点刺"委中"放血对兔腰椎间盘突出症的影响

目的观察点刺"委中"放血对兔腰椎间盘突出症(lumbar intervertebral disc protrusion,LIDP)触觉与步态功能﹑血浆中前列腺素E2(Prostaglandin E2,PGE2)和髓核组织中磷脂酶A2(phospholipase A2,PLA2)含量的影响。方法将40只健康新西兰兔随机分为4组,即空白组、LIDP模型组、点刺委中组和点刺非经穴对照组。自制的LIDP动物病理模型造模器造LIDP病理模型,采用Siegal法记录触觉和步态功能,放射免疫方法测定血浆中PGE2和髓核组织中的PLA2的含量。结果点刺"委中"放血可改善家兔的触觉与步态功能,降低LIDP家兔血浆中PGE2和髓核组织中PLA2的含量,与模型组、对照组比较有显著性差异(P<0.01)。结论通过减少PGE2、PLA2等炎症因子含量减轻炎症反应可能是点刺委中放血治疗LIDP的作用机制。     

肌电图检查在腰椎间盘突出症诊治中的意义

对９９例经手术证实为椎间盘突出患者的四种术前检查结果进行了对比分析。结果表明，肌电图检查虽在诊断符合率（为７２．７％）上稍低于ＣＴ扫描和椎管造影（二者分别为８７．５％和７８．６％），但其在神经根损害定位上则独具优势，对提高突出定位准确率及手术方法的选择上有着重要意义。且肌电图检查无损害、费用低，是目前临床诊断腰椎间盘突出症的理想方法。     

腭杠腭托联合支抗矫治双颌前突的临床研究

目的:通过研究不依赖于患者配合的腭杠腭托口内支抗系统矫治双颌前突的临床疗效分析其支抗作用.方法:选取12~26岁安氏Ⅰ类双颌前突患者34例,均在拔除4个第一前磨牙后,应用标准方丝弓固定矫治技术治疗,支抗设计采用腭杠腭托联合支抗系统(横腭杆 Nance弓);分析治疗前后X线头颅侧位定位片以及牙颌研究模型的各项指标变化.结果:磨牙平均前移(1.50±0.85)mm,但未达到拔牙间隙的1/3;上下切牙平均内收量分别为(4.73±2.64)mm和(5.52±4.62)mm;双颌前突软组织侧貌有较大改善(Ls-E,Li-E,Cm-Sn-Ls,Pg′B′-FH,A′Ls-FH,Z角的改变,P<0.01);磨牙伸长量有统计学意义(P<0.05),但下颌平面角、面高比以及后牙弓宽度改变没有显著性(P≥0.05);上下牙槽骨的变化没有显著性(P≥0.05).结论:腭杠腭托联合支抗系统对于矢状向、垂直向、水平向支抗控制较好,是一种简单有效的非依赖性口内强支抗系统;对于矫治双颌前突拔牙病例是一种非常有效的强支抗.     

瘀麻痛消汤结合早期功能锻炼治疗腰椎间盘突出症术后麻痛综合症

目的：观察瘀麻痛消汤结合早期功能锻炼埘腰椎间盘突出症术后麻痛综合症的治疗效果。方法：对65例（观察组）小切口手术摘除椎间盘的患者，采用术后早期主动训练及中药瘀麻痛消汤治疗，以采用小切口手术术后口服VitB1和西乐葆治疗对比。结果：术后随访6月～2年（平均1．2年），以术后患肢麻木、疼痛和肌力减弱改善情况为指标观察其临床疗效，结果显示，观察组临床疗效明显优于对照组（P〈0．01）。结论：瘀麻痛消汤结合早期功能锻炼能促进神经传导功能的恢复，恢复腰椎最佳的生物力学动态平稳，治疗腰椎间盘术后麻小综合征疗效确切。     

中西医结合治疗腰椎间盘突出症93例临床观察与护理

目的为了观察护理腰椎间盘突出症的疗效。方法对93例腰椎间盘突出症患者采用牵引、推拿、针灸、内服及外敷中药，配合西药对症处理治疗20d。结果全组治愈35例，好转56例，无效2例，总有效率97．8％。结论对于腰椎间盘突出症采用牵引、推拿、针炙，中西医结合治疗，疗效显著。     

