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《脊柱内固定系统临床评估》翻译项目报告.pdf

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分类号HO巧密级公开UDC翻译硕±学位论文ProectROil:ontlie化y紅欣Vw0Cj巧/砍ClinicalEvaluationofSpinalInternalFixationSstemy《脊柱内固定系统临床评估》翻译项目报告霍倩学科专业英语笔译指导教师王义捷副教授论文答辩日期2015年5月17日学位授予日期2015年6月30日答辩委员会主席关烙珍教授 FroecrtReoli:onthe7hi/is/a献w0《jp/诚ClinicalEvaluationofSpinalInternalFixationSystemAReort細bmitted化ptheForeinLanuag的ColleeofGuanxiUniversitggggyin化rtialFulfillmentof化e*Reqmiementsfbr化eDegreeofMas化rofTransla村onandInterpretingByHuoQianUndersupervisionofProfessorWanWeniegjJune2015 广西大学学位论文原卸性和使用授校声明本人声明所呈交的论文,是本人在导师的指导下独立进行研究所取得的研究成果。除已特别加W标注巧致谢的地方外,论文不包含任何其他个人或集体己经发表或撰写的研究成果,也不包含本人或他人为获得广西大学或其它单位的学位而使用过的材料一。与我同工作的同事对本论文的研究工作所做的贡献均已在论文中作了明确说明。本人在导师指导下所完成的学位论文及相关的职务作品,知识产权归属广西大学。本人授权广西大学拥有学位论文的部分使用权,目P:学校有权保存并向国家有关部口或机构送交学位论文的复印件和电子版,允许论文被查阅和借阅,可W将学位论文的全部或部分内容编入有关数据库进行检索和传播,可采用影印、缩印或其它复制手段保存、汇编学位论文。本学位论文属于:W叙密。,在年解密后适用授权保密。""(请在上相应方框内打V)(.论文作者签名:曰期./餐:么OAT66指导教师签名:曰期.f化:义66作者联系电话;电子邮箱: AcknowledgementTwoyearsago,Icame化thisGreenCityandstartedmyMTIstudy.Atthattime,Inotonlfeltexcitedabouttranslationstudbutconfusedaboutmfuture.ButtwoearslaterIyyyy,havelearnedalotgrownalotjbecomecalmerandmoreconfident.Iamready化confrontupsanddownsinmylife.Althoughtheroadaheadisstilllong,nomatterwhat,IhavefinishedmyMTIstudhereandIwouldlike化takethisoortunittoextendmsincereyppyytitudeandareciationformdeararentsallmresectedniceandknowledeablegrappyp,yp,gteachersandwarmhearted,kindandfriendlyfriends.TheyaremylifetimetreasurethatIwillpossessandrememberforever.Firstly,Iwouldlike化extendmyheartfeltareciation化marentswhosarenoppyp,pefortstorovidefinancialsuortformstudfortheirentirelife.IfahadnotbeenforpppyytheirhardworkandcareIwouldnothavefinishedmyostraduatestud.SecondlIampgyy,alsoreatlindebtedtoProfessorWangWenjie,whohasnotonlybeenuidingmeongygtranslati畑study,butencouragingme化studytranslationindiferentfieldsinthepasttwoears.Herinvaluablesuggestionshaveguidedmetiiroughthisthesiswritinandwillygenlihtenmeinmyfuturestudies.Msuervisorisustlikeastaruidintranslationgypjggmystud.NextjIwouldlike化showmythankstotheGrandStronLimitedComanywhichygpprovidesthetranslationrojectforme.Finally,IamparticularlyratefultoallteachersinthepgForeignLanguagesCollegeofGuangxiUniversitywhoprovidesignificantuidanceformgyltudhfiituretransationsyandresearc.i 《脊柱内固定系统临巧评佑》翻语项目报告摘要近年来,随着医学科技的飞速发展,中西方在医学领域的交流与合作日益频繁,为便于交流,需要译成英文的医学论著日益增多,对于医学领域的翻译人才的需求量也曰益増大。作为服务于改革开放的先导力量和世界沟通的桥梁,译员的作用愈发突出但,合格的医学英语译员却极度缺乏。为了满足时代和市场的需求,专业译员需要了解医学知识,精通医学翻译的方法与技巧,这对于英语翻译学习者来说具有重要的意义。本文是一篇基于翻译项目的项目报告,作者受深圳立创信息系统有限公司翻译部委托,对《脊柱内固定系统临床评估报告》进行汉英翻译。报告介绍了这个项目实施的总""与""体流程:重点介绍了译前分析案例分析,译前部分对原文本的类型,目标语读者,译文的风格及翻译策略的选择进行了分析:案例分析着重介绍翻译程中遇到的兰种典型的案例,分别从医学翻译中无主句,长句,W及相关统计数据翻译这H个角度着手进行分析。最后,总结了翻译实践中译员获得的经验与启示及存在,并提出相应的解决方案的问题与不足。笔者期望本翻译项目报告能为其它类似临床报告文本翻译的译者提供借路。关键词:医学翻译;脊柱内圃定;案例分祈巧 ProectReortontheTranslationof化e口inicalEvaluationoipfSpinalInternalFixationSystemABSTRACTInrecentearsexchanesandcooerationbetweenChinaandforeincountriesiny,gpgmedicalfieldhavebeco風eincreasinlfreuentaainst化0backdrooftheraidgyqgppdevelopmentofmedicalscienceandl;echnology.InordertofacUitatetheexchange,therearelotsofmedicalmaterialsneededt;obetranslated.ButualifiedmedicalEnlishtranslatorsareqginreatdemandinChina.Tomeettheneedsofthemarketrofessionaltranslatorsneedtog,pknowaboutmedicalknowledgeandbeskillfulintranslationmethodsandt;echniques.Thisisofgreatsinificancefortranslationlearners.g"TheauthoriscommissionedbyGrandStronimhed1:0translateClinicalEvaluationgL"ofna*SpilInternalFixationSystemintoEnglishveisionandthisreportisbasedo打it.This"""reportintroducestheoperatio打ofthistranslationproje別,withtranslationprocessandcase"-化eaustudiesasitsfocuses?虹reanalsisthoranalzes化estleofsourcetexttaretpy,yy,greadertranslationstleandtranslatio打methods.Threekindsoftyicalcasesareintroduced,ypincasestudies:thesentenceswithnosubject;longsente打ces;textsconcerningstatisticaldata.Corresondinsolutionsaresuestedinthisreort.Atlasttheauthorsummarizesthepgggp,experienceshelearnedfromthisproject.Itishopedthatthisreportcanofferanewperspectivetoseeksomestrategiesforsimilarclinicalreporttranslation.Kewords:medicaltranslationsi打alinternalfixationss1;emcasestudiesy;py;iii ContentsAcknowledgementsiChineseAbstractiiEnglishAbstractiiiChapter1Introduction1Chapter2ProjectDescription2Chapter3IVanslationProcess43-1PretranslationalAnalsis4.y3.1.1AnalysisoftheSourceTextandtheTaigetReader43il.1.2TranslatonStye53.1.3TranslationMethod63-.2PretranslationalPreparations73BPlllTetPearatio7.2.1Referenceooksandaraexrpn3.2.2GlossaryPrearation*8p3.2.3ToolsPreparation103.2.4WorkingSchedule10-3Pttrltion12.3osansa3.3.1ualitontrol13QyC3.3.2CustomerEvaluation14Chapter4CaseStudy1541TranslationofSentenceswithNoSubect15.j4TnslationTechniueofPassiveVoice.15.1.1raq4i17.1.2Addtion4.2TranslationofLongSentences194.2.1TranslationinOriginalOrder204ivision22.2.2D 4.3TranslationofTextsConcerningStatisticalData.24ChaptersConclusion30Bib32lioraphy.gAendixISourceText33ppIIFil52AppendixnaVersionoftheTranslationendixCtEvalion86AppHIusomeruatAppendixIVProectContact88j 广西大学翻译硕古學化论文《脊桓内固定系统胳床i平巧》翻译项目报吿Chapter1Introduction虹recentyearsexchanesandcooeratio打betweenChinaandforeincountriesin,gpgme化calfieldhavebecomeincreasinglyfrequentagainst化ebackdropoftherapiddevelopmentofmedicalscienceand1;echnology.Inorder1;ofacilitatetheexchange,thereareoofmedicalmaterialsneededtobetranslatedbutualifiedmedicanlishtranslatorsareltslE,qgi凸reatdemandinChina.Tomeettheneedsofthemarketrofessionaltranslatorsneed化g,pknowaboutmedicalknowledeandbeskiUfiilintranslatio打methodsandt:echniues.ThisisgqofgreatsigniGcancefortransIationleamers.TheauthorcommissionedbGrandStronLimi1:ed过translatio打comantranslates,yg,py,""ClinicalEvaluationofSpinalInternalFixationSystem(hereinafterrefersasCESIFS)intoEnglishversionandthistranslationreportisbased0打it.Thesourcetextisarelativelycompleteanddetailedclinicalevaluationreportwhichintroducesmedicaldeviceitsintended,application,intendedtherapeuticefect,evaluationbackground,performance,safety,introductio打foruseandsoon.ThisreortintroducesthetranslationrocessinthetranslationofCESIFS.ItCO打sistsofppfivechapters.Thefirstchapterisanintroduc巧o打totheoriginoftheprojed:andthelayoutofthereport.Thesecondchapterbrieflydescribesthetranslationtasktheauthorundertook.Thetttrot-hirdchaerinduceshetranslationprocessincludinreanalsisreratio打sworkinp,gpy,ppa,gschedule,qualitycontrolandcustomerevaluation.Chapterfourisastudyofsometypicalcasestheauthorencounteredintranslation.Theauthorresentsthetranslationmethodsshepaliedinarticularcontext.Thisartisdevelopedfromthreeasects:translationofpppppsentenceswithnosubectlonsentencesandtextsconcerninstatisticaldata.Chaterfive,gpjgrovidesanoverviewofthewholetranslationractice.Theauthordemonstratestheppexperienceshehaslearntinthepractice,andsummarizesherunderstandingoftherofessionalualitiesatranslatorneeds.pq1 广巧大学海译硕古学仗论文《脊哲巧固與系綠临床巧巧》巧译项目报告Chater2ProectDescritionpjpThecustomeroftheroectisWuhanDraonbioOrthoedicProductsCo.Ltdapjgp,,s-tinoforeininvestedcomanbasedinWuhanubeiChina.Iundertakesnationalgpy,H,industrializationdemonstrationroectsinbiotechnoloandsecializesinmedicalpjgy,pmaterialsandmedicaldevicesresearchanddevelopment,i打tegratingscience,industryandtrade.Ithascreatedaseriesofroductssuchasarti归dalointstraumaineorthoedicp,,s,jppreplacementaswellasorthopedicfixationroductswhichareusedtoexport.pTheproject,CESIFS,isaproductclinicalreportofWuhanDragonbioOrthopedicPcodheuroseofheroecivaluaeheefectofhesinlinernal:rodutsC.,Lt.Tpptpjts化etttpatfixatio打systemroductsandrovideinformationabouttheroducts.Theauthoristheonlpppya-translatorauthorizedbythetransltio打companyGrand哀tro打gLimited.了hetranslationprojecti化mNo.isGSLSZl410005.Thesourcetext,givenby化ecompany,isinChineseversio打i打Microso行Wordformat.Thetotalwordcountisabout14220.Theroectlasts,pj化化fromOctober17,2014化Octob巧24,2014.Asthesourcetextisdividedintothreearts,p-theauthorisrequired1;odeliverthefinaltranslationversionofeachartinCEMicrosoftpWordformatindependently.Be妃rethetranslatio打roect化eauthorisfirstlreuested化takeatranslation化Stpj,yqdesignedbythecompa打y.Afterassi打gthetranslation1;esttheauthorneotiatesthep,gtranslationpriceandsignsthecooperationcontactandconfidentialityagreementwi化thecomany.Thecontactclearlydefinestherightsandobligationsofbothartiescooerationpp,ppaternandqualityrequireme打ts.Theauthorisrequired化abideby1;hereuiredreulations.qgInbrmsoftherequirementsofthecustomertheauthorisasked化othrouhthetext,ggcare扣lletfamiliarizedwiththecontentcomaninformationandthecontenneededfory,g,pyt化e化anslation;makesurethetranslationisaccuratecorrectadconsistent,eseciallin1:erms,pyofaccuracyandterminology;applytheChineselanguagerules;usethestandardindustryterminologyandreserve化emeaninandstleof化esourcetextincaseofdoubts,feelfreep;gy2 广田夫単巧位论义《舞隹A因巧巧部悔床评巧》巧带吸目报吿化suggestandask;andkeepthebusinessconfidential,abidebytheinformationsecuritymanagementandoflierregulationswritteninthecontact.Theauthordecides化writeareportonthisprojectdue化the拓llowingreasons:1)WththefreuentmedicalcooerationbetweenChinaandothercountriesthemarketisinreatqp,gdemandofskillfultranslatorswithmedicalbackroundsasastudenttranslatortheauthorg,,wishes化shareherexperienceinthisfield;2)Wthtwoyearsintensivestudyandpractice,theauthorwouldliketochallengeherselfinapplyingwhatshehaslearntintheroramandpg"""’"thttisreortofersheraoodchanceoreviewhosedosanddontsbeforeshestartsherpgreertranslationca.告3 广西巧译项古単位论义《巧?接巧因巧呆满化床巧巧》巧巧巧目报吿Chapter3TranslationProcessThischapterwillreviewthewholetranslationrocesswhichincludesthefollowinpgsects-onalanalsisre-lationlrearationndos-nlaia:retranslatitransaattraston.ppy,pppp3-.1PretranslationalAnalysisPre-trasnbnlationalanalysisrefers化aseri的ofaalys妨conductedbutheauthoreforetranslatinintheaspectsofthesourcetexttaretreadertranslationstleandmethodsunderg,,g,y’thianceR-lleudofeisstexttolotheor.Pretranslationaanalsislasaleadinroeforgypgyyypygtheauthorduringthetranslationprocess.3.1.1AnalsisoftheSourceTextandtheTargetReaderyAsarelativelcomleteanddetailedclinicalevaluationreortthesourcetextCESIFSypp,,,belo凸gs化me出caltext.Itmainlyintroduc的medicaldevice,itsintendedapplication^intendedtheraeuticeffectevaluationbackrounderformancesafetintroductionforusep,g,p,y,andsoon.化aimstolettaretreadersknowaboutthemedicaldeviceoftheWuhangDragonbioOrthopedicProductsCoLtdand化rovethattheirroductsarewelldeveloed^pppwithoodualitandhavebeenwidelusedinclinicwithsatisfinffect.gqyyygeTobeterunderstandthesourcetextandtranslateitfaithftilly,化isnecessaryfortranslatorstoknowaboutthestylisticfeaturesofmedicaltext.Generallyseakin,medicalpgtexthasitsowndistinctivelanuagecharacteristics.WanYanhasmentionedsomefeaturesggofChinesiemedicaltextinherbook口008:23.1Thelanuaeisformalinmodeofseech))ggp,whichismademanifestbnumeroussentenc故withnosubect.Due化humanbeingareyjalwassectivesentenceswithnosubectisthedemonstrationofformalseech.Medicaly峭,jp4 脊柱内固巧系統临床i平巧广西大学巧译硕古学位论义(〈》翻译巧目化吿textmainlreortinmedicaldiscoveriesandracticeratherthantheeolewhodid化eypgppp*workisalsooneofthereaso。whytheiearesentenceswithnosubectinmedicaltext.2Thej)lanuaeisstandardwhichshowsuasrammarstandardizatio打.了hereaso打whthegg,pgygrammar;sstandardi。medical化xtisthatmedicaltextdescribesobectivefacts.3Thej)statementinmedical1:extisobjectiveandaccurate.Medical1:extofte打巧fleetsobjectivemedicalfacts,sothestatementhas化beobectiveandaccurate.4Plaininstle.Themainj)ypurposeofmedicaltextistoconveyinformation,sothestyleismanifestbythesimplesentencestructureanddirectnarrationwkhcmtmodifiedsyntax.5Therearemanmore)yterms.Inadditionduetothemedicaltextisstrictinloicsomanlonsentencesareused.,g,ygTrans-latio打actionisakindoftargetorientedaction.AccordingtoNida(1993:139),taretreaderistherimarfactorneeded1:0beconsideredwhendecidingthetranslationgpystrateiesandtheleveloflanuae化beused.Generallseakintaretreadersofthegggypg,gCESTFSareforeineolewhoenaeinthemedicalfieldeseciallorthoedistsandgppgg,pypthosewhoarerespons化leformedicalproducturchasin.Thereforethereadabilitofthepg,ytranslationmustbeconsidered.3.1.2TranslationStyleGermanfunctionalschoolconsiderthattranslationisapurposefiilactivityofhumanbeinsandtranslationurosedecidesthetranslationstrateiesandmethodstheauthorg,ppgadopted化achievetheexpectationfunctionoftranslation.Theauthorgiveshighriority1:0p,thefimctionalcharacteristicsoftt.Attthetranslaio打sfimetionisembodiedinheexttypeis,necessarytoanalzethetextteandthefunctionoftranslationfirst.Theoroftexttoloyypyypgy,isthecomideaofReissstranslatio。criticism.AccordintoReissitistheteofat:ex:tthatg,ypconcernsessentiallythetranslationmethodandrelativerioritiesofwhatistobereservedinppthetargetlanguage.Thekindoftextconcernsthelinguisticelements化beconsideredwhenR200424-tttranslatio打iscarriedon.eiss:38hasdividedthetexeintothreekinds:()yp5 脊柱内固巧系統晦床评巧报告广西大学巧译硕女単位论义(〈》颗译项目conen-focusedform-focuedandaea-ttslfocused.Asthetranslationuroseistomakethe,pppptargetreadersknowabouttheperformanceofthemedicaldevice,itcanbedecidedthatthis-iienan-textisconteirtfbcused化xt.Ressontsthatwhtrslatinacontentfocusedtextitspg,rimarconcernistheaccuracofinformationsotheaccuracof出einformatio打conveedpyy,yymustbeattachedreatimortance化for化etranslatio打ofsuchtexts.Theesse打ceofthegpco打-扣ntioftranslatio打isthecommunicative扣nctionandLeech1981:404utsforward(巧pthatthecommunicativefimctionoflanguagecanbeendividedintofivetypes:informational,exressivedirectiveaestheticandsocialfunction.ForthetranslationofCESIFStakinthep,,,g,translationaimandtargetreaderi打toconsiderationitsnothard化cometoaCO打elusionthat,thetranslationshouldbelaininstlelaemhasisonconveininformationcorrectlandy,ypyypg,itsaimistoexressthecontentof化e1;extrecisel.Thereforethecontentandinformationppy,shouldbefullreresentedinthetaretlanuae.ypgggBased0打alltheseanalysesaroertranslationstlecanbedecided.Thetranslation,ppystyleshouldbelainconsistinwi化thestleof1:hesourcetext.AccordintoYuanFanp,gygg2010:632claritandsimlicitarcalsothemai打translatio打rincilesinmedicaltext(),ypypptranslation.Thelanguageoftranslationshouldbeformal,standardconciseclearandlogical,,,makinsuretargetreaderscanunderstand.g义.13TranslationMe化odReiss(2004:17)mentionsinhisbook也at化e1;extstyleis比eprimaryfactor化atafects化,echoiceoftranslatio打strategiesandmethods.Fromaboveanalsis,itsobviousthatthey-sourcetextbelongst;ocontentfocused1:extanditaimsatdeliverininformationaboutthegperformanceofmedicaldevicetotargetreaders.Takingthestyleandthepurposeofthesourcetexti打toconsideratio打theauthordecidestouseliteraltranslationmethodineneral,gdeliver化einformaio打faihfullccordinhuteworow:era化tt.AtoSlth&Cie200495Iklyg),(*ttDranslaiondefinedbze打0内幻〇幻化s/幻化9巧汉w况&yiefers化thedirecttransferof江,y/,6 广巧大単巧译巧古単位论义《并接々因巧表满瞄床评巧》巧巧巧目化舍sourcelanguagetextintoaappropriatetargetlanguagetextgrammaticallyandidiomaticall.yAlthoughthistranslationmethodplaysapositiveguidingroleduringthewholetranslationrocessingeneraltheauthoradots出ferenttranslation化chniuessuchasadditionp,pq,,^divisionandpassivevoice,indiferentcontentsso犯化produceareadabletranslationfortargetreaders.32-PretsltiolPti.rananareparaonsGoodrearationisveressential拓rawork化bedone.Ineneralrearationsppyg,ppincludereferencebooksandaralleltextrearation^lo战arakin化olsreparationandpppgymg,pschedulemaking.The化llowing化ctiondescribeseachpartKspectivelyindetail.3.2RBosndParalllTextPti.1eferenceokaereparaon?Beforetheroecttranslationtheauthorreadthrouhthesourcetextottheideapj,g,gofthetextandmarkedthetermsatthesametime.Thentheauthorborrowedsomebooksand,medicaltermdictionaryfromlibrar.Thesereferencescontainexressionsusedinmedicalyptexttranslation^whicharehel)fiiltoguidethetranslatioii.j"'Inadditiontheauthorsearchedthewww.cnki.netbinttingthekeywordssinal,ypup^*internalfixationanddownloadedsomerelatedapersasaralleltextsforreference.Thesepp'referentialmaterialsrovideuidanceintheasectofthetranslatorsstleusaeofwordspgpy,gandsentencestructure.Atthesametime化roidesbackroundinformationhihihlfil,vwcseipgpfortheauthortobetterunderstandthesoxircetext.Paralleltextsselectedare1)'*B-mue-ioechanicalTestingofaUniBuiltinExandableAnteriorSpinalInternalFixationqp。"