Objective To compare effects of intra-articular injection of corticosteroid or viscoelastic agent alone or a combination of the two drugs for treatment of temporomandibular joint disorders. Methods A prospective quasirandomized controlled trial was conducted to compare 3 treatment protocols of intra-articular injections in the upper compartment of the joint immediately following arthrocentesis repeatedly every 10 days: ① triamcinolone 8 mg alone for 3 times, ② 1% hyaluronate 1 ml alone for 4 times, and ③ triamcinolone 8 mg for 2 times then 1% hyaluronate 1 ml for 2 times. Clinical examinations were done at baseline, 1, 12, and 24 months after end of the treatments. According to improvement of the symptoms and clinical signs, the effectiveness was graded in 3 classes: excellent, better, no change, or worse. The first two were classified as effective. Effective rates of the treatments and subgroups were compared statistically. Results Five hundred and sixty four patients with temporomandibular disorders were included and randomly allocated to 3 groups with 188 patients in each group. The rate of lost follow up at 24 months was 6.9% to 10.1%. At one month after treatment, the triamcinolone group had a better effective rate at 92.0%. At 12 and 24 months of follow up, effective rates of the hyaluronate group were better than those in the triamcinolone alone group (84.6% vs. 54.1% and 83.4% vs. 40.4%). Effective rates of combining triamcinolone and hyaluronate group at 12 and 24 months were 90.4% and 66.3% respectively. Conclusion Intra-articular injection of corticosteroid has better results in a short term and hyaluronate has better results in a long term in the treatment of temporomandibular joint disorders.
目的:總結分析子宮內膜癌臨床特點、治療方法的療效及與各預后高危因素之間的關系，以提高臨床診療水平。方法:回顧性分析我院1998年1月～2005年12月收治住院的子宮內膜癌患者499例的臨床病理資料，總結患者的一般情況、臨床特點并進行隨訪，分析內膜癌高危因素對預后的影響。采用壽命表法計算患者生存率，Wilcoxon (Gehan) 比分法及Cox比例風險模型分析預后因素。結果:(1) 手術－病理分期I、Ⅱ、Ⅲ期患者5年生存率分別為94%、100％、75.3％，IV期患者1年生存率57.1%、2年生存率11.4％。(2) 單因素分析顯示：病理類型、手術－病理分期、組織學分級、肌層浸潤深度、淋巴結轉移和是否行淋巴結切除術是影響預后的高危因素。（3）多因素分析顯示：病理類型、手術－病理分期、組織學分級和肌層浸潤深度是影響患者預后的獨立危險因素。結論:(1) 對具有高危因素的患者，如特殊病理類型、手術－病理分期期別晚、組織學分級為G3和深肌層浸潤，應輔以術后治療以提高生存率。(2)分期越晚，生存率越低（Plt;0.05）。