterior internal sphincterotomy and simple sphincter-stretching respectively in the treatment of anal fissure. The most reliable and satisfactory operation at present available for this condition seems, therefore, to be lateral subcutaneous internal sphincterotomy.     

复方利多海浮膏对混合痔患者外剥内扎术后肛缘疼痛的临床效果

目的：探讨复方利多海浮膏用于治疗混合痔外剥内扎术后肛缘疼痛和水肿的临床疗效。方法：选择2012 年7月-2014 年12 月在我院接受混合痔外剥内扎术治疗的患者70 例,随机分为治疗组和对照组,每组各35 例。治疗组采用复方利多海浮膏外敷换 药治疗,对照组采用黄连膏换药治疗。观察并比较两组患者治疗前后肛缘疼痛和水肿的变化情况。结果：两组患者术前疼痛评分 及肛缘水肿得分差异无统计学意义（P＞0.05）;治疗组患者治疗后1 天、2 天、3 天、5 天的疼痛评分和肛缘水肿得分均显著低于对 照组,差异有统计学意义（P＜0.05）;治疗组患者治疗总有效率显著优于对照组,差异有统计学意义（P＜0.05）。结论：复方利多海 浮膏外敷换药用于治疗混合痔外剥内扎术后肛缘疼痛和水肿方面的疗效更好。     

Results of treatment of trigeminal neuralgia by microvascular decompression of the Vth nerve at its root entry zone.

Eighty five patients suffering from trigeminal neuralgia resistant to medical therapy underwent surgical treatment for relief of pain at the Department of Neurosurgery University Alexander Hospital Sofia from 1981 until 1997. Microvascular decompression at the root entry zone of the V(th) nerve has been performed using the technique of Jannetta. The operative exploration of the parapontine root entry zone disclosed neurovascular conflicts in 87.1% of the cases. They represented displacement and/or distortion, sometimes pressure grooves, discoloration, altered vascularity of the V(th) nerve. The analysis of early postoperative results have shown an excellent outcome in 90.6% of the cases, good in 3.5% and poor in 2.4% with mortality of 3.5% early in these series when no postoperative monitoring was available. The follow up study one year after surgery revealed 90.2% excellent and 3.7% good results and poor outcome and recurrences in 6.1% of the cases. Patients with long lasting trigeminal neuralgia, previous destructive procedures, venous compression, lack of convincible evidences for neurovascular conflicts had less favorable outcome or recurrences. In the last years partial sensory rhizotomy was performed in cases when no neurovascular conflicts were found out. Patients with unquestionable arterial compression leading to displacement associated with distortion and pressure grooves had excellent outcomes. Early recurrences were associated with missed pathology at the entry zones. During reexplorations for late recurrences new arterial compression was found in less than half of the cases.     

凉血地黄汤对湿热下注证混合痔外剥内扎术后患者创面愈合、肛门功能和新生血管形成的影响

摘要 目的：观察凉血地黄汤对湿热下注证混合痔外剥内扎术后患者创面愈合、肛门功能和新生血管形成的影响。方法：采用随机数字表法,将北京中医药大学东直门医院2019年10月~2021年9月间接收的150例混合痔外剥内扎术后患者分为对照组（n=75）和研究组（n=75）。对照组患者接受常规处理,研究组患者在对照组基础上接受凉血地黄汤治疗。对比两组疗效、创面愈合、肛门功能、新生血管形成情况和并发症。结果：研究组的临床总有效率为94.67%（71/75）,高于对照组的74.67%（56/75）,差异有统计学意义（P<0.05）。研究组的创面缩小率大于对照组,创面愈合时间短于对照组（P<0.05）。研究组视觉疼痛模拟评分（VAS）评分低于对照组,瘙痒症状消失时间、出血消失时间、排便疼痛消失时间、肛门分泌物消失时间短于对照组（P<0.05）。两组治疗7 d后血小板源性生长因子（PDFG）、血管内皮生长因子（VEGF）及碱性成纤维生长因子（bFGF）水平均升高,且研究组高于对照组（P<0.05）。两组治疗7 d后wexner便秘评分、肛管收缩压、肛管静息压下降,且研究组低于对照组（P<0.05）,两组治疗7 d后直肠最大容量阀值、直肠感觉阀值下降,但研究组高于对照组（P<0.05）。研究组的并发症发生率低于对照组（P<0.05）。结论：凉血地黄汤用于湿热下注证混合痔外剥内扎术后患者,可减轻患者术后疼痛,促进患者创面愈合,改善机体肛门功能,降低并发症发生率,可能与调节机体新生血管形成有关。     