Sstem2TreatmentofAtlanto-axialVertebralInstabilitFractureswithCervicaly,)y,,crewaation-PosteriorandnerbodusionPe化cleSInternlFixIty.F7 广西天古#化论文《巧电A因巧系化化床评巧》巧巧巧目化?32.2GlossaryreparationPNewwordsandmedicaltennshavebeenmarkedwhentheauthorreadsthroughthesourcetext.Then,theauthorchecksoutthetranslationofnewtermsandwordsbysearchinginYoudaoGooleBaiduandmedicaltenndictionar.TheauthoralsousesBaiduand,g,yGoogle化recheckthetranslationofterms化makesurewhetherthetermexistsandhasbeenwidelusedinauthoritativewebsites.Finallytheauthormakesalossarwhichisvery,gyyconvenientandnecessaryforthetranslationbecausesomewordsaearreeatedlinthe,pppytext.ThelossarisshowninthenextaeeeTable1.gypg巧)8 广西译项古単tfc话文《挣往々因巧呆满J店床评巧》巧巧巧目报吿Table1GlossaryTermsTranslationTermsTranslation椎间桂骨interbodyboneraf也塞luscrewg巧螺pg淆脱巧ondylolysis沉?Lbolthole植骨融合bonegraftfusion胸腰椎骨折thoracolumbarfracture脊柱vertebralcolumn椎板减压laminectomy-vertebra椎板间植interlbone椎间盘突出lumb化intervertebraldisc#graftingprotrusion-bone骼前上棘n椎骨横突interdiapophysisateriorsuperiorUiacspine关节桂骨grafting椎体vertebralbody近端胸弯proximalthoracic,PTertebralarchainhoi椎弓v主胸弯mtraccMT,椎弓板laminaofvertebralarch胸腰弯/腰弯化oracohunbar/luinbarTL/L,-vertebra椎间隙interlspace支点弯曲影像fiilcrumbendingradiographR,FB-vertebra椎间孔interlforamen顶椎旋转度巧icalvertebralrotationAYR,入路aroachaicalvertebraltranslationpp顶椎偏距p,AVTreconsruct-接骨板tionlatentersaceanleaical椎间角I;ppgpvertebral脊柱前田lordosiscurvature下关节突inferiorarticularprocess椎弓根vertebralpedicle下关节面inferiorarticularfacet棘突spinousproc的s横突transverseproc的s9 广巧大单巧译巧古単tfe论文《并牲A固巧呆满I化床评巧》巧巧巧目化舍3.23ToolsPreparationThesoftwarexisedduringthisprocessincludeswordprocessingprogram,CAJviewer,YoudaodesktoonlinedictionaryortableDocumentFormatPDFGooletranslation.p,P(),gAlso,emailserviceandinternetexplorerareusedfrequently.ThesoftwarementionedQQaboveareallusedthrouhoutthewholetranslationroectandoeratedonalatfonnagpjpp,comuter.Internetaccessisalsorequiredforsomesoftware化operate.B朗ides,acellphonepisd化communicatewiththeroectleader.usepj‘n?mHeishen2010ihisbook■Pra如如/Cow旅/加onentionstheQ(),j於,useofinternetresourcesandtools.Searchenginesmainlyusedbytheauthorduringthistranslatio凸proc的sareSaidu.comjGoogle乂om>Yahoo.comandPubMcd.com.MthmassiveamountsofinformationBaiduismainlusedforsearchinChinesebackundinfonnation,,yggrosuchas椎根弓钉.Thewebsitehttp://images.baidu.comycanbeusedtocheck.GoogleandYahooeusedluerminoloiescllocationandre-checkandhalsohelarmainltoookptgoteyyp化obtainrelatedEnglishbackgroundinformationandimages.WWW.PubMed-comisafreesearchengine,providedbytheUnitedStatesNationalLibraryofMedicine,(NLM).Ifsmainlyusedforsearchinrelatedmedicalthesisandabstractsforreferencesotranslationg,fromthiscorusismorereliableandauthoritative.Thismedicalcorpuslasanessentialppyroleintranslation,3.2.4WorkingScheduleSchedulesarenecessaryforcomletintheroectsstematicallandeffectivel.Proerpgpjyyypsched山货油ouldbemadebasedontheoverallworkloadandworkintime.Thisroectisgpjdividedintothreeartsaccordin化thereuirementofthecomanandtheauthor伍lishespgqpyeachartresectivel.ppyTheauthorhasmentionedintheroectdescritionthattheroectlastsfromOctoberpjppj10 广苗大単巧巧喝g古弟值论义《舞巧巧固巧系統晚床评巧?巧巧巧百报舍也化172014化October242014andthesourcetexthasabout14220Chinesehterscaracso,,,,,theauthorhas化finishatleast25為0everyday.Thewholetranslationroce巧includesthreep-hases-nnaanson:retraslatioltrlationandsttraslationstae,pp,pgPre-transnaleiiofre-analndrelatiostagconsstnsisaarationsaveswafor,gpypp,py任anslation.Thisstagemakes江oodrearationforsmoothtranslatinanduidesthewholegppggtranslationroces义Prearatio打referstorearenecessar化olsandreferencematerialsppppyneededdurintranslation.TranslationstagereferstothestaewhensourcetextistranslatedggintoEnglishbtheauthorindeendentlwihinthelimiedimePo-translationstaeypyttt.stgconsistsofualitcontrolandcustomerevaluation.ualitcontrolisconductedinthewaqyQyyofproofreading.Whenthetranslationofeachpartisfinished,itisproofreadbytheauthor,,化eau化orsclassmatessuervisorresectivel.Thenitisdelivered化化eroectleaderof,ppy,pj,thetranslationcompanyinMicrosoftWord.Mththeheloftheauthorssuervisorandppclassmates,thequalityofthetranslationguaranteedfurtherbyproofreadingwhichfinishedonimeh泣sinft.Afthetranslationcomanisitotheauthortwitsatifygeeceedbackofvenpygaftertiiistranslationroectfimshes.Theworkinscheduleoftheroectisresentedinthepjgpjpnextae.SeeTable2pg()11 广西大集巧译巧古単值论义《#?狂々因巧系巧晚床巧化》宙译巧目报告Table2WorkinSchedulegTimeStageTasksNotes--Oct.172014PretranslationA.PreanalsisToanalsisthesourcetexttaret,yy,g-dtrltiOct.18reaersansaonfunctionmethods,,,2014andstyle.B.PreparationsSearchingparalleltextsfromtheinternetborrowinreferencebooksfrom,glibrarrearin化olsandmakinthey,ppggglossaiys.Oct.l8014TranslationndFirstPartTranslatinaround3900words.^ag,-t-tposranslationproofreadinganddeliverin.gOct.202014,Oct.202014TranslationandSecondPartTranslatinaround4,800words.,g--ndosttranslationproofreadingadeliverin.pgOct.222014,Oct.222014TranslationandThirdPartTranslatinaround5500words.,,g--ndroofteadindlieriosttranslationgaevn.ppgOct.242014,义3-PosttranslationPost-translationstaeconsistsofualitcontrolandcustomerevaluation.Inthisstaegqyg,thetranslationwillbe扣rtherimproved化makesureitsreadabilityand化meettherequirementsoftheclient.12 广西大古集位论文《舞锭内困定巧满跑床件巧》巧巧项目报含3.3.1ualitControlQyualitcontrolisaartofualitanaementaimintomeetthetranslationQypqymg,grequirements?虹thisproecttranslation^ualitcontrolisconductedinthewaofjqyyproofreadinginthreelevels.Thetranslationisroofreadbtheauthor,twoofherclassmatespyandsuervisorl.prespectiveyProofreadinlas泣reallessentialroleintranslationrocesswhichaimstoolishthegpyyp,ptranslationandimrovetheaccuracandthexialitofthtrnslation.Besiderineasoofread,pyqy,pgcanmakesxirethetraoslationwillmeettiierequirementsofthetargetreaders.Theauthormainlfocusesoncorrectingmistakesandcleaningupambiousexpressions.HeryguclassmatesaretochecktiieauthorityoftermsandwhetherIhetranslationisconciseloical,gandreadableforthereaderinthisfield.Thesupervisorreviewstiiewholetranslationtocontrolitsuality.Theroofreadinscheduleofthetranslationroectisshowedinthenextqpgpj—laeSeeTabe3.pg()13 广西大樂古単往论文?靑技巧因义哀巧1店床巧巧》巧巧巧目报舍町ble3ProofreadingScheduleMissionPartTimePeopleinchargeOct-PartOne.12014Selfroofreadincorrectiimistakescleanin式,pg^,gupafter12:00a<m.ambiuousexressionsgp,C-lassmatesroofincheckinifthetranslationispggconcise,logicalandreadable-nsSupervisorproofreadingreviewingthewholetralationP-artTwoOct2014Selfroofreadincorrectinmistakescleaninu.2L,pgg,gpafter12:00a.m.ambiguousexressionsp,C-lassmatesproofingcheckingifthetranslationisconciseloicalandreadable,gSuerv-pisorproofteadingreviewingthewholetranslation-mPartThreeOct.232014Selfroofreadincorrectinistakescleaninu,,pgg,gpafter12:00a.m.ambiguousexpressions,C-lassmatesroofincheckinifhnlationispggtetrasconciseloicalandreadable,gi-whoSupervsorproofreadingreviewingtheletranslation33.2CustomerEvaluationTheGrandStrongLimitedgivestheauthorafeedbackintheformofcustomerevaluationwhichisattached虹theappendixofthethesis.Thefeedbackseakshighlyofthep’professionalquality,recognizestheauthorstranslationskillsandextends化eirsatisfaction化thequalityofthistranslationproject.Atthesametime,theyshowsincere化maintain-longtermcooperationrelationwiththeauthor.Throughthisroecttranslationtheauthorpj,notonlygainsmuchexperienceinmedicaltranslation,butisencouragedbyit.Also,theexperiencewillbesharedintheconclusionpart.14 广西古案位论义?脊社々因巧胞床巧巧》存巧巧目报合Chapter4CaseStudiesInthispart,theauthorwillresentthreekindsofcasessheencountereddurinthepgtranslationpro说巧nameltranslationofsentenceswith打osubecttranslationoflon,y,j^gsentences,andtranslationoftextsrelated化clinicalstatisticaldata^化出scusshow化dealwiththeseroblemsanddemonstratetheskillsandstrateiesshealied.Tocertainextendpgpp,tiiesecasesarethetypicalfeaturesofthisclinicalreport.4.1TranslationofSentenceswithNoSubectjFromtheanalysisofthesourcetextinchapterthree,itiseasy化gettheprominentfeatureofmedicaltexttranslationistiiattherearelentofsentenceswitiinosubectpyj,becausetheclinicalreportis化obectivelillustratemedicaltru化discoveriesandjyexerimenlltsf-ptaresuratherthanthepeoplewhodidsooneothediflScultiesofCE,translationistodeterminethesubect.Thereforetheauthorasextraatentioiitosentencesj,pywithnosubject,abstractsseveralsimilarsentencesfromthesourcetextandresentstheptranslationtechniquessheappliedinthetranslation,suchaspassivevoiceandaddition.However,allthesetranslationtechniquesareappliedonthebasisofliteraltranslationmethod.Thestudyoftranslationofsentenceswithnosubjectisofgreatsignificanceformedicaltexttranslation.4.1.1TranlatiuesonTechniqofPassiveVoice>’化swellknownthatpassivevoiceiswidelyusedinEnglish.Usually,itsusedwhenthe,,activesubectisunknownorcantbereadilstatewhenhedo巧fheonneednbejy;totactit化mentioned;whentheactorisemphasizedforsomepurposeorwhentheoriginalsentences15 广巧大単巧译巧古*位论义?并化々因义呆化晚床评巧》巧巧巧目报告havenosubect.Theauthorhasanalyzed化atthesourcetextbelongs化medicaltextwhichjputsemphasisona山stratingedicalresultsratherthantheeolewhodid化AsFanmppZhongying(1990,inhisbook,AnAppliedTheoryofTranslatioiijmentionedthedynamic)euivalence.Due化化ediferentexpre泌ivewaysofassivevoicebetweenChin的eandqp--wordEnlishtranslatorscanHcotheoriinalformandtranslatewordfor.Thereforeg,pyg,passivevoicecanbeusedintranslatingsentenceswithnosubect.Theauthordemonstratesjtheapplicationofassivevoi说basedontheanalsisofthe仿Uowinsamles.pygpSample1:早期给予整复、减压、固定、恢复椎管形态,可为损伤的脊髓神经功能恢复及早期康复创造条件。Translation;Givenearlrestorationdecomressioiifixationrestorationofsinalshaey^pj^pp,goodconditionscanbecreatedforneurologicalrecoveryofinuredsinalcordandearljpyrehabilitationoftheatient.pAnalsis:Obviouslthereisnosubectinthissentenceandhmeansthatiftheatientyy,jpreceivedspinalshapeisrestored,decompressedandfixedearlytothepatient,ifsgoodfortrehabilitationof.robhetheatientHeretheauthorus货assivevoice化solvethislemp,pp^becausethiswacanavoidtheroblemoftranslatinwithoutsubectanddelivertheypgjinformationclearl.Inotherwordstakintheobectof化eoriinalsentencestheubtasecofy,gjgjtranslation.Th旭ivevoiceisoneoftranslationtechniu的化translatesimilarsentence,passqstructure.Sample2:在达到治疗的前提下,尽可能选择简单、安全、创伤小的治疗方法。Translation:Underthepremiseoftreatingthedisease,relativelysimple,safetreatmentmethodwitiilittletraumaischosen.16 广西大学翻课项古学位论义《脊枉内因巧系統略床评巧》病译巧目报吿Analsis:Inthissente打cethedoeroftheactio打isnotmentioned.化ustemhasizesthey,jpactionso化issuitabletousesivevoicetotranslateandthetranslationivencan^p犯gemhasizethetion汹thtime.pacesameSamples;X脊柱内固定术前应仔细分析侧位及站立位线片来确定脊柱前凸曲度,并估计合适的椎弓根钉长度。andn-rafiTranslation:ThelateralandstigXylmsshouldbecarefullanalzedbeforetheyysinalinternalfixatio打surgeryinorder化makesurethelordosiscurvatureandestimatethepappropriatepediclescrewlength.,Analsismheucture…?…来确定……itseas化eheoriiiIy;Frotstr应巧细分析并估计,ygttg切sentencehasnosubectInordertoemhasizestheactionanddelivertheinformationclearljpyandobjectively,theauthoradoptsassivevoicetotranslate.p4.1.2AdditionAdditionamlificationreferstotheaddinofwordshrasesorevensentencesin(p)g,p,translationonthebasisofaccuratecomprehensionofthesourcetexttoachievesemanticIcompletionandsyntacticcompletion.Whentranslatingsentenceswithnosubect,sometimesjitsnecessary化addsomewordstoconveytheoriginalmeaningclearl.Thefollowinareygdiealicationadditiontranslationtechniue.ppofqSample1;最终锁紧螺母好,将内六角改锥插入抗旋转扳手中,将抗旋转扳手安置在钉与捧之上,巧紧螺母的同时,把持住抗旋转扳手来对抗其旋转力矩。17] 广巧大古掌tfc论义《?耗A固巧乂筑I色床评往》々淨巧目化吿Translation:Whe田tighteningthelocknutjyoushouldinsert化6internalhexscrewdriver-intotheantirotationwrenchwhichshouldbelacedonthescrewandrod,andholdonthep-momenantirotationwrenchatthesametime化resisttheturningt泌as化reventdamae化pgtheinternalfixationstructure.Analysis:ThiskindofstructureisverycommoninChinese,especiallyinthisclinicalreport,""",,",,withoutthesubjectsbutwithseveralverbs,suchas插入,安置,持住.CaiYinhuan"”(2010:103)hasputforwardinhisaerthataddinoucanbeadotedwhentranslatinppgyp*gChinesesentenceswithambiguoussubectorwhenthesubectmakesaeneralreference.jjg"*"Heretheauthortranslatesthesentencebaddinoushouldbecausethiswaclearl,ygy,yyshowstheoerationstes化taretreaders.Itcanbeconcludedthatanotherwa化translateppgy【"sentenceswithnosubectis化addsomewordsforexamleu.j,p如Samples:连接捧的折弯,先用模棒测量所需连接棒的长度和曲度。Translation:Asforthebendingoftheconnectingrod,itisadvised化measurethelengthandcurvatureofIheconnectingrodbamodelrod.yAnalsisObvioulthinosubtithit.Ittlthewa化bdthy:syeresjecnssenenceelsene,y’indandimliaberconnectgesthatste化measurethelenthandcurvaturefirst.虹orderropg"化makethetranslationfluentandclear,theauthoraddsAs化introducethesentence""andformalsubjectitisadvised化connectthesentence.QuanJigang口010:57)alsohas"‘‘mentionedinhisaerthatthestructureitis".that...canbeused化侦nslatesentenc的ppwithnosubject.Theauthorfindsoutthatmakinguseofformalsubect化translateisj"’’’commoninmedicaltext.ForexamleItsbseved".tht...poraSamples:螺塞的预装,用螺塞预紧扳手持住螺塞,将其旋入螺巧槽。提拉复位,用压18 广巧大举病^Mgr古单他论义?脊栏内固巧杰統|巧床评巧》巧译巧目报舍棒错夹住椎弓根钉头两侧的沉孔中,再把皮捧错往下推压将连接捧皮入U形槽,同时用螺塞预紧扳手旋入锁紧螺母。