Risk factors of nausea and vomiting syndrome after thyroidectomy / 现代临床护理

Objective To investigate the risk factors of nausea and vomiting syndrome after thyroidectomy.Method The clinical data of 214 patients undergoing thyroidectomy were analyzed retrospectively to look into the risk factors.Results Seventy-two patients contracted nausea and vomiting syndrome after thyroidectomy,with an incidence of 33.64%.All of them had nausea of degrees 1,2 and 3,taking up 47.22%,27.78%and 25.00%,respectively.38.89%of them had vomiting of mild,intermediate and severe degrees, accounting for 32.14%,57.14% and 10.71%,respectively.Gender,smoking history,anesthesia and surgical duration were correlated with the syndrome(All P<0.05).Non-conditional Logistic regression analysis showed that female,general anesthesia, operative duration ≥2h were independent risk factors(all P<0.05).Conclusions Syndrome of nausea and vomiting after hyroidectomy has a higher incidence.Female,general anesthesia and surgical duration are independent risk factors.Interventional measures pertinent to these factors may reduce the incidence of nausea and vomiting syndrome after thyroidectomy.

THE CUBITAL RADIAL ARCH AND THE MUSCULAR BRANCHES OF THE RADIAL NERVE IN THE ANTERIOR CUBITAL REGION / 解剖学报

Fifty adult cadavers have been dissected bilateraly. Judged from our anatomical study, the site of division of the radial nerve into its superficial terminal and posterior interosseous branches is above the lateral humeral epicondyle in 96％. Usually, the brachialis, brachioradialis, and extensor carpi radialis longus and brevis all receive several muscular branches, which stem from different portions of the radial nerve. Muscular branch for ECRB arising from the superficial radial nerve of one side amounts to 25％.Two arcades are found to be situated along the radial side of the anterior cubital region, one being formed from the proximal tendinous margin of the ECRB muscle, and the other from the proximal edge of the superficial portion of the supinator. The lateral half of the ECRB arch, which covers that of the supinator arch, is definite and sharp and is crossed by the posterior interosseous nerve (PIN) obliquely. Its medial half coincides with the corresponding half of the supinator arch, but occassionally they may fuse together. The supinator arch may be divided into loop or circular types, with its longitudinal and transverse diameters of nearly 1～1.2 cm. Those which are tendinous in nature (arcade of Frohse)amount to 18％.There are 28 sides of PIN being compressed by the ECRB arch during passive supination, while 18 sides by the supinator arch (Frohse' arch in 2) during passive pronation. For this reason, in addition to their close relationship and position on the radial side, they are preferred to be combined and named as the cubital radial arch.

THE MORPHOLOGY OF THE OSTEO-FIBROUS CANAL FOR THE PASSING OF THE POSTERIOR RAMUS OF THE LUMBAR NERVE WITH SPECIAL REFERENCE TO ITS CLINICAL SIGNIFICANCE / 解剖学报

1. 40 cadavers were dissected in order to observe the position, formation and morphology of the osteo-fibrous canal (400 canals) of the posterior rami of the lumbar spinal nerves.2. The average lengths of the osteo-fibrous canals for the posterior ramus of the lumbar nerves in both sexes are: L_1 4.88mm, L_2 4.71 mm, L_3 4.61 mm, L_4 4.57mm, L_5 4.39 mm.3. The average longitudinal diameter of the outlets of the osteo-fibrous canals of the posterior rami of the lumbar nerves in both sexes are: L_1 6.38mm, L_2 6.73 mm, L_3 6.34mm, L_4 5.75mm, L_5 2.61mm.The average transverse diameters of the outlets of the osteo-fibrous canals of the posterior rami of the lumbar nerves in both sexes are: L_1 2.69mm, L_2 2.66mm, L_3 2.68mm, L_4 3.14mm, L_5 2.06mm.4. The shapes of the outlets of the osteo-fibrous canals of the posterior rami of lumbar nerves may be classified into four types: nearly circular 64.75% (259 sides); approximately ellipsoid 30.25% (121 sides); nearly triangular 3.00% (12 sides); nearly oblate 2.00% (8 sides).5. 320 inter-transverse ligaments were observed and measured.6. There was always an iliolumbar ligament interposed between L_5 and S_1.7. Further more, the authors discussed the relationship between the morphology of the nerves and the osteo-fibrous canals in connection with the possible causes of low back pain.

THE RELATION BETWEEN THE OSTEO-FIBROUS CANAL OUTSIDE OF THE LUMBAR SPINAL CANAL AND THE SPINAL NERVE PASSING THROUGH IT. Ⅰ. THE MORPHOLOGY OF THE OSTEO-FIBROUS CANAL OF THE MEDIAL DIVISION OF POSTERIOR RAMUS OF THE LUMBAR NERVE WITH SPECIAL REFER / 解剖学报

1. 40 cadavers were dissected in order to observe the position and formation of the osteo-fibrous canal (384 canals) of the medial division of posterior ramus of lumbar nerves together with the occurrence of the articulo-accessory (process) ligament.2. The form of the external opening of the osteo-fibrous canal may be classified into three groups; nearly circular 35.1% (151); approximately ellipsoid 32.3% (124); crack detector 28.4% (109).3. The osteo-fibrous canal consists of four walls, bounded by mammillary process, accessory process, bony wall and superior articular process ligament respectively. According to the constitution of the anterior and posterior walls of the canal, it may be divided into three categories; osteo-aponeuroticoligamentous type 29.4% (113); osteo-membranous type 66.4% (255) and bony type 4.2% (16).4. The length and width of the superior articular process ligament were measured. The sexual difference of the lengths of L_(1～5) lumbar is significant.5. The sulcus between the superior articular process and the alar portion of the sacrum was observed and measured.6. The ligament on the posterior wall of the canal is nominated as the ligament of the superior articular process.7. Based on the anatomical structures thus studied, some clinical significances were discussed.