A型肉毒毒素治疗面肌痉挛65例疗效观察

面肌痉挛(HFS)是神经科常见疾病,临床治疗既往多采用口服药物、面神经阻滞术、显微神经血管减压术等,效果均     

面肌痉挛及三叉神经痛神经-血管MRI与手术所见比对60例分析

目的术前了解REZ区神经血管关系对预测面肌痉挛(HFS)手术所见具有重要临床价值。方法为了评估REZ区是否存在血管神经压迫,3种不同的3D高分辨率MRI方法用于评估60例HFS。神经影像学表现与术中结果比对。对侧无症状的神经作为对照。结果 3D高分辨率MRI能够正确发现67%(14/21例)三叉神经痛(TN)和87%(34/39)HFS。神经血管接触在无症状侧出现的比率为15%。神经变形也是判定手术适应证的有用征象。结论 3D高分辨率MRI能够高效地正确判定HFS,利于预测术中所见。     

乙状窦后入路微血管减压术治疗原发性面肌痉挛

原发性面肌痉挛(hemifacial spasm,HFS)指一侧颜面部阵发性、不自主的肌肉痉挛性抽搐.目前已确认是面部神经根受责任血管压迫而发生脱髓鞘病变,传入与传出神经纤维之间冲动发生短路所致.微血管减压术(microvascular decompression,MVD)是治疗原发性HFS的惟一有效的方法,具有完整保留神经、血管功能的特性,因而它成为HFS的首选治疗方法[1-3].我科从2006年6月-2009年6月应用MVD治疗HFS患者124例,取得良好疗效,现报告如下.     

3D-TSE序列结合DRIVE诊断面肌痉挛病因的价值

目的:探讨MRI三维快速自旋回波序列(3D-TSE)加入DRIVE脉冲对面肌痉挛(HFS)患者的病因诊断及图像质量改善的价值。方法:应用3D-TSE及加入DRIVE脉冲的序列,对55例HFS患者行桥小脑角薄层扫描,并行后颅窝探察术,分析HFS患者桥小脑角区面神经与周围血管等结构的关系,并与手术结果进行对照。结果:(1)MRI诊断面肌痉挛病因中血管压迫占95%(52/55),神经源肿瘤占3.6%(2/55),其它占1.8%(1/55)。HFS患者痉挛侧与非痉挛侧的血管神经压迫差异有统计学意义(P<0.005)。(2)3D-TSE序列与加入DRIVE脉冲序列比较,可以将扫描时间缩短50%,图像质量明显改善。手术结果表明,3D-TSE序列对面肌痉挛患者诊断的敏感性为96%,特异性为100%;3D-TSE加入DRIVE脉冲序列对面肌痉挛患者诊断的敏感性为98%,特异性为100%。结论:面神经脑池段的血管压迫是面肌痉挛的主要病因,3D-TSE加入DRIVE脉冲可以明显提高图像质量,缩短扫描时间,值得推广应用。     

探讨显微血管减压术治疗面肌痉挛的手术技巧

目的:探讨显微血管减压术治疗面肌痉挛的手术操作及效果。方法:回顾性分析MVD治疗的56例HFS病人的临床资料,术前常规行MRI(3D-TOF)检查,明确神经与血管的关系。所有患者采用显微血管减压术进行治疗,根据术中所见确定责任血管并减压。结果:所有患者均有血管压迫面神经,均属于动脉压迫,随访仅1例复发。结论:MVD是目前治疗HFS的首选方法,娴熟的显微外科技术和正确辨认责任血管是确保MVD安全有效的关键。     

显微血管减压术治疗原发性面肌痉挛临床疗效分析

原发性面肌痉挛(hemifacial spasm,HFS)是一种无痛性、间歇性、不自主的、无规律的同侧面神经所支配区域内的肌肉强直或阵挛发作。目前关于HFS的发病机制仍存在争议,治疗方法较多。微血管减压术(microvascular decompression,MVD)由于疗效好、创伤及不良反应小,已成为治疗HFS的最有效方式。我院2008年11月至2011年8月采用MVD治疗206例     

34例面肌痉挛术后循证护理体会

目的探讨神经内镜辅助锁孔入路微血管减压术治疗面肌痉挛34例中,运用循证护理模式防治术后并发症的成效.方法选择2008年11月~2011年12月收治原发性面肌痉挛(HFS)患者34例,均实施神经内镜辅助锁孔入路微血管减压术,在术后并发症的防治过程中运用循证护理模式指导临床实践.结果34例患者出现并发症较少,且恢复时间较短.结论运用循证护理模式,减少护理人员工作盲目性,可以有效防治神经内镜辅助锁孔入路微血管减压术后并发症.     

神经电生理监测在微血管减压术治疗面肌痉挛中的应用

面肌痉挛(hemifacial spasm,HFS)是神经外科常见的疾病之一,虽然是良性疾病,但严重影响患者的日常生活及社会心理,该疾病诊断较易,目前认为微血管减压术(icrovascular decompression,MVD)是HFS唯一的根治方法,虽然手术并发症较少见,但术后并发症依然成为患者担心手术的主要因素,影响对疾病的早期治疗,神经电生理监测的应用可以提高该疾病的早期诊断及指导手术治疗,成为不可或缺的部分,现结合文献,就神经电生理监测在MVD治疗原发性HFS中的应用做如下综述。     

临床路径指导下显微血管减压术治疗面肌痉挛的围术期护理

目的 探讨临床护理路径下显微血管减压术治疗面肌痉挛(HFS)围术期的应用方法及效果.方法 选取该中心2019年1月至2020年1月采用显微血管减压术治疗HFS患者128例,按随机数字表法将患者分为观察组和对照组,两组各64例.观察组在常规护理基础上采用临床路径护理模式;对照组采用常规护理.比较两组患者术后并发症发生率、平均住院时间、平均住院费用及护理满意度评分.结果 观察组并发症发生率及主观不适症状发生率均低于对照组,观察组平均住院时间与平均住院费用均少于对照组,护理满意度评分高于对照组,差异均有统计学意义(P<0.05).结论 在临床护理路径指导下HFS患者围术期采用综合护理措施有助于降低不良事件的发生率,缩短患者的住院时间,降低住院费用,提升护理满意度.     

磁共振断层血管成像对面肌痉挛病因的诊断价值

目的探讨磁共振断层血管成像(MRTA)对面肌痉挛(HFS)病因诊断的临床应用价值。方法HFS患者52例(观察组)和健康成人20例(对照组)进行MRTA检查,观察3D-TOF成像序列结合3D-CISS序列中脑桥小脑角(CPA)池内面神经与周围血管的关系,并与手术结果进行盲法对照。结果观察组患侧与健侧及对照组相比神经血管接触或压迫差异均有统计学意义(P<0.05),健侧和对照组差异无统计学意义(P>0.05)。MRTA对神经血管接触或压迫的敏感度为94.1%,特异度为86.7%,阳性预测值为88.9%,阴性预测值为92.9%。结论MRTA证实面肌痉挛患者在面神经出脑干段(REZ)存在神经血管接触或压迫。MRTA诊断CPA池内血管接触或压迫敏感度和真实性高。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.