rsaton-wTanli:Whenitcomestothereinstallofthescreluoushoxildholdtheluppg,ypgw-iththeplugpretighteningwrenchandscrewitinto化escrewslotWhenpullingtoreductionoushouldclitheboltholesontwosidesoftheediclescrewwithclamthen,yppp,ress-p化eclampdownwardtoushtheconnectinrodintotheUshaedrooveandselect江pgpg-ihteninrnlocknutwiththeluretwech油化63出116也11氏pgpgg,"""Analysis:Itsobvio朋化seethattherearemanyverbsinthissentence,such泌预紧,旋"",,""""入,提控,推压,旋压,butithasnodoeroftheaction.Twosentencesdescribehow化installthescrewluandhow化oeratewhenullin化reduction.CaiYinhuan010:10pgppg口)mentionedinhisaerthatonewa化translatesentenceswithnosubectistotranslateitppyjintoactivevoicebyaddingwords.Inordertomaketheoerationstesclearlconveed,theppyy""authoraddsthewordyoushouldwhentranslating,becauseonlybythiswaycantheconcreteoerationtebllstatedtothedoerf&eactiorupspsecearyoBanalyzintheabovesamles化canbeconcludedthatwhentranslatinsentencesygp,gwithnosubectinmedicaltextthealicationofassivevoiceandadditiontranslationj,ppp"techniquecansolvethisdificulty.Amongtheadditiontranslationtechniueaddinouq,g勺",,andformalsubectitareoftenused.j4.2IVanslationofLongSentencesTheauthorhasmentionedinthesourcetextanalysisartnumerouslonsentencesarep,gliclrlaionshioflonsentencesinmedicalexiuleweincluded.TheogaetpttsusalhiddenbtengytelineswhileloicalrelationshiofEnlishsentencesisusuallexressedbconunction.h,gpgypyj19 广西大#^^8译巧古单化论义《背接A因巧呆满I店床评巧》巧译巧目报古LongsentencestranslationhasbeenadifiScultyinmedicaltexttranslation.Therefore,studyinghow化倘nslatelonsentencesinmedicaltextisofreatnec的sit.TheauthorggydemonstratestwowastodealwiththisdiflScultnameltranslationinoriinalorderandyy,y,gdivision.4.2.1TranslationinOriginalOrderWangYan(2008)putsforwardinherbook,ACourseinMedicalEnglishTranslationandWriting,onewaytotranslatelongsentences山medicaltextis化preservetheoriginalorderofthesourcetextjbutaisjustapplicableto化elongsentenceswi化onlyonesubect.jTheauthorwillresentheralicationofthistechniuethrouhtheanalsisofthefollowingpppqgysamples.Samle1腰椎骨折合并脊髓损伤的手术目的是恢复神经通道,解除神经压迫,重建p:胸脊柱稳定性,为神经损伤恢复提供环境和预防迟发性神经损伤。Transla枯on:Thesurgeryaimofthe化前泌〇1地比狙fracturewithspinalcordinuris1;〇jyrestoreneuralathways化relievenervecomre站ioii化reconstructthesinalstabilit化p,pjpy,providetheenvironmentfornerverecoveryand化venttheinurofdelaednerve.prejyyAnalysis:Thissentencestructureisverycommoninmedicalclinicalreport,containingmuch""-information.Theonlsubectis手术目的followedbthreeverbobectVOyj,yj()‘"cons-truction.Due化thereisonlonesubectthree化doconstructionscanbeusedtoyj,translatethreeVOstructure,keepingthesameorderwiththeoriginaltext.Samples;后路手术相对简单,利用张为带原理,椎弓根系统的轴向撑开为使后纵初带伸展,带动椎体周围的软组织牵引骨块复位,从而恢复椎体的高度,达到满意的复位和20 广巧大论文《斧拴A因龙底典晚床评巧》翻巧巧目化告坚强的固定。Translation:Posteriorsurgeryisrelativelsimleanditusesthetensionbandrincileandyppptheaxialdistractionforceofpediclesystemtostretchtheposteriorloi^itudinalligament^化drivethesofttissuesurroundingthevertebrae化tractthebone化巧storevertebraeheiht,gjand化reachasatisfactoryreductionandstrongfixation.地"。Anal:Obviousltheonlsubectofthissentenceis后路手术followedbseveralyy,yj,y"""。VOstructures,suchas伸展,带动処dsoon.Duetothereisonlyonesubject,theauthor’’-wali货、odostructure化translateVOstructurekeeinthesameorderiththeoriinalpp,pggtextandtrying化keepthesameformwith化eoriinalsentence.gSamles:椎弓根螺钉进钉点选好后按照Weinstein解剖定位法选好进针点后,用手动pT形手推按上述方向钻至4.5cm左右刻度线,用细克氏针探查骨道并留置测深及定位用。,用明胶海绵填塞骨道口止血Translatio田ertheediclescrewe凸仕anceointwaschosenaccordintotheWeinstein:Aftppgacazationmeod-rewnatomillocali化drillwhheeveruathouneeditt了tscdrimanll化the,yypylacehereiabmit4.5cmdee化thebtlwithKirchnerwhichillbpwsprobeoneunneswe,pleaved化measurethedepthand化determinethepos化on化fillthebonetunnelhemostasis,withGelatinsponge.Analysis:Throughanalysis,ifsapparenttoknowthatthisisalongsentencewithnosubectj"。‘’’‘‘andthreeverbs华pears,such化钻,礙査and填塞Theauthortranslatesthesentence***'byaddingneedassubjectfirst,andthenmakesviseofthreedoconstruction,such"‘*""as、〇drilltorobeand、〇fill化杜anslate.Thistranslationtechniuereservesthe,pqporiinalorderandkeesthesamefonnwiththeoriinalsentencewhichuaranteesthegpg,g21 广西大古举往论文《資巧巧固巧JRJ聚値床评巧》巧巧巧目报舍precisenessofEnglish.4.2.2Division巧nPining皮ZhangLi01化27putforwardthatdivisionas江translationtechniuegp口)^q,referstosplitalongsentenceintoseveralshortsentences,whichcanstiUremainthemain-styleandmeaningoftheoriinal.DivisioniswidelxxsedinCElonsentencestranslation.gygThereforetheauthoraliesthistranslationtechnie化lonsentencestranslationin,ppqugmedicaltextbasedonacciiratecomprehension.Sam-le1;GSS口有很强的椎弓根错固作用及提拉复位作用固定方式为短节段固定,p,固定牢靠,能贯穿H柱,在提供强力固定的同时又可通过背伸加压撑开来恢复伤椎的前中柱高度及椎体间隙,重建生理弯曲,加上横联装置后,产生良好的固定稳定性。Trans-nchornanunrlation:CSS口hasstrongaidlliductionfimctionfoedicle.Itsgpgrepfixationisho-fiivdiichissbledhlwasrtseentxatontaancanrunthroutlireecoumns.ygm,gWhenrovidinstronstrenth化fasteiiitcanrecov却theheihtofanteriorsineandpgggjgpvertebralclearanceoftheinuiedsinebstretchinthebackthrouhcomressionandcanjpyggp,-reconstructthehsioloicalcurvature.Wheneiedwiththecrossconnectindevicesitpygquppg,hasitoodfixationtabilit.auesqgyAnalysis:Thislongsentencehasover90words,whichiscomposedbyeightshortsentences.Byanalyzingthemeaningofthesentence,theauthoretsthatthissentenceintroducesGSSg’-wa口sfimctioiifixatio凸fimctionmechanismandstabilit.Theauthoradotsadditionjy,yptechnique化translate巧intofourshortsentences.Eachshortsentenceexpressdiferentmu-iuindivisionechniinhransliheanng.BsgteteCEtatontemeaninofthesentencecanyq,gcanclearlyexressed.p22 广西犬単宙古酱位论文《背柱々因巧糸筑胞床评巧》巧译巧目化告Samles:如无良好的植骨融合p,后路椎弓根钉固定系统术后易发生内固定失效、椎体。高度和矫正度丢失,进而发生脊柱失稳和腰背痛,甚至继发性神经损害TranslatioD:WithoutoodfosioH化eosteriorediclefixationsstemisronetofailingjppypinternalfixationafter出esurgerywithlo泌ofvertebraeheightandcorrectiondegree.ITicHjsinalinstabilitlumbaoandbackacheevensecondarnervedamaewillhaen化thepy,g,ygppatient.pAnalsis;Theabovesentenceismadeupoffourshortsentences.Due化thealicationofyppcommaisnotstrictinChinese,thissentenceisconnectedbythecomma.Thefirsttwoshortsentencb化on-的elo且esenseroutellintheresultsoffixationfeilureandthelasttwoggp,g,belong化theothersenseroutellinhatwillhaen化theatient.Basedonabovegpgwpppanalsistheauthortranslates化intotwosentencesbusindivision.y,ygSamples:植骨融合是保持脊柱长期稳定的根本方法,植骨的方法很多,有后路椎板间"植骨、ir植骨、直接植骨、侧后方横突关节突间植骨及前路或后路椎体间植骨等,但横突关节突间植骨的假性融合。,术后滑脱的复发率高Transberaftin&sionisthefundamentalmethodtomintinhelon-mlation:Theonaattergggmethod-verstabilitofsine.Therearemanboneraftinsincludinosteriorintertebralypygg,gp",bonraftrner-einITraftingdirectaftinitdiaophsisboneraftinandanteriororgg,g,gg,pyggosteriorinter-bonraftwlumbarbodyeingetc..Hoevertheseudofusionofpg,,p-iahsisboneraftinhaurhihrecurrenceraofondlolsisaftererinterdpopysatess.gggpyygyAnalsis:Thissentenceiscomposedoffiveshortversionsandhasover80words.Thefirstyexressesthefundamentalmethodthelasttwointroducestherecurrenceofsondlolsisp;pyy,andtheresttellstheboneraftingethod.Theauthortranslatesitintothreeshortsentencesgm巧 广巧大单巧古单位论文《資耗巧固化化床评巧》巧译巧目报舍bydivisio打soastomeettherequirementsofEnglishe邱ressionanddelivertheinformationclearly.4.3TranslationofTextsConcerningStatisticalDataThesourcetextaclinicalreortincludestextsconcerninclinicalstatisticaldata,p,gcomparisonandanalysis.Inpartsixofthesourcetext,theclinicalreportdescribesinformationaboutthesurgeryandcomparesthechangeofparameters,andillustratescustomersatisfactionsurveyofthemedicaldeviceandcustomercomlaintsafterthemarketplamchoftheroductwithlonararahs.Italwastakesreaderslontimetounderstandpgpgpygthemeaninthikindtxtsotheauthoratachereatimortancetothetransltionofofsofesagjgp,thiskindoftext!Itswellknownthatcomparedwi化wordexpression,tablescanshowstatisticdataclearlyanddirectl.Asforthetranslationofthis抑inordertoclearlandypydirectlyshowthechanesofarametersfortaretreaders,theauthorusestablestoshowthegpgrelevantinformationafterotthepermissionofthetranslationcoman.Examlesaregpyppresentedbelow.Sample1:后路手术治疗的15例Kingn和5例KinIV患者患者冠狀面矫形率分别为47.3%g°°°和㈱0%,随访时椎间角分别为4.3±4.4嘴3.4±3.4。而在前后路联合手术治巧的14例Kingn患者和6例KingIV患者的冠状面矫形率°°。分别为77.7%和95.5%,随访时椎间角分别为8.7±5.0哪7.5±8.3。0e前后路联合方法术后椎间角为8.4±6.OS仅行后路者为4.P±4.i,二者之间存在<显著差异(P0.01)。24 广西大^# ̄9^^古单化论文?脊柱內因巧胞床评巧?宿巧巧目化告Translationversion1:Theosteriorsurerhasbeenerformedfor15caseswithKinIIand5caseswithpgypgKingIV.Theircorrectionrateofcoronalplaneis47.3%and69.0%respectivelyandtheir0ooo--n^intersacelin化化11〇\\184.3±4.4沮1(13:4±3.4巧86〇巧¥61.page6啤口又Theosteriorsurerincombinationwithanteriorsurerhasbeenerformedfor14pgygypcaseswithKingIIand6caseswithKingIV.Theircorrectionrateofcoronallaneis77.7%p。"°。and--u95.5%reectivelandtheirinterslinthfollowis8.7±5.01(17.5±8.3ispyaceanee沉pgprespectively.〇**-Theersaceanleis.4±6.0afterthsriorsurerincombinatio狂withintpg8epotegy〇〇nrior-ilhitrl.1±41afterhtriouThereatesurgerywhetenesaceaneis4.teosersrer.,pgpgy<existssinificantdiferenceP0.01.g()Translationve巧ion2;巧eeTable4)古Table4ClinicalDataComparisonSuwaseoorrectonnter-sacente-ei^eryCaN.CiIpIrspaceanglyratefanleintheaftersureroggycorona-llanefollowupp°°°?PosteriorKinn1547.3%4.3±4.44.1±4.1gsurergy°°°°脚gw560.0%3.4±3.44.1±4.1????posteriorKingII1477.7%8.7±5.08.4±6.0&。。。。KinIV699.5%7.5±8.38.4±6.0ganteriorsurergy25 广西大游巧译项古単位ife?义《舞爸A因史义化陆床评巧》巧巧巧目化舍Sample2:我们针对嘴柱后路内固定系统(铁合金产品开展了顾客回访工作。2006""‘‘"年度顾客满意程度调査表统计显示:客户对该产晶质量评价很满意达65%,满意"""引%35%。2007年度统计显示:客户对该产品质量评价很满意嘴的%。达,满意达""‘‘"2008年度统汁显示:客户对该产品质量评价很满意达72%,满意达28%。2009年""""达度统计显示:客户对该产品质量评价很满意达73%,满意27%。Translationversion1:"’’WehaveconductedcusomeiforPoriorSnal巧xaiS.Intrvsitsstepitonystem(titanium)2006theCustomerSatisfactionSurveyshows:65%customersareversatisfiedwiththe,yproductquality35%areustsatisfied.In2007,theCustomerSatisfactionSurveshows:;jy69%customersareversatisfiedwiththeroductualit31%atst.In2008they;reusaisj5ed,pqyjCustomerSatisfactionSurveyshows:72%customersareverysatisfiedwiththeproductquality;28%arejustsatisfiedin2009,theCustomerS地sfactionSurveyshows:73%customersareversatisfiedwiththeproductquaUty;27%areustsatisfied.yjTVanslationversion2:巧eeTable9Table5CustomerSatisfactionSurv巧TranslationYearVerysatisfiedSatisfied200665%%%200769%31%200872%28%200973%27%Sample3:"关于脊柱后路内固定系统(铁合金产品有2次产品顾客投诉,具体情况如下:档案编号:CS07060009::;顾客名称巧南世杰医疗器械有限公司;反映问题产品名称一椎弓根钉;反馈内容:椎弓根巧5.扣50(0701)(T)的支产品的螺纹处有毛刺;原26 广巧大古单怔论文?#起A困巧呆满化床评巧》巧带巧目化*因分析:该支产品在处理加工毛郝时不到位,而后期检验未检出;改善对策:加强对产。品表面质量的检验!;责任单位质检部;确认处理:姜栋档案编号:CS08070101;顾客名称:广州施康!反映问题产品名称:椎弓根钉;联系x人:李钦:6.050(0806)(T)1;反馈内容椎弓根钉的支产品表面有瑕疵;原因分析:该支表面处理不到位,检验未检出;改善对策;加强对产品表面质量的检验!责任单位:质检部;确认处理:姜栋。Translationversion1:Customercomplaint1:則eNo:CS07060009;CustomerName:JinanShijieMedicalDevicesCo"Ltd;Producte:ediclescrewProblem:ediclescrew5.5x500701OnescrewthreadThasmetalNamp;p()()n*blur;ProblemAnalysis:Themetalblurisoteliminatedinrocessinandtheroblemisnftpgp-techeckedo也inost:5tImrovementmeasures:tostrenthentheroductsurfaceualitp;pgpqyinspection;Responsibleunit:Qualityinspectiondepartment;Personincharge:DongJiang.Customercomplaint2:FileNo:CS08070101CustomerName:GuanzhouShikanMedicalDevicesCo..Ltd;gg;Contact:LiinProductName:ediclescrewProblem:TherearedefectsonthesurfaceofQ;p;onescrew5.5x50巧701T.ProblemAnalsis:Themetalblurisnoteliminatedin)()y’heb-proc的singandtprolemisntcheckedoutinposttest.Improvementmeasures:化strenthentheroductsxirfaceualitinsectionRsonsibleunit:ualitintiongpqyp;epQyspecdepartment.Personinchaige:DongJiang.Translatio凸version2:(Seetable6&7inthenextpage)27 广西大単巧巧项古単tt论文《巧?柱巧固巧系筑你床巧巧》巧巧巧目报舍Table6CustomerComplaint1FileNo.CS07060009CustomerNameJinanShiieMedicalDevicesCo.Ltd.j,ProductNamepediclescrewxProblemscrewthread:5.55007(HT),onescrewthreadhasmetalblur()(’AnalsisoftheroblemThemetalblurisnoteliminatedinroc的sinandtheroblemisntyppgpchecked-outinosttestpImrovementmeasureTostrengthentheroductsurfaceualitinsectionppqypualitinsectionQualityInsectionDeartmentQypppdepartmentPersoninchargeJiangDongTable7CustomerComlaint2pFileNo.CS08070101CustomerNameGuangzhouShikangMedicalDevic的献,Ltd.ProductNamepediclescrewContactLi虹QxProblemscrewthread:6.〇50(080巧(T),Therearedefectson化esurfaceofonescrew.’Analsisof化eroblemThemetalblurisnoteliminatedinroce泌inandtheroblemisntyppgpcheckedtin-ouosttestpImprovementmeasureTostrengthentheroductsurfaceualitinsectionpqypQiialitinsectionQualitInsectionDeartmentypyppdepartmentPersoninchargeJiangDong28 广苗大洋窗巧巧古单值论文《脊住内固巧統晚床评巧》翻带巧目报告AnalsisThrliaboareallfollowedbttrltiy:eeexampesvenvewoansaonversionsandonegyversio打isthewordtranslationandtheotheris泣tabl氏Threeexamplesshare泣copmoallildlisf化liiilfeaturethattheabeloi巧tostatistcaataanas.Asoretransatonofthesesmaryytexts,theauthoradoptstablestoshowthespecificstatisticaldataindiferentsituations.>Throughthecomparisongivenabove,itsobviouslytoknowthattablesnotonlyexpressanddelivertheinformationclearlydirectlandvividltothetaretreadersbutachievethe,yyg,,translationurose.Thereforeitsadvised化usetables化translatetextsrelated化statistical,ppdata.29 广西大単巧译硕古尊化论义《脊枯内固巧系统略床评T古》翻译项目报告Chater5ConclusionpTh-sroectofeCEtranlationpCESIFSgivenbGrandStro打imitedbelonstoj,ygL,g-whacontentfocusedmedicalbxttranslationrovin也eairthoranoortunit1:0altshe,pgppyppyhasleamt.Thistranslationreportnotonlywitnessesthetranslationprocess,includingre-rans-tlationalanalysistranslationandosttranslationstaebutillustrateshowtheauthorp,pg,,conductedunder化eguidanceof民eissstexttypology化eory.ConclusionsandexperiencedrawfromthistranslationracticewUlberesented.ppencarr打ouaans打recre-ransaonaanamortanWhittrlatioottltillsisisverit化ygp,pypjyuidethefollowingtranslatio打work.Asasai打oesri打di打achoerwill打otholdugygg,ggpppheworkofcut-tinfirewoodsoroerretranslationalanalsisisneeded1:0analsis也eg,pppyytargetreadersandthesourcetext,todeterminethetexttypeofthesourcetext,translationsteandansaonmethodsLearninabouebacrountandmaayltrlti.gtthkgdinformaionki打gscheduleforthewholeworkishelpfiilforconducting也etranslationworkefectivelyand-eficientlyontime.Moreimortantlybasedon化econclusio打fromretranslationalanalsisp,pyandsupportedbytheexamples,translatio打ofsentenceswithnosubectlonsentencesandj,gtextsconcerningdatacomparisonandanalysisarestudiedanddiferenttranslation1:echniuesqareappliedaccordinglyinorder化makeareadabletranslationfortaretreaders.Forinstanceg,assevoceandaddonareusedwhenansatnsentetpiviititrlignceswihnosubecttranslationinj;oriinalorderand出visionarealiedwhentranslatinlonsentencesinmedicaltextandgppgg;tablesareadoptedwhentranslatingtextsrelated化statisticaldatacomparisonandanalysis.Wht-afsmoreaindisensableset;heroofreadinof也etranslationbothersenior,pppgyan*’mkedtrslatorscannotbeinoiedbecauseaenonsabilitisliandcollectivewisdomisg,pymoreowerful.Onlbthiswacanatranslatormakesuretheualitofthetranslation.pyyyqyThrouhthistranslationracticetheauthorrealizedthattranslationisnotustthegp,jlanuaetransformationatwordlevelbutasocialracticethatinvolveslanuaeservicegg,pgg30 广西大単IB巧硕古単怔论义《青社々困义哀化晚床评巧》宙巧巧目化舍andinterpersonalcommunicationjwhichrequirestranslato巧化payextraatteiitio凸化n-conmumicationskillsseseofresonsibilitandroblemsolvii:skillsaartfromthe,pyp^planuaeskills.Alsoaoodtranslatorsho山dtr化虹owaboutallkindsofknowledeingg,gygsaretime.Whatismoreimportant化mentionisthatwhenundertakinaroectitispgpjsnece姑aryfortranslators化evaluatethe出ficultyofmaterial,thetranslatioiiprice,translationtimeandthepaymentrisks.Translatorsshouldinvestigatesomebackgroundinfonnatioiiaboutthetranslatio凸comanbycheckitheemailkktaithepyng)maesurewhehernc山desnameaddresstelehonenumberfaxandinternetaddressofthecoman.Also,searchinits,,p,pygoficialwebsiteandinputtingtheemailaddressandcomannameintothesearcheninecanpygguaranteethereliabilityofthecoman.Ifsomeneativeinformationapearsontheintemetpygpjtranslatorsshouldpayoreatentionto比mTheconclusionandexperiencementionedaboveiswhattheauthoraineddurintheggwholetranslationroc的s.Theauthorwouldlike化takethisoortunit化recordthewholepppytranslationprocessreviewandsortoutthetranslationmethodsthatareeffectivein,’translatingmedicaltext.Howeveritsimpo姑ible化describeallthefeaturesoficaltextmed,andthecorresondintranslationtechni货5.