内窥镜辅助下显微神经血管减压术治疗 特发性偏侧面肌痉挛

目的为进一步提高神经血管减压术治疗特发性偏侧面肌痉挛的疗效。方法经乙状窦后小骨窗开颅加用内窥镜辅助显微血管减压术治疗特发性偏侧面肌痉挛３５例。结果术后３４例症状消失,１例症状减轻,３５例随访６个月至３年半,术后面肌抽搐消失者３３例,１例症状减轻,１例１年后复发。结论内窥镜可弥补手术显微镜的不足之处,减少组织损伤和判断错误,提高治疗效果。     

The provocation of coronary arterial spasm in patients with recent transmural myocardial infarction

Provocative tests for coronary spasm were performed in a groupof 131 patients (124 men and 7 women) with recent (<6 weeks)transmural myocardial infarction. Coronary arteriography wasperformed 27±9 days after the onset of the infarction.The provocative test was performed using a single IV bolus of0.4 mg of ergometrine. Aortic pressure, ECG and arteriogramsof the two coronary vessels were repeated 3 and 5 min later.Provoked spasm was observed in 27 (21%) of the patients. In13 (48%) the coronary spasm occurred in a vessel presumed tobe responsible for the myocardial infarction, while it was observedin coronary artery unrelated to the area of the infarct in 14(52% of the cases with spasm). Thus, this study demonstratesa high degree of reactivity of the coronary tree of patientswith recent transmural myocardial infarction suggesting thelikelihood of a role for spasm in the infarction process andoffering some explanation for subsequent recurrent ischemicevents.     

Arterial spasm as a finding intimately associated with the onset of vascular headache

Summary A patient with migraine headaches of the cluster variant type is presented in whom vasospasm of the middle cerebral artery, the anterior cerebral artery and the internal carotid artery triggered a pain episode identical in character and severity to the headaches which had led to her investigation. Vasospasm associated with the painful phase of headache in this case conflicts with the more accepted theory that the pain phase of a vascular headache is related to vasodilatation of cerebral or extracerebral vessels. The literature is reviewed.     

穴位注射治疗面肌痉挛的疗效观察

目的　观察 A型肉毒毒素穴注治疗面肌痉挛疗效和不良反应。方法　将 90例患者随机分为两组 ,穴注组 4 5例采用A型肉毒毒素穴位注射 ,针刺组 4 5例采用针刺治疗。结果　穴注组有效率、治愈率同针刺组相比差异有显著性意义 (P <0 .0 0 1)。结论　针刺治疗面肌痉挛有效 ,A型肉毒毒素穴注的应用更显著地提高了疗效。     

脉络宁注射液治疗半面痉挛的实验研究

目的:探讨脉络宁对半面痉挛脱髓鞘面神经的保护作用,为半面痉挛的治疗提供依据。方法:将24只新西兰大白兔随机分为对照组、脉络宁组和生理盐水组,在手术显微镜下分离出其茎乳孔处的面神经主干和颞浅动脉,使二者密切接触,以制备半面痉挛动物模型;术后第5周起对脉络宁组和生理盐水组分别自耳缘静脉推注脉络宁注射液和生理盐水持续2周;第7周取3组动物血清测定丙二醛(MDA)和超氧化物歧化酶(SOD),并处死取材行面神经光、电镜观察。结果:脉络宁组血清MDA明显低于生理盐水组(P<0.05),SOD明显高于生理盐水组(P<0.01),而与对照组比较变化不明显(P>0.05)。生理盐水组面神经纤维溃变明显,髓鞘松解分离,轴突肿胀有空泡或全部消失;脉络宁组面神经病变较轻。结论:脉络宁注射液对半面痉挛脱髓鞘面神经有明显的保护作用,对半面痉挛的治疗具有极其重要的应用价值。     

Simultaneous display of MRA and MPR in detecting vascular compression for trigeminal neuralgia or hemifacial spasm: comparison with oblique sagittal views of MRI