磁共振检查对复杂性肛瘘手术治疗患者的指导价值及术后复发的危险因素分析

目的:探讨磁共振成像技术(MRI)对复杂性肛瘘诊断和术前评估的指导意义及术后复发的危险因素。方法:前瞻性选取2015年6月至2017年12月到我院诊断并接受手术治疗的359例复杂性肛瘘患者,将其随机分为观察组182例和对照组177例。对照组患者术前未行MRI检查,术中行亚甲蓝染色指导手术治疗。观察组术前行MRI检查,术中给予亚甲蓝染色结合术前评估行手术治疗,以术中探查结果为金标准,统计MRI术前检查复杂性肛瘘的准确率,Kappa检验评估MRI检查结果与术中探查结果的一致性,经1-2年的随访统计所有患者复发情况,单因素和多因素Logistic回归分析术后复发的危险因素。结果:观察组术中探查共发现瘘管内口281个,合并肛周脓肿57例,多发瘘管及支管151例,MRI术前检查瘘管内口、合并肛周脓肿、多发瘘管及支管的准确率分别为98.22%(276/281)、85.96%(49/57)、96.03%(145/151),观察组中MRI结果与术中探查结果对患者Parks分型通过一致性检验显示,两结果一致性较好(k=0.890,P=0.001)。单因素分析结果显示,肛瘘位置、内口位置、合并肛周脓肿、既往肛瘘手术史及术前是否行MRI检查均会影响复发率(均P0.05),Logistic回归多因素分析显示,术前未进行MRI检查、高位肛瘘、内口位于后正中线、既往肛瘘手术史是复杂性肛瘘术后复发的危险因素(均P0.05)。结论:MRI检查复杂性肛瘘能够术前明确瘘管及内口数量,可较为精确地识别瘘管Parks分型,有助于提高手术疗效,合并肛周脓肿、术前未进行MRI检查、高位肛瘘、内口位于后位、既往肛瘘手术史是复杂性肛瘘术后复发的危险因素。     

锡类散联合复方黄柏液对肛瘘术后创面的临床疗效

摘要 目的：观察锡类散联合复方黄柏液对肛瘘术后创面的临床疗效。方法：收集了2019年1月至2022年1月期间接受肛瘘手术治疗的60名患者的临床数据。基于不同的术后治疗方案,将患者分为观察组和对照组,每组30例。比较两组患者在创面疼痛评分、渗出评分、愈合时间、血清炎症和愈合指标方面的表现。结果：观察组患者在创面疼痛评分、渗出评分、愈合时间、血清炎症和愈合指标方面较对照组具有一定优势,具有统计学意义（P<0.05）。结论：锡类散联合复方黄柏液对于肛瘘术后治疗具有显著地临床疗效,有助于减轻患者的疼痛感和炎症反应,促进手术后创面愈合,并缩短了康复周期。这一发现为改进肛瘘患者的术后治疗提供了有益的临床参考。     