虹过wordthereare她11alot化bestudiesonpgqujthetranslatioiiofmedicaltext.Therefore,theauthorhopes化makeuseofthisreporttoremindtranslationlearnerstoattachreatimortancetomedicaltexttranslationandwishesgpthatthiseortwouldbearsomeracticaluidinsinificnceforothertranslatoresillrasecappggg,pythebeinnersinthisfieldinthefuture.g31 广巧太単巧■隹内因巧SHOT古掌化论义?背JK化跑床评巧》巧巧巧目化舍BibliorahgpyLeechGSemantics:1981巧le况1〇0?切&2nded.Harmondsworth:Penuin.[。j娜/她[M]g[2]Nida,E.A.1993.Language,Culture,andTranslating[Mj.Shanghai:ForeignLanguageEducationPress.-.巧MReiwK.2000奶〇?5/伽〇。仍诚切《.色化化""。/么NewYork:[引,[]AmericanBibleSociety.[4ShutUeworfhjM.&M.Cowie.2004.Dkriona/7h?w/a俯w汾M成es.Shanhai:]y分间gShanhaiForeinLanuaeEducationPressgggg.[5]蔡银环2010没译英翻译中汉语无主句主语的选择技巧[J]福建教育学院学报(句100-104.6范仲英1998实用翻译教程M北京:外语教学与研究出版杜[][]7其萃仲伟合许钩.2010..岡.北京:[]何,,翻译实用手册外语教学与研究出版化全继刚20-10汉语无主句的翻译方法探究J长春理工大学学报85758.口][]()2010医学英语翻译特色与实例分析J科技信息.,树2例袁芳,[]’-10尹萍乾章觀2〇10.彷I化沉y/加如?oZo?麻/2似公化扣〇?..03[]/g化海外英语()27-28U王燕.2008医学英语翻译与写作教程.M重庆:重庆大学出版狂.[][]口2htt://image.baidu.com.]p13]htt://www.ncbi.nlm?恤.ov/ubmed[pgp32 广西大#巧^^古#位论文《背隹用因巧呆化I化床诛巧》巧巧巧目化告AppendixISourceText?/^顆》师巧柳轴贿腑临床评估报告产品:脊柱内固定系统,编号DB/CE-E-005-A/0:版本:1.0--日期:20120705作者:审阅:批准:WuhanDragonbioOrthopedicProductsCo.,Ltd.武汉德骼拜尔外科植入物有限公司33 广西単位论义《?^A因巧哀化化床评巧》巧巧巧目化舍目录1.总述2.器械描述和预期用途3.预期治疗和诊断说明、要求4?评价背景和临床数据类型的选择5.总结临床数据和评价6?数据分析6.1性能6.2产品文献和说明7.总结34 ?#位论文I化床评巧报舍广西大#巧^^|[古《巧技内因巧呆众》翻味巧目1.总述on--产品sterileinalinternalfixationisstems;N化y脊柱内固定系统是由武汉德骼拜尔外科植入物有限公司生产的产品。一种金属器械脊柱内固定物是,它们可在椎体上产生机械力量,从而利用它们引导脊柱及周围的力量,脊柱复位和稳定脊柱的作用。,来达到椎管减压脊柱内固定产品分为脊柱后路内固定系统和颈椎前路接骨板系统。2.器械描述和预期用途2.1器械描述:该产品采用〇〇Crl8Nil4Mo3不镑钢材料或Ti6A14V铁合金材料制造,表面无着色。按结构可分为;AF内固定系统、RF内固定系统、GSS内固定系统、RC内固定系统,部件包括(包括U型椎弓根钉(长尾)、U型椎弓根钉(短尾)、万向椎弓根钉(长:矫形巧尾)、万向椎弓根钉(短尾)、椎体钉化尾)、椎体钉(短尾)、椎体钩);连接块(包括角度巧、调节块)(、。;矫形椿包括连接捧、角度连接椿、调节套筒连接器)该产品非无茜状态提供一,次性使用。2.2预期用途描述脊柱内固定椎弓根钉用于对患者骨折断端进行固定,帮助骨折处愈合。在使用过程一中,脊柱内固定椎弓根钉般与连接杆配套使用,固定金属接骨板到骨麻有时也可单一独使用被作为拉力螺钉而将骨折片抓持固定在起。颈椎前路接骨板适用于颈椎骨折脱位前路内固定;脊柱后路内固定系统使用于脚腰椎骨折后路内固定。3.预期治疗和/或诊断说明和要求3.1胸腰椎骨折合并脊髓损伤的手术目的是恢复神经通道,解除神经压迫,重建脊柱稳-定性。GSSn通用型脊柱内固定系,为神经损伤恢复提供环境和预防迟发性神经损伤一一种改良统属于钉杆系统,是、操作简便的新型椎弓根固定系统。部件少,有单轴或,多轴椎弓根螺钉,利用棒预弯,转棒复位锁紧螺钉塞,X线透视如复位不全时可巧撑一开错复位。其螺纹纵剖面为自上而下外径致的圆柱形,螺纹深度自钉尖至颈部逐渐变渐在颈部趋于光滑。而钉巧实也部分的纵剖面为锥形,这种结构不但消除了深螺纹结35 广西大単巧译项古単值论文《舞往々固巧系統临床评T古》韶巧巧目报吿-。GSS构引起的螺纹颈部应力过于集中,而且可W避免反螺旋调整引起的螺钉松动II有很强的椎弓根错固作用及提拉复位作用固定方式为短节段固定,固定牢靠,能贯穿王柱,在提供强力固定的同时又可通过背伸加压撑开来恢复伤椎的前中柱高度及椎体间隙,重建生理弯曲,加上横联装置后,产生良好的固定稳定性。、、X、CT、MRI脊柱损伤的治疗应根据病史受伤机制线片等综合分析,选择不同的治疗方法。手术方案的确立应根据脊柱损伤类型、脊髓损伤程度、自身技术力量等因素综合考虑。前路手术能直接去除脊髓前方的碎骨片,减压效果确实,但比后路手术复杂、出血多、创伤大、条件要求高。后路手术相对简单,利用张力带原理,椎弓根系统的轴向撑开力使后纵初带伸展,带动椎体周围的软姐织牵引骨块复位,从而恢复椎体的高度,达到满意的复位和坚强的固定.。在达到治疗目的前提下尽可能选择相对简单、安全、创伤小的治疗方法。早期给予整复、减皮、固定、恢复椎管形态,可为损伤的脊髓神经功能恢复及早期康复创造条件。稳定的内固定是骨折愈合的必要条件,而内固定所取得的复位的效果要靠良好的植骨飄合来维持。如无良好的植骨融合,后路椎弓根钉固定系统术后易发生内固定失效、椎体高度和矫正度丢失,进而发生脊柱失稳和腰背痛,甚至继发性神经损害。临床所见发生的断钉、断棒、内固定物松动的主要原因是骨折节段未行植骨或植骨融合不佳,导致巧棒局部应力过于集中所致。SS-总之,GII内固定系统可维矫形、三柱固定,具有操作简单,固定牢靠,创伤小,并发症少的特点。(摘自文献3)3.2禁忌症:1.急性感染。2.先天崎形,解剖不正常或椎弓根缺失或骨骼有变异3.。髓部骨质异常要慎重考虑是否可W手术。4.对金属过敏者。5.僵硬脊柱侧弯。6.病态性肥胖和有药物或酒精成癒术后不能服从医生指导。7.严重骨质疏松症。4评估背景和临床数据类型的选择4.1腰椎滑脱复位内固定的必要性早在巧32年Carpener就提出对腰椎滑脱的治疗的问一题,但因当时没有很好的器械,操作技术复杂而无法展开。传统的手术方法直是W后一直不理想路复位后路横突关节突植骨飄合为主,但治疗的疗效,植骨后假关节发生率36 广巧大単巧译硕古単化论文《巧社内固巧系统临床评T古》涵译巧目报吿?为18%81%。腰椎后路椎间融合术是Cloward1943年提出的在,即经腰椎后路用模形骨块行椎体间植骨,W重建椎体高度及稳定相邻脊柱节段,但是当时没有合适的内固定器化这种技术未能得到普及。直到20世纪70年代椎弓根螺巧内固定系统应用于脊,柱外科IU后对腰椎滑脱的手术复位和固定提供了可行性,但对是否需要复位的意见仍一不统。(摘自文献2)腰椎椎间蘭合术的适应证:a)腰椎椎节不稳(即腰椎滑脱)是椎间誕合的首选适应一证。常规的椎间盘切除、椎板减压、甚至关节突部分切除,,可进步加重脊柱的不稳目前较为妥当的治疗方法是在腰椎后方固定的同时辅W椎体植骨飄合;b)腰椎椎间盘源?。考虑到椎间盘源性的下腰痛及腰椎椎间盘45,性疾病,尤其是L椎间盘载荷特点即病理上存在椎间盘退变及瞬间旋转中也的改变,,可导致腰椎早期不稳故治疗可选择椎。间盘切除,也可同时行融合固定,W减少日后椎间盘再突出及继发性的椎管狭窄特别,、C。腰适用于肥胖患者因其载荷大活动量大,可给予融合固定)再手;术的椎间融合一椎再手术通常需彻底减压,往往造成腰椎稳定性进步下降,如患者的条件允许应行合适的固定加椎间融合;d)慢性下腰痛。许多学者的研究发现,部分慢性下腰痛患者存在潜在的下腰椎不稳,而临床量化的指标并未达到,对于这类慢性下腰痛患者行椎间融合治疗有一定的缓解率2。(摘自文献)后路固定椎间植骨的特点后路固定的优点为:a)增加了椎间的稳定性,从而可避免假关节形成及滑脱加重b;)可发挥固定的稳定作用,保证植骨融合;C)恢复脊柱的正常序列,使其生物力学和生理功能正常化;d)可解除神经根或马尾神经的压迫症状。植骨融合是保持脊柱长期稳定的""、H根本方法,植骨的方法很多,有后路椎板间植骨植骨、直接植骨、侧后方横突关,节突间植骨及前路或后路椎体间植骨等,但横突关节突间植骨的假性融合术后滑脱的。经:复发率高多年的临床实验发现,腰椎滑脱植骨W后路椎体间植骨更加可靠,因为a体承受腰椎的大部分载荷,故椎体间植骨使腰椎的稳定性更佳;b)椎体间接触)由于椎C,,d面积大,为理想的植骨床););可恢复椎间隙的高度扩大椎间孔利于神经根减压后路椎间植骨的创伤性小,入路简单、安全、清楚,便于手术操作;e)与应用椎间植骨AKTFC器(B)或镜质螺纹融合器()行后路椎体间植骨相比,可达到相同的效果,又降低了37 广西大学巧译硕古単位论文《脊社々固巧系统化床评巧》巧巧项目报吿临床费用,2),大大减轻了患者的负担有利于该项技术的推广应用。(摘自文献4.2我公司脊柱内固定系统产品在临床使用中的评估:X脊柱内固定术前应仔细分析侧位及站立位线片来确定脊柱前凸曲度,并估计合适的椎弓根钉长度。通过椎弓根层面的椎体断层扫描(CT扫描/MRI)来评估椎弓根的内向角度指导螺钉的植入。螺钉的长度和直径也可W通过断层扫描确定。椎弓根的宽度可通过峡部的测量得到>1,。选择合适的椎弓根钉,直径1^充满骨内膜皮质孔的管道为宜 ̄一长度W侧位片进入椎体50%80%为宜。病人体位为俯邱位,般采用标准的中线切口,直到棘突,切口足够长W充分暴露,通过触摸来辨别棘突的位置。确认椎弓根进巧点,椎弓根位于W下H个独特的生理结构的交汇处:横突中部,上、小节节面,上下关节突间部分;进钉点也可W通过横突中线与上关节突外缘的切线的交点来确定。可选择使用咬骨错清除关节面和横突上坚硬的皮质骨,暴露椎弓根的松质骨部分。椎弓根钉钉道准备,用开日器建立进入椎弓根的开口。用显影针通过影像透视来确定椎弓根的位置,用探锥通过椎弓根插入椎体。插入时不需要费很大力,医生应有穿通。应重新插入显影针通过影像透视检查松质骨的手感如果感觉受阻或骨密度发生变化,确认钉道位置。确定椎弓根钉的长度,建立钉道后,用探子检查巧道四壁,W确保椎弓根皮质没有破损。然后用探锥插入钉道,通过探锥的刻度,测量钉道的深度,从而决定合适的螺钉长度。植入椎弓根钉,将合适规格的U型钉、万向钉安装在相应的上钉器上。万向钉可做 ̄°55。50%80%。自由调整来配合连接棒位置椎弓根钉进入椎体,并与上终板平行连接棒的折弯,先用模棒测量所需连接棒的长度和曲度。连接棒折弯到合适的弧度可W降低植入物的切迹,提高整体的生物力学强度,并减少作用于螺钉的应力。植入连GSS,接棒,系统配有各种长度连接棒手术时可W减少剪棒操作。将连接棒从椎弓根钉U形槽处放入,最好用持棒巧夹持住连接捧将其植入。。螺塞的预装,用螺塞预紧扳手持住螺塞,将其旋入螺钉槽提拉复位,用压棒错夹住椎弓根钉头两侧的沉化中,再把皮棒错往下推压将连接俸压入U形槽,同时用螺塞预38 广西大古单位论文《舞柱内因巧I哀化I化床件巧》巧译巧目化舍一紧扳手选入锁紧螺母。加压或撑开进行操作时,应锁紧需要加压或撑开的端的螺母,一而另螺巧的螺母松开。,然后加压或撑开然后用六角改锥抒紧螺母。最终锁紧螺母时,将内六角改锥插入抗旋转扳手中,将抗旋转扳手安置在钉与椿之上。,挣紧螺母的同时,把持住抗旋转扳手来对抗其旋转力矩。。W防止破坏内固定结构植入横连器,用钉尾折断错折断可断钉的尾翼片43预期副作用:1.硬膜破裂。2.手术所致的疼痛。3.感染4.内植物所致的疼痛,不适感。5.金属物的敏感过敏。6。—.内植物的弯曲和断裂7.延迟愈合和不愈合。*8.应力遮挡所致的晉质疏松。’9.:。可能的操作不当并发症紧固不紧;植骨不当或不充分4.4所采取的评价掠准或和统计学方法:根据临床症状和体征及摄像学表现分为:;优植骨融合良好,无疼痛和神经损害体征,活动功能正常或接近正常,自我感觉良好,能恢复原工作。良,,活:植骨融合良好,轻微疼痛无神经损害体征动功能明显改善,自我感觉良。好,能从事原工作可:桂骨融合良好,有轻微腰痛或轻度神经损害体征,活动功能轻度受限,能坚持一般轻工作。差:活动功能明显受限,不能从事轻工作。39 广西天祭巧巧项古単位论文《背巧巧因巧哀統晚床评巧》宿译巧目报告5.总结临床数据和评价1有关脊柱内固定系统产品有很多文献资料,我们搜集了几篇,摘篇总结评价如下:""国产说S系统内固定治疗胸腰椎骨折18例(摘自文献5)自从1983年Denis提出脊柱的H柱理论来,后路减压经椎弓根复位内固定系统已得到广泛运用。近20年来相继推出了Dick、Steffee、CD、RF、AF、TS畑、故S等内?固定装置。下述资料是某医院自2001年11月2005年4月采用战S(generalspinesystem)脊柱系统治疗胸腰椎骨折化例,疗效满意。1临床资料一1.1.般资料?+化例,男巧例,女3例;年龄18日6岁,平均31.23.7岁。骨折按Denis分型:爆裂型11例,压缩型4例,骨折脱位3例。损伤部位:T123例,U9例,L22例,L31例,T12L13例。:高处坠落伤口例,交通事故4例骨折脱位致伤原因,压砸伤2例。合并其他部位骨折14例,合并重症急性呼吸窘迫综合征1例。术前脊髓神经功能Frankel分级:A级5例,B级2例C级6例,D级3例,E2。8按,级例本组1例术前均行常规X线检查和CT检查。X线示:椎体变形,椎体高度丢失。CT检查:椎体骨折线影,双边征,骨块突入椎管,压迫硬膜囊。18例中17例均于巧h内手术,合并重症急性呼吸窘迫综合征1例经抢救全身情况稳定后于伤后2周手术。1.2手术方法采用全麻,俯卧位,置于可透视的骨科手术台上。双肩部及體前上棘处垫中等硬度海绵厚垫,使腹部悬空且身体略反屈W利于复位。骨折脱位者可在术中直视下用巾错牵引或提拉上下棘突复位,必要时可咬去部分关节突利于复位。椎弓根螺钉进钉点按照Weinstein解剖定位法选好进针点后,用手动T形手锥按上述方向钻至4.5cm左右刻度线,用细克巧针探查骨道并留置测深及定位用,明胶海绵填塞骨道口止血。C臂X线透视克氏针的位置、方向及深度,必要时加W调整。螺钉选用:胸椎通常选用直径6mm,??深4.55.0cm6mm5.05.5cm80%左,腰椎通常选用直径,长,要求深度达椎体的右。安装好螺IX后先复位然后再行椎板减压。C臂X线透视证实椎弓根钉位于椎弓根中也后,将预弯的连接杆畜上球形垫圈后,安装至椎弓根螺钟尾槽内。巧上所有螺栓后逐40 广西大単画译项古単位论义《脊栏内固巧巧统I店床巧巧》巧译巧目报告次加压撑开,将螺帽放入钉尾,最后锁紧螺拴。对于严重不稳定的爆裂骨折及骨折脱位,。48h3d尚需作小关节突及横突间植骨术后常规置引流管,未植骨者术后即可坐起,植骨者术后卧床3周。1.3结果?(1)神经功能恢复情况:本组18例获随访1124个月16,平均个月。神经功能按Frankel5例A级无任何恢复外,13例均有不同程度的恢复分级,术后除其余,功?能提高12级,无1例加重;(2)椎体高度及Cobb角:测量伤椎上、下正常椎体高度的平均值作为伤前椎体的高度。伤后椎体前缘及后缘的高度其与伤前所占百分数表.95.1%,.示,椎体前缘高度由术前的479%提高至椎体后缘高度由术前的780%提高至。°术后的98.5%,0)bb角由术前的平均22.3恢复至术后的5.8。2.讨论经椎弓根复位内固定治疗胸腰段脊柱骨折具有王维空间复位和短节段固定等优点,10多年来在国内外己广泛开展,使胸腰椎骨折的巧效大大提高。椎弓根钉主要目的是通过椎弓根将螺钉巧入椎体中,从而起到错固作用。这种铅固强度足W保证通过短节段内固定装置上的椎弓根钉与纵向连接棒之间的撑开、加压等作用力。提供了H维矫正和坚强内固定,恢复脊柱的正常排列,使前后级初带、纤维环等结构充分伸展。同时最大程度地保留了脊柱的活动节段[2]。但W往的椎弓根系统包括Dick、Steffee等,由于,且连接装置并不十分牢靠缺乏精确度复位效果并不十分理想。在术后反复的生理载荷A下易导致松动,甚至断钉而失败。近年来椎弓根内固定系统如RF、F、TS畑等在复位和连接上不断改进,复位效果和稳定性明显提高。一GSS是近年来研制的椎弓根内固定系统之:1,它具有W下几个特点()锥形螺钉定°位准确;(2)特殊牙形设计,提高螺钉的附着力;(3)30内任意方向连接,更适应脊柱°的生理弯曲;(4)棒的%0圆周锁紧;(5)长臂结构更有利于棒的植入;(6)万向横连8GSS系统是接结构有效防止锁紧力的丢失;口)具有极高的机械性能和影像兼容性;()°一半刚性内置物,螺巧与杆的连接为球形垫圈,螺钉在垂直面存在30活动范围,从而避免应力集中。41 广巧大古掌位论义《背枉々固巧■系满胞床评巧》巧带巧目化吿GSS系统治疗胸腰段脊柱骨折,其优点在于:(1)操作简便其金属杆在螺钉上方与之连接,与外侧置棒的系统相比操作简单。尤其在行脊柱多节段固定化如应用(^^往的一-螺钉系统。钢板,椎弓根螺钉不在同平面因此放置钢板会很困难,而故S光滑杆易于放置似损伤小该系统安置所需的手术视野小,两侧分离的肌肉化饼固定牢固GSS螺巧呈锥形,通过自攻与骨嵌合,结合更牢固不易松动。由于椎弓根钉螺纹仅在骨折早期起支撑固定作用,脊柱长期稳定,决定于椎体本身的生物学稳定的建立,即椎体间的骨性融合。因此椎体间的植骨融合,是防止内固定失效、断裂和纠正度的丢失及远期脊柱后凸畴形的关键。本研究的病例均使用椎板间敲合未出现断钉,减少了术后椎间高度的丢失。同时熟练掌握内固定技术,术中用C臂X线动态透视手术进展,对避免手术失误非常重要。综上所述,G%系统具有良好的复位和固定作用,手术较小,时间短,安置方便,牢固性好,术后不需拔除螺钉,并发症少,能早期起床,是治疗胸腰椎骨折一的有效方法之。6.数据分析6.1性能""6.1.1后路复位植骨内固定治疗腰椎滑脱的临床观察(摘自文献2)一一随着脊柱外科领域生物力学研究的进步深入,医疗器械的进步改善,手术技术的曰益提高,对腰椎滑脱的手术治疗日益受到重视,但对其术式的选择及其适应证尚有一不同的见解。我们((盐城市第人民医院)采用RF或GSS复位内固定加后路单纯椎间植骨融合的方法治巧腰椎滑脱,取得了满意的效果,现报告如下。1.临床资料一1.1般资料?本组腰椎滑脱患者28例,男8例,女20例:年龄巧63岁,平均年齡46.8岁。L4淆脱13例5巧例。eerdin,I8,II,L滑脱根据Myg分类法分类度例度14例,。田度4例,IV度2例根据患者的临床症状,我们将28例患者又分为轻度8例,中度14例,重度6例。轻度,只有腰部症状;中度,除腰部症状外,有间断性下肢症状;重度,有明显的腰痛且伴有下肢症状。单侧下肢放射痛或麻木11例,双侧下肢放射痛2,6例5。麻木1例间隙跋行,大小便功能障碍例42 广西大単哲译项古単化论文《舞社内固巧系统化床评巧》巧译巧目报吿1.2影像学资料本组28例患者,皆常规摄腰椎正侧位和左右斜位胖及CT检查,提示L4椎弓单侧崩裂6例,双侧崩裂9例;L5椎弓单侧崩裂5例,双侧崩裂8例。CT检查提示合并有腰椎间盘突出18例,明显的椎管狭窄巧例。1.3手术方式采用RF复位内固定或GSS复位内固定加后路椎间植骨及椎弓根植骨术治疗腰椎滑23脱患者。主要手术步骤有:硬膜外麻醉日例,全麻插管麻醉例。作下腰椎后正中纵L5S、,1行切口,逐层电切电凝止血,显露两侧的椎板及关节突首先确定的椎板间隙,L4确定滑脱的椎体。如为滑脱,则于L5两侧的横突与关节突连线的交点定位,有刻度的锥子任5mmX45mm)锥洞,C型臂透视,证实定位准确后旋入固定钉,于L4两侧C型臂透视L5S1滑脱,则W同样的的椎弓根处定位打入提拉钉,确定定位正确;如为S1两侧打入固定钉5方法分别于,L的两侧椎根处打入提拉钉。腰椎滑脱的患者往往合一,全椎板切除神经根管减压是很必要的并有神经根管狭窄,减压操作时定要细必、耐也。,,避免加重马尾及神经根损伤安装椎弓根连接系统先撑开再提拉固定,滑脱的椎体大部分能复位,但是不能强行追求完全的复位。切除滑脱椎体间的髓核,W专用工具或髓核错摘除髓核及纤维环,,然,咬除软骨板。术中操作切勿过深W免损伤腹主动脉后将切除的棘突及椎板骨修剪成小骨片从后路植入滑脱的椎体间,最后W1枚较大的骨口。,片封堵骨,W免小骨片滑入椎管将剩余的骨块植于两侧的椎弓根如果骨量不足可,取骼前骨块补充。术毕放置引流手术的创伤较大,术中放置引流管很重要,W免术后椎管内血肿形成压迫脊髓,引起马尾综合征。2结果本组患者随访6个月,平均21个月。患者的腰腿痛症状消失或明显缓解28例,腰椎的滑脱完全纠正9例,明显纠正16例,术后椎体间植骨融合良好22例。根据日OA111,522.9%。本矫形协会(J)评分标准[],优例良1例,可例,优良率为93.讨论43 广西大単涵译硕古単化论义《資柱內固巧系统I佐床评T古》巧巧巧目报吿。作者认为,脊柱滑脱引起的脊柱不稳是此症的主要病理学基础对滑脱的椎体行后路椎弓根内固定加椎间植骨融合及椎弓根植骨术是为了稳定脊柱,重建椎体间的高度及稳定相邻脊柱节段,解除马尾W及神经根的压迫,手术复位内固定是很必要的。""6-.1.2GSSII通用内固定系统治疗38例胸腰段脊柱骨折的临床疗效评价(摘自文献3)?35%胸腰椎骨折在创伤骨折中约占,多合并脊髓神经损伤、椎体滑脱。治疗的目的为恢复椎体的离度与脊柱生理弯曲,重建脊柱稳定性,并解除对脊髓神经的压迫。后路短节段经椎弓根钉内固定己广泛应用于胸腰椎骨折、脱位。我院河南省固始县人民医2005-院自年1月至2009年12月应用GSSII通用型脊柱内固定系统治疗胸腰椎骨折38例,效果满意,现报告如下。1资料与方法一1.1般资料?48本组%例中,男33例,女日例;年龄1762岁,平均岁。致伤原因:车祸伤20例,高处坠落伤17例,压砸伤1例。损伤部位::T115例,T1210例,L114例,L28例,L31例。术前脊髓损伤程度按Frankel分级;A级3例,B级3例,C级13例,D级14例,E级日例。。常规行术前术后X线正侧位片检查,测量伤椎高度及压缩率,记录后凸角(Cobbs法);胸腰段的CT扫描、MRI检查,W便准确了解骨块移位、椎管内占位、脊髓压迫及脊髓信号改变。1.2治疗方法全麻或硬膜外麻醉,患者俯卧位。后正中级行切口、,显露伤椎及其上下椎的椎板。关节突和横突,自动拉钩显露手术视野先行椎管减压,切除伤椎椎板及临近椎体的部分椎板,探查椎管。摘除椎管内碎骨片,修补破裂的硬膜囊,用咬骨巧咬除伤椎上、下2各个小关节的关节囊、关节间软骨及骨皮质,显露松质骨,骨创面要求平整,显露将要融合范围的横突并造成粗糖面,便于植骨。按椎弓根进钉的角度及要求分别在伤椎上下各2个关节突钻孔,用开孔锥钻透皮质后改用椎弓根打孔器徒手经椎弓根插人椎体,穿过松质骨时有明显的感觉,直至进钉受阻,表明深度已达椎体前缘皮质下。C型臂X""线机透视测量螺钉直径及深度合适后,括入椎弓根钉,将预弯固定棒安装到椎弓钉U44 广巧大单巧古學化论义《舞柱々固巧哀統I化床评巧》巧巧巧目化吿型槽内,撑开复位固定,置横向连结,将备用植骨条植入到横突间和小关节突间,骨量不足財可用自体植骨或人工骨海合植骨融合。常规放置引流。术后常规应用抗感染、激??h素、脱水药物治疗,弓麻于2448拔除。手术后腰围或支具保护68周,逐步斤功?能锻炼1224。术后定期来院复诊,手术后个月取出内固定物。1.3评估方法术前、术后W伤椎为中也摄正侧位X线片及CT片。在侧位X线片上W骨折上下相邻椎体前沿高度平均值为骨折椎体正常高度。,计算锥体前后缘压缩率1.4统升学方法应用SPSS11.5软件分析数据。数据W均数±标准差表示。计数数据行X2检验,组间差异比较采用t检验,组内前后比较采用配对t检验。P<0.05为差异有统计学意义。2结果?3862417本组例均获随访,时间个月,平均个月。所有病例均达到骨性愈合,'无断钉、断椿、脱钩现象。术后在椎体前缘高度、椎体后缘高度、后凸崎形Cobb角矫正等方面明显优于手术前,差异有统计学意义。见表1。Fra址el分级改善:A级2例,B级2例,C级2例,D级5例E级27例。见2。,表表1手术前后椎体高度和ColDb角比较姐别椎体前缘高度(%)椎体后缘髙度(%)Cobb角r)手术前39.45+6.5477.%±3.8821.%±3.62+2*;97手术后93.51.94.92+1.65*4.68+1.73*注;与手术前比较,冲<0.05表2神经功能Frankel分级恢复情况术前化ankel分术后随访情况(例)例数(例)敬ABCDEA321000I145 广巧大単巧》^古単位论文《舞技内因巧呆化化床巧■巧》巧译巧目报舍B301200C13000310D14000212E5000053讨论:38GSS-n通用型脊柱内固定本组例行,术后在椎体高度恢复、后凸崎形Cobb角矫正等方面明显优于手术前。、,差异有统计学意义所有病例均达到骨性愈合,无断巧断棒、脱钩现象。术后神经功能恢复良好,Frankel分级改善。6.2Safet;y安全6.2.1青少年特发性脊柱侧凸前路矫形、固定誕合术后椎间角的变化(摘自文献4)随着人们对特发性脊柱侧凸认识的増加,其治疗越来越规范化。不同类型的脊柱侧一凸其手术入路也不样。,胸腰段和腰段脊柱侧凸多选择前路手术前路矫形内固定术后,下融合椎(lowestinstrumentedvertebraLIV)下终板与下方相邻椎体上终板之间椎间隙的开角称为椎间角(interspaceangle),有文献报导此角常较术前増大,但无详?细的文献分析。本文总结中国医学科学院1998年11月2003年5月收治的特发性脊柱侧凸接受前路矫形内固定的患者,分析椎间角的变化情况。1、材料和方法?回顾性分析北京协和医院骨科自1998年11月2003年5月行前路矫形内固定的特发性脊往侧凸病例,入选标准如下;(1)侧凸为特发性,椎体无先天性畴形;(2)青少年患者,年龄不超过18岁;(3)侧凸类型为胸腰弯或腰弯(PUMC比/Ic型;Lenke5型);或者胸腰双弯但胸弯较柔初,适合单纯行前路手术仅固定腰弯(PUMCIlcl/IIdlenke5一5型;L型);(4)单前路矫形固定融合)至少。;(随访半年W上通过对术前站立正侧位相、仰卧位左右Bending相、术后及随访时站立正侧位相的测量,记录冠状面及矢状面Col)b角、侧凸柔初性、侧巧矫形率、顶椎旋转度、顶椎偏距、冠状面平衡、下誕合椎旋转度、术前椎间角、Bending像上椎间角及术后和随访时的椎间角变化一。如果椎间角开角方向同侧凸主弯凸侧方向致定义此椎间角为正值,负-责为负值。顶椎旋转度按NashMoe方法测量0度I;双侧椎弓根对称,无旋转;度;46 广西大古単位论义?青往々因巧呆巧I化床评巧?宙巧巧目化舍一一凸侧椎弓根移向中线,但未超出第格,凹侧椎弓根变小;II度:凸侧椎弓根进步III:向内侧己移至第二格,凹侧椎弓根消失;度凸侧椎弓根移至中央,凹侧椎弓根消失;IV度:凸侧椎弓根越过中央,靠近凹侧。根据SRS定义,顶椎偏距是指在站立位正侧位相上,侧凸顶椎中点到册正中线的垂直距离(皿1),冠状面平衡是指紙骨中点至经C7铅垂线的垂直距离(腿)。SPSS10.0forWindowst本组资料所使用的统计软件为,统计方法为检验,P值<0.05时认为有统计学差异。2、结果共有30例患者符合入选标准,其中男性4例,女性26例,平均年龄14.8岁(1旷巧?岁)17.7(624)。脊柱侧凸中单弯8例,双弯22例,侧弯类型PUMC比,平均随访月月3例,Ic5例,IIcl2例,Ildl20例。主侧凸向左25例,向右5例。手术选用駒腹联合切曰或腹膜后切曰行前路侧凸矫形内固定植骨敲合术,术中均行标准的去旋转操作。融合节段范围选择遵循Hall原则,要求融合区上下椎间盘活动性良好。手术所使Isol-擅TSRH9CDH12例,MosMiami8例,a1例。甄合节段T10用的矫形器械包括例,:--T---2例11L21,T10L32,,T11L34T12L3巧T12L46。下融,例例例,例,例L2L32---含椎位于3例1L46;L233L3421L456,例,例。椎间角位置例,例,例。°。?°术前主弯慰状面Cobb角平均48.9(3362),反向Bending像冠状面Cobb角平。-。?。?均16.1(1540),侧弯柔初性平均67.2%(31.0%100%)。双弯者次弯冠状面。。。。?。?°C31.o化.3(2048)BendingCobb角121(224,角平均,反向相冠状面平均)?侧弯柔初性平均62.0%(化.7%92.9%)。-°。°??11717610100术后主弯冠状面CoW)角平均.(%),矫正率平均.%(4%%)。。。。??双弯者术后次弯冠状面Co化角平均巧.1(1032),自动矫正率平均%?8%(3.0%。。=60%3..P)。术前椎间角平均.2,术后改善至18,但此差异无统计学意义(tl146,--===3L34t0.261)。其中L2椎间角、椎间角术后比术前改善不明显(l.309,P0.321;==-==0.3.517P0.017t.299,P0768)L45,)。;椎间角术后比术前明显改善a在随47 广西大単涵巧硕古学化论文《脊枉巧固巧系筑略床评巧》涵课巧目报舍=二访时,差异也2.684,P0.012。,椎间角比术后増大具有统计学意义a)随访时主弯==冠状面Co化角也比术后加大,差异也具有统计学意义(t5.郎,P0.000)。==术后椎间角同Bending像上椎间角相关(r0.418,P0.022),随访时椎间角同术==后椎间角相关(r化625,P0.000)。随访时椎间角的丢失同主弯冠状面的丢失存在相==关性(r0.483,P0.007)。单弯与双弯患者的椎间角在术后及随访时化及椎间角的丢。。==。。2.6VS.1.4t0.452P0.654.VS..失方面的差异均无统计学意义(;3254,,,=二。。二一t-0=.665P0.511;3.6vs.4.0t0.177P0.860)。下融合椎在下端椎上,,椎,体与下融合椎在下端椎的患者相比,其椎间角在术后及随访时及椎间角的丢失方面均更大,差异均有统计学意义。讨论对胸腰段或腰段AIS患者施行前路手术相对于后路手术有许多优势:(1)矫形力量优于后路(2),1](3)减少誕合节段,保留更多的运;脊柱缩短脊髓损伤危险降低[;(4)动节段,从而降低融合区远端脊柱的退变及腰背痛的发生;骨骼发育未成熟患儿远期发生曲轴现象危险降低。随着内固定器械的发展克服早期前路手术器械的缺陷,加上脊柱外科医生对前路手术技术也逐渐熟悉,对合适病例施行前路矫形固定融合术的效果越来越好。脊柱侧凸前路矫形手术后,由于下方融合椎在术后很难完全平行于相邻的下方椎体,因此在下方融合椎(lowestinstrumentedvertebra)的下终板与相邻的下方椎一体的上终板之间存在定的角度,称之为椎间角(interspaceangle),也有人称之为椎间盎換形变(discwedging)或椎间盘成角(discangulation)。Majd[l]等报告22。。。?例AIS患者接受前路手术治疗,冠状面Co化角4590,术前椎间角平均10,术后°=2P0.0001。改善至,较术前明显改善()他们认为术后此角度越大,对下方椎体的剪切应力越大,远期退变的危险也增加。同时他们认为此角度的改善可减少远期腰背痛及。Satake等61例接受前路手术治疗的特发性胸腰弯/腰弯患者退变的发生,术前椎间。。。°449±548-..5.85±4.37。角为,术后为他们总结认为术后椎间角同术前椎间角及Bending像上椎间角存在相关性。同时他们认为矫形操作时的加压力会在下融合椎下方产生模形变,把下誕合椎更向顶椎牵拉。Kane化等报告使用Kaneda双棒对特发性胸腰48 广西大単巧译项±単化论义《脊赵内固巧系統临床巧巧》巧译巧目报吿弯/腰弯患者施行前路矫形手术,在他们的报告中,接受短节段融合的患者术后椎间角°°平均为6.6,而将下端椎包括在融合范围内的患者术后椎间角平均为3.0。他们认为下融合椎越靠近头侧,,飄合节段越短,在下融合椎下产生的椎间角越大。在本组研究中=-=(r0.025P0.894)Bendin术后椎间角同术前椎间角无明显相关性,但同上椎,g像二=间角存在相关性(r0.418P0.022。,)随访时的椎间角同术后椎间角存在相关性(r二二化625P0.000)。但下L2、L3和L4的不同患者相比,术后椎间角差异无,融合椎在统计学意义。在后路矫形手术后,同样也存在椎间盘成角问题。Stasikelis等报告29例KingII,?11例KingIVAIS患者接受后路手术或前后路联合手术矫形内固定治疗,术时年龄1020岁,最短随访时间1年。