手指血管球瘤的MRI表现

目的探讨手指血管球瘤的MRI表现,以提高对本病的认识,减少误诊。方法回顾性分析经手术病理证实的11例手指血管球瘤的临床及MRI资料,11例均行MRI平扫,其中7例行MRI增强检查。结果11例中位于指甲下10例,1例位于指骨背侧;肿瘤边界清晰,在T1WI上呈等信号8例、稍低信号3例,在T2WI及PDWI上均呈高信号,增强扫描呈均匀明显强化。结论手指血管球瘤多具有典型的部位及MRI表现,MRI是诊断手指血管球瘤的首选方法。     

两种不同手术方法修复拇指末端缺损的效果对照研究

目的探讨手指掌侧推进皮瓣修复拇指末端软组织缺损与尺动脉腕上穿支皮瓣修复拇指末端软组织缺损两种手术方法的效果。方法选取2013年12月~2016年12月我院收治的拇指末端缺损患者106例作为临床研究对象。将行手指掌侧推进皮瓣修复拇指末端软组织缺损的病例作为对照组,共53例;将行尺动脉腕上穿支皮瓣修复拇指末端软组织缺损的病例作为实验组,共53例。观察两组患者的伸屈功能分级、感觉分级和皮瓣血运。结果实验组伸屈功能分级、感觉分级均高于对照组,差异有统计学意义(P0.05)。两组动脉危象、静脉危象发生率比较差异无统计学意义(P0.05)。结论尺动脉腕上穿支皮瓣修复拇指末端软组织缺损对于术后手指功能恢复和感觉恢复具有较好的效果。     

以温针上八邪穴为主治疗中风后手指拘挛的疗效观察

目的 观察以温针上八邪穴为主治疗中风后手指拘挛的临床疗效。方法 将95例患者随机分为观察组（48例）和对照组（47例）。两组均采用针刺治疗、内科基础治疗和康复治疗,观察组在对照组的基础上加温针上八邪穴。1次/d,10d 1疗程,3疗程后比较两组治疗前后简化Fugl-Meyer运动功能评分（FMA）、改良Ashworth痉挛评分（MAS）以及神经功能缺损程度评分。结果 两组治疗后Fugl-Meyer运动功能评分（FMA）均有提高（P<0.00）,观察组手指运动功能优于对照组（P<0.05）;两组治疗后Ashworth痉挛评分（MAS）均有减少（P均<0.00）,观察组与对照组相比减少程度更明显（P<0.05）;观察组愈显率81.3%、总有效率95.8%,对照组分别为53.2%和85.1%,观察组愈显率优于对照组（P<0.028）。结论 以温针上八邪穴为主的治疗方法可明显改善中风后患侧手指挛缩程度,提高手指运动功能,对临床应用推广有一定意义。     

补气益血针刺处方对糖尿病周围神经病变患者神经功能及神经传导速度的影响

目的:观察补气益血针刺处方对糖尿病周围神经病变麻木疼痛患者临床症状、神经功能及神经传导速度的影响。方法:糖尿病周围神经病变麻木疼痛患者86例按随机数字表法分为对照组和观察组各43例,对照组给予常规糖尿病周围神经病变治疗方案,观察组在对照组基础上加用补气益血针刺处方治疗,取膻中、气海及双侧脾俞、曲池、太溪、悬钟等穴,每次30 min,隔日治疗1次,共治疗2个月。对比两组患者的中医症候评分、多伦多临床评分系统(TCSS)评分及神经传导速度。结果:治疗后,两组患者中医症候评分均较治疗前下降(P<0. 05),且观察组低于对照组(P<0. 01)。两组治疗后TCSS评分均较治疗前下降(P<0. 05),且观察组低于对照组(P<0. 01)。两组治疗后运动神经与感觉神经传导速度均较治疗前提高(P<0. 05),且观察组高于对照组(P<0. 01)。结论:补气益血针刺处方可改善糖尿病周围神经病变患者的临床症状及神经传导速度。     