A new technique, simultaneous display of magnetic resonance angiography (MRA) and multiplanar reconstruction (MPR), was performed by a workstation to identify the involved vessels in patients with trigeminal neuralgia (TN) or hemifacial spasm (HFS), and the results were compared with those of oblique sagittal MRI technique. Twelve patients with either HFS or TN were prospectively assessed by simultaneous display of MRA and MPR, and oblique sagittal techniques, to point out the neurovascular compression and to identify the involved vessels. Three-dimensional (3D) time-of-flight (TOF) spoiled gradient-echo (SPGR) images were acquired to create MRA and MPR. Oblique sagittal views were also created and displayed on films. A total of 15 vessels in 12 patients were identified as compressing vessels during surgery. Simultaneous display of MRA and MPR technique pointed out the presence of vessels at and/or around root entry/exit zone (REZ) in all 12 patients, but proper identification by the name of the individual vessel was correct in 13 of 15 cases. However, oblique sagittal technique indicated the presence of vessels at and/or around REZ in 11 patients, but only 8 of 14 vessels were correctly identified. Our new method, simultaneous display of MRA-MPR, facilitated correct identification of the involved vessels compared with the oblique sagittal view method. Received: 30 June 1999; Revised: 9 September 1999; Accepted: 23 November 1999     

Qianzheng powder for the treatment of primary Hemifacial spasm: A protocol for systematic reviews and meta-analysis

Background:Hemifacial spasm (HFS) is a clinical common neurological disease, its main performance for 1 side or 2 sides muscles (the orbicularis oculi muscle, expression, orbicularisoris muscles) recurrent paroxysmal, involuntary twitching, aggravating when excited or nervous, more severe cases of the disease may include difficulty in opening the eyes, crooked corners of the mouth, and twitching noises in the ears, etc.^[1] Early manifestations of the disease are intermittent mild convulsions of the orbicularis oculi muscle, and then gradually spread to 1 side of the facial muscles, such as frowning muscles, nasal muscles, buccinalis muscles, etc, especially the most obvious spasms of the oral muscles, which can involve the ipsilateral platysma muscle in severe cases, with each twitch for a few seconds to a few minutes. The disease will affect the quality of life such as speaking, eating, seeing and so on, and even cause psychological effects such as inferiority, anxiety and depression. At present, the incidence of the disease in China is 11 per 1.1 million, females are more common than males. There are many ways to treat HFS, but the Qianzheng powder has a unique advantage in treating this disease. Therefore, our systematic review aims to evaluate the efficacy and safety of Qianzheng powder in the treatment of Primary Hemifacial spasm, and to provide a reliable basis for clinical decision makers.Methods:From its inception until April 2021, we will search electronic databases, including PubMed, Embase, Cochrane Library, China Biomedical Literature Database, China Knowledge Infrastructure, Wanfang Database, and China Scientific Journals Database. The authors will independently sift through studies, extract data information, and assess methodological quality using the Cochrane Risk of Bias tool. The RevManV. 5.3 software will be used for statistical analysis.Results:The results of this study, which will be published in a peerreviewed journal, will evaluate the efficacy and safety of Qianzheng powder in the treatment of primary Hemifacial spasm.Conclusion:This systematic review will provide reliable evidence-based basis for treating primary Hemifacial spasm with Qianzheng powder.INPLASY Registration number:INPLASY202130037.     

外伤性血尿患者膀胱痉挛的护理干预

目的探讨护理干预对降低外伤性血尿患者膀胱痉挛发生率的作用.方法回顾性分析昆明市延安医院2010年4月至2012年9月之间不同方式护理干预处理的外伤性血尿147例患者的护理经验.结果改进护理措施处理78例患者中有18例发生过膀胱痉挛,发生率为23%;采用常规护理措施的69例患者中计有27例发生过膀胱痉挛,发生率为39%.两者相比差异有统计学意义(P<0.05).结论改进护理干预可有效降低外伤性血尿患者膀胱痉挛的发生率.