后路手术治疗的巧例KingII和5例KingIV患者患者冠。。。。状面矫形率分别为47.3%和69.0%,随访时椎间角分别为4.3±4.4和3.4±3.4。而在前后路联合手术治疗的H例KingII患者和6例KingIV患者的冠状面矫形率分别为°°°°77.7%和95.5%,随访时椎间角分别为8.7±5.0和7.5±8.3。前后路联合方法术后椎°°°°间角为8.4±6.0,仅行后路者为4.1±4.1,二者之间存在显著差异(P〈0.01)。从中可W看出,施行前后路手术组比单纯行后路手术组矫形率要大,但同时术后及随访时其椎间角也大,因此他们认为上腰椎侧田的过度矫正是导致下腰椎椎间角增加的原因。本组资料显示,前路手术矫形率平均为76.1%,术后椎间角得到改善,在随访时,椎Co化二?483间角比术后增大,且却.。,主弯冠状面也增大在者间存在相关性(I)在随访时,。单弯与双弯患者比较,椎间角及椎间角丢失的差异均无统计学意义在术前Bending相上,椎间角的朝向大部分患者可反向张开,说明此节段间盘柔初性良好,但术后椎间角的度数均较Bending相上的角度大,说明椎体并不能如我们想象的会随着下一融合椎的位移而产生相应的变化。在随访时,此角度比术后又进步增大,考虑原因是由于双弯患者上弯的自动矫正W及患者的躯干平衡是W牺牲下方椎间角为代价完成的。我们使用3段肋骨条植骨,术后仅2例患者发生融合固定节段角度的丢失。因此,我们认为冠状面Co化角的丢失主要同椎间角的丢失有关,这可能是由于融合节段较短所致,。o化而不是源于假关节形成虽然,冠状面C角和椎间角的丢失有些明显,但我们仍不一想延长融合节段,因为患者的整体冠状面平衡很理想。Satake等也注意到了这点。49 广西大単巧部巧古単化论义《青往A因巧系化化床评巧》巧巧巧目化舍虽然现在知道这一变化是由于上腰椎侧凸的过度矫正导致的,但是否还有其它原因及如一一何预防这现象,尚无相关文献报道,目前还不能通过减小侧巧的矫形率这方法来降低椎间角,从而可W在凹侧撑开,。另外,后路手术在下方融合椎使用双侧椎弓根螺钉凸侧加压,W使双侧螺巧尽量巧持水平,这样也可W使椎间角减小。一种影像学表现目前,前路矫形誕合术后椎间角的变化还仅是,国际上也是刚刚注一意到这个问题。,并没有实验室的相关数据,也没有大样本的长期随访这现象的自然病史还不清楚一。从本组资料来看,所有椎间角增大的患者均无临床不适,仅为种影像一,学表现,但由于随访时间尚短其临床意义尚待进步随诊观察。6.2.2产品上市后不良事件信息"我们针对脊柱后路内固定系统(铁合金r产品开展了顾客回访工作。2006年度""""":客户对该产品质量评价达65^顾客满意程度调查表统计显示很满意,满意达""""35%。2007年度统计显示:客户对该产品质量评价很满意达朗%,满意达31%。""""2008年度统计显示:客户对该产品质量评价很满意达巧%,满意达28%。2009"。""年度统汁显示:客户对该产品质量评价很满意达73%,满意达27%。""关于脊柱后路内固定系统(铁合金)产品有2次产品顾客投诉,具体情况如下;;CS07060009:档案编号;顾客名称济南世杰医疗器械有限公司;反映问题产品名X50一:.5(0701)(T)称:椎弓根钉椎弓根钉5的支产品的螺纹处有毛刺;反馈内容;原因分析:该支产品在处理加工毛刺时不到位,而后期检验未检出:;改善对策加强对。产品表面质量的检验::;责任单位质检部;确认处理姜栋CS08070101档案编号;;顾客名称;广州施康!反映问题产品名称!椎弓根钉;联6.X系人:李钦:050(0806)(T);反馈内容椎弓根钉的1支产品表面有瑕疵;原因分析:该支表面处理不到位,检验未检出:;改善对策加强对产品表面质量的检验;责:任单位:质检部;确认处理姜栋。6一.3下面就些已经上市销售多年的公司产品与我公司的产品进行比对。^威髙骨科创生医疗德豁拜尔50 广西大単巧译硕±掌化论文《脊桓内固巧巧统I佐床评巧》巧巧巧目报吿SINO脊柱内固定系统通用脊柱内固定系统脊柱内固定系统。-一-a-^Bs.:a■。—BMMMEl^MiPijgj||i|j|^^jH^^EEBSSn产品图J片主要原〇〇Crl8Nil4Mo3、00打化化14Mo3、OOCr化Nil4Mo3、材料Ti6A14VTi6A14VTi6A14V加工工车加工外形螺纹、锭车加工外形螺纹、就加车加工外形螺纹、锐艺加工U槽及平台等工U槽及平台等加工U槽及平台等术前湿热灭茵术前湿热灭菌术前湿热灭菌巧他田供脊柱骨折、病变或化浴吐A此:結亦供脊柱骨折、病变或时作矫正細定形时作矫正酬定途^用形时作矫正細定用。^。用。II对比说明从上表中我们可W看出,我们所认证的产品与上市的产品,他们的预期用途相同,使用材质相同、灭菌方式相同,而材质决定了性能。在医院的实际使,加工工艺相同用中,材质的生物相容性决定风险的大小,针对我公司产品而言,所使用的材料为0(K:rl8Nil4Mo3、Ti6A14V、,这些材料经医学界临床使用多年,细胞毒性皮内刺激、迟发性超敏反应检验等均符合ENIS010993相关指标。6.4ProductLiteratureandInstrucitionsforUse产品文献和使用说明6.、、.41搜集文献数据库;万方医学网维普网中国医药网等、、关键词;胸腰椎骨折前路融合、脊柱骨折内固定术、路S、腰椎滑脱通用脊柱系统;6.4.2产品文献目录;1)后路椎旁肌间隙入路行椎弓根钉内固定取出的临床效果分析.发表者;张啟维、路奎元、王强、孙常太卫生部北京医院中国脊柱脊髓杂志2012年2)后路复位桂骨内固定治疗腰椎滑脱的临床观察51 广巧大単有》^古#位论义《舞往々因巧呆满I伍床巧巧》巧译巧目报告作者》20071311;曹正春,郑闽前《实用骨科杂志年第卷第期3说S-38)II通用内固定系统治疗例膊展段脊柱骨折的临床疗效评价作者:张国則河南省固始县人民医院骨科《中国实用医药》20口年第12期4)青少年特发性脊柱侧凸前路矫形、固定融合术后椎间角的变化一;王^作者[^朋,邱贵兴,于斌,化建国,李佳忆,翁习生,沈建雄,费埼,李其,中国医学科学院中国协和医科大学北京协和医院骨科5GSS18)国产系统内固定治疗脚腰椎骨折例作者:张浩《南通大学学报(医学版)》2007年第06期6.4.3依据相关文献及临床资料,在编制产品使用说明书中考虑到产品的使用风险和影。响器械使用的信息,确保产品的使用安全7.Conclusions结论通过上述临床文献资料,我公司对产品进行了风险分析,充分考虑到器械的预期用途,涉及了从风险管理文件中识别出的风险,确定器械的性能和安全W及与患者的受益相权。衡,与器械使用相关的风险是否是可接受的用户可W放也使用。52 广西大単巧巧硕古単位论文《脊社内固巧系统临床巧巧》巧译巧目报吿AppendixIIFinalVersionoftheTVanslation1i.GeneralDetals-Product:Nonsterieanernaxao打ssemslSpi打litlfitiytItisroducedbyWuHanDraonbioOrthoedicProductsCO.LTD.,pgpSpinalinternalfixationisakindofmetalmstrument,whichcanproducemechanicalfbrceon也evertebrauidethesineand化estrentharound也esine化achievetheefect^gpgpofsinaldecompressionsinalreductionandsinestabilization.p,ppSpinalinternal打xationproductscanbeclassi打edinto化eposteriorspinalfixationsystemandanteriorcervicalbonelatesystem.p2,DescriptionoftheDeviceandItsIntendedApplication2.1Descriptionof化edeviceTheroductismadeof00Crl8Nil4Mo3stainlesssteelorTi6Al4Vtitaniumallowi化pynocolor〇打thesurface.化canbedividedi打tothefollowingsystemsaccording化thestructure:AF,RF,GSSandTh-RCinternalfixationsystems.ecompone打tsinclude:orthopedicscrew(includingUtypen-ee-ediclescrewlogtailUtdiclescrewshorttailuniversalediclescrewlontailp()p,,yp(),p(g)universalediclescrew(shorttaU),vertebralscrew(longtail),vertebralscrew(shorttail,p)vertebralhook;connectionblock(indudi打ganglescrew,adjustingblock);orthopedicrodincudintheconnecti打rodtheanleconnectinrodtheadusinsleeveconnector.Thel,,t(ggggg,^j)roduc--ptisrovidedinnonsterileconditionforonetimeuse.p2.2DescribeoftheintendeduseThespinalinternalfixationpediclescrewisusedtofixthefracturefragmentsoftheatientheli打thehealinofthefracture.Generallthesinalinternalfixatio打edicleisp,pggy,ppusedincombinatio打withtheconnectinrodtofixthemetalbonelatetothebonebutgp,sometimesitcanbeusedaloneasalagscrewtofix化ebonefrae打ts.Anteriorcervicalgmbonelateisalicable化theanteriorfixationofcervicalspinefractureanddislocation.pppPosteriorsinalinternalfixationsystemisapplicable化theosteriorfixatio打ofpp53 广巧大学巧译硕古学巧:论文《舞起內固巧系统晦床评巧》箱译巧目报舍thoracolumbarfracture.3.Intendedtherapeuticand/ordiagnosticindicationsandclaims3.1Thesurgeryaimofthe也oracolumbarfracturewithspinalcordinuris化巧store打euraljypathways,torelievenervecompressio打,化reconstruct化espinalstabUity,andtoprovide化eenvironmentfbr打erverecoveryandrevenUheinurofdelaed打erve.pjyy^-rnaTheOSSIIuniversalspinalintelsystemiefers化thesystemwhichnailsustarod.j-Itisanimrovedeasoerated打ewediclefixationsstemwithfewercomo打entssuchas,p,yppyp-whe-esingleormultiaxialedicles,ichu化throd化rebnt.Therodisrotated化restoreandpp-theretain!打gscrewshouldbefastened.IfthereductionisnotcompletethrouhXraytheg,distractionclampcanbeused化restore.Thelongitudinalsectio打of化escrewthreadiscylinderwith化esameouterdiameterfromtop化botom,化edepthofwhichisbecomingshallowfrom化etiptotheneck.The打eckofthenailisalmostsmooth.Theverticalsectionofthesolidportionoftherodiscone,whcannoonavotheCO打centratedse巧打screwthreadnecksorecteichtlyidtributalcrt也,p-"puUoutofthescrew.GSSIIhasastro打anchoringandullinreductionfiinctionforgpged-micle.The巧xatio打methodisshortseentfixationwhichisstableandcanrunthrouhpg,gthreecolumns.Whenrovidinstrongstre打thitcanKcovertheheihtofanteriorspineandpgg,gvertebralclearanceoftheinjuredspinebystretchingthebackthrouhcompression,andgWhen-reconstructhysioloicalcurvature.euiedwiththecrossconnectindevicesithaspgqppg,auiteoodfixatio打stabilit.qgyThetreatmentofspinalinuriesshouldbeanalzedcomrehensivelbased0打出ejypyhisoinurmechanismX-raMRIandsoonroiindifferenmenmstrCTvdttreattethod.y,jy,y,,,pgThesurgeryplanshouldbeestablishedbasedonthetypeofinjury,theinjuryextent,*化chniue化selfando化erfactois.Anteriorsurercandirectlremove化ebonechisinfrontqgyypofspinalcordwithgooddecompressionefect,butitismorecomplex化anosteriorsurery,pg*muchmiebleedinoretraumaandhiheruirementswkhmore.Posteriorsurerisg,gqgy54 广西単化论义《青柱内因巧乐化I化床评巧》g巧巧目化舍relativelsimpleusinthetensionbandrincileandtheaxialdistractionforceofedicley,gpppsystem化stretchtheposteriorlongitudinalligamenttodrivethesofttissuesurroundingthevertebraetotractthebone化restorevertebraeheightj巧achingasatisfactoryreductionandstrongfixation.Underthepremiseoftreatingthedisease,try化chooserelativelysimple,safetreatmentmethodwithlesstrauma.Givenearlyrestorationdecomressionfixationrestorationof,p,,s'inalshae化cancreateconditionforneuroloicalrecoverofinuredspinalcordandearlpp,gyjyrehabilitationof化eatient.pStableinternalfixationisanecessaryconditionforfracturehealinbutthereductiong,efectismaintainedbyoodboneraitinfusion.^V^thoutoodfusion,theosterioredicleggggppfixationsystemisprone化failininternalfixationafter化esurgery.Thevertebraeheightandcorrectiondereeillbelost.Thensinalinstabilitlumbaoandbackacheeecondaigw,py,g,vensynervedamaewillhappen化theatient.According化the过inicalfindinsnoboneraftingpg,ggandoorraftininfusioninfiacturesegmentcausetheconcentratedstrenthinlocalrodofpggg-thescrewwhicharethemainreasonsofthebrokenscrewbrokenrodandulloutofinterLal,,pnfixation.虹awordCSS-口raxationsncudes-coumnintenlfistemil3Do地oedicsthreel,yp,l-lithfixadonwhichsimeoeratedfixedstabwlittletraumaandfewercomlications.,arepp,y,pQuoteFromReference(句3.2Contraindications:1actifection..uen2.congenitalmalformations,abnonnalanatom,absentedicleorbonevariation.yp3.Ifthehipboneisabnoimalthesurershouldbeconsideredcarefull.,gyy4.址eric化metals.g5.rigidscoliosis.55 广西大学翻译项古学化论文《脊私巧固巧《统I应床评T古》捆译巧目报吿6.morbidobeseandthepeoplewhoareaddicted化drugoralcoholcannotfollowthe,dodorsadviceafter&esurgery.7.severeosteoporosis.4hevaluaiandChoiceofClinicalDaaTe.ContextoftEto打typs4Asr1enecessofreductioninternalfixatio打forsondostssaiener.1fo;hitypylliheiC,pproosedthetreatme打tofspo打dylolisthesisin1932buttherewasnoadvanceddevicesandp,也eoperation化chniquewassocomplexthat化etreatmentcouldnotbecarriedout.ThetraditionalsurgeryhasalwasfocusedontheosteriorreductionfbrosteriordiaohsisyppppyboneinfUsionbutthetreatmenteficacisunsatisfactor.Theincide打cerateof化e,yypseudarthrosisafterbonegraftingrangesfrom18%化81%.Clowardputforw祉d化eposteriorlumbarfUsio打in1943.ThatisU)say,u化thesphe打0idbone化graftinterbodythroughosteriorlumbar化reconstructthevertebralheightandstabilizetheadacentsinalpjpsegment.However,thistechniquewasnotpopularizedatthattimeowningtounsuitabletttinternalfixationdevices.Unilhe1970sheediclescrewfixationsstemhasaliedto,pyppsi打esurerwhichrovidesfeasib"itforreductio打andfixatio打ofso打dlohsthesisbupgy,pyytp,theopinions0打theneedfbrreductionisstillnotconsensus.Quo化fromReference2()Theindicationsoflumbarinterbodyfiisio打:aInstabilitofvertebraesementie)yg(,spondylolisthesis)isthefirstindication.Conventio打alintervertebraldiscdiscectomy,laminectomorevenartialresectio打ofarticularrocessmaflirheraravathey,pptte,yggtttinstaWlit.Nowamorearoriaereamentme化odis化fixosteriorvertebraeiny,ppppcombinationwi化lumbarintei:bodyfusionblumbarintervertebraldiscrelated出seases.;)Takinlowbackai打andlumbarintervertebraldiscintoaccounteseciallthediscloadgp,py-characteristicsofL45iethereexistsdiscdeenerationandthechaneofinstantaneous,,ggrotationcenteratholoicallwhichcanleadtoearllumbarinstabilit.The巧仿re1;hegy,p,yytreatmentcanbediscectomyincombinationwi化ftisionfixationinorder化avoidrotrusionpofintervertebraldiscandseco打darsinalstenosiswhichiseseciallsuitableforobeseyp,pypatients,becauseoftheirheavyloadandtheyhavemoreactivities.Fusionfixationcanbe56 广西大学巧译项古学他论文《背哲内固定系统临床i平巧》翻译巧目报吿iventothiskindofatientsC^oerationinterbod扣sion.Ifthelumbarvertebraeneedsag;p)pysurgeryagain,itwillusuallyneedacompletedecompression.Thatwillcausefurtherstability,decli打eofthelumbarvertebrae.IftheatientsCO打ditio打ermitsaroerfixationinpp,ppcombinatio打withinterbodyfUsio打shouldbegiven;d)chroniclowbackain.ManscholarspyfoundthatsomepatientswithchroniclowbackpainhavepotentiallowerlumbarvertebraeinstabUity.They过idnotKachdinicalquantizationi打dex,so也etreatmentofinterbodyfiisionforthiskindofpatientscanremitthepain.uotefromReference2(Q)Thecharacteristicsofosteriorfixationforinterbodboneraft.pygTheadvantagesofposterior打xation:a)increasingthestabilityoftheintervertebral化avoidtheformationofpseudarthrosisandtheaggravatedspondylolysisblaina;)pygstabilizi打groleinthe打xation!:〇guaranteethebonegraftfosioncrestorinthenormal;)gseue打ceofthesine1;omakei1:sbiomechanicalandhysioloicalfunctionnormalizationqpp呂;drelievinthecomressionsmtomsof打erverootorcaudaeuina.Theboneraftin)gpypqgg-fusionisthefiindamentalmethod1;omaintai打thelong1;ermstabilityofsine.Therearemanpy""aft-bonegringmethodsincludingposteriorintervertebralbonegraftin呂Hraftindirect,,gg,ft-grainginterdiaosisboneraftinandanteriororosteriorlumbarinterbodbone,pphyggpyft-graingetc.?However也epseudofusio打ofinterdiaophysisboneraftinhasahih,,pgggrecurrencerateofspondylolysisaftersurgery.Afteryearsofclinicaltrials,itisfoundthatitismorereliabletoadottheposteriorinterbodboneraftinforlumbarvertebraepyggspondylolisthesis.Thereaso打sareasfbllows:a)Thevertebralbodybearsmostoftheloadfromlumbarvertebraesotheinterbodbonerafti打isbeterforthestaMlitoflumbar,yggyvertebraeb.Thecontactareabetweenvertebraebodiesisbienouh,whichisanideal;)gggraftingbed;cTheheihtoftheintervertebralsacecanberestoredandtheintervertebral)gpforamencanbeexpandedwhichishel扣1fbrthenerveroot(16〇〇111巧55;〇11dThe,p口;)odaft-insittletraasimlesafecinterbbonerhalumandthearoachisleareasoeratedyggppp,,,yp;e)Comparedwiththeinterbodybonegraftingdevice(BAK)andtitaniumthreadedflisio打caeTFC,itcannotonlachievethesameeffectbutalsoreduceclinicalfeereatlg()y,,gy57 aI佐床评广苗大学翻译硕古學t:论文《資枉巧固巧系統T古》翻课巧目报吿reducintheburde打0打atients.Allthesearehelfulforthealicatio打ofthis1:echniue.gppppquotefrom民eference2(Q)42TheAssessmentoftheSinalInternalFixationSstemProductsinClinicalUse;.pyThe-lateralandstandingXrayfilmsshouldbecareflillyanalyzedbeforethespinalinternalfixationsurgeryinorder1:0makesure化elordosiscurvatureandestimate化eappropriateediclescrewlenth.ThevertebraltomorahofedicleCTscan/MRIisusedpggpyp()toevaluatetheentranceangleofthepedicle!;〇guidetheimplantofthescrew.Thelengthanddiameterofthescrewcanbedeterminedbyscans.ItswidthcanbeobtainedbmeasurinCTygtheisthmus.Itisbeter化chooseaappropriateediclescrewwithadiameterfillinthepgchannelofendosteumcorticalhole.Itissuitableft)r1:hescrewtoaccountfor50%化80%of,thesinebasedonthelateral打Im.Becauseofatientsbodositionisroneositiontheppyppp,-standardmidlineincisioniseneralladoted.TheincisionextendstosinousrocessandgyppptKulonenouofiillexosesothelocationofsinousrocesscanbeidentifiedbchin.gghyp,ppygItisnecessary化confirmtheinsertinointoftheedicle.Itislocatedatthegppintersectingplaceofthreeuniquephysiologicalstructures,化emid姐epartofdiapophysis,theuerartofthesueriorarticularfacetandtheartbetweensueriorandinferiorarticularppppppprocessesrespectively.Thenailingointcanalsobedeterminedbdiaohsismidlineandpyppy化etangentinteKectionpoi打tof化eouteredgeofsuperiorarticularprocess.Thebonero打geurcanbeusedtodean化ehardcorticalboneon化eartic山arfacetand过iapophysis.Then化ecancellousboneof化eediclewillbeexosed.ppAsforthepreparationforthepediclescrewchannel,themouthgagisusedtomakeaopeninginto化epedicle.Thelocationofpedicleisdeterminedby化econtrastneedlethroughfluoroscoicimainsstem.Theconeenetrometerisinsertedintothesinethroughthepggyppedicle.Wheninsertinitthedoctordonotneedtouse1;oomuchstrenhandshouldhavepg,gt化efeelingofassinthrouh化ecancellousbone.If化eassinisblockedorthebonepggpg58 广西大学翻译硕古举位论文《舞栓内固巧系统胞床评巧》颗译巧目报告densitychanesthescrewchannelshouldbecheckedandguaranteedthroufluoroscoicg,ghpimagingsystembyinsertingintothecontrastneedle.Afterdeterminingthelengthofthepediclescrewandestablishingthescrewchannel,check1;hewallsofscrewchannelwithenetrometer化makesure化ereisnodamaetopgediclecortexTheninsert化econeenetrometerino化escrewchanneltomeasure出ep,ptdepthof也escrewchannelthroughscalesofconeenetrometerinorder化determine出epappropriatelengthofthescrew.Aftertt-implantingheediclescrewhearoateUteanduniversalscrewshouldp,pppriyp。