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e054831577
Wysłany: Czw 10:34, 10 Mar 2011
Temat postu: Beware of spinal tuberculosis with paravertebral a
Beware of lumbar paraspinal abscess misdiagnosed Tuberculosis
Actually defective. 2.3.4 Then again the results of bacterial culture of pus is still back on the right track for another good time. 2.3.5 After the failure of another surgical drainage, clinical director of MD, and superior doctors realized the seriousness of the problem, in large surgical consultation, the details recalled by history, physical examination and targeted system, laboratory examinations, and then clear the diagnosis. 2.3.6 orthopedic treatment failure are: lack of formal pre debridement effective preoperative preparation, in theory, should be combined with preoperative anti-tuberculosis drugs for 2 weeks or more, in general, and erythrocyte sedimentation rate improved, body temperature normal to arrange for surgery. In fact, orthopedic surgeons have been taking into account the longer length of stay of patients,
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, has had two operations mistakes, spent large amounts of hospital costs, patient burden heavier, plus the previous two doctors in charge of operations continued to press, thus the line anti-tuberculosis drugs into the orthopedic treatment for 5 days after surgical debridement arrangements. Astonishingly, 13837, 2 days after surgery appeared paraplegia below the level of pubic symphysis. 2.3.7 explore the causes paraplegia by post hoc analysis, concluded a long history for the patient, severe lesions in the continuing failure to accept the application of system specification under anti-tuberculosis drug therapy, the occurrence of paraplegia is only a matter of time, which the evolution of the lumbar spine tuberculosis become the inevitable result. This time the fight hit by three operations can be considered to contribute to external causes occurred in patients with paraplegia. 2.3.8 paraplegia has taken place, although the hospital presided over by the President of consultation, but because of the lack of theory and experience of the participants failed to correctly determine the real cause of occurrence of paraplegia, paraplegia shift the blame in the injury to surgery To. 2.3.9 At this point, for postoperative paraplegia occurred within 24 hours that is the reason,
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, orthopedics and anesthesiology have accused each other bear full responsibility. Both sides blame each other for not taking the correct theory and effective evidence to refute each other, and had the final decision by the President: the spinal cord cavity open exploration to clear the real cause of paraplegia and try to take remedial measures. 2.3.10 Open the spinal cavity surgical exploration of the 4th, although the real reason is proven in patients with paraplegia itself changes due to tuberculosis, but the serious error is: Open the spinal cavity exploration, making the canal outside the spread of TB changes to the medullary cavity, making the scale-up TB change, induced tuberculous meningitis, encephalitis and epilepsy, the patient eventually died died. 2.4 should draw the lessons of 2.4.1 need to raise awareness of the disease, thought should pay attention to, in theory, to enhance learning, especially in general surgery doctor, but also need to have appropriate terms of theory and practice of orthopedic experience. 2.4.2 Details of history taking to the full, differential diagnosis of possible track to detail, do not be misled by the patient described. 2.4.3 emphasis on surgical patients admitted to conduct a detailed comprehensive examination, the former two operations, doctors and the senior doctor in charge, are in the visits the patient before and too sloppy, twice visited the preoperative epidural anesthesia, and no detailed history and physical examination spine line, which, anesthesiologists should be some remorse. 2.4.4 The judge does not correspond with the clinical laboratory and special test results, II Fou-bed physicians should maintain a fairly cool head, two bacterial culture results were error diagnosis and treatment continues, this should be a warning. 2.4.5 enhance the accumulation of clinical experience in the business to learn and follow the orthodox theory and the standard treatment, not because of some objective reasons, the right treatment from the principles of orthopedic treatment of errors that stems from this. 2.4.6 Spinal tuberculosis (including the combined paravertebral abscess) in orthopedic surgery, such as debridement, drainage and duct exploration cutting schedule,
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, etc., do not open the dura into the canal, otherwise, will be retrograde spread of tuberculosis infection brain tissue,
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, the result difficult to get. This is a well-known experts, academic dean of Orthopaedic Surgery, Union Hospital of Tongji Medical University's Professor Zhu Tongbo, at that time (1989) to participate in accident appraisal summary statement by talking about,
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! Lamivudine Treated Phyllanthus Clinical study of chronic hepatitis B Third People's Hospital in Yongzhou City 1 (425100) Fu Xiaofeng chronic hepatitis B (C bleed at the nose) is seriously endangering the health of our people, infectious diseases, but because of hepatitis B virus (HBV) the special biological characteristics, is still no effective treatment. As nucleoside analogues lamivudine, patients can be virological, biochemical liver function and liver histology improvement in quality of life
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