磁共振血管成像技术与高压注射器匹配的应用探讨

目的 探讨磁共振血管成像技术与高压注射器应用的匹配问题.方法 本组68例,年龄36岁-85岁,平均60岁,其中男53例,女15例.使用德国西门子1.0T超导磁共振成像仪及德国Ulich高压注射器和北陆的造影剂GD-DTPA静脉团注.结果 动脉显影良好64例(94%),3例患者血管显影欠佳(4.4%),1例患者出现药液渗漏失败(1.4%),所有检查病人均无出现不适.结论 正确熟练掌握高压注射器,使3D-CE-MRA成像扫描时间和团注速度相匹配,是获得高质量图像的重要环节,也是3D MRA检查成功的关键之一.     

生活方式干预对食管癌二级预防的应用

目的:通过对食管癌的患者不良生活方式进行干预,探讨对食管癌二级预防的效果。方法:选取住院患者87例,入院时、住院时和出院后共进行为期6个月的生活方式干预,观察干预前后的情况。结果:干预后患者情绪波动、高脂饮食、吸烟、饮酒、不良生活习惯下降,健康饮食、遵医嘱用药的行为上升。结论:生活方式的干预可促进患者建立健康的生活习惯,有利于食管癌的二级预防。     

新生儿溶血病末梢换血疗法

新生儿溶血病末梢换血疗法米延李晶王竹颖张文双崔岚巍李希娟哈尔滨医科大学第一临床医学院（１５０００１）新生儿溶血病是新生儿急救医疗中主要疾病之一。对于有发生胆红素脑病危险性的新生儿溶血病必须采取急救治疗，即换血治疗。现将我院于１９９６年１１月～１９９７...     

新型感染参数——降钙素原

感染(infection)是指微生物入侵体内引起的炎性反应。长期以来，细菌感染一直是临床医师所面临的重大课题。细菌由创面、呼吸道、泌尿道、消化道入侵，在严重创伤、全身抵抗力下降时，体内正常菌群失调、细菌移位等，均可引起机体严重的细菌感染。尽管清创术、组织修复术以及抗     

东北地区2000～2005年住院军事飞行人员疾病构成和常见病疾病谱调查

目的 探讨东北地区2000～2005年住院军事飞行人员疾病的发生、发展与分布规律,为完善新时期飞行人员疾病预防、诊治和医学鉴定提供客观依据. 方法 采用流行病学回顾性调查方法 ,统计分析东北地区2000～2005年2223人次住院军事飞行人员的病例资料,并按国际疾病分类法第9版(ICD-9)编制"东北地区2000～2005年军事飞行人员疾病构成"和"东北地区2000～2005年军事飞行人员常见病疾病谱".应用SPSS 10.0统计软件进行统计分析. 结果 疾病构成显示,军事飞行人员肌肉骨骼系统疾病多年居首位,构成比是居第2位的消化系统疾病的2～3倍.与1995年比较,肌肉骨骼系统、感觉器官及泌尿生殖系统疾病的构成比上升显著;疾病谱显示腰椎间盘突出症、颈椎病、头痛、神经性耳聋和心律失常居前5位. 结论 21世纪前6年东北地区军事飞行人员常见病是腰椎间盘突出症、颈椎病、头痛、神经性耳聋和心律失常.提示转氨酶增高、半月板损伤和颈椎间盘突出症增加迅速,应引起关注.     

Effect comparison between sacral blocking and massage combined with traction on protrusion of lumbar intervertebral disc