应用健康教育路径对腰椎间盘突出患者进行健康教育

目的提高健康教育质量，保证患者得到及时有效的健康教育。方法将175例住院患者随机分成2组。实验组进行健康评估，设计健康教育路径表，应用路径表对患者实施健康教育计划：对照组采用常规健康教育方法。结果实验组接受健康教育后的效果和对护理工作的满意度均显著提高p〈0．01（x^2=7．574），健康教育达标率95．74％（90／94）优于对照组74．07％（60／81，x^2=16．690，p〈0．01）。结论腰椎间盘突出患者按健康教育路径实施健康教育，可减轻患者痛苦，缩短住院日，减轻患者经济负担，促进康复，是一种行之有效的工作方式。     

出口梗阻性便秘手术的护理体会

目的：总结直肠前突及直肠黏膜脱垂患者手术护理体会，进一步提高患者的护理质量。方法．28例用手按压阴道后壁排出粪便，多数患者长期服用导泻药物以协助排便。结果：对本组38例直肠前突和直肠黏膜脱垂患者经过积极的手术治疗和实施护理措施，大便排出困难均明显得到改善，临床症状消失，减轻了患者的痛苦，取得了良好效果，33例患者每日排便1次，有3例为每日排便2次，2例每2—3天排便1次。避免了并发症，使患者尽快的康复。结论：对直肠前突和直肠黏膜脱垂患者实施的本护理措施是有效的，提高了临床治愈率。缩短了患者住院时间，使他们早日康复。     

骶管与硬膜外阻滞治疗腰椎间盘突出症疗效对比研究

目的 研究骶管阻滞与硬膜外阻滞治疗腰椎间盘突出症临床应用价值,并对骶管阻滞的技术操作及适应证和禁忌证进行探讨.方法 腰椎间盘突出症患者120例采用骶管阻滞(骶管组),于骶管腔注入(曲安奈德40 mg、维生素B1 100 mg、维生素B12 1 mg、2%利多卡因100 mg,用0.9%氯化钠稀释为20～30 ml),2周1次,3次为1个疗程.并与硬膜外阻滞治疗腰椎间盘突出症患者120例(硬膜外组)的疗效进行对比观察.结果 一次性穿刺成功率骶管组为93.3%(112/120),硬膜外组为82.5%(99/120),两组比较差异有统计学意义(P<0.05).治疗后骶管组、硬膜外组优良率分别为85.0%(102/120)、93.3%(112/120),差异无统计学意义(P>0.05);可差率分别为15.0%(18/120)、6.7%(8/120),差异有统计学意义(P<0.05).结论 骶管阻滞和硬膜外阻滞均为治疗腰椎间盘突出症的有效疗法,能较快解除神经根压迫症状和强迫体位.而骶管阻滞较硬膜外阻滞操作简单、安全性较高.     

The relationship between static and dynamic occlusion in 14-17-year-old school children

This study investigated the relationship between static and dynamic occlusion in school children. A total of 447 subjects, within an age range of 14-17 years with no history of orthodontic treatment or trauma to the teeth were included in this study. Static occlusion was determined for both incisal and molar relationship. Dynamic occlusion was determined in lateral and protrusive movements of the mandible. The majority of the subjects had class I static occlusion for both incisor and molar relationship (45 and 54%, respectively). Canine-guided occlusion was the dominant type of dynamic occlusion (57%) and most of the subjects had no posterior contact in protrusive movement (78%). There was an association between canine guidance with class II static occlusion. Statistically, a significant relationship was found between the dynamic and static occlusion of the incisor (P < 0.001) but not with the molar (P > 0.05).     

Correlation of intravesical prostatic protrusion with bladder outlet obstruction

OBJECTIVES: To determine the effect of intravesical protrusion of the prostate (IPP, graded I to III) on lower urinary tract function, by correlating it with the results of a pressure-flow study. PATIENTS AND METHODS: In a prospective study men (aged> 50 years) with lower urinary tract symptoms were initially evaluated as recommended by the International Consultation on Benign Prostatic Hyperplasia, together with the IPP and prostate volume, as measured by transabdominal ultrasonography. These variables were then correlated with the results from a pressure-flow study. RESULTS: The IPP was a statistically significant predictor (P < 0.001) of bladder outlet obstruction (BOO) compared with other variables in the initial evaluation. In all, 125 patients had significant BOO, defined as a BOO index of> 40. Of these men, 94 had grade III and 30 had grade I-II IPP. Seventy-five patients had a BOO index of < 40; 69 had grade I-II and six grade III IPP. In patients with BOO confirmed on the pressure-flow study, grade III IPP was associated with a higher BOO index than was grade I-II (P < 0.001). CONCLUSION: The IPP assessed by transabdominal ultrasonography is a better and more reliable predictor of BOO than the other variables assessed.