足趾移植再造手指术后留置PCA泵镇痛效果观察及护理干预

目的探讨足趾移植再造手指术后留置自控镇痛(PCA)泵镇痛的效果及护理干预。方法选取行足趾移植再造手指的手指缺损患者80例作为研究对象,随机分为两组各40例。对照组患者给予常规镇痛及护理干预,观察组患者术后给予一次性自控镇痛泵进行镇痛及循证护理,观察比较两组患者的术后镇痛效果、再造指的成功率、血管危象的发生率以及患者满意度。结果观察组患者的镇痛效果明显优于对照组,血管危象发生率明显低于对照组,满意度明显高于对照组,差异均有统计学意义(P<0.05)。结论对足趾移植再造手指患者实施PCA泵镇痛和循证护理,能减少血管危象发生率,提高手术成功率和满意度。     

Repair of brachial plexus lower trunk injury by transferring brachialis muscle branch of musculocutaneous nerve: anatomic feasibility and clinical trials

Background There are few effective methods for treating injuries to the lower trunk of brachial plexus, and the curative effect is usually poor. The purpose of this study was to provide anatomic references for transferring the brachialis muscle branch of musculocutaneous nerve （BMBMCN） for selective neurotization of finger flexion in brachial plexus lower trunk injury, and to evaluate its clinical curative effects.
Methods Microanatomy and measurement were done on 50 limbs from 25 adult human cadavers to observe the origin, branch, type of the BMBMCN and median nerve, as well as their adjacent structures. Internal topographic features of the fascicular groups of the median nerve at the level of the BMBMCN were observed. In addition, the technique of BMBMCN transfer for selective neurotization of finger flexion of the median nerve was designed and tested in 6 fresh adult human cadavers. Acetylcholinesterase （AchE） staining of the BMBMCN and median nerve was done to observe the features of the nerve fibers. This technique was clinically tried to restore digital flexion in 6 cases of adult brachial plexus lower trunk injury. These cases were followed up for 3, 6, 9 and 12 months postoperatively. Recovery of function, grip strength, nerve electrophysiology and muscle power of the affected limbs were observed and measured.
Results The brachialis muscle was totally innervated by the musculocutaneous nerve （MCN）. Based on the Hunter＇s line, the level of the origin of the BMBMCN was （13.18±.2.77）cm. Ache histochemical staining indicated that the BMBMCN were totally made up of medullated nerve fibers. At the level of the BMBMCN, the median nerve consistently collected into three fascicular groups as shown by microanatomy in combination with Ache stain. The posterior fascicular group was mainly composed of anterior interosseous nerves and branches to the palmaris Iongus. The technique was tested in six fresh cadavers successfully, except that stoma split occurred in one case. Five of the six cases reco     

酒后含服甲硝唑引起多发性神经病1例报告

1 临床资料 患者,男性,40岁.因双上肢麻木,疼痛1 h来院就诊.询问病史:患者12 h前因牙周炎开始分5次含服甲硝唑片10片(每片0.2 g,辽宁康泰药业有限公司,国药准字H21020118,产品批号070601).     

36例指动脉逆行岛状皮瓣的分析

目的 分析指动脉逆行岛皮瓣修复手指缺损临床效果.方法 从2004～2007年,根据缺损部位采用该方法修复手指缺损36例.结果 皮瓣全部成活,但有二指出现并发症.结论 指动脉逆行岛状皮瓣是修复指端缺损的简单有效方法.     

邻手指背侧带蒂翻转筋膜皮瓣治疗手指骨外露

目的：探讨手指皮肤软组织缺损伴骨外露的治疗方法。方法：采用邻手指背侧带蒂翻转筋膜皮瓣修复手指的皮肤软组织缺损,覆盖指骨外露共36例。结果：皮瓣具有良好的血供,供区隐蔽,外形及功能恢复满意等优点。结论：该皮瓣是修复手指骨外露的理想办法。