单纯半导体激光局部照射或联合药物治疗压疮的临床疗效分析

目的 探讨半导体激光治疗压疮的疗效.方法 压疮患者60例,随机分为治疗组和对照组,每组30例.治疗组轻度压疮患者皮肤溃疡较浅,仅以激光照射局部;中重度压疮患者皮肤溃疡较重,激光照射后加压疮贴膜治疗.半导体激光波长810nm,中、重度压疮功率80～100mW,轻度压疮功率100～150mW,光斑直径10 cm,照射距离5 cm,照射时间10min,每日1次,10次为一个疗程.对照组仅采用压疮贴膜治疗.治疗两个疗程后判定疗效及疗效,并分析压疮程度和压疮部位的相关性.结果 治疗组痊愈21例,显效4例,有效3例,无效2例,总有效率为93.3%;对照组痊愈10例,显效5例,有效6例,无效9例,总有效率为70.0%,治疗组总有效率明显高于对照组,差异有显著意义,P<0.05.两组疗效与压疮程度和部位具有相关性.结论 单纯半导体激光治疗压疮比单纯药物治疗压疮疗效好,根据压疮程度行单纯半导体激光照射治疗或半导体激光联合药物治疗.     

半导体激光照射联合外用药物治疗急性甲沟炎临床疗效观察

目的观察半导体激光照射联合外用药物治疗急性甲沟炎的疗效。方法急性甲沟炎患者122例,随机分成2组。对照组60例局部消毒后外用莫匹罗星软膏治疗。治疗组62例在对照组治疗基础上加用半导体激光照射皮损部位。比较两组的疗效,分析疗效与疾病分期、治疗时间和病变部位的相关性。结果治疗组的痊愈率与有效率高于对照组;治疗组不同分期、不同部位患者的痊愈率与有效率均高于对照组;治疗组疗程短于对照组。结论半导体激光照射联合外用药物治疗急性甲沟炎疗效较单纯外用药物治疗疗效好,无不良反应。     

半导体激光外照射治疗脑血管病患者静脉炎的疗效观察

目的探讨低能量半导体激光体外照射治疗老年脑血管病患者的静脉炎的疗效。方法脑血管病伴发静脉炎老年患者80例,随机分为两组,激光治疗组40例,采用激光体外照射方法治疗静脉炎;对照组40例采用湿敷方法治疗。对比两组患者治疗前后主观疼痛级别、静脉炎治疗有效率等指标。结果激光体外照射治疗组患者静脉疼痛级别与对照组相比,差别有显著意义(P<0.05);激光体外照射治疗组患者的静脉炎治疗有效率为95%,与对照组有效率80%相比,差别有显著意义(P<0.05)。结论应用半导体激光体外照射可以有效治疗神经内科老年患者静脉炎,减轻老年患者痛苦。     

半导体激光联合外用药物治疗湿疹的疗效观察

目的 观察半导体激光结合外用药物治疗急慢性湿疹的疗效.方法 急慢性湿疹患者58例,随机分为两组,治疗组采用波长810 nm半导体激光照射联合外用皮质激素类药物治疗,对照组以湿敷或外用激素类药物治疗.结果 急慢性湿疹的有效率比较,治疗组优于对照组,患者未见不良反应.结论 半导体激光照射联合外用药物治疗急慢性湿疹疗效好,安全性高,具有较好的临床应用价值.     

半导体激光联合普瑞巴林治疗带状疱疹后神经痛的疗效观察

目的探讨半导体激光联合普瑞巴林治疗带状疱疹后神经痛的有效性和安全性。方法带状疱疹后神经痛患者55例,分成治疗组和对照组,分别行半导体激光照射联合口服普瑞巴林和单独口服普瑞巴林治疗,疗程2周,比较患者的疗效及不良反应。结果两组患者的治疗总有效率分别为77.8%、64.3%。两组患者治疗前后视觉模拟评分比较差异均有显著意义（P〈0.05）。治疗组与对照组疗后视觉模拟评分比较差异有显著意义（P〈0.05）,治疗组效果优于对照组。不良反应有头晕、嗜睡等。结论半导体激光联合普瑞巴林治疗带状疱疹后神经痛安全有效。     