吻合器痔上黏膜环切术联合外剥内扎手术治疗Ⅲ-Ⅳ度环状混合痔的疗效及对患者肛门功能的影响

目的:研究吻合器痔上黏膜环切术(PPH)联合外剥内扎手术(MMH)治疗Ⅲ-Ⅳ度环状混合痔的疗效及对患者肛门功能的影响。方法:选择2016年3月~2018年3月我院收治的III-IV度环状混合痔患者128例为研究对象,将入选患者按照随机数字表法分为MMH组(n=58,采用MMH治疗)和联合组(n=70,采用PPH联合MMH治疗),比较两组手术指标及术后恢复情况,术后对两组患者进行为期3个月的随访,随访结束后,比较两组治疗疗效、肛门功能以及并发症的发生情况。结果:与MMH组比较,联合组手术出血量明显更少,住院时间、伤口愈合时间明显更短,各时间点的疼痛评分明显降低(P0.05)。与MMH组比较,联合组治疗总有效率升高,差异有统计学意义(P0.05)。与MMH组比较,联合组患者肛管静息压、肛管高压带长度、直肠肛门抑制反射阳性率均升高,肛管最大收缩压降低(P0.05),但两组直肠静息压比较差异无统计学意义(P0.05)。联合组并发症发生率为10.00%(7/70),低于MMH组的34.48%(20/58),差异有统计学意义(P0.05)。结论:较传统的MMH单独治疗,PPH联合MMH治疗Ⅲ-Ⅳ度环状混合痔具有更好的效果,可以缩短术后恢复时间,改善术后疼痛程度及肛门功能,且安全性较高。     

消肿溃痈方联合湿润烧伤膏对肛周脓肿术后患者创面愈合效果、肛门功能和血清生长因子的影响

摘要 目的：观察消肿溃痈方联合湿润烧伤膏对肛周脓肿术后患者创面愈合效果、肛门功能和血清生长因子的影响。方法：按照双色球法,将2020年5月~2022年12月期间湖南中医药大学第一附属医院收治的120例肛周脓肿术后患者分为对照组（n=60,接受湿润烧伤膏治疗）和观察组（n=60,消肿溃痈方联合湿润烧伤膏治疗）。对比两组疗效、临床指标、肛门功能指标、血清生长因子指标。结果：与对照组相比,观察组的临床总有效率更高（P<0.05）。与对照组相比,观察组的疼痛消失时间、肿胀消失时间、住院时间和创面愈合时间更短（P<0.05）。与对照组相比,观察组治疗3个疗程后肛管静息压、肛管最大收缩压、直肠最大耐受阈值更高（P<0.05）。与对照组相比,观察组治疗3个疗程后碱性成纤维细胞生长因子（bFGF）、酸性成纤维细胞生长因子（aFGF）更高（P<0.05）。结论：消肿溃痈方联合湿润烧伤膏可促进肛周脓肿术后患者创面愈合,改善患者的肛门功能,促进血清生长因子分泌。     

内镜下负压套扎术对Ⅱ、Ⅲ度痔疮患者肛肠动力学、炎症反应及免疫功能的影响

摘要 目的：探讨内镜下负压套扎术对Ⅱ、Ⅲ度痔疮患者肛肠动力学、炎症反应及免疫功能的影响。方法：选择2021年3月到2023年3月期间邯郸市中心医院收治的120例Ⅱ、Ⅲ度痔疮患者。按照手术方式的不同将患者分为A组（传统外剥内扎术,n=58）和B组（内镜下负压套扎术,n=62）。对比两组围术期指标、肛肠动力学、炎症反应及免疫功能变化情况,同时观察两组并发症发生率。结果：B组术中出血量少于A组,手术时间、首次排便时间、住院时间短于A组,术后24 h疼痛视觉模拟量表（VAS）评分低于A组（P<0.05）。两组术后3个月直肠最大耐受量、直肠感觉阈值、肛管静息压、肛管最大收缩压下降,且B组低于A组（P<0.05）。两组术后3 d白介素-6（IL-6）、白介素-8（IL-8）、白介素-12（IL-12）、C反应蛋白（CRP）升高,但B组低于A组（P<0.05）。两组术后3 d CD8⁺升高,但B组低于A组,CD3⁺、CD4⁺、CD4⁺/CD8⁺下降,但B组高于A组（P<0.05）。B组的并发症发生率低于A组（P<0.05）。结论：与传统外剥内扎术治疗相比,内镜下负压套扎术用于Ⅱ、Ⅲ度痔疮,具有创伤小,术后恢复快的优势,同时还可促进机体肛肠动力学恢复,减轻炎症反应和免疫抑制,降低术后并发症发生率。     

