新法中药离子导入联合康复训练治疗膝关节术后功能障碍的远期疗效

目的 探讨新法中药离子导入联合康复训练治疗膝关节术后功能障碍的远期疗效.方法 按照简单随机化方法将纳入的研究对象120例分为电脑中频药物导入联合CPM组（A组）40例;电脑中频药物导入组（B组）40例;CPM组（C组）40例.以膝关节活动范围为指标进行临床观察,并于治疗后3周、1月、3月、6月、12月、24月进行近、远期疗效观察,记录观察指标,进行统计学分析.结果 电脑中频药物导入联合CPM组患者治疗后3周、1月、3月、6月、12月、24月膝关节活动范围均高于CPM组和电脑中频药物导入组,CPM组膝关节活动范围又高于电脑中频药物导入组,组间在不同时间段膝关节活动范围比较均存在差异（P＜0.05）.电脑中频药物导入联合CPM组患者治疗后3周、1月、3月、6月、12月、24月VAS评分均低于CPM组和电脑中频药物导入组,电脑中频药物导入组VAS评分又低于CPM组,组间在不同时间段VAS评分比较均差异有统计学意义（P＜0.05）.结论 电脑中频药物导入联合CPM治疗下肢骨折术后膝关节功能障碍的远期疗效好,是一种新的治疗膝关节功能障碍的新方法.     

Chorionic villi sampling: Laboratory experience with 4,000 consecutive cases

Experience with 4,000 consecutive CVS cases shows that 1) the combination of both the direct and culture methods greatly reduces false diagnoses and maternal cell contamination; 2) the time interval between the sampling procedure and processing of villus specimens influences the quality of direct preparations; 3) maternal cell contamination (MCC) can be minimized with dissection of CVS specimens. We have compiled a large volume of confined placen-tal mosaicism (CPM) cases to serve as a resource in interpreting mosaic cytogenetic findings. It was noted that, in up to 92% of the mosaic cases, the abnormal cell line was confined to the placenta. The frequency of true chromosomal mosaicism was 0.2%, and is not different from that for amniocentesis. © 1994 Wiley-Liss, Inc.     

The use of continuous passive motion after arthroscopically assisted anterior cruciate ligament reconstruction: help or hindrance?

One hundred and eight patients having undergone arthroscopic anterior cruciate replacement and having had continuous passive motion (CPM) as part of their immediate post-operative regime were prospectively compared with 108 patients having an identical operative procedure but not receiving CPM. All patients were operated on by the same surgeon, and the two groups were well matched for age, weight and associated injuries and procedures. These not receiving CPM required significantly less analgesia (P-0.0001), had less blood loss measured in the drains (P=0.001) and had a shorter hospital stay (P=0.0001). At review 6 months after surgery, there was no significant difference between the two groups in the range of movement of the operated leg compared to the normal leg.     

动力髁部螺钉治疗股骨远端骨折

目的报告应用动力髁部螺钉(DCS)治疗股骨远端骨折15例的体会。方法本组15例均采用DCS手术治疗,固定方法因骨折类型不同而异,手术后均辅以持续被动活动(continuouspassivemotion,CPM)。结果15例病人均获得随访,时间为6～12个月,骨折愈合良好,平均愈合时间3.1个月,膝关节功能按Merchan评分标准,优良率为13/15(86.7%)。结论DCS是治疗股骨远端骨折的良好方法之一,它具有固定可靠,有利于骨折愈合和膝关节功能的康复等优点。     

中药塌渍合CPM机锻炼治疗膝关节功能障碍

目的探讨中药塌渍配合CPM机(下肢康复治疗仪)锻炼治疗膝关节功能障碍疗效观察及护理。方法用中药塌渍配合CPM机锻炼治疗膝关节功能障碍,分别在治疗前后测量患者膝关节屈伸活动范围,以评价其临床疗效及护理方法。结果患者经过治疗后,效果显著,优良率86.5%,总有效率100%。结论中药塌渍配合CPM机锻炼治疗膝关节功能障碍,经过系统的治疗及护理干预,可有效缓解膝关节功能障碍,提高康复的速度及效果。     

CPM机在断指再植术后功能锻炼中的应用

目的 探讨断指再植手术治疗后患指使用CPM机进行功能锻炼的恢复效果.方法 2004年1月至2006年12月,对32例患者44指离断伤行断指再植术治疗,其中20例术后使用CPM机进行功能锻炼,12例术后未使用CPM机进行功能锻炼.观察手指功能的康复情况. 结果 32例患者术后获6～14个月(平均10个月)随访,患指全部成活.20例使用CPM机患者与12例末使用CPM机患者均纳入结果分析.运用顾玉东断指再植评定标准,使用CPM机组共20例26指,优6指,良13指,可4指,差3指,优良率为73.1%;未使用CPM机组共12例18指,优2指,良7指,可5指,差4指,优良率为50.0%. 结论断指再植术后2～12周使用CPM机进行功能锻炼,早期可以减轻疼痛,防止术后粘连,促进指间关节的功能恢复.     

解剖钢板内固定和应用CPM治疗胫骨近端骨折

目的探讨解剖钢板(高尔夫型)内固定和应用CPM治疗胫骨近端骨折的临床价值。方法采用切开复位、高尔夫钢板内固定(必要时植骨,对损伤的韧带、半月板进行修补,腓总神经损伤者探查修复)和应用CPM机治疗胫骨近端骨折,对关节功能进行评价。结果43例患者均获随访,随访6～81个月,平均28个月,膝关节功能评分:优28例,良11例,可3例,差1例。结论切开复位、高尔夫钢板内固定(必要时植骨)和应用CPM机治疗胫骨近端骨折,是目前治疗胫骨近端骨折较为理想的治疗方法之一。     

A psychophysical study of endogenous analgesia: The role of the conditioning pain in the induction and magnitude of conditioned pain modulation

Endogenous analgesia (EA) can be examined experimentally using a conditioned pain modulation (CPM) paradigm. While noxious conditioning stimulation intensities (CSIs) are mainly used, it has not been fully investigated in the same experimental design whether the experienced conditioning pain level affects CPM responses. The principal goal of the present study was to characterize CPM induction and magnitudes evoked by various conditioning pain levels. Furthermore, we explored associations between conditioning pain reports and CPM responses across various CSIs. Thirty healthy, young, right‐handed males were tested with a parallel CPM paradigm. Three different CSIs (hand water‐immersion) induced mild, moderate and intense pain levels, rated 12.41±7.85, 31.57±9.56 and 58.1±11.43, respectively (0–100 numerical pain scale) (P<0.0001). Contact‐heat ‘test‐stimulus’ levels were compared before and during conditioning. Within the group, (i) CPM was induced only by the moderate and intense CSIs (Ps≤0.001); (ii) no difference was demonstrated between the magnitudes of these CPM responses. Regression analysis revealed that CPM induction was independent of the perceived conditioning pain level, but associated with the absolute CSI (P<0.0001). Conditioning pain levels were correlated across all CSIs, as were CPM magnitudes (Ps≤0.01). We conclude that among males, (i) once a CPM response is evoked by a required conditioning pain experience, its magnitude is not further affected by increasing conditioning pain and (ii) CPM magnitudes are inter‐correlated, but unrelated to conditioning pain reports. These observations may suggest that CPM responses represent an intrinsic element of an individual's EA processes, which are not significantly affected by the experienced conditioning pain.