Background:Epidural injection is an important method in treatment of protrusion of lumbar intervertebral disc.Especially in the recent decade sacral injection is adopted more and more often.Objective:To compare the clinical effects of sacral blocking and massage combined with traction.Unit:Yinhe Hospital of Beijing.Subjects:290 outpatients with grade Ⅱ of ASAI were selected from May,1994 to July,2000.Patients were randomly divided into observation group(n=145)and control group(n=145).Sacral blocking was adopted in observation group and 80 males and 65 females aged 20-78(mean:46.4)years old were included with disease course 3 days to 30 years.Massage combined with treaction was adopted in control group and 74 males and 71 females aged 22-74(mean:44.9)years oled were inmcluded with disease course 2 days to 10 years.Interention:Sacral blocking:Operation was according to sacral blocking and druge(dexamethasone injection,2 mg;0.75% bupivavaine hydrochloride,5 ml;saline,50ml) were injected slowly after success of puncture.Patient rested for 0.5h after injection and left treatment room if no adverse effects occurred.Massage combined with traction:Massage was adopted after traction to every patients.(1)Massage:Patient was seated at square stool and lower limbs separated naturally with same width of shoulders.Doctors sit behind patient.First,thubs of both hands were pressed on projecting part near spinous process(pressing points were selected according to different projecting part).Flexing and extending forward and backward were taken at the same time and extent was ddecided addording to patients‘ maximal endurable degree,5-10 timmes.Upper part of body was turned 45 degrees to left and right.Massage was still taken to affected part,3-t times.(2)Traction:Pelvis was extracted with general physical therapy and massage table.Supine position,chest and treaction bandage were fixed,tractiron wheel was turned slowly until patient felt comfortable with maximal endurance as limit(traction force,20-40kg),After extracting for 5 minutes,massagee switch was turned on to take rolling massage to bck and both lower libmbs.Traction force was increased every5 minutes and limit was still according to patient‘s maximal endurance,30 minutes for every time,once a day and ten times as a therapeutic course.Cohclusion:Effect of sacral blocking on protrusion of lumbar intervertebral disc was positive and fewer therapeutic time were needed.Massage combined with traction was also effective,safe and no adverse effects wer observed,but more therapeutic times were neeeded and inconveinient.     

颈前路钛网植骨融合术后钛网沉陷的原因探讨

目的：探讨颈前路钛网植骨融合术后钛网发生沉陷的原因及其对临床疗效的影响，并提出相应对策。方法：回顾性分析在我院行颈前路钛网植骨融合术的各类颈椎疾患患者179例，观察患者骨密度、钛网修剪及放置情况、终板处理情况、钢板类型、植骨及椎体撑开情况等。采用日本骨科学会（JOA）评分法评价神经功能的变化。结果：有17例患者发生钛网沉陷，沉陷的原因主要为骨密度下降、钛网修剪放置不当、术中过度撑开、终板刮除过多、使用非限制性钢板、采用同种异体骨植骨、螺钉进钉深度过浅和方向不当、钢板放置位置偏斜等。术后所有患者JOA评分比术前平均增加3．5分（P〈0．01）。162例未发生钛网下沉患者术后3个月和6个月的JOA评分比术前平均增加4．4分和4．7分：发生钛网下沉患者中。6例有临床症状者沉陷时和沉陷3个月时的JOA评分为2．9分和3．8分．7例无临床表现者为3．3分和3．9分．4例有临床症状行翻修手术者翻修术后1周和3个月时JOA评分比翻修前提高3．3分和3．7分。结论：颈前路钛网植骨融合术后可发生钛网下沉，骨质疏松患者应该避免使用钛网。手术时应尽可能增加钛网与终板接触面积，多保留相邻终板，选用限制性钢板，尽量选择自体骨植骨，避免椎间过度撑开等。防止术后钛网沉陷。     

钢板张力带化治疗胫骨Pilon骨折

胫骨Pilon骨折治疗难度大,治疗方法争议较多,处理不当易至踝关节不稳及创伤性关节炎.自2003年9月～2005年6月,笔者对23例胫骨Pilon骨折采用钢板张力带化治疗,取得了良好疗效.     

前列腺增生症手术放置支架术患者的护理

前列腺支架术是近年来治疗前列腺增生的新技术，特点是病人痛苦小，见效快，且安全有效。2000年9月～2004年2月，我院利用这一技术治疗前列腺增生患12例，现将治疗护理体会介绍如下。     

抑郁障碍的综合治疗

目前，对抑郁障碍的治疗多采用抗抑郁剂治疗为主，本文通过应用心理治疗和药物治疗相结合的综合疗法，为提高抑郁障碍的治愈率、降低致残率、降低疾病负担和改善患者的生活质量，为抑郁障碍的治疗探讨有效的治疗途径。