beinstalledo打thecorrespondingscrewcatcher.Universalscrewscanrotate55freelytoado-usttthepositionoftheconnectingrod.Thepediclescrewaccountsfor50%80%ofthejspineandisarallelwiththesueriorendlate.pppAsforthebendingoftheconnecti打grod,itisadvised1:0measurethele打gthandcurvatureof化econnectingrodbamodelrod.Thearoriatecurvatureof化ebendinypppgconnectingrodcanreducetheincisuraoftheimlantimrovetheoverallbiomechanicalp,pstrenthandreducethestre巧onthescrew.Whenitcomes化theimlantedconnectinrodsgpg,GSSsstemiseuiedwithvariousconnectinrodwithdiferentlenthwhichcanreduceyqppgg,化erodcut打esurererro-ingith.AftutintheconnectindintoUshaedrooveof也egypggpgediclescrewitisbettertoimlanttheconnectinrodbholdingitwith过clam.p,pgypWhen-itcomes化thereinstallofthescrewuoushouldhoeuwttepplg,yldthplgihh-plugpretighteningwrenchandscrewitintothescrewslot.Whenulling化reductionyoup,shouldcliptheboltholesontwosidesofthepediclescrewwithclampthenresstheclam,ppt-downward化ushheconnectinrodinto也eUshaedrooveandselectalocknutwiththepgpg'-ttwrenchIttsluieihenin.fre巧ureordistractionneededhenuhouldbelocked0打onepg,pggpendethenutntheotherendsreeasedandtracedwhiliiilcompressedordist.Then,youshouldusethehexscrewdrivertolightenthelocknut.Whenlighteningthe-locknutinserttheinternalhexscrewdriverintotheantirotationwrenchwhichwillbe,,59 ?耗用因巧系化广巧大単巧译项古単化论义《巧I化床巧巧》巧巧巧目报告placedonthescrewandrod.Whenscrewingthelocknutouneedtoholdonthejynt-tionnh化resishriirderrevedheinrnlairotawrecttetunngmomentno化ntamae化tteapg-mfixationstructure.Afterthecrossconnectingdevicewasilantedthebrokenclamatthep,pendofthecrewaneused化brekrestttsc.scba化earofherewp4.3ExpectedSideEffects:1duralrupture.2aincausedbsurer.pygy3infection4ainanddiscomfortcausedb化ementalimlants.pypS.alleigictometals.6bendingandbrokenoftheimlantedp7delayedunionandnonunion.id-8osteoorosscausebstressshieldinpy.g9complicationscausedbyimprop妊operation^suchasloosefixation;improperOfinadequateboneraftin.gg4.4EvaluationCriteriaorStatisticalMethods:Thecriteriaaredividedintothefollowingaspectsbasedonliieclinicalsignsandsymptomsandphotographingerformance.pExcellent:havinggoodbonegraftingfusion,withnosignsofpainandnervedamage,havingnormalactivityfimctioiijfeelinggoodaboutthemselves:beingable化goback化rkwo.Good:havingoodboneraftinfusionwithslihtainandnosinsofnervedamaeggg,gpgg,activitinctionimedsinificantlfeelinoodaboutthemselvesbeinable化enaeyftprovgy,gg,gggintheoriinalwork.g60 广西大女学位论义《脊巧内固巧系统晚床巧巧》巧巧巧目化舍Fair二havingoodboneraftinfUsionwithsinsofslihtlumb狙ainormildnerveggg^ggpdamage,sli班tlylimitedactivityfimction^beingable化canengageineasywork.Poor:limitedactivityfunction,cannotengageineasywork.5.SummaryoftheClinicalDataandAraisalppTherearemanyliteratureaboutsinalinternalfixationsystemandwehavecollectedseveralpaers.Thefollowinarethesummariesof化evaluationfromar.ppge泣epp18caseswi化thoracolumbarvertebralactureinthetreatmentodomesticGSSsstemfrfy扔tema/斯。(Quotefromreferene5)Theosteriordecomressionediclereductioninternalfixationsstemhasbeenwidelpppyyusednceenroosederee-coumntheorinsiDisththly1983.TheDickStefeeCDRFAFpp,,,,,TSRHGSSandotiierinternalfixationdeviceshavebeenlaunchediast20earsnthe.,pyThefollowingaretheinformationabout18caseswiththoracoliimbarvertebralfracturefrom泣hositaltreatedwiththeGSSeneralsinesstemfromNovember2001化Aril2005p(gpy),pwithsatisfactoryefects.1.ClinicalData1.1Generalinformation18casesincludes15maleand3female,whoareagedbetween18and56,withanaverageageof31.2主3.7years.According化thefracturetypeclassifiedbyDenis,thereare11burstfi*acturecases4comressionfracturecases3fracturedislocationcase-,p,inursite:3casesinT129casesinLI2casesinL21casesinL33casesinT12LLjy,,,,Inurycauses:12casesfellfromhihlaces;4casesinuredbecauseoftraficaccidents;2jgpjcaseswerecrushed.14casessuferedfromfracturesinspinalandotherartsofthebody.OnecasesufferedfrompfractureincombinationwithsevereAcuteRespiratoryDistressSyndrome.61 广巧大学巧译硕女学tfl:论文《脊柱巧固巧《統略床评T古》巧巧项目报吿Accordingtothelevelofreoerative打euroloicalfbnctio打classifiedbFrankel:5casesppgybelong化levelA,2casesbelontolevelB6casesbelontolevelC3casesbelontolevelg,g,gD.casesX--18inthisgroupconductedroutinerayandCTexamination.TheXrayshowedvertebraldeformatio打andlossofvertebralheight.CTscaimi打呂showedvertebralfracturehroorahbdateralsmtomsbonebrakinintothesinalcanalandcomressionofduralgpy,yp,gppsac.17casesin18hadasurgerywithin72hours.TheonewithsevereAcuteResiratorpyDistre巧Syndromewasi打stableconditionafterrescueandhadthesurerytwoweekslater.g1t.2SurgicalMehodsThepatienthadthesurgeryundergeneralanes化esiai打proneposition,lyingontheorthoedicsiirertablewhichcanbeseen.Thesoneadswithmediumhardnesswereutpgypgppundertheshouldersandanteriorsueriorsinemakinthetheabdomensusendedandthepp,gpbod*iniecurvatio打whichwashelfiilforthereduction.Theatientwithdislocationcanbeypp杜eatedthroughtractionwith化welclamporbullinsueriorandinferiorsinousrocess.ypgpppThearticularprocesscanbecutifitisnecessary,whichishelpfulforthereduction.AfterchoosingthepediclescrewentrancepointwiththeheloftheWeinsteinanatomicalp-localizatio打methodouneedtodrillwiththeTtescrewdrivermanuall1:0thelace,yypypwhereisabout4.5cmdeeandrobethebo打etunnelwi化KirschnerWkewhichwillbeppleavedtomeasure化edepthanddeterminetheosition.Gelatinsoneisusedtofilltheppgbonetunnelhemostasisheositiondirectionandeofrscweremaed.TpdpthKihnerWireigby,C-arm-rawhcanuwhennecessarXyichbeadsted.jyt-Selecionofscrew:Thescrewwi化6mmdiameterand4.55.0cmdethareusuallusedinpy-1;horacic.Thescrewwith6mmdiameterand5.05.5cmdep化areusuallyusedi打lumbarvertebrae,accounting抗rabout80%ofthevertebralbody.AfterIhescrewwasinstalled,n--reductioncamefirstthalaminectom.CarmXraimaecanrovethattheediclescrewyygpptt-islocaedbehindhecenterofthepedicle.Therebentconnectinrodwithshericalwasherpgp62 -?jw大古単化论文々因巧《ilfei拓床评妨翻详巧目化舍<冷柱>wasinstalledintherooveattheendoftheediclescrew.Thenresseddistractionwasgp,perfonnedafteralltherewboltswescrew.Ththtwscrewedthofpscreedonen,enuasoneendthescrewandtheboltwaslocked.Theatientwithsevereunstableburstfractureandfiacturepdislocationweretreatedwitharticularrocessandtransverserocessboneraftin.Theppggdrainagetubewasenerallaplied化化eatientfor48h.Theatientwhowerenottreatedgypppwithbonegraftingcouldsatafter3days,whilethepatientwhoweretreatedwithbonegraftingshouldstaonbedforthreeweeks.y1.3ResultslRecoveryofneuroloicalfunction:()g-urranedrc泌货foratimran化Followwereafo18eriodeinfromn24monthspg,pgg,化’’anaveraeof16months.AccordingFrankelsclassification5casesinlevelAdidntetg,ganyrecoverybuttheFemaining13casesgotrecoveredtodifferentdereeswithimroved,gpftmction化rade1or2andnoonewasaravated.ggg口VertebralheightandCol)bangle:)Youneedtomeasurethehei^tofthevertebralbodustbeforeandafterinuredandyjjcalculatetheaverageheight.Comparedwiththeconditionbeforeinjury,thepercentageoftheanteriorandosterioredeofthevertebralbodafterinurshowedanincreasefrom47.9%pgyjy化95.1%andanincreasefrom78.0%化98.5%respectively.Cobbanglerecoveredfromanooaverageof22.3化5.8.2DiscussionIntreatingthoracolumbarsinefracturestheediclereductioninternalfixationboastsp,pthtD-ieadvanaesof3reductionandshortseentfxationwhichhavebeenwidelcarriedggm,youtfor10yearsandgreatlimprovedthetheraeuticefectoffhoracoiumbarjBractures.Theypmainuroseofthee出clescrewis化screwthescrewintothevertebralbodthrouhpppygpedicleandanchorit.Theanchoringisstrongenoughtobearthedistractionandpressurebetweenscricrodshehort-mnvidedwihtheedicleewandvertalconnection山tsseet.Protpg63 广巧大學巧译项古樂位论文《青社A因巧系統晚床沖巧》巧巧巧目报舍3-DcorrecnandinernalfixationheinnovernormlnditioiiSOtio伍皿ttsecarec化acothat^pjthetosteriorlonitudinalliameannuusrosusandthttuaneri前andpgg卿也lfiboersrucrescanfollyextend.At化esametime,thesinalmotionseentsaremaintained化姐extreme.2.pgm[]However,theoldpediclesystemincludingDick,Steflfee,etc.,lackofrecisionreductionandp,theefectisnotverysatisfactorandtheconnectiondeviceisnotfirm.Underreeatedyphsioloicalloadtisronetolooseevenfailwithbrokenscrew.Inrecentearsedicpyg,ip,y,pleinternalfixationsystem,suchasRF,AF,TSRH,hasimprovedcontinuouslyinreductionandtidutiftdilithaveimdiconneconsothereconefecanstabrovesnificantl.,ypgyGSSisoneoftheedicleinternalfixationsstemsdevelopedinrecentears.Thepyyfollowinareitscharacteristics:aconicalscrewwithaccurateositioning()pg;-n化bsecialtoothshaeddesiimrovetheadhesionof()ppgpthescrew;°cconnectinwithin30inandirectionandadattothe()gypphysiologicalcurvatureofthespine;dTherodwaslockedcomletel()py;eThelonarmstructureismoreconducive化the()gimlantationoftherodp;n-(fTheuiversalcrossconnectionstructurecaneffectivel)yentthelo班oflockinforceprevg;(g)havinghighmechanicalpropertiesandimagecomatibilitpy;hGSSsteimi-riidntsmsaseimla.Theconnection()ygp°betweenthescrewandrodisasphericalwasherandthescrewcanmovewithin30raneing也everticaldirectionsoas化avoidstressconcentration.64 广巧大単巧译巧古掌位论义?斧怯々困巧JR統晚床巧巧》巧译巧目报告TheadvantagesofGSSsystemfortreatmentofthoracolumbarspinefracturesareasfollows.a化issimleoerat对comaredwiththeoutsiderodsstembecausethemetalrod()pppy,caniththescrewaboufixmuli-ilebeconnectedwovethescrew.Whentsementstheedcyg,pisnotinthesamelanewiththescrewifouadottheoldsteelscrewsstem.Thereforeitpypy,isdificult化placethesteelshe成whilethesmoothrodinGSSsystemiseasytobeplaced.(b)WithIMedamage,lesssurgicalvisionisneededandlessmuscleseparationonbothsides;firm-clfixationThescrewofGSSisconeshaedanditismorefirmthrouh()y^pg-selftappingandbonechimerism.Becautheedl-seiclescrewthreadcansuortoninearlfracturethelontermpppyy,gstabilityofthesinedeendsonthebioloicalstabilitofthevertebralboditselfnamelppgyy,yboneftisionbetweenvertebrae.Thereforetheinterbodboneraftin扣sionistheketo,yggypreventfailureandbreakofinternalfixationcorrectionlossandkhosis.Brokenscrew^ypdoesnothappentoihcatientsinthisrouwhoweretreatedwitiitheinterbodbonepgpygraftingfosioiijavoidingthedecreaseofintervertebralheightaftersurgery?化isvery-n-imortattomastertheinternalfixationtechniueandmakeuseofCarmXraytoobservepqthesurerroress化avoidsurg知yerrors?虹summarGSSsstemisoneof化eefectivegypgy,ymethodsoftreatingthoracolumbarvertebralfractures,withgoodreduction,fixation,andfi加础ti,rmness,e泌yaon^litlecomplication^andtakingshorttime.Thescrewd〇0sntneedtoberemovedafterthesurgeryandtheatientcanmoveearl.py6.1.1Clinicalobservationofosteriorlumbarsondlolisthesisreductionandbonefixationppyuotefromreference3(Q)Withthefurtherstudofbiomechanicalinsinalsurerfieldmedicaldeviceshaveypgy,beenfurtherimprovedandthesurgicaltechniquehasbeenenhancedincreasingly.Increasinlatentionhasbeenaidtothetreatmentofsondlolisthesisbuttherearegyppy,65 ?广西大単宙译项古#位论义《巧巧A因义巧满I化床评巧》巧课项目化舍'diferentopinionsonchoosingthesurgerymethodanditsindications.WeFirstPeoples(HospitalofYancheng)haveadoptedtheRForGSSreductionandinternalfixationincombinationwiththeposteriorinterbodybonegraftingfusioninthetreatmentofsondlolisthesisachievinsatisfactoreffects.Hereisthereort.py,gyp1.Clinicaldata1.1GeneralInformationThereare28patientswithspondylolisthesisincludin8maleand20femalewhoare,gagedbetween25and63,withanaverageageof46.8yearsold.13casesinL4,15casesinL5.*AccordingtoMeerdingsclassification,8casesbelongtodegree1,14casesbelongtoy,degree口,4casesbelong化degreein,2casesbelong化degreeIV.Basedonpatientsclinicalstoms28atientswillbedividedinto3kinds:8mildcases14moderatecases6severeymp,p,,cases.Themildhavelumbarstomsthemoderatehavelumbarandintennittentlowerymp;limbstoms;theseverehaveIximbaoandlowerlimbsmtoms.Thereare11caseswithympgypunilateralradiatinainoflowerlimbornumbness12caseswithbilateralradiatinainofgp,gplowerlimbornumbne扣6caseswithclaudicatioA5caseswithurinationanddefecation,dsfunction.y1.2ImagingData28attm-raftientsinhisroi)areallexainedbroutineXinositiveleandrihtpgqyyp,gobliueositionanscanninhowin6casessuflFerinfromunilateralspondllsisinqdCTg,sgyopgyL4,9casessuferingfrombilateralspondylolysisinL4;5casessuferingfromunilateralllii8casefrinfromltlsllii5CTihowspondyoyssnL5ssuebiaeraondossnL.scannnss,gpyygIScaseswithlumbarintervertebraldiiscrotrusion15caseswithobvioussinalstenosis.p,p1.3SurgicalMethodsTheRForGSSreductionandinternalfixationincombinationwithosteriorinterbodpyboneraftinandedicleboneraftingisadotedinthetreatmentofspondlolistihesis.ggpgpy66 广西大學巧译硕古聲tfc论义《脊柱巧固起系統临床评T古》翻译巧目报吿Maorsuricalroceduresareasfbllows.jgpFirst5casesweretreatedi打eiduralanesthesiaand23casesweretreatedineneral,pganesthesiaanesthesiawithintubation.Second,theyotlonitudinalincisionatthebacki打theggeccslowerlumbar.Theeltricalinisionwaadotedfromlaerblaerwithpyyye-ttttlectrocoaulaio打hemosasisrevealinverebrallateandarticularrocessatbohg,gpp-msides.Third化isnecessartodeterminetheinterlainarsaceonL5SIfirstandthe,ypdisplacedvertebralbody.Forexample,比edisplacedvertebralbodyisL4,whichcanbeosionedbthei打tersectio打betwee打transverserocess0打bothsidesoandpitypftheL5mm><-articularrocess.Itshouldbeimletedwithaawl3.545mmandcheckedwithCarmpg()扫uoroscoconfirmintheaccuratepositioning.Thenoucanscrewin化enailandfixp,,gyn-ullinscrewobothsidesoftheedicleatL4.Carmfluoroscocanmakesureifthepgppypositioniscorrect.Ifthespondylolisthesishappens化L5S1oucanscrewi打化enailo打,ybotitisidesofSIandfixullinscrew0打bothsidesof化eedicleatL5.So打dylolis化esispgpppatientsalsosufferfromlumbardischemiawithlateralrecessstenosis(LDHLRS),soitis打ecessary化performlammectomytodecompress.Whe打decompressing,youmustbecarefulandatientenouh化avoidinur1;othecaudaeuinaandnerveroot.Asfortheinstallationpgjyq*ofedicleconnectionsstemdistractioncomesbefoieullinandfixation.Mstdislacedy,呂opppcano*vertebralbodbeKstredbutcan打otursueerfectrestoration.Thenucleusulsy,pposuppbetweenthedisplacedvertebralbodiesannulusfibrosusandcartilaelateneedtobe,gpremovedwi化secialtoolsornucleusulosusclam.Whatismore化eoeratic打cannotbepppp,poverly,oritwilldamagetoabdominalaorta.The打,cut化eremovedspinousprocessandvertebralplateintosmallpiecestoimplantinto化einterbodyfromtheposteriorandfinallybmou'lockthebonethwhhalargeiece化ieventthesmall0打efromslidinintothesinalppgpcanaTheresbonelateswillbeimlantedonbothsisoftheediclescrewIfteonel.tde.hbppphblirio化aplatesarenorenougoucanuseo打eates打anteriorsuercsi打e.Becausethe,ypppmorancondranarsesurertraumaisbigitisitt化uctdieafteurerwhichcanavoid化gy,pggy,67 广巧大単巧译项古単位论义?背检巧因巧呆满I巧床评巧》巧译巧目化舍ostoerativehematomaformation虹spinalcanalcompr扮singspinalcord,causingcaudappequinasyndrome.2ResultsThf-tsiisrfo6iteollowarearrangedforthepatiennthgoupr化36monthswh地呼,averageof21months.Thesymptomoflowbackpaindisappearedorwererelievedin28cases.Theentirecorrectionofspondylolisthesishappenedin9casesand16casesweretil22ttiitbonif.Aicorrecobvousy.caseshasoodosoperavenerboderaftnusionccordngpyggg化thescoringcriteriaofJapaneseOrthopaedicAssociation(JOA)口],Excellent:11cases;Good:15casesFair2cs.Theteis92.9%.:aseoodra;g3DiscussionTheauthorconsidersthatvertebralinstabilitcausedbsinalsondlolisthesisistheyyppymainatholoicalbasisofthisdisease.Inorder化stabilizethesinereconstructvertebralpgp,heightandstabilitybetweenadjacentsegmentsofthespine,andrelievethecompressionatcaudaequinaandnerverootthesosterioredicleinternalfixationincombinationwitii,ppvertebralinterbodyboneraftinfbsionisadotedinthetreatmentofthisdisease.Theggpreductionandinternalfixationareverynecessar.y"6-.\.