筋膜间隔综合征的高压氧治疗与血浆纤粘素变化的关系

本文首次报道采用253kPa的高压氧治疗24例创伤后筋膜间隔综合征(PACS)病人并采用免疫单扩散法检测了治疗前后血浆纤粘素(FN)的变化与预后的关系。30例健康人作为血浆FN的对照组。结果表明:16例早期PACS病人,经3～5次高压氧治疗,症状和体征逐渐好转,无1例作筋膜切开减压。6例筋膜切开减压后行高压氧治疗者,水肿、炎症消退,体温降低,临床症状好转。2例坏死期PACS虽然临床症状好转,但效果差。高压氧治疗后,病人血浆FN显著高于治疗前。分别较治疗前高43(18.9％;P<0.01)、61(24.7％;P<0.01)、49(17.2％;P<0.01)、57(17.4％;P<0.05)和55mg/L(16.6％;P<0.05)。根据本组研究的结果,提示高压氧是治疗早期PACS的有效非手术疗法和筋膜减压后有效辅助疗法。     

急性脑梗死患者血清铁蛋白含量变化的临床意义

目的 探讨急性脑梗死患者血清铁蛋白（SF）含量变化的临床意义.方法 选择发病24 h内脑梗死患者72例,入院第1天及第3天分别进行血清铁蛋白测定,并进行神经功能缺损程度评分,同时选择72例健康者作为对照,比较急性脑梗死患者与健康者SF水平变化、不同严重程度脑梗死SF水平变化、进展性脑梗死及非进展性脑梗死不同时期SF水平变化.结果 急性脑梗死组SF水平较健康对照组显著增高（P〈0.001）;重型脑梗死组SF水平较轻、中型脑梗死组显著增高（P〈0.001）;进展性脑梗死组入院第3天SF水平较入院第1天显著增高（P〈0.001）,非进展性脑梗死组入院第3天SF水平较入院第1天比较增高无显著差别（P〉0.05）.结论 检测急性脑梗死患者SF水平对判断病情及评估预后有重要临床价值.     

Relationship of Hyperbaric Oxygen Therapy of Acute Compartment Syndrome with Changes of Plasma Fibronectin Concentration

This report describes for the first time the effects of hyperbaric oxygen therapy with 253kPa on patients(n=24) with post - trauma acute compartment syndrome, and the relationship be-tween the prognosis of the syndrome and the changes of plasma fibronectin. Plasma fibronectin wasmeasured using single radial immunodiffusion both before and after therapy with hyperbaric oxygen,with 30 healthy people as control for plasma fibronectin. The results showed that the clinical symp-toms and signs of all 16 patients with acute compartment syndromes in early stage were significantlyimproved after 3 times of hyperbaric oxygen therapy and disappeared after 5 times withoutfasciotomy. Six patients who were treated with hyperbaric oxygen after fasciotomy showed reductionin the infection, and, edema of the injured limb However, the effects were less favorable for 2 pa-tients with necrosis although their clinical symptoms and signs were partially improved. Besides,we found that these patients' plasma fibronectin concentrations were significantly afterhyperbaric oxygen therapy. The mean increase was 43 (18. 9％; P<0. 01), 61( 24. 7%, P<0. 01),49 (17. 2%, P<0. 01), 57 (17. 4%; P<0. 05) and 55 mg/L ( 16. 6%; P<0. 05) after 1, 2, 3, 4and 5 times of therapy, respectively. Plasma fibronectin concentrations returned to the level of thecontrols after 3 times of therapy (P>0. 05). After fourth and fifth therapy plasma fibronectin lev-els of the patients rose higher than those of the controls (P<0.05). The results suggest that hyperbaric oxygen therapy has a beneficial effect on patients withacute compartment syndrome in the early stage Hyperbaric oxygen therapy can reduce edema andskeletal muscle necrosis The method can be used to treat patients with acute compartmentsyndrome in early stage and as an effective adjunctive treatment after fasciotomy.     