Mesenchymal stem cells can improve anal pressures after anal sphincter injury

Objective.Fecal incontinence reduces the quality of life of many women but has no long-term cure. Research on mesenchymal stem cell (MSC)-based therapies has shown promising results. The primary aim of this study was to evaluate functional recovery after treatment with MSCs in two animal models of anal sphincter injury.Methods.Seventy virgin female rats received a sphincterotomy (SP) to model episiotomy, a pudendal nerve crush (PNC) to model the nerve injuries of childbirth, a sham SP, or a sham PNC. Anal sphincter pressures and electromyography (EMG) were recorded after injury but before treatment and 10 days after injury. Twenty-four hours after injury, each animal received either 0.2 ml saline or 2 million MSCs labelled with green fluorescing protein (GFP) suspended in 0.2 ml saline, either intravenously (IV) into the tail vein or intramuscularly (IM) into the anal sphincter.Results.MSCs delivered IV after SP resulted in a significant increase in resting anal sphincter pressure and peak pressure, as well as anal sphincter EMG amplitude and frequency 10 days after injury. MSCs delivered IM after SP resulted in a significant increase in resting anal sphincter pressure and anal sphincter EMG frequency but not amplitude. There was no improvement in anal sphincter pressure or EMG with in animals receiving MSCs after PNC. GFP-labelled cells were not found near the external anal sphincter in MSC-treated animals after SP.Conclusion.MSC treatment resulted in significant improvement in anal pressures after SP but not after PNC, suggesting that MSCs could be utilized to facilitate recovery after anal sphincter injury.     

小剂量纳洛酮硬膜外应用对胃癌术后芬太尼静脉自控镇痛效果及胃肠功能的影响

目的:探讨小剂量纳洛酮硬膜外应用对胃癌术后芬太尼静脉自控镇痛效果及胃肠功能的影响。方法:选取我院2010年7月-2015年7月收治的110例胃癌患者为研究对象,将所有患者随机分为试验组和对照组各55例,两组患者均行根治性肿瘤切除术,术后采用芬太尼静脉自控镇痛,试验组于术后硬膜外注入小剂量纳洛酮,对照组注入等量的生理盐水,对两组术后不同时间点(4 h、8 h、12 h、24 h)疼痛程度进行评分,对比两组肠鸣音恢复时间、肛门排气时间、肛门排便时间、胃动力恢复时间,镇痛泵药物消耗量及并发症发生率。结果:术后4 h,试验组疼痛评分明显低于对照组(P0.05),术后8 h、12 h两组患者的疼痛评分均有显著上升(P0.05),且试验组患者的疼痛评分均远低于对照组(均P0.05),术后24 h,试验组与术后12 h比较差异无统计学意义(P0.05),对照组术后24 h疼痛评分与术后12 h分相比有显著差异(P0.01);试验组患者肠鸣音恢复时间、肛门排气时间、肛门排便时间、胃动力恢复时间、镇痛泵药物消耗量、芬太尼用量均远远低于对照组(P0.05);试验组并发症总发生率(7.27%)远远低于对照组(23.64%),差异具有统计学意义(P0.05)。结论:采用小剂量纳洛酮硬膜外应用方法辅助术后镇痛可以有效的减轻患者的疼痛,降低并发症的发生率,促进胃肠功能恢复,疗效显著,值得在临床上推广使用。     

Successful treatment of 19 consecutive groin lymphoceles with the assistance of intraoperative lymphatic mapping

Postoperative groin lymphoceles that fail to resolve spontaneously or with interventional therapy present a formidable problem that is associated with a high degree of morbidity. Numerous interventional methods and operative techniques have been described to treat these fluid collections, yet recurrence rates remain high. The use of lymphatic mapping has gained widespread use in the treatment of cutaneous malignancies and breast cancer and has been proven effective in delineating the course of lymphatic channels. We present here a series of 17 consecutive patients with 19 problematic groin lymphoceles who were treated with the assistance of intraoperative lymphatic mapping using isosulfan blue dye. To date there have been no recurrences and minimal morbidity associated with the technique and prescribed postoperative treatment regimen.     

The Significance of Regional Lymph Node Metastases in Breast Carcinoma

The significance traditionally attached to regional lymph node metastases has been questioned following a retrospective review of 922 patients with early breast cancer.Conservative surgical removal of axillary lymph node metastases and conservative irradiation of internal mammary lymph node metastases did not prejudice the five- and 10-year survival rates of patients so treated.Axillary lymph node recurrences had an ominous prognosis and occurred more commonly in the conservatively treated patients, yet survival rates were the same as those following radical mastectomy. Many axillary lymph node recurrences occurred more than five years after primary therapy, or with or after other evidence of reactivation of the breast cancer.It is suggested that breast cancer patients do not do poorly because they have regional lymph node metastases, but rather they have these metastases when they do poorly.     

