螺旋CT三维重建脊柱的临床意义和应用前景

目的：探讨螺旋CT扫描和三维重建在脊柱病变中的临床应用价值。方法：对12例脊柱疾病患者进行螺旋CT扫描和三维重建。结果：腰椎间盘突出症和椎管狭窄症3例，脊柱骨折5例，侧弯畸形2例，肿瘤2例，均得到正确诊治。结论：螺旋CT扫描及三维重建技术可广泛应用于脊柱病变的诊断，能直观显示脊柱病变部位的形态。     

成功抢救外伤性横窦大出血致心跳停止一例

患者女,6岁。2005年5月12日因车祸致枕部外伤2h伴头疼、呕吐入院。查体:神清,精神欠佳。右枕部旁开中线3.0处有一2.0cm头皮裂口已缝合,近乳突后侧头皮有一约3.0cm×3.0cm淤血斑。颅脑CT片示:右枕骨近乳突后处颅骨凹陷性粉碎性骨折,范围约2.5cm×2.5cm。入院24h后出现头疼、呕吐症状加重并烦躁不安症状,复查颅脑     

鼻内镜下微波热凝治疗变应性鼻炎60例

变应性鼻炎以鼻黏膜反应性增高为其主要特点，引起打喷嚏、流鼻涕、鼻痒，嗅觉减退等症状。我院自1999年6月开始采用鼻内镜下微波治疗常年性变应性鼻炎60例，效果较好，报道如下。     

联合抗焦虑治疗持续性胸背痛伴焦虑症状患者的疗效观察

目的 探讨氟哌噻吨＋美利曲辛（商品名，黛力新）等药物联合治疗胸背痛伴焦虑症状患者的临床疗效。方法 将符合胸背痛伴焦虑症状的56例患者，随机分为A、B两组，每组28人．A组予以黛力新＋多虑平抗焦虑治疗，同时予以西乐葆止痛治疗；B组予以西乐葆单纯止痛治疗。观察治疗4周后患者胸背痛的疼痛程度的视觉类比评分（VAS）和汉密尔顿焦虑量表评分（HAMA）的变化。结果 A组患者治疗后VAS评分由（8．56±1．43）分下降到（3．42±1．71）分，HAMA焦虑量表评分由（29．48±8．75）分下降到（12．73±7．29）分；B组患者治疗后VAS评分由（8．61±1．24）分下降到（6．57±2．16）分，HAMA焦虑量表评分由（29．33±8．91）分下降到（20．36±5．77）分。2组治疗后VAS评分、HAMA焦虑量表评分的差值比较有显著性意义俨〈0．05）。结论 黛力新＋多虑平等联合治疗能显著改善患者的胸背痛伴焦虑症状，而单纯西乐葆止痛治疗效果不佳。     

凯妮汀栓治疗妊娠合并外阴阴道念珠菌病疗效分析

目的观察凯妮汀栓治疗妊娠期外阴阴道念珠菌感染的临床疗效。方法将妊娠24~32周的患者100例随机分为2组,各50例,观察组给予凯妮汀栓,对照组给予克霉唑栓。结果两组治疗1、4周后的总有效率无显著性差异(P>0.05)。结论凯妮汀栓治疗妊娠期外阴阴道念珠菌感染给药次数少,患者易接受,能更好地配合治疗,值得临床推广使用。     

下颈椎经关节螺钉联合侧块或椎弓根螺钉固定的效果

Objective To discuss the effect of transarticular screws combined with lateral mass screws or pedicle screws through posterior approach in the lower cervical spine. Methods From February 2003 to October 2007, 22 patients were treated using transarticular screws internal fixation combined with lateral mass screws or pedicle screws in Axis plating system and Vertex system. There were cervical fracture and dislocation in 13 patients, ossification of the posterior longitudinal ligament in 4, cervical canal stenosis associated with dentoid process fracture in 1, and cervical disc herniation associated with cervical stenosis in 4 patients. Lamina or facet bone grafting were used to achieve a long-term stability, with decompression and anterior approach or not. The starting point for screw insertion was located 1 mm medial to the midpoint of the lateral mass and the direction of the screw was 40° caudally in the sagittal plane and 20° laterally in the axial plane. Results All screws insertion was successful. A total of 45 transarticular screws were inserted, with 2 in C4,5, 39 in C5,6 and 4 in C6,7. A total of 12 lateral mass screws were inserted, with 6 in C3 and 6 in C4. A total of 41 pedicle screws were inserted, with 4 in C2, 2 in C3 and 6 in C4, 21 in C7 and 8 in T1. There was no complication related to screw insertion, such as injury to the vertebral artery, nerve roots or spine cord. The follow-up period ranged from 10 months to 3 years and 8 months (mean 17 months). All cases got bone fusion. Only one instance of screw partial backout was identified, but fusion was achieved in all pa-tients. In the follow-up period, only one instance of screw partial backout was identified, but fusion was achieved in all patients. Conclusion The combined use of transarticular screws and lateral mass screws or pedicle screws fixation in the lower cervical spine can enlarge the advantages of strong stability,relatively simple, and reduce operating risk when performed appropriately.     

双手多发性短指畸形1例

患者：女性，20岁，身高158cm，双手外形显示：双手大小正常，左手中指、小指明显短小；右手中指、无名指、小指明显短小（图1～2）；无并指现象，手部各关节运动灵活自如，无运动障碍，各关节大小正常。双脚无短指、并指现象，肘关节不外翻，其他各关节均无异常。X线片显示（图3）：双手各骨数目正常，腕骨形态、大小、排列正常；左侧1-5掌骨的长度为：3．3cm、5．0cm、3．1cm、4．1cm、2．5cm，第1、3、5掌骨呈显著缩短，     

文拉法辛与氟西汀门诊治疗伴躯体症状的抑郁症对照研究

目的比较文拉法辛与氟西汀的抗抑郁效果及不良反应。方法随机将60例符合CCMD-3情感性精神障碍(抑郁发作)诊断标准的患者分为文拉法辛组(30例)和氟西汀组(30例)。疗程6周。在0、1、2、4、6周评定汉密尔顿抑郁量表(HAMD,17项),并评定疗效、记录出现的不良反应。结果文拉法辛组从疗后第1周HAMD评分开始显著下降,而氟西汀组从疗后第2周HAMD评分才显著下降;治疗6周后,文拉法辛的临床治愈率显著高于氟西汀(分别为66.7%和36.7%)。两组患者的不良反应相似,差异无显著性(P>0.05)。结论文拉法辛较氟西汀起效快,临床治愈率高。     

47例集体亚硝酸盐中毒救治体会

我院于2003年10月成功救治了47例集体亚硝酸盐中毒患者，现报道如下。     

远志与伪品幼椿白皮的鉴别

远志为常用中草药。主产于山西、山东、河南等地。春秋两季均可采挖，除去残茎及须根抽去木质心、甘草水浸渍后，晒干切段炒用。最近发现有掺伪现象，所掺伪品经鉴定为奥椿的幼根皮。二者来源、功效截然不同，今将两种药材识别方法介绍如下：1来源与形状鉴别远志为远志科植物远志或卵叶远志的干燥根皮，呈皱缩筒状，中空，长2cm～15cm，直径0.2cm～1cm。外皮灰黄色至灰棕色，全体有较密并深陷的横皱纹乃裂纹，或有细纵纹及细小的疙瘩状支根痕。质脆易断、断面黄白色，味苦微辛，嚼之有刺喉感。幼椿白皮为苦本科植物臭椿的幼根皮，呈不整齐的…