\TheevaluationofclinicaleectoGSSUmiversalinternalxationssteminthefffiy"treatmentof38caseswiththoracolumbarspineactures(Quotefix)mReference3fr)Thoracolumbarfracturesaccountforabout3%化5%intraumaftactureswithinured,jspinalnervessondlolisthesis.Theobectivesofthetreatme扛tare化restorevertebralbod,pyjyheihtandsinalcurvaturereconstructthesinalstabilitandrelievethecomressionongp,py,p-xaspinalnerves.Posteriorshortsegmentediclescrewinternalfitio凸hasbeenwidelusedinpy’thoracolumb扭fractureanddislocation.OuthositalPeolesHositalofGushiCountp,(ppy,HenanProvincehastreated38caseswiththoracolumbarfractureswiththehelofthe)p-口enera2005化DecembefacGSS(glspinesystem)sinceJanuaryr2009withsatistor,,,yresreorresults.Heithept.68 广巧:化论文《青往巧因巧呆挽化床巧巧》巧巧巧目报舍1DataandMethods1.1GeneralInformation38casesinhirouinclud33ml5femalv^oareabtwe1and62withtsesaeandeedeen7gp,g,anaverageageof48years.Inurycauses:20casesinjuredbycaraccidents;17casesfellfromhighplaces;1casewasjcrushed.Invirsite:5casesinTil10casesinL1214casesinLI8casesinL21caseinL3.jy,,,,According化thepreoperativeinjurydegreesofspinalcordclassifiedbyFrankel,3cas的belong化LevelA,3casesbelongtoLevelS,13casesbelong化LevelG,14casesbelong!;〇LlltLevelE-eveD5casesbeono.Theatientshave処routineexaminationofXrain,gpyositiveosition.Alsotheirvertebralheihtandcomressionratioweremeasuredandpp,gpkhosisanlewasrecordedCobbsmethod.CTscanandMRIexaminationinypg()thoracolumbarcanmakedoctorsknowaboutthemovementofboneplates,theoccupyinginthesinalcanalandcomressionandsinalchaneofsinalcord.p,pggp1reatmentehods.2TMtFirsttheatientwastreatedineneralanesthesiaoreiduralanesthesiaintherone,pgppos出on.SecondthelongitudinalincisionatthebackcouldexosethereoeratiYeandpjpppostoperativevertebrallatearticularrocessandtransverserocessoftheinuredsine処dpp,ppjpth-iilllesineandselfretanngretractorcoudexposetheoperativefied.Thirdsinap,pdecompressioncamebeforetheremovaloftheinuredvertebrallatesandaartofvertebraljpplateoftheadacentvertebralbod.Thenrobethesinalcanal.Also化wasnece战artopjyjpp,yremovehebonefraentsintheinllbraketheintsuletilbonecotextgmspacana,oca,carae,rjpgofthetwosmallointsoftheinuredsinewithboneroneurtoexosecancellousbone.Thejjpgpbonedhoudbthowinhithithfitwounssleneastetransverserocesswneusonraneandhe,gpgrouhsurfaceofthetransverserocessiseas化berafted.Youneeded化drillholesonthegpygtwoardcularprocessesoftheinjuredspinebasedontheinsertionangleoftheediclescrewp汾 广巧夫単*8巧巧过:掌化论文《伴feA因巧系巧胞床评巧》巧巧巧目化告andrequirements.Afterdrillingthroughthecortexwithaawl,youneeded化usepediclepuncher化insertintothevertebralbodybhandsandouwouldhavestronfeelinhenyyggwinsertingthrouhcancellousbone.Theblockedscrewindicatedthatthescrewhadreachedgthecortexoftheanterioredgeofvertebralbody.IfthediameteranddepthofiJieediclepriaft--screwaoteaermeasuredbGannxraoucouldscrew化in.Thenwhatouwaspprpyy,y,yneed--化dowas化installtherebentscrewintotheUshaedrooveoftheediclescrewppgp,出s-ntthetractreductionfixatioii抑dlacecrossconnectiondevice.Finallimlasaredjpy,ppbonelatesintothetransverserocessesandsmallarticularrocesses.If化ebonelateswereppppinsuficientoucouldconductautoraflinorartificialboneraftin.Theroutinedrainae,ygggggwasperformedaftersuigeryandremovedafteraperiodrangingfrom24化48h.Thepatienthadtotake犯批ioticshormonesdehdrationme出cines.Thesinewasrotectedbthe,,yppybracefor6化8weeksaftersurgery.Theatientnotonlneeded化doexercisesbutal孤化pyattendtheclinicregularlyaftersurer.Theimplantcouldberemoved12化24monthslatergyaftersurgery.1.3EvaluationMethodsBasdonhreoerand-etetiveaostoerativeXrafilmsoftheatientinositiveandppppypp-lateralos出onandCTscanninoftheinuredvertebrae.Accordin化theXrafilmofthepgjgypatientinlateralosition,theheihtoftheinuredvertebralbodistheaveraevalueofthepgjygvertebralbodybeforeandafteritThen,thecompressionratiooftheanteriorandposterioredgeofvertebralbodycanbecalculated,1.4StatisticalMethodsThedataisanalyzedbySPSS11.5孤ftwareandstatedinthewaof气nean±standardy**dev-wanduiation.AtlastaChisuareTestscoctedtotestdataandtTestwasusedto,qcomparediferenc的betweenrousanddiferenc的beforeandafterthesurer.Thereexistsgpgystati泌callsinificantdiferenceP<0.M.\yg()2Results70 广西:值论文《#往々因巧最^1庙床评巧》巧译巧曰化告38cas放inthisrouarefollowedfor6化24months姐averaeof17months.AUgp哗,gtilecasesotbonehealinnobrokenscrewsandrodsandxillin-outhookanerior.Thetgg,,pgandosteriorvertebralheihtCobbanlecorrectionofkhosissoarettthanthateforeg,gbeerbpypthesurer.Thereexistsstatisticallysini扫cantdiferen说.Table1showstheimprovedlevelgygofFrankel:2casesbelontoLevelA2casesbelon化LevelB2casesbelon化LevelGg;g;g;5casesbelongtoLevelD27casesbelontoLevelE.Youcanseefromtable2.;gThecomparisonofthevertebralheightandCobbanglebeforeandafterthesurgery〇GroupsThehei班toftileTheheightof化eCobbangle()anterioredgeofposterioredgeofvertebralbody(%)vertebralbody(%)Beforethesurgery39.45±6.5477.36±3.8821.38±3.62***Afterthesurgery93.51±2.9497.92±1.654.6&tl.73R*eference:comparedwiththeconditionbeforesurgeryP<0.05T’able2:Therecoveryoftheneuroloicalfimctionaccordin化theFrankelsclassificationgg’Frankelsclassification-casesFollowupaftersuiercasesgy()beforethesurgeryABCDEA321000B301200C1300031071 巧译巧古単位论义?#往内因巧jR化店床巧巧》巧巧巧目报舍D14000212E5000053Discussion38casesinthisrouaretreatedwithGSS-IIeneralsilfigpinenternaxation.Thegpvertebralheightrestoration,Cobbanglecorrectionofkyphosisaremuchbetterthanthatiilliifibeforethesurgery.Thereexistsstatstcaysnificantderence.Alltheatentsetbonegpghealinwithoutbrokenscrewsrodsandllinouthook.Theneuroloicalfunctiong,,,puggrecoverswellaftersurgeryandtheFrankellevelhasbeenimroved.pSafetyThechangeofinterspaceangleofadolescentwithidiopathicscoliosisinthetreatmentwithanteriorcorrectionandfixedinfiisionuotefromreference4(Q)Withtheincreasinglyunderstandinofidioatitucscoliosis,thetreatmentofitismoregpstandardized.Thesurgicalmethodsarediferentfordiferenttyp的ofscoliosis.Theanteriorsurgeryismoresuitableforthoracolumbar犯dlumbarscoliosis!.AftertheanteriororthoedicpfixatioHtheoeniranleoftheintervertebralsacebetwee凸化einferiOTendlateoflowestjp堪gppinstrumentedvertebraLIVandthesuperiorendplateofadacentvertebralbodybelowitis()jcalledintersaceangle.Itisreortedthatthisanleincreaseda^rsurerbutthereisnoppggy,detailedanalysis.ThisaersummarizessomeinformationoftheatientwithidioathicppppscoliosistreatedwithanteriorcorrectioninChineseAcademyofMedicalSciencesfromNovember,1998化May,2003andanalyzedtheinterspaceanglechanges.1MaterialsandMethods72 广巧大学巧译硕女聲化论文《脊柱巧固巧系統临床评巧》巧课巧目报含Aretrospectiveanalysisof1:hecasessuferingfromidiopathicscoliosistreatedwi化anteriorcorrectioiiinternalfixationinDepartmentofOrthopaedicsofPekingUnionMedicalCollegeHospitalfromNovember,19981x3May,2003.Thecriteriawereasfbllows:1i出oathicscoliosiswithoutconenitalvertebral()p,gdefbrmity;(2)adolescentpatients,agedbelowl8years;口)thescoliosistype:化oracolumbarorlumbarscoliosis(PUMCIb/Ictype;Lenke5type);orthoracolumbarincombinationwithlumbarscoliosis,wi化mildlumbarcurve,whichismoresuitablefbranteriorcorrectionsurgeryust打xinlumbarcurvePUMCIIcl/IldlteLenke5te4sinleanteriorjg(yp;yp);()gcorrectio打andfixationfusion5followeduforoversixmonths.;()psedonX-丘athemeasurementofthefoUowing:therayfilmoftheatientinpositiveps-oitionandBendinrahoftheatientindorsalositionbeforethesurer,andtheXrap,ggpppgyyf-日heaientinoiiveositio打inthefollowrecordinthechanleImottstuesofCobbanpppp,gggofcoronallaneandsagitalsectio打scoliosis打ex化ilityscoliosiscorrectionrateaicalp,p,,vertebralrotation,apicalvertebraltranslation,coronalplanebalance,lowestinstrumentedvertebrarotationintersaceanlebeforesurersueriorintersaceanleonBendinrah,pggy,ppgggp,aerthesurerand-tttftgyinfollowup.Ifthedirecionofheinterspaceangleisthesamewihhaof*ttscoliosistheintersaceanleisdefi打edasositivevalueor化willbeneativevalue.,pgpgThNash-eclassi打cationofaicalvertebralrotatio打byMoeDeree0:wkharallelbilateralp,gpedicleandwithoutrotationDereeI:edicleofthescoliosismovestowardthemidline,butp;gpnotbeyondthefirstgrid,withsmalleredicleontheconcaveside;DereeII:edicleofthepgpscoliosismovest;owardthesecondridandtheedicleontheconcavesidedisaearedgppp;dereeni:theedicleofthescoliosismovestothecenterandtheedicleo凸theconcavesidegppdisappeared;DegreeIV:theedicleofthescoliosismovesbeondthecenterandisclosetopytheconcaveside.Accordingto化edefinitionofSRS,apicalvertebralrotatio打refers化也everticaldistance(mm)betweenthemidpointofthescoliosisapicalvertebralandthemidhneo-ofthesacruminsitiveositionofXra打Im.ThecoronalplanebalancereferstotheppyverticaldistancemmbetweenthemidointofthesacrumandlumblineointhrouhC7.()ppggg73 ■TW大单在古单位论文《青往々因smUSt胞床评巧》译巧目化舍StatisticalsoftwareisSP1SS….0forWindowsandstati泌calmethodisthet恥St.ThererexistsreatstatisticallsignificantdiflFeenceP<0.05.gy()2.ResultsAtotalofmetthecriteriaincludin4maleand26femalewithanaveraeae30cases,g,gg-ul-of14.8ears0化18yearsoldwithanaveragefollowaeof17.7montis24y"),pg巧months).Thereare8caseswithcurvatureoneoneside,22caseswithcurvatureonbothsides.Thescoliosistype:3casesbelong化比,5casesbelong化Ic,2casesbelong化IIcl,20c泌的belong化ndl.25c化的isthe1油scoliosisand5cas的istherightscoliosis.Thoracoabdominalorretroeritonealincisionischosenwhenthesurerthatanteriorp,gyscoliosisconectioninternalfixationbonegraftingfusionisperfonned.Standardt-anirotationoperationisadoptedinthesurgery.Thechooseoffusionsegmentsare抗llowedbasedontheHallprinciple,reqxiirii^goodvertebraldieactivity.OrthopedicinstrumentsusedinthesurerincludesTSRHfor9casesCDHfor12casesMosMiamifor8casesgy),),(),((Isola(for1cases).Fusment----ionses:T10L2casesT"L2casesT10L3casesTilL3g口),。),口),W--casesT12L35casesT12L4cases.),),巧)〇Thelocationofthelowestinstrumentalvertebral:L2casesL31caseisL4口),口,)巧cases.)---Interscelson:L233caseL3421casesL45.paangeoiti,casesp(句,()巧)Beforethesurgery:TheaverageCobbangleofthecoronalplaneoftheprimaryscoliosis。。*。。??h-is48.93362,TeaveragereverseCobbangleontheBendingrahis16.r1540.()gp()ax%?Theaverevalueofthesecondarscoliosisfleibilitis67.21.0%WO%.Forthsegoyy口)withbilateralscoliosis,theaverseCobbangleofthecoronalplaneofthesecondary*°° ̄scoliosisis31.3(2048.TheaveraereverseCobbanleontheBendinrahis)ggggp°’??12.r224.Theaveragevalueofthesecondarscoliosisflexibilitis份.0%6.7%()yy"92.9%.)74 广西大古単化论义灼?巧;*|因定哀娩I色床评巧》g部巧目报告Afterthesurer:TheaverageCobbanleofthecoronallaneofthirigygermascolosisppy。。。??-rateis11.7136)withanaveraecorrectionof76.1%40%100%.For化的ewith(,g()bilateralscoliosistheaveraeCobbanleofthesecondarscoliosiscoronallaneis,ggyp°°??19.r1032withanaveraecorrectionrateof38.8%3.0%60%.(),g()TheCobbangleofthecoronalplaneoftheprimaryscoliosis,AVRandAVThavebeensignificantlyimroved.SeealsoTable1.pTable1:parametricvariationoftherimarscoliosisbeforeandafterthesuieipygyBeforetheAfterthetvaluePvaluesuigeiysuigery°°°Cobbangleofthecoronal48.9±9,211.7±8方19.760.000planecoronallanebalancemm14.1112.015.化13.00.660.516p()AVRdegree2.1+0.61.2±0.59.360.000()AVTmm43.3±13.213.4±9.010.拍0.000()ChanesoftheinterspaceanglebeforeandaftersurgeryareshowninTable2.g。°Theaverageinterspaceangleis3.2before化esurgeryandahasimproved化1.8afterthe==suierbutthereisnostatisticallsinificantdifferencet1.146P0.261.Thegy,yg(,) ̄===-imrovementofintersaceanleL23andU4isnotobvioustl.309P0.321t0.299ppg(:;,P=0768-=.ThtrslL45isidiifittht3.517,eineaceanemrovesncanlafteresurer,)pgpgygy(=-nP0.nhfollowi)ifhintersacelincritmistatisticall.017Iteteaeeaseseansthereexsts)q,pg,y==significantdifferencet2.684P0.012.(,)ll-ilhrInthefoowuftheCobbangeoftepimarscoliosisisbierthanthatafterthep,ygg==ifsurerthereexistsstatisticallsinificantderencest5.58?0?000.Theintersacegy,yg(,)p=angleafterthesurgeryisassociatedwiththeinterspaceangleonSendinggraph(r0.418,?75 广巧大古单位论义《背柱々因定病肪庙床巧?巧》巧译巧目化告=er-P0.022theintsaceanleinthefollowupisassociatedwiththeintersaceanleafter);pgpg==nthell-thlinteraceanisaociatedthesurerr0.625P0.000.Ifoowueossofslessgy(,)p,pg==withthelossofcoronalplaneofprimaryscoliosis(r0.483,P0.007)(Table3).Thereexistsstatisticallysignificant出ferenceinthe化llowingaspects:theintersp犯eangleof-uvinilateralandbilateralscoliosisaftersurerinthefollowandthelossoftheintersacegy,p,p°。。?。°====■anle.6vs.L410.452P0.6543.2vs.5.4片O.GGSP0.5113.6vs.4.0t0.177g口,,;,,;,,=P0.860.Comaredwiththetientswlttrutrtndlatepaithowesinsmenedveebraininferiore)pp,也einterspaceangleofthepatientswithlowestinstrumentedvertebra虹thevertebraebeforeh-teinferiorendlateincreasesafterthesurerinthefollowuanditslossisbisotherepgy,pg,existsstatisticallysinificantdiference,table4.g()Table2:thechangeofinterspaceanglebeforeandafterthesurgeryXtS()locatioCasesBeforetheBendingrahAftertheInthegpnNorrurer-u.sugeysgyfollowp°?°°°°°°-6L2331.7±2.91.0±3.55.7±4.0.3±2.9,°°°°°°°L342-12.8±3.11.9±6.72.4±6.r6.7±8.10,。。°°°°°°---L4.,565.5垃.545±4.62.3±5.82.2±5.2°°°°°°°total303.2+3.1-2.3±6.P1.8±6.24.9+7.9Table3:thechangesandrelationofCobbanleandintersaceanlebeforeandafterthegpgd-sureraninthe化llowupXtSgy,()BeforetheAfterthesurgery虹thelo泌urerfo-sllowugyp°°°?°°°°Cobbangleofthe48.9±9.211.7±8.818.1±11.263±6276 广巧大单巧巧呵村T学ta:论文《资巧内因巧哀統瞄床评话》巧银巧目报告coronallanep^°°°°°Interspaceangle32i3.r1.8±6.24.9呼7.92.4±4.7re--lationr0.0670.0600.2420.485()P0.7270.7510.1980.007Table4:ThecomparisonoftheinterspaceanglechangesbetweenGroup1theatientswith(plowestinstrumentedvertebrainthevertebraebeforetheinferiorendplateandGrou2the)p(patientswithlowe巧instrumentedvertebraininferiorendplateX±S)()nn=n=ItersaceangleGroupl9Grou221TvaluePvaluep()p()?〇?一°Beforethesurgery3.1±3.03.3±3.30.1610.873???Afterthesurgery4.5±3.80.4吁6.72.1290.042°?**?-uIthfll93±6.42.6±7.92.3160.028neoowp.??〇?Intersaceanleloss4.8±3.31.2±4.92.0730.047pgDiscussionComaredwithanteriorsurertheadvantaesofosteriorsurerinthetreatmentofpgy,gpgythoracolumbarorlumb姐AISareasfollows.(1strongorthopaedicstre打gth;(2shortening))ofthesineandreducintheriskofsinalcordinur["decreasinfiisionseentspgpjy;口)ggmandmaintainingmoremovementsementssothatreducinthedeenerationofdistalsinegggpinthefusionzoneandavoidingtheoccurrenceoflowbackpain;(4)reducingtheriskofcrankshafthenomenonforhildrenwithimmaturebonedeveloment.Withthdltceeveopmenppofinternalfixationdevicestheshortcominsoftheoldsuricalinstrumentshavebeen,gg77 广西大學巧译硕古単泣论文《脊检巧固巧系統略床巧?巧》巧译巧目报吿overcome.Atthesametimesureonsarebecominfamiliarwiththesuricaltechniueof,gggqanteriorsurgery,so化eefectofanteriorcorrection行xationinfUsionisincreasinglyoodforgtheappropriatecases.Aftertheanteriorcorrectionsurgeryinthetreatmentofscoliosis,thelowestinstrumentedvertebraisnoteualtothevertebrabelowitsotheanlebetweentheinferiorq,gendateofthelowestinstrumentedvertebraandthesueriorendlateofthevertebrabelowplppeneraceanlelknownasdiscwinordianulaiitiscalledthitspgasoedscton.,gggMajd[1]reportedthat22caseswithAIShaveacceptedtheanteriorsurgery,withCobb00oo>,?anleofcoronallane扛om4590theintersaceanleofwhichdecreasedfrom101;o2gp,gp=afterthesurerwithreatimrovementP0.0001.Thebelievethebiertheanleisgygp()ygggafterthesurgery,1;hegreatertheshearstresswillonthevertebrabelowandthegreaterriskof-m化elongterdegeneration.At也esametimethebelievethatthereductio打ofthisanlecan,yg-owackanonceofeeneratonimprovethelongtermlbpiandtheccurredgi.61patientsincludingSatake,withidiopathicthoracolumbarorlumbarscoliosisaccepted°°'thetreatmentofanteriorsurgeryUhreoerativeinteisaceanleof4.49±5.48and,wpppg0o-postoerativeintersaceangleof5.85±4.37.Theyconcludethatthereisacorrelationppbetween化eostoerativeinterspaceanleandreoerativeintersaceanlean过intersaceppgpppgpangleontheBendinggraph.At化esametime,theybelievethatthecompressio打fororthopedicopemtio打swillcausediscwedi打i打thelacebelowthelowestinstrumentedggpvertebrauin化elowestinstrumentedvertebraU)theaicalvertebralll.