Prevalence of myofascial pain in general internal medicine practice.

Myofascial pain is a regional pain syndrome characterized in part by a trigger point in a taut band of skeletal muscle and its associated referred pain. We examined a series of 172 patients presenting to a university primary care general internal medicine practice. Of 54 patients whose reason for a visit included pain, 16 (30%) satisfied criteria for a clinical diagnosis of myofascial pain. These patients were similar in age and sex to other patients with pain, and the frequency of pain as a primary complaint was similar for myofascial pain as compared with other reasons for pain. The usual intensity of myofascial pain as assessed by a visual analog scale was high, comparable to or possibly greater than pain due to other causes. Patients with upper body pain were more likely to have myofascial pain than patients with pain located elsewhere. Physicians rarely recognized the myofascial pain syndrome. Commonly applied therapies for myofascial pain provided substantial abrupt reduction in pain intensity. The prevalence and severity of myofascial pain in this university internal medicine setting suggest that regional myofascial pain may be an important cause of pain complaints in the practice of general internal medicine.     

吻合器痔上黏膜环形切除术对环状混合痔患者肛门功能及生活质量的影响

目的:比较吻合器痔上黏膜环形切除术(PPH)和外剥内扎手术(MMH)治疗环状混合痔的疗效及对患者肛门功能恢复、生活质量的影响,为临床治疗环状混合痔的术式选择提供依据。方法:选取2016年8月-2018年1月我院收治的84例环状混合痔患者作为研究对象。采用随机数字表法将患者分为PPH组(n=42)和MMH组(n=42)。比较两组患者的疗效、手术及术后恢复情况。随访3个月,观察两组患者的并发症发生情况,并采用生活质量综合评定问卷(GQOL-74)评价两组患者的生活质量变化情况。术后6个月对所有患者进行直肠肛门测压,记录并比较两组测量结果。结果:PPH组患者治疗总有效率为97.62%,高于MMH组的83.33%(P0.05)。两组患者手术时间、创面愈合时间、住院时间及恢复工作时间比较,PPH组均明显短于MMH组(P0.05)。PPH组总并发症发生率为14.29%,低于MMH组的40.48%(P0.05)。术后3个月,两组患者GQOL-74各维度评分均高于术前,且PPH组患者GQOL-74各维度评分均高于MMH组患者(P0.05)。术后6个月,PPH组患者肛管静息压、肛管高压带长度、直肠肛门抑制反射阳性率均明显高于MMH组(P0.05),但两组肛管最大收缩压和直肠静息压比较无统计学差异(P0.05)。结论:PPH治疗环状混合痔疗效确切且兼具较高的安全性,可促进患者的术后恢复,明显改善患者肛门功能和生活质量。     

可吸收螺钉内固定治疗多发性肋骨骨折的临床疗效

目的:分析可吸收螺钉内固定治疗多发性肋骨骨折的临床疗效。方法:选择2013年10月-2015年10月在我院接受治疗的多发性肋骨骨折患者89例作为研究对象,根据内固定材料不同将患者分为研究组和对照组。研究组45例患者采用可吸收肋骨钉内固定治疗,对照组44例患者采用记忆合金接骨板内固定治疗。观察并比较两组患者的临床疗效及术后并发症的发生情况。结果:与对照组比较,研究组患者术中出血量少,术后胸痛缓解时间以及下床活动时间较早,差异均具有统计学意义(P0.05);两组患者的手术时间、术后引流时间、住院时间比较,差异均无统计学意义(P0.05);研究组患者并发症的发生率(6.67%)明显低于对照组(20.45%),差异具有统计学意义(P0.05)。结论:可吸收肋骨钉内固定治疗多发性肋骨骨折具有术中出血量少、术后胸痛缓解时间和下床活动时间快的特点,可作为临床治疗首选材料。     

