目的總結(jié)近年來胰源性門靜脈高壓（pancreatic portal hypertension，PPH）的相關(guān)研究，以期能對(duì)其進(jìn)行更及時(shí)、更有效的診斷和治療。方法在中國知網(wǎng)、PubMed等數(shù)據(jù)庫中搜索PPH的病因及機(jī)制研究、臨床特征、診斷標(biāo)準(zhǔn)和治療方法相關(guān)研究的文獻(xiàn)并作一綜述。結(jié)果PPH的發(fā)生與胰腺區(qū)域的解剖結(jié)構(gòu)有關(guān)，主要病因?yàn)橐认傺装Y和胰腺腫瘤；其診斷由于臨床表現(xiàn)不具有特征性，需借助相關(guān)輔助檢查進(jìn)行診斷。PPH的治療主要針對(duì)胰腺本身疾病和門靜脈高壓，其中針對(duì)門靜脈高壓的治療又分為合并或者不合并消化道出血的情況，在臨床上應(yīng)根據(jù)不同的情況采取不同的治療措施。結(jié)論目前臨床上對(duì)PPH的診治手段比較成熟，但其預(yù)防性治療尚存在較大的爭(zhēng)議，這將是今后的研究重點(diǎn)。
【摘要】 目的 比較脛骨平臺(tái)骨折術(shù)后輔助與不輔助持續(xù)被動(dòng)運(yùn)動(dòng)（continuous passive motion，CPM）的臨床療效。 方法 對(duì)2008年6月-2009年6月86例行手術(shù)治療的閉合性、無合并損傷的脛骨平臺(tái)骨折患者進(jìn)行回顧性分析。根據(jù)是否輔助CPM分為CPM組27例和非CPM組（對(duì)照組）59例。對(duì)兩組患者的傷口愈合情況，膝關(guān)節(jié)屈曲、伸直角度，以及膝關(guān)節(jié)功能恢復(fù)情況進(jìn)行比較?！〗Y(jié)果 兩組傷口甲級(jí)愈合率差異無統(tǒng)計(jì)學(xué)意義（P=0.566）。在術(shù)后2周和6周，CPM組患者的膝關(guān)節(jié)屈曲角度明顯大于對(duì)照組（Plt;0.001），但在術(shù)后3個(gè)月和12個(gè)月，兩組的差異無統(tǒng)計(jì)學(xué)意義（P=0.219，P=0.512）。在術(shù)后2、6周，3、12個(gè)月，CPM組和對(duì)照組患者的膝關(guān)節(jié)伸直角度差異無統(tǒng)計(jì)學(xué)意義。在術(shù)后12個(gè)月的Rasmussen膝關(guān)節(jié)功能評(píng)分方面，CPM組和對(duì)照組的差異無統(tǒng)計(jì)學(xué)意義?！〗Y(jié)論 脛骨平臺(tái)骨折術(shù)后輔助CPM能早期提升膝關(guān)節(jié)屈曲角度，但并不能提高遠(yuǎn)期的膝關(guān)節(jié)活動(dòng)度和最終的膝關(guān)節(jié)功能。【Abstract】 Objective To compare the therapeutic effect of continuous passive motion (CPM) treatment after tibial plateau fractures operation. Methods From June 2008 to June 2009, 86 patients were treated due to closed tibial plateau fractures without combined injuries. The patients were treated with (27 patients, CPM group) and without (59 patients, control group) CPM. The wound healing rates, range of motion and the knee function were compared between the two groups. Results There was no significant difference between the two groups in wound healing rates (P=0.566). Two and six weeks after the operation, there were significant differences between the two groups in flexion degree (Plt;0.001); three and 12 months after the operation, there were no significant differences between the two groups (P=0.219, P=0.512). At the 2nd and 6th week, 3rd and 12th month postoperatively, there were no significant differences between the groups in extension degree. Twelve months after the operation, there were no significant differences between the groups in functional recovery of the knee. Conclusion CPM in the post-operative treatment of tibial plateau fractures is effective increasing knee flexion in the early stage, but is not effective increasing range of motion or knee function in a long term.