^pgpItisreportedthatKanedadualrodisused;打化eanteriorsurgeryinthetreatmentofidioathicthoracolumbarorlumbarscoliosis.虹比eirreorttintivshtsementpp,paesreceedorgs〇fusionwithanaverageinterspaceangleof6.6.Ifthelowestinstrumentedvertebrais°includedintotheinfiisionrange化eatientshasanaveraeintersaceanleof3.0.,pgpgThebelievethatifthelowestinstrumentedvertebraiscloser化theheadtheinfusiony,segmen化wiUbeshorterand也einterspaceanlewillbebier.ggg78 广西大译巧古単化化义?柱々因巧呆满??#■晚床件巧?巧译巧目报々Inhiheriaarentcrrelationttheraveinletsroutesnoobeweeneostotitersaceangp,pppppg==diersl-0025P0894butanreoerativentaceaner..thecorrelationexistsbetweenthepppg(,),=ostoerativeintersaceanleandtheintersaceanleonBendinr0.418pppgpgggraph(,=-P0.022.Also也ereiscorrelationbetweentheintersaceaileinthefollowuand),p巧p==ostoerativeintersaceanler0.625?0.000?Comparedwith化eatientswi出thepppg(,)plow的tinstrumentedvertebrainL2L3andL4thereisnostatisticallsinificantdiference.,,ygIntheposteriororthopedicsurgery,化evertebraldiscangleisalsoaproblem.Itisreportedthatposteriororanteriorsurgeryhasbeenerfonnedfor29caseswithKinII11p,gcaseswi化KingrvAIS.Theaeoftheatientsranesfrom10化20earsoldandtheirgpgyll-uitatfoowptmelassleastforoneear.y;Theosteriorsurerhasbeenerformedfor15caseswithKin口and5caseswithpgypgKingIV.Theircorrectionrateofcoronalplaneis47.3%and6乂0%resectivelyandtheirp°°°°-intersaceithfllis4.3.4.43.4l.pangleneoowup±4and3±resectivepyTheosteriorsurerincombinationwithanteriorsurerhasbeenerfonnedfor14pgygypcaseswithKing口and6caseswithKinrV.Theircorrectionrateofcoronallaneis77.7%gp°°*°dheanif-u±5nd7±and95.5%respectivelyantirintersaceglentheollowis8.7.0a.58.3pprespectively.°°heposteriorsurgeryincombinationwithanteriorsurgery,theinterspaceangleis8.4±6.0,°?whiletheinterspaceangleis4.1±4.1aftertheosteriorsurer.Thereexistssinificantpgyg出ference?<0.0.(〇Table--SurgerywaCaseNo.correctionrateintersaceintersaceyppofcoronalanleinlftgtheangeaer-plane仿Uowupsurgery°°°*+?IosteriorKingII1547.3%4.34.44,1±4.1surgery^。。。。KingIV160.0%3.4±3.44.1±4.1巧 广西文古举值论文《#往内固巧系巧怕床评巧》巧巧巧目化?°°。。posteriorKingni477.7%8.7±5.08.4±6.0pI|皮孤teriorsuigery ̄°°。。IV699.5%7.5±88.4±60Kin.3.gAscanbeseen,thecorrectionrate,theinterspaceangleafterthesurgeryandinthe-the化Uowupinroutreatedwiththeposteriorsurgerincombinationwithanterior,gpysuieiarebierthanthatintheroutreatedwithonltheosteriorsuier.Thereforegygggpypgy,heidthevr-corectconserthatoertionofuerscoliosisisthemaincauseofheincofytreasepptheintersaceanleoflowerlumbarvertebra.pgThedatashowsthattheaveragecorrectionrateofanteriorsurgeryis76.1%.Inthefo-ullowboththeostoerativeintersaceanleandCobbanleincreasewithcorrelationp,pppgg,=r0.483.()虹-thefollowup化eintersaceanleandintersaceanlelosshasbeenobserved,pgpgamontheunilateralscoliosisandbilateralscoliosisatientsthereisnostatisticallgp,ysignificantdifference.OnthereoerativeBendinhtheintersaceanleofmostatientsoenrevere化lppggrap,pgppy,indicatinthatthe出schasoodflexibilitwhile化eostoerativeinterspaceanleisbierggy,ppgggthanthatontheBendinggraph,indicatingthatthevertebralbodywillnotchangewiththemovementofthelowestinstrumentedvertebra.n-Ithefollowuaftirtherincreaseswhichiscausedbtheautomaticcorrectio凸thep,,yofuerscoliosisfortheatientswithbilateralscoliosisandthesinebalanceisachievedatppp,pthethitl.expenseofenerspaceangeWeusedthreeribstoconductboneraftinandfoimdthattheanlelostonlintwogggycases.ThereforewebelievethattheCobbanglelossofcoronallanehasrelationwiththe,p80 广西大単宙古単化洽文《背柱A因巧乂化I曲床评巧》巧巧巧目报舍interspaceangleloss,whichmaybecausedbyashorterfusionsegmentsratherthanthepseudaithrosis.Althoughtheobviouslo泌ofCobbangleofcoronalplaneandinterspaceangleexists,westilldonotwant化extendthe扣sionsegments,becauseoverallcoronali処ebalanceispideal.Satakealsotooknoteofthis.Althoughwedoknowthischangeiscausedbythe-overcorrectionoftheupperlumbarscoliosisnorelevantliteraturehasreortedothercauses,pandhow化preventthishenomenonsowecannotreducetheintersaceanlebreducinp^pgygthecorrectionrateofscoliosis.虹addition^bilateralpediclescrewwasusedinlowestinstrumentedvertebraintheosteriorsurgerwhichcandistractedontheconcavesideandcomressedontheopositepy,ppsidei化keetheilralscrewlevelanreducetheintersacenle.norderbatedappgCurrently,thechangesofinterspaceangleaftertheanteriorcorrectionfusionsurgeryisalsostaradioloicalmanifestationwithoutrelevantator-labordataandlontermjugyg-whichfollowuoflaresamaacsatnieinailitpagplettrttetoninthterntonacommun.,y*Wedontwthenaturalhistorofthishenomenon.knoypAccording化化edataofthisrouallatientshadnoclinicaldiscomfortwithincreasedgp,p-intersaceanlevsiiichisustaradioloicalmanifestation.Thefollowueriodisshortsopg,jgpp,weneed化讯servethetheclinicalsignificance.6.2.2Adverseeventinformationafterthemarketlaunch"Weaidvisit化thecustomerfortheroductsofosteriorsinalinternalfixationsstemppppy。titanium.()ThefollowingtableshowsCustomerSatisfactionSurveyin2006,2007^008and200义YearVersatisfiedSatisfiedy200665%35%81 -r西天单在古单位论文《巧?柱々因定呆化化床件拓》巧巧巧目报舍200769%31%200872%28%200973%27%^'Therearetwocustomercomplaintabouttheroductoftheosteriorsinalinternalfixationppp’’systemtitaniumandthedetailedinformationareis犯thetwofollowingtables.()Table1Custoercomlint1::mpaFileNo.CS07060009CustomerNameJinanShiieMedicalDevicesCo.Ltd.j,ProductNamepediclescrewProblemscrewthread:5.5x500701Tonescrewthreadhasmetalblur()(),*AnalysisoftheroblemHiemetalblurisnoteliminatedinrocessinandtheroblemisntppgphk-cecedoutinosttestpImprovementmeasureTostrengthentiieroductsurfaceualitinsectionpqypQualityinspectionQualityInsectionDeartmentppdepartmentPersoncinhareJiangDonggTable2;Customercomplaint2:FileNo.CS08070101CustomerNameGuangzhouShikangMedicalDevicesCo.,Ltd.ProductNamepediclescrewContactLiinQ82 广巧大単巧译硕古学化论义《脊柱内固巧系統胞床巧■巧》巧译巧目报吿xProblemscrewthread:6.〇50(080巧(巧herearedefectson出esurfaceof,Tonescrew.^AnalysisoftheroblemThemetalblurisnoteliminatedinrocessinandtheroblemisntppgpchecked-outinposttestImprovementmeasureTostrengthentheproductsurfacequalityinspectionQualitinspectionQualityInsectionDeartmentyppdepartmentPersoninchargeJiangDong^6.3ProductsofourcompanyVStheroductsofothercompaniesthathavebeenmarkedforpmanears,yyManufacturShandongwegoorthopedicTrausonChinaWuHanDragonbio-edeviceCoLtd.medicalOrthoedicProducts,p‘instrumentLtd.CO.Ltd.,ProductSINGSpinalInternalFixationGeneralSpinalSpinalInternalnameSystemInternalFixationFationSstemixySstemyProductpictureMain00Crl8Nil4Mo3、Ti6A14V00Crl8Nil4Mo00Crl8Nil4Mo3、materials3、Ti6A14VTi6A14V83 广巧大学宙译项古掌值论文因巧哀巧化床评巧?巧巧巧目化AProcessinhescrewthreadisrocessedbThescrewThescrewthreadisgTpytCNC-crafTuning.TheUtypedroovethreadisrocessedbCNCgpy-andplatformareprocessedbyprocessedbyTuning.TheUtypedmillin.CNCTuning,grooveandplatformgTheU-tedareprocessedbyypgrooveandmilling,platformareprocessedbymilling.sterilizationPreoerativemoi巧heatPreoerativePreoerativemoi巧pppmethodssterilizationmoistheatheatsterilizationsterilizationIntendedInternalfixationforspinalInternalfixationInternalfixationforusefractureslesionsanddeformitforinalinalfractures,y巧巧,fi*actureslesionslesionsand,anddeformitydeformityComparison:Fromtlietablewecanseethatourcertifiedroductsandtheroductsmarkedhavethesame,ppintendedusematerialsrocesscraftandsterilizationmethodswithothercomanies.Weall,,ppknowthatmaterialdetemiinestheerformanceoftheroduct.Intermsoftheracticaluseofpppthehositalthebiocomatibilitofthematerialdeteiminestherisks.Ourroductsusethep,pypmaterialsof00Crl8Nil4Mo3andH6A14V>^chhavebeenusedformanearsinclinic.,yyItsctotoxicityintradermalstimulationdelaedhersensitivittestmeettherelatedy,,yypyindicatorsofENISO10993.6.4ProductLiteratureandInstructionsforUse84 ■■Tw大单?anadb#位论义《#往内因义店床评巧?在译巧目报告片4.化化liographicdatabase:WanfangMedOnline,VipDatabase,PharmNetKeords:thoracolmnbarvertebralfractureGeneralSineSstemanteriorfusionyw,py,,internalfixationofsinalfixtureGSSlumbarllithesisondossp,,py6.4.2Reference:1)ZhangQiwei,LuKuiyuan,WangQiang,SunChangtai,ofBeijingHospitalTheanalysisoftheclinicalefectsoftheediclescrewinternalxationinthetreatmentoosteriorpfifpjams加o/fiusc/e.2G12.ChinJSineSinalCord/取pp?.2CaoZhengchmiChenMiniaii邱ec化/rfca/。占玉erv加〇?ooWmorre减如脱)jgqj/pgrainginternalxationinthetreatmentolumbarsondylolisthesis.2007.Volume13No.ftfifp,11.JournalofPracticalOrthoaedicsp.’3)ZhangguogangofPeoplesHospitalofGushiCounty,HenanProvince.TTieeva扣伽0。〇/thecl ̄inicalefectsofGSSfGeneralFixationSstem化thetreatmentocaseswithyf巧horacobarnalres-.2012.12.ChiPtiMiltlumspifractunaraccaledca.enaceanlechanesoadolescenh'4Thiterstwiti出oathicscoliosisinthetreatmento)pggfpfanteriorcorrection,xationandusionsurger.fifyWanYiPengiuGuixinYuBinZhanJianuoLiJiaiWenXishenChenJianxiong,Qg,,gg,y,gg,g,FeiQi,LiiiofChin的eAcademofMedicalSciences,Chine化PekinUnionMedicalQyygColleeandOrthoedicDeartmentofPekinUnionMedicalColleeHosital.gppggp5ThmUao.18caseswiththoracolumbarV饥ebralactureshithetreatmentoGSS)琶frfsysteminternalfixation.2007.6.JournalofNantongUniversity6.4.3Basedontherelevantreferenceandclinicaldata,theinstructionbookoftheproductincludestherisksandthefactorsinfluencintheuseofdevice化ensuresafeuseofthe,groduct.p5Concluions.s85 广西大古単化论文?*?往巧因巧杰化胞床件巧》翻译巧目化任 ̄Basedontheclinicaldata,owcompanyconductedaproductriskanalysis,takingtheintendeduseofthedevicesintoaccountinvolvintheidentifiedriskfromariskmanaement,ggfile,determiningtheerformanceandsafetoftiiedevicesandweihinthebenefitsofpyggpatientsandtheacceptableoftherisks.Pleasebeassureduse.86 广西大学巧庫巧古単位论文《酱柱々固巧呆说临床巧■巧》宿巧巧目报告AendixIHCustomerEvaluationpp译员霍倩在经过本公司的试译后,成为本公司的长期兼职译员,与本公司一直保持着良好的合作关系。该译员在与本公司合作期间,基本达到了(^^下几项要乘首先,具有扎实的英语基拙和较高的英语阅读能力。能准确地理解原文,了解區学英语的特点,能准确地进行翻译。第二,该译员根据委托入的翻译耍求或特定情景的翻译目的,能够确定翻译策略,提供符合客户所需的翻译产品,努力再现原文所需反映的客观现实。、、、第三,翻译语气正式陈述客观语言规范文体质朴、术语丰富、简洁、地遣、具有遇辑性,遵循了医学翻译的原则。科技文体,尤其是医学翻译注重语篇风格的严谋性、庄重性与推确性,医学语篇的翻译更是注巫语篇风格的专业性、。术语性与准碗性,译文基本满足了要求第四,具有良好的科学素葬和丰富的医学知识。译文表达准确、到位,具有读者可接受性。同时,准确有效地传达了原文的内容或信息,译文符合地道的译入语的习惯用法和表达方式,总体翻译质量较好。一、第五,译员认真负责丝不苟、考据求证、译风严谨,能够按时完成翻译巧务,同时,能够按照合同约定,保守本公司的商化秘密,是我公司优秀的兼职译员。W上为我公司对译员霍倩的综合评价。合祀巧87 广西大學巧译项古学位论文《脊往內固巧系統略床评巧》巧课项目报告AppendixIVProjectCon化ct0-1兼职人员合作协议.pdf02-^作保密协议.pdf88 I3@L立劇兼职人员合作协议K"甲方:深排陆立创信息系统有陵么司(护F统祿立创公司)"’乙方;下统称兼职人贤)—1般《款11.立创公司是国内领先的专业翻译、本地化服务提供商,立创公司始终坚持为客户提供优良的服务和质量。立创公司非常珍视和兼职人员的合作,希望同兼职人员建立长久互利的合作关系.W期达到双贏的目的。为此双方就合作事宣订立W下协议。一立创公司将粮据1.2在本协议下,立创公司确认您已正式成为立创公司服务兼职人员么。一实际项目需求与兼巧人员联系具体合作事宜,并且按照双方协商致的具体《款向兼賜人员支付报酬(WPO或双方电子邮件形式确认的价格为准)。一一旦实际发生合作事项1.3本协议是双方协商致后达成的约束性协议。经双方确认后,巧方将严路麗行本协议的规定。2合作方式立创公司所有业务均W项目方式进行管理一,每巧工作均有唯的项目编号作为项目运作和付款的依掘。沟通方式W电子邮件、即时通信工具和电话为主,因此兼职人员要确保电子邮件系统安全可靠,电:,即时通讯工具随时在线话保持随时杨通。具体合作事项如下""*发送需求。立创公司的项目经理或相关工作人员(下统称项目经理)向兼职人员发出项目需求。*确认需求。当兼职人员收到项目需求后,请及时确认是否可承接,承接后必须保证按约定交付。如果对项目领域不熟悉或无法保证交付时间,兼职人员可W拒绝此项目,这不会影响将来的合作。相反,如果兼职人员不能提供保质保量的服务,哉无法按所承巧的时间交付文件,则会在很大程度上影响双方的合作关系。*项目接收。收到兼职人员的确认后.项目经理会将所有项目文件发送给兼职人员,同时随附项目P0或在确认工作量后发送P0。在收到项目文件后,兼职人员须在第一时间向项目经理确认收到,并须及时提出任何疑问(如有)。切一些基本的问题勿等项目过半才问。*项目运作。立创公司要求兼职人员必须亲自独立完成项目任务,不得全部转包或部分拆分给任何第兰方来完成(如发现有此情形,立创公司有权立即终止本,协议),并且须对自己完成的项目做好充分的自检确保交付件达到承诺的质,量耍求。项目运作过程中,如果有任何与项目相关的问题须及时向项目经理提出。如对巧做内容不确定或有与语言相关的问题,请及时向项目经理反馈。*项目提交,。按项目说明(独立的说明文件和域邮件中的说明)中的要求W约?定的交村格式将完成后的交付件发送给项目经理,。项目经理收到后,予W确认表示兼职人员提交完成。?反馈修改,项。立创公司质量控制部口和客户可能会提供关于项目工作的反馈目经理获得客户的反馈信息后将随之反馈给兼职人员。兼职人员如有不同意见,,可W提出讨论。对于出错之处应按照反馈要求迸行修改并重新提交文件(项目经理明确不要求修巧和不要求重新提交的情况除外)。因兼职人员交付www.hksl.co饥gPage1of3 削,立创公司不再另外支付报酬件中的错误导致的反馈修改而产生额外工作量。?项目结柬。项目反馈修改完毕后,项目结束。注;与项目相关的文件均包含在发给兼职人员的项目文件包中,兼职人员应在)。收到项目文件包后及时检查确认,并及时提出问题(如有3工作盘対赁巧付款3。.1兼职人畏的工作量计算W项目后动时间为准一3.2当月各部nPM使用统对账模板与各自合作的兼职人负核对上月工作量,核对无误后,PM于当月25日将准确的兼职人员工作量数据提交訓nvoice@hkgsl.的m邮箱。"3.3兼职人员汇总各PM核对无误后的工作量UT项目清单方式于当月最后H(3)个工作曰内提交劑^0!0己@11崎51.(:0111邮賴。3.4立创公司财务部进行数据核对化及审核;各数据吻合,次月化日支付所有兼积人员款项。3,5提交的工作量或信息(如银巧账户信息)有误的INV,OICE邮箱要求译员核实后于两(2)个工作日内重新提交。因兼职译员个人原因造成未按时提交数据的或者当信息有误时,一兼职译员又未按时核实重新提交的.应付款项自动顺延至下付款周期。3一.6付款日(巧日)如遇周末或节假日,相应顺延至下工作日。3.7为了减少巧方(甲、乙)税务巧险,现提供如下方案供算选择一方案:己方工资1600元(人民巧)W内,提供两个账户信息(即不用提供发票)。方案二,:乙方工资超出1600元(人民巧)需提供收集发票或个人报说。a、收集发票寄到本公司。傑票种类不限,尽量收集定额发票,如;交逝费、餐饮、房费等)b、个人报税请到当地税务局申化报完税请把《发票》、《完税凭证》寄到本公司。(产生的相应税费由个人承担)一105发票请统寄到;深圳市南山区科技园留学生创业大厦巧(邮編:18053)财务室出纳收,(甲、乙双方产生的快递费用由各自承担)W上信息如有疑问可咨询本公司财务人员。4斌遵4.1立创公司承诺向客户提供优质的翻译和本地化服务。在本协议项下,兼职人员也承诺向立创公司提供优质的翻译或审校质量。翻译或审校项目的质量应巧合立创客户的质量要求。42,.客户裕对立创公司交付的译稿或审校稿进行质量验收并给出质量评级。并且,客户会根据译稿或审校稿的质量评级对立创公司采取全额付款、部分扣款或全额扣款的措施。相应地,立创公司将根据客户的最终质量评级对兼职人员采取如下奖励或惩罚提施。a)翻译项目(由立创公司负责翻译、内部审校和排版的项目) ̄ ̄客户验收评级客户对立创的处理措翻译人员ilAlIm工作量增减比例工作量增减比例A全额付款增加50%增加化0%_ ̄B全额付款不增不减不增不减'"C扣订单金额50%扣减30%扣减30%D扣订单金额100%扣减50%扣减100%[www.hksgl.comPae2uf3g B@L立簡1b)审校项目(由其他供应商翻译、审校、排版,仅由立创公司进行语言审核的项目)客户对审校稿件的抽检结果审校人员工作量増减比例 ̄" ̄合格^或B)不增不减不合格(C或D)扣减30%4.3如果客户对最终交付的译文质量评级为C或D,兼职人员有义务协助立创公司完成质量,,回潮流程找出根因并采取纠正措施。此外.在立创公司对客户的质量评级提出申诉时,相关的兼职人员应积极予,^^协助提供反馈意见。5蜜付兼职人员向立创公司承诺保证及时和准确地完成交付。及时准确交付是指在预定交巧时间之前W约定方式提交内容和格式正确且符合质量巧准和客户要求的交付件。如因交付不及时或不准确致使立创公司或客户蒙受损失的,立创公司有权向兼职人员索赔。6竞争限制与保密兼职人员必须邀守通巧的商业道德惯例,不得绕过立创公司直接与所合作项目的最终客户直接联系,更不可向最终客户透露与立创公司的合作信息。兼职人员承诺在本协议期满后H年内,,不会利巧因完成立创公司安排的项目获得的信息与立创公司的客户直接联系。>兼职人员对巧方合作中交换的信息负有保密责任I兼职人员承诺尽最大努力保证此类信息的保密性,。双方的保密义务W另行签署的《合作保密协议》为准。7头效与终止7.1违皮本协议任何《款都可导致本协议整体尖效。因特别原因造成个别条款的失效时,不影响其它条款的执行。7.2双方均有权W提前三十(30)天书面通知的方式,终让本协议。侣在终止日期前已经开始或发生的任何项目?、付款事项W及责任和义务,仍按本协议执巧。8其它其他未尽事宜,由协议双方本着坦诚平等的原则通过友好协商解决。一式两汾一本协议,巧方各执份,具同等法律效力。冷蘇弓:瑜系艺方:I證命皆Rf1蛋Ira签字’日期a日期:年月日wwAV.HKgrJcomPa3of3g? 合作保密协议甲方:深測市立御信息系统有限公司乙方(兼职人员):鉴于乙方为甲方提供兼职服务,梅接触到甲方的保密信息,巧方特就保密事项达成臥下橡议:1.保密信息:艺方为甲方提供兼职服务期间获得和细晚的甲方商业秘密""(化下衔称商业祕密)及属于第兰方但甲方负有保蜜义务的信息,都属于甲方巧保密信息。商业秘密包括技术秘密和经营秘密,其,艺方对此均度保守秘密中技术秘密包指但巧限于工作迸度、技术方案、工程设计、巧路设沐、制造方法、配方、工芝流程、技术指祿、计算机软件、数据库、研究开发记录、技术报告、测试报告、检测报吿、实验数据、试验绩果、图纸、样品、样机、模型、模具、操作手册、技术文档、专利文档、相关的函电等。经营秘密包摄但不限于客户名单、行销计划、采贿资料、定价政藥、财务资斜、进货梁道、法律事务倩息、人力资獨镑息等,2.保密措施:乙方应当凶审憤态度对侍甲方的商化秘密。1遵守甲巧的信息安全管理制度及有关保密的各项管理规氣()2未经甲方书面许可,乙方不得将所知的甲方商业秘密化任何方式提烘()给任何第云方,也不得擅自披露遂脯息:*""""(3)未经甲方书面许巧,不得擅自查巧、复制甲方标有秘密、机密、""绝密字祥的支件、文搜和其它保窜黎料;(4)除了完巧甲方委托的项目么外,未经甲方书面许可,不得擅自巧用甲方的上述商化热密;巧未经巧方书面许可,己方不得带走从甲方辑到的任何文档、固銀、资料、磁盘、胶片等载有甲方商业儒密的介质;(巧当己方与甲方么巧的合作終止化方应当将包含甲方上述商业秘密 的一切资料及其复制件如数交还甲方,或应甲方要求彻底删除或销毁上述资料及其复印件,不得擅自保留;7.()未经甲方许可,乙方不得获取、持有或保存甲方的任何保密信息。3.对于甲方提供给乙方使用的任何资源、,如网络邮箱、规范、学习案例、术语表、共享知识点等,乙方都只能将其用于工作,而不能用于其它目的特别是从事侵害甲方或甲方客户剌益的活动。4.乙方所承担的保密义务自本协议生效时开始,直至该保密信息非因己方过错成为公开信息。5.石方同意遵守本协议各项义务:如有违反,甲方有权立即终止双方之间的合作,并依法追究乙方的法律责任。6.如因本协议发生纠纷,双方应提交至深圳仲裁委员会解决。一7一.本协议式两化,双方各执份,具有同等法律效力。8.本协议自甲方盖章及乙方签字之日起生效,并不因双方之间合作的终止而终止。/壽甲方:深圳巧立径1:緑系统限公司乙方(签字);^^;.\、换.為日期:日期:'