高压氧对周围神经损伤后再生作用机理的探讨

通过手术切断大白鼠右侧坐骨神经，应用显微外科技术进行端－端吻合并辅以高压氧治疗；观察该神经功能的恢复、组织学改变及神经吻合口瘢痕的含量，探讨高压氧对周围神经损伤后再生的影响。结果表明：高压氧治疗对周围神经损伤后不同时期的修复过程有明显的促进作用，可减轻神经间质水肿、减少神经吻合口的瘢痕、加快轴索再生和神经功能恢复。     

依达拉丰联合疏血通治疗脑梗死(附32例疗效观察)

目的观察依达拉丰联合疏血通治疗发病72 h以内的脑梗死疗效。方法选择发病72 h以内的脑梗死64例,随机分为两组:治疗组32例,依达拉丰30 mg,静滴,2次/d,14 d;疏血通8 mL,静滴,1次/d,14d。对照组:低分子右旋糖酐500 mL加复方丹参16 mL,静滴,1次/d,14 d。治疗前后两组病例分别进行神经功能缺损评分,测定血尿常规、血液流变学、肝肾功能、大便潜血等,并进行两组比较,同时观察其副作用。结果治疗组神经功能缺损评分减少较对照组明显(P<0.01),总有效率(96.88%)亦较对照组(75%)高(P<0.01),且血液流变学指标较治疗前明显改善(P<0.01),与对照组相比差异具有显著性(P<0.01)。结论依达拉丰联合疏血通治疗发病72 h内的脑梗死安全有效。     

强直性肌营养不良基因CTG重复数与EMG、NCV对比分析

目的：探讨强直性肌营养不良（ＤＭ）患者及家系成员三核苷酸重复数ＣＴＧ（胞嘧啶、胸腺嘧啶、鸟嘌呤）的变化与ＥＭＧ、ＮＣＶ的关系。方法：用聚合酶链反应（ＰＣＲ）扩增及ＤＮＡ杂交法对５例临床诊断ＤＭ患者及三个家系的１６名成员进行ＤＭ基因的ＣＴＧ重复数和ＥＭＧ、ＮＣＶ测定。结果：１０名正常人ＣＴＧ重复数是３０个，ＥＭＧ、ＮＣＶ正常，５例ＤＭ病人ＣＴＧ重复数均在８５个以上，其中２例在１６０５个以上，明显高于正常，１６名家系成员中除４名正常，余１２例ＣＴＧ重复数均超过正常基因，而且，ＣＴＧ重复数与临床症状、ＥＭＧ、ＮＣＶ轻重有关。结论：ＤＭ基因诊断与其临床诊断、ＥＭＧ、ＮＣＶ改变相一致     

高压舱内反搏对心输出量和颈总动脉血流的影响

本文报告在常压与2.0ATA绝对压下反搏对24名正常人心输出量和颈总动脉血流的影响。发现在2.0ATA绝对压下反搏比未反搏前颈总动脉舒张期血流量增加135％,心输出量亦略有增加(300～400ml/min)。结果证明体外反搏与高压氧相结合既能增加颈总动脉舒张期血流量和心输出量,又能提高血浆中物理溶解氧量。两者结合能取得更满意的疗效。     

丹奥治疗脑梗死32例疗效观察

<正> 脑梗死是神经科常见疾病之一,治疗方法较多.我院自1997～1998年使用丹奥治疗脑梗死32例,取得了满意疗效,现报告如下.1.临床资料病例选择 本组脑梗死患者共64例,均为首次发病,病程<3天,并经头颅CT证实为基底节单个梗死灶.凡有出血性疾病.近期有手术、外伤史及严重肝、肾     

耳穴局部隆起对肝癌等疾病的诊断意义

当人体某个脏腑发生器质性病变时,在耳廓的一定部位往往会出现相应的各种反应,故有人以耳穴视诊作为诊断疾病的辅助手段。近年来,利用耳穴视诊诊断肿瘤疾患,逐渐为人们所重视。为进一步探明耳穴局部改变对肝癌等疾患的诊断价值,我们作了以下观察。观察对象1.肝癌组经手术病理确诊或临床诊断的在我院肝外科病房住院治疗的原发性肝癌患者。2.肝硬化组在我院内科消化系病房住院并经临床确诊的病人。