阿奇霉素联合甲强龙治疗小儿支原体肺炎的疗效观察

目的:观察阿奇霉素联合甲强龙治疗小儿支原体肺炎的临床疗效。方法:选择113例某院收治的确诊患儿,按随机和自愿原则分为治疗组63例和对照组50例,其中对照组患儿施以阿奇霉素序贯治疗,治疗组在此基础上给予甲强龙长达1周的治疗。以肺部炎症吸收情况为疗效指标,1周后观察两组患儿肺部X线检查结果,记录观察期内两组患儿的喘息、咳嗽、咯痰消失时间、退热时间和不良反应发生情况。所得数据采用SPSS17.0软件进行统计学处理。结果:肺部炎性反应吸收情况方面,治疗组的有效率(87.3%)显著优于对照组(32.0%)(P0.05);治疗组的喘息、咳嗽、咯痰消失时间和退热时间均显著短于对照组,差异均具统计学意义(P0.05)。结论:阿奇霉素联合甲强龙治疗小儿支原体肺炎,临床症状改善迅速,疗效理想,安全性较高,值得临床上进一步推广。     

活血祛瘀汤对股骨粗隆间骨折患者关节功能和骨代谢指标的影响

目的研究活血祛瘀汤对股骨粗隆间骨折患者关节功能和血清中骨代谢指标的影响。方法选择2016年5月-2017年5月在本院行股骨粗隆间骨折手术的患者40例作为观察组,所有患者在股骨粗隆间骨折常规治疗的基础上联合活血祛瘀汤进行临床干预,选择2015年5月-2016年5月实施常规治疗的股骨粗隆间骨折患者40例作为对照组,采用Harris评分评价2组关节功能,并对比2组患者骨代谢相关指标的水平。结果观察组患者术后第3个月、6个月、12个月时Harris评分均高于对照组患者;观察组患者血清中BALP、PICP、BGP水平均高于对照组;而t-PINP、β-CTX水平均低于对照组,上述差异均有统计学意义(P0.05)。2组患者治疗后管径、血流量、血流峰时度均较治疗前升高,且观察组更加明显,差异有统计学意义(P0.05)。结论活血祛瘀汤有助于改善股骨粗隆间骨折患者关节功能和血清中骨代谢指标及下肢血流。     

黄氏愈伤贴抗炎镇痛作用的研究

目的 研究黄氏愈伤贴的抗炎镇痛作用。方法 采用二甲苯致小鼠耳廓肿脓实验、蛋清致大鼠足肿胀实验，观察该药的抗炎作用；采用小鼠醋酸扭体实验、小鼠热板实验，观察该药的镇痛作用．结果 黄氏愈伤贴低、高剂量对二甲苯所敛小鼠耳廓肿胀、10％蛋清注射引起大鼠足跖肿胀均有明显的抑制作用，均能显著延长小鼠的痛觉反应时间，高剂量黄氏愈伤贴对醋酸致小鼠扭体反应有明显的抑制作用。结论 黄氏愈伤贴具有显著的抗炎、镇痛作用。     

面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘

Objective To assess the effixacy of a nasally inhaled corticosteroid(ICS) through a spacer with mask aiming at simultaneou treatment of allergic rhinitis and asthma in children and make an analysis on the costs.Method A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups.Experimental group received budesonide inhaler(400 μg/d) through the nose using a spacer attached to a face mask,control group children orally inhaled budesonide dry powder (400μg/d) plus a nasal spray of budesonide aquae(256μg/d).Result The patients were obsenred for 12 weeks.The symptom scores of rhinitis of both experimental group and control group declined(F=6.529 and 7.014,all P<0.01),symptom scores of asthma in both group were also reduced(F=4.132 and 4.950,P<0.01).The pulmonary function PEF(L/win)in both groups continuously increased(F=2.750 and 3.282,P<0.05).But the clinical scores,PEF value and FEVl all did not differ between the two groups at admission or at nearly all follow-up visits(P>0.05 for all).The proportion of dry nose was lower in experimental group than in the control group(5.6% vs.19.4%),but the difference was not statistically significant.The cost in the experimental group was lower than that in the control group(P<0.01).Condusion Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthula in children,especially it result in higher compliance,lower costs,and fewer side effects.     