四肢骨折矫形术后患者慢性手术后疼痛的发生率及其危险因素分析

目的:研究四肢骨折矫形术后患者慢性手术后疼痛的发生率及其危险因素。方法:以2014年12月-2017年10月于我院接受四肢骨折矫形术患者300例为研究对象,于术后6个月分析慢性手术后疼痛的发生率。收集所有患者年龄、性别、体重、术前疼痛程度、二次手术、麻醉方式、术后镇痛、术后引流、合并骨质疏松、骨折类型以及骨折部位等资料,并采用单因素以及多因素Logistic回归分析术后疼痛的危险因素。结果:术后6个月内有96名患者术后发生慢性手术后疼痛,发生率为32.00%(96/300)。单因素分析结果显示:慢性手术后疼痛患者与术前疼痛程度、是否二次手术、麻醉方式、术后有无镇痛、是否合并骨质疏松、骨折类型、骨折部位有关(P0.05),与患者的性别、年龄、体重、术后是否引流无关(P0.05)。多因素Logistic回归分析结果显示:术前重度疼痛、二次手术、麻醉方式为非全麻、术后无镇痛、合并骨质疏松、开放性骨折以及下肢骨折均是四肢骨折矫形术后发生慢性手术后疼痛的独立危险因素(P0.05)。结论:四肢骨折矫形术后患者慢性手术后疼痛的发生率较高,术前重度疼痛、二次手术、麻醉方式为非全麻、术后无镇痛、合并骨质疏松、开放性骨折以及下肢骨折均增加了慢性手术后疼痛的发生风险,临床应根据危险因素给予针对性的干预措施。     

微创式治疗胆囊结石并胆总管结石的临床研究

目的：探讨腹腔镜与十二指肠镜联合治疗胆囊结石合并胆总管结石的临床应用价值。方法：74例胆囊结合并胆总管结石患者随机分为EST＋LC组（44例）和OC＋OCHTD组（30例）,其中EST＋LC组行十二指肠镜Oddi括约肌切开术（EST）加腹腔镜下胆囊切除术（LC）,OC＋OCHTD组行开腹胆囊切除术（OC）加胆总管切开取石T管引流术（OCHTD）,比较两组手术过程、术后恢复、并发症情况等。结果：①EST＋LC组手术时间长于OC＋OCHTD组,切口长度与术中出血量少于OC＋OCHTD组（P〈0.01或0.05）。②EST＋LC组手术成功率90.91%,取石成功率100%,OC＋OCHTD组手术成功率100%,取石成功率93.33%,两组间差异无显著性（P〉0.05）。③EST＋LC组镇痛药使用率低于OC＋OCHTD组,术后引流时间、肠鸣音恢复时间、肛门排气时间和平均住院时间短于OC＋OCHTD组（P〈0.01或0.05）。④EST＋LC组与OC＋OCHTD组均并发症少,无结石复发。结论：十二指肠镜Oddi括约肌切开术联合加腹腔镜下胆囊切除术治疗胆囊结石和胆总管结石具有创伤小、恢复快、并发症少、住院时间短等优势,值得进一步临床推广。     

背侧单切口与桡尺侧双切口钢板内固定治疗尺桡骨中上段双骨折

目的:研究成人尺桡骨中上段双骨折使用背侧单切口与桡尺侧双切口钢板内固定的治疗效果。方法:选择我院2011年3月至2014年7月行双钢板治疗成年尺桡骨中上段双骨折患者41例,其中手术入路选择背侧单切口患者25例,选择背侧双切口患者16例。比较两种手术方式的临床效果。结果:背侧单切口入路组患者在手术出血、切口长度等方面要优于背侧双切口组(P0.01);两组在术前时间、骨折愈合时间方面未见明显差异(P0.05)。单切口组的疼痛VAS评分在术后1周和术后12周时要优于双切口组(P0.05);单切口组的膝关节HSS评分在术后1周时要优于双切口组(P0.01),而在术后12周时两组未见明显差异(P0.05)。结论:选择背侧入路单切口和双切口双钢板治疗尺桡骨中上段双骨折均有较好的临床效果,而背侧单切口入路,手术操作相对简单易行,创伤较小,术后恢复较好。