针刺治疗假性球麻痹

本文从头针和舌针治疗假性球麻痹阐述了针刺是治疗该病的重要方法之一。针刺疗法作为治疗本病的主要手段,以局部取穴为主,远端取穴为辅,将近治与远治相结合,是治疗本病的重要方法。     

血必净灌肠治疗急性胰腺炎肠麻痹的临床研究

目的:分析并评价血必净灌肠治疗急性胰腺炎肠麻痹的临床疗效。方法:对照组37例病人给予常规对症治疗措施;观察组35例病人在上述常规治疗基础上给予血必净灌肠治疗。治疗48h后比较两组的腹痛腹胀、恶心呕吐症状消失时间以及自主排便时间。结果:观察组总有效率88.57%;对照组总有效率70.27%,观察组与对照组疗效比较,差异显著(P0.05),具有统计学意义。结论:应用血必净灌肠治疗急性胰腺炎肠麻痹的临床疗效令人满意,值得临床推广应用。     

辨证选穴针灸治疗周围性面瘫97例疗效观察

目的观察辨证选穴针灸治疗周围性面瘫的效果。方法选取本院2011年5月-2012年4月收治的周围性面瘫患者97例，所有患者接诊后进行辨证选穴针灸治疗，观察各证型患者治疗的临床效果。结果97例患者中风寒型42例，风热型23例，风痰型19例，气血亏虚型13例，经治疗后风寒型及风热型总有效率为100。00％，风痰型总有效率为94．74％，气血亏虚型总有效率为92．31％。各证型患者治疗后总有效率比较差异无统计学意义（P〉0．05）。97例患者治疗的总有效率为97．94％。结论辨证选穴针灸治疗周围性面瘫疗效确切，值得临床推广应用。     

关于中西医结合治疗面瘫患者的护理心得体会

观察面瘫患者中西结合治疗面瘫的临床疗效，配合针对性护理，并总结临床护理经验，促进患者康复。方法：就我院2015年10月---2016年10月72例面瘫患者，在中医整体观的指导下，通过辩证施护，同时结合西医辅以优质的护理，随机将72名患者分为温灸针结合西医治疗辅以优质护理观察组和温灸针组，分别用温灸针结合肌肉注射腺苷钴胺辅以优质的护理和温灸针治疗，每日一次，治疗时间1个月，对比观察两组面瘫临床治疗效果。结果采用中西医结合方法的观察组36例共痊愈30例，显效4例，有效2例，无效0，总有效率100%；温灸组36例，痊愈20例，显效3例，有效4例，无效9例，总有效率75%，通过两组比较，P〉0.05，差异无显著意义。结论在中医整体观指导下，通过辩证施护，同时结合西医治疗辅以优质的护理，均有效果。     

Infantile-onset ascending hereditary spastic paralysis: A case report and brief literature review

BackgroundInfantile-onset ascending hereditary spastic paralysis (IAHSP) is a rare, early-onset autosomal recessive motor neuron disease associated with mutations in ALS2.AimWe studied a 17-year-old boy who had features of IAHSP. We also reviewed the current literature on ALS2-related syndromes.MethodsClinical and neuroimaging studies were performed. Blood DNA analyses were combined with mRNA studies in cultured skin fibroblasts.ResultsLike previously described cases, the patient presented with severe spastic paraparesis and showed rapid progression of paresis to the upper limbs. He also developed bulbar involvement and severe scoliosis during childhood. In blood DNA we identified a novel splice-site homozygous mutation in ALS2 (c.3836+1G > T), producing exon skipping in fibroblast mRNA and predicting premature protein truncation.ConclusionsThis case adds to the allelic heterogeneity of IAHSP. Review of the pertinent literature indicates a fairly homogeneous clinical picture in IAHSP that should facilitate molecular confirmation and prevention of long-term complications.     

Case Study of Phrenic Nerve Paralysis: “I Can't Breathe!”

BackgroundThe anatomic course of the phrenic nerve runs in the fascia covering the anterior scalene muscle. Interscalene blocks are commonly performed by an anesthesiologist for shoulder surgery, such as a rotator cuff repair, total shoulder replacement, humeral fracture, or other arm surgery. Phrenic nerve palsy or paralysis is a known complication from interscalene block and is covered in multiple case reports and series in both Anesthesia and Neurosurgical literature, but only one case report in the Emergency Medicine literature.Case ReportThis case involves a 57-year-old man who had an uncomplicated arthroscopic rotator cuff repair with placement of interscalene block under care of anesthesia. He was discharged with a pain pump in place and then subsequently presented to the Emergency Department (ED) later that same day for evaluation of dyspnea. Using point-of-care ultrasound, his right diaphragm did not appear to be moving. Chest x-ray study revealed an elevated right hemidiaphragm. He was diagnosed with iatrogenic right phrenic nerve paralysis from interscalene block.Why Should an Emergency Physician Be Aware of This?Emergent diagnosis of phrenic nerve paralysis in the ED is complicated by a distressed patient and need for quick intervention. Most formal tests for this diagnosis are not immediately available to emergency physicians. Ultrasound is a rapid and reproducible, noninvasive resource with high sensitivity and specificity, making it an ideal imaging modality for the emergent evaluation of possible phrenic nerve palsy or paralysis.     

针灸联合川芎茶调散治疗周围性面神经麻痹(风寒证)

目的:观察川芎茶调散加减方联合针灸治疗周围性面神经麻痹(风寒证)的临床效果。方法:选取2018年2月至2019年2月威海市中医院收治的急性周围性面瘫患者108例作为研究对象,按照随机数字表法分为对照组与观察组,每组54例。对照组给予常规西药治疗,观察组给予川芎茶调散加减方口服联合针灸治疗。比较2组患者主要症状的改善时间、肌电图检查相关指标、面部神经功能分级的变化,测定血清中相关因子水平,比较临床效果。结果:观察组、对照组的有效率92.59%、75.93%,以观察组临床效果更好(P0.05);观察组患者治疗后的闭目、抬眉、鼓颊的改善时间明显短于对照组(P0.05);观察组患者的肌电图结果RI潜伏期低于对照组,CMAP波幅高于对照组,面部神经功能分级改善更明显(P0.05);观察组患者血清中TNF-α、IL-17含量明显低于对照组,GDNF含量显著高于对照组(P0.05)。结论:川芎茶调散加减方联合针灸利于促进患者临床症状的缓解,改善肌电图指标,促进面部神经功能的恢复,推断其起效可能与通过调控血清中TNF-α、GDNF、IL-17等水平以减轻患者神经病变的炎性反应损伤程度有关。