单髁置换术与腓骨上段截骨联合关节镜清理术治疗膝关节内侧间室骨性关节炎的对比研究

目的比较单髁置换术与腓骨上段截骨联合关节镜清理术治疗膝关节内侧间室骨性关节炎的临床疗效,为临床上选择个体化治疗方案提供依据。方法选取中老年膝关节内侧间室骨性关节炎患者63例,其中采用单髁置换术治疗26例（单髁置换组）,采用腓骨上段截骨联合关节镜清理术治疗37例（截骨清理组）。比较两组患者手术时间、住院时间、住院费用、手术前后美国纽约特种外科医院（HSS）膝关节评分、疼痛视觉模拟量表（VAS）评分和术后并发症发生情况。结果截骨清理组患者手术时间、住院时间和住院费用均低于单髁置换组,差异均有统计学意义（均P＜0.05）。与术前比较,两组患者术后1周、6个月和12个月HSS评分均增加,VAS评分均下降,差异均有统计学意义（均P＜0.05）。单髁置换组患者术后无一例出现感染及脱位等并发症。截骨清理组患者术后1例出现小腿及足外侧麻木,给予对症处理后明显好转。结论两种方法均可明显改善膝关节功能,缓解疼痛,提高患者生活质量。临床上应根据患者各方面综合情况（特别是经济情况）、医院条件、术者的手术经验等,个体化选择治疗方案。     

背侧钢板辅助固定桡骨远端月骨窝背侧骨折块

目的：探讨背侧钢板辅助固定桡骨远端月骨窝背侧骨折块的临床疗效。方法：自2019年1月至2022年1月,采用背侧钢板辅助固定30例桡骨远端月骨窝背侧骨折块患者,其中男13例,女17例;年龄42~68(48.7±5.6)岁;骨折参照Doi分型:3块型24例,4块型6例。术中透视背侧钢板固定前后桡骨远端掌倾角度数,术后观察骨折愈合和腕关节功能恢复情况,术后12个月采用Gartland和Werley评分系统进行功能评价。结果：所有患者获得随访,时间12~13(11.3±0.9)个月。骨折全部愈合,时间4~5(4.7±0.8)个月。背侧钢板固定前、后桡骨远端掌倾角中位数(P25,P75)分别为5.30°(4.85°,6.03°)、12.45°(11.98°,13.43°),差异有统计学意义(P<0.01)。术后12个月Gartland和Werley评分(1.1±0.4)分,优27例,良3例。结论：背侧钢板辅助固定有利于月骨窝背侧骨折块的复位和掌倾角的恢复。     

面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘

Objective To assess the effixacy of a nasally inhaled corticosteroid(ICS) through a spacer with mask aiming at simultaneou treatment of allergic rhinitis and asthma in children and make an analysis on the costs.Method A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups.Experimental group received budesonide inhaler(400 μg/d) through the nose using a spacer attached to a face mask,control group children orally inhaled budesonide dry powder (400μg/d) plus a nasal spray of budesonide aquae(256μg/d).Result The patients were obsenred for 12 weeks.The symptom scores of rhinitis of both experimental group and control group declined(F=6.529 and 7.014,all P<0.01),symptom scores of asthma in both group were also reduced(F=4.132 and 4.950,P<0.01).The pulmonary function PEF(L/win)in both groups continuously increased(F=2.750 and 3.282,P<0.05).But the clinical scores,PEF value and FEVl all did not differ between the two groups at admission or at nearly all follow-up visits(P>0.05 for all).The proportion of dry nose was lower in experimental group than in the control group(5.6% vs.19.4%),but the difference was not statistically significant.The cost in the experimental group was lower than that in the control group(P<0.01).Condusion Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthula in children,especially it result in higher compliance,lower costs,and fewer side effects.     

双钢板治疗复杂胫骨平台骨折32例

我院自2002年～2006年1月采用双钢板治疗复杂胫骨平台骨折32例，现报道如下。     

黄氏愈伤贴治疗急性软组织损伤临床观察

黄氏愈伤贴是在我院已故著名老中医黄乃聪先生所创制的黄氏治伤软膏的基础上,经过处方整理筛选和剂型革新研制而成的一种新型外用药.具有活血化瘀、舒筋活络、消肿止痛等功效,临床应用数十年,深受患者的好评[1].本研究评价黄氏愈伤贴治疗急性软组织损伤患者的有效性及安全性,采用随机消炎止痛膏平行对照,现报道如下.     

铍针治疗臀上皮神经卡压症52例

臀上皮神经卡压症是指由于臀上皮神经在髂嵴“入臀点”处的骨纤维管内受到卡压而引发臀痛或臀腿痛的一种症状。多由于腰臀部急性扭伤或慢性劳损引起，本病为骨伤科常见病。作者自2000年以来应用铍针治疗，取得满意效果。