抱膝滚腰法治疗腰椎管狭窄症

自 1994～ 2 0 0 1年 ,我们采用抱膝滚腰手法治疗腰椎管狭窄症 38例 ,临床效果较好 ,现介绍如下。1　临床资料本组 38例 ,男 2 0例 ,女 18例。年龄 35～ 76岁 ,平均 5 0岁。病程 1个月～ 10年。均有腰腿痛、间竭性跛行、腰椎过伸试验阳性。跟腱、膝腱反射均有改变。 30例有肌力及感觉减退。均无二便障碍或 (和 )马鞍区麻木。全部病例CT或MRI均提示腰椎管狭窄。2　治疗方法2 .1　循经按摩　患者俯卧位 (如有困难 ,可于腹部垫小枕 ,使腰后凸 ) ,医者在背部、臀和腿部循足太阳膀胱经自上而下施用手法 ,先用滚法约 3～ 5遍 ,然后用点法循足太…     

小梁切除术后慢性滤过泡炎一例

患者女 65岁因右眼疼痛,视力下降两天.于2008年2月拟诊断为滤过泡炎,收入院.体检:右眼视力4.3,眼睑结膜少许脓性分泌物,滤过泡周围充血明显且滤过泡内可见乳白色物质,前房稍浅,房水闪辉(++),稍许KP,无前房积脓,瞳孔中等大,对光反射迟钝,晶体周边轻度混浊,玻璃体未见有炎性细胞,眼底C/D=0.6.视神经乳头明显凹陷,血管黄斑未见异常.     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

Ahmed青光眼引流阀在难治性青光眼人工晶状体植入术中的应用

复杂性青光眼合并白内障行抗青光眼手术联合白内障摘出和人工晶状体植入术可造成眼内手术炎症反应和结膜瘢痕化,使传统滤过手术的成功率大为降低.为此,越来越多的青光眼引流管植入物用于治疗此类复杂性青光眼.本文回顾性分析了Ahmed青光眼引流阀治疗合并人工晶状体植入术的难治性青光眼资料,报道如下.     

星状神经节阻滞治疗椎动脉型颈椎病的效果及其机制

目的:探讨星状神经节阻滞治疗椎动脉型颈椎病的临床疗效及其机制。方法:通过星状神经节阻滞术,观察椎动脉血流速度的变化特点及临床治疗效果;选用成年人尸体,借助显微镜,观察星状神经节发出的交感神经在椎动脉Ⅱ段周围的分布特点。结果:阻滞星状神经节可明显改善椎动脉血流速度:治疗前的平均血流速度为32.25cm/s,治疗后的平均血流速度为42.02cm/s,治疗前后比较差异有显著性意义(F=1.046,P<0.01),临床效果:31例痊愈,8例显效,3例有效,1例无效;解剖发现星状神经节发出的交感神经攀附于椎动脉的表面。结论:椎动脉型颈椎病可能主要是由于颈椎病变压迫、刺激椎动脉周围的交感神经所致。     

星状神经节阻滞治疗椎动脉型颈椎病的效果及其机制

目的：探讨星状神经节阻滞治疗椎动脉型颈椎病的临床疗效及其机制。方法：通过星状神经节阻滞术，观察椎动脉血流速度的变化特点及临床治疗效果；选用成年人尸体，借助显微镜，观察星状神经节发出的交感神经在椎动脉Ⅱ段周围的分布特点。结果：阻滞星状神经节可明显改善椎动脉血流速度：治疗前的平均血流速度为32．25cm／s，治疗后的平均血流速度为42．02cm／s，治疗前后比较差异有显著性意义(F=1．046，P&;lt;0．01)，临床效果：31例痊愈，8例显效，3例有效，1例无效；解剖发现星状神经节发出的交感神经攀附于椎动脉的表面。结论：椎动脉型颈椎病可能主要是由于颈椎病变压迫、刺激椎动脉周围的交感神经所致。     

6mm无缝线不同位置切口白内障术后散光变化

目的 研究角巩膜缘无缝线不同位置切口对白内障超声乳化摘除联合人工晶体植入术前后散光变化的影响并评价其手术效果。方法 对67例（70只眼）白内障患者根据切口位置随机分成两组，A组：上方切口组34只眼，B组：颞上侧（右眼）或鼻上侧（左眼）切口组36只眼，用钻石刀在角巩膜缘后0．5mm做隧道长1．75mm阶梯形切口行白内障超声乳化摘除人工晶体植入术。分别于术前及术后1周、1个月、3个月及6个月用Nikon自动角膜屈光曲率仪测量角膜散光度、轴向。采用Holladay矢量分析法计算手术源性散光度和轴向，比较两组术后不同时间的平均角膜散光度、平均手术源性散光度和术后裸眼视力。结果 术后1周B组平均裸眼视力明显好于A组，差异有显著性（P〈0．05），术后1、3和6个月两组差异无显著性（P〉0．05）。平均角膜散光度和平均手术源性散光度术后1周、1个月和3个月，A组明显大于B组，差异有显著性（P〈0．05）。术后散光以术前逆规性散光最甚，术后6个月两组差异无显著性（P〉0．05）。A组术后散光轴向全部为逆规性变化，B组术后散光轴向以顺规性散光变化为主。结论 颞上侧或鼻上侧切口可有效地减少切口的扩张力并且产生较小的角膜散光，早期可获得良好而稳定的裸眼视力，6mm无缝线角巩膜缘隧道切口安全、可靠。     

单象限后眼球筋膜下麻醉在白内障手术中的应用

１９９７～１９９８年,我们对３０例（３０只眼）行白内障人工晶体植入术患者采用后眼球筋膜下麻醉,并与３０例采用球后麻醉的患者进行比较,现将结果报告如下。临床资料：本文老年白内障患者６０例（６０只眼）,其中男３４例,女２６例;年龄５８～８６岁,平均６８岁。将６０例患者随机分为实验组与对照组各３０例均排除严重高血压及心脏病。两组均施行白内障人工晶体植入术,实验组采用后眼球筋膜下麻醉。麻醉针为英国产,规格１．１０ｍｍ×２６ｍｍ,曲率半径为３０ｍｍ,针头为扁平钝头;球后麻醉针为国产５号牙科针,长４０ｍｍ。…     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.