调Q翠绿宝石激光联合胶原蛋白膜治疗褐青色痣的疗效观察

目的探讨调Q翠绿宝石激光联合胶原蛋白膜治疗褐青色痣的疗效。方法褐青色痣女性患者267例,按就诊年度,分为2组,实验组138例,对照组129例。两组患者均先以调Q翠绿宝石激光（波长755 nm,光斑直径3 mm,频率2或5 Hz,脉宽100 ns,能量密度6～7 J/cm2）垂直照射患处。照射后即刻实验组患者以胶原蛋白膜冷敷患处20 min,对照组患者以水袋冷敷患处20 min。每日治疗1次,共5次。治疗后6个月比较两组的治愈率、总有效率和色素沉着发生率。结果试验组有效率为92%,痊愈率为64.5%,色素沉着率为13.8%;对照组有效率为86%,痊愈率为59.7%,色素沉着率为28.7%%。两组痊愈率比较,差异有非常显著意义（P〈0.01）;两组总有效率比较,差异无显著意义（P〉0.05）;两组色素沉着发生率比较,差异有显著意义。结论调Q翠绿宝石激光联合胶原蛋白膜治疗褐青色斑痣效果好,可减少色素沉着的发生。     

伊曲康唑联合甲床修整术治疗重症甲真菌病的疗效观察

目的观察口服伊曲康唑联合甲床修整术治疗重症甲真菌病的临床疗效。方法将140例甲真菌病患者随机分为两组,治疗组68例采用甲床修整术联合口服伊曲康唑治疗;对照组72例单纯口服伊曲康唑治疗。结果治疗组痊愈率及总有效率分别为70.6%及88.2%,对照组分别为45.8%及65.2%,两组患者痊愈率及总有效率差异均有显著统计学意义(P<0.01)。结论伊曲康唑口服联合甲床修整术治疗重症甲真菌病疗效高,能显著改善新甲的生长速度及外观。     

神经节苷脂在急性脑出血治疗中的效果及对血清超敏C反应蛋白的影响

目的 观察神经节苷脂对急性脑出血患者的临床疗效及对血清超敏C反应蛋白(hs-CRP)的影响.方法 筛选的92例符合入组标准的急性脑出血患者,按随机数字表分为观察组50例和对照组42例,对照组给予降血压、降颅内压、止血、抗感染、调节水电解质平衡紊乱等常规治疗,观察组患者在常规治疗的基础上加用单唾液酸四己糖神经节苷脂治疗.观察两组患者治疗前后血清hs-CRP水平的变化,并进行临床疗效观察.结果 治疗后两组NIHSS评分和ADL评分均较治疗前改善,且观察组优于对照组(t=14.201,t=5.031,P均<0.05);观察组痊愈率54.0%,总有效率94.0%,对照组痊愈率35.7%,总有效率78.5%,两组痊愈率、总有效率比较差异有统计学意义(χ2=4.791,P=0.029);两组治疗后血清hs-CRP均明显降低,且观察组降低的更明显,差异具有统计学意义(t=11.350,P<0.05).结论 采用神经节苷脂治疗脑出血可显著促进受损神经功能的恢复,降低脑出血患者hs-CRP水平,提高患者生存质量,值得临床推广使用.     

半导体激光局部照射在全膝关节置换术后康复训练中的应用

目的 探讨810 nm半导体激光局部照射对全膝关节置换术后疼痛及关节活动度的治疗效果.方法 将60例全膝关节置换术后患者随机分为治疗组及对照组,每组30例.治疗组于置换手术后第2天开始在手术部位以波长810 nm、输出功率50～100 mW、光斑直径8～10 cm半导体激光局部照射,照射距离5 cm,照射时间10 min,每日1次,10次为一疗程.同时开始使用持续被动运动(continuous passive motion,CPM)训练仪进行训练.对照组单纯使用CPM训练仪进行训练.疗程结束后两组采用视觉模拟评分法(visual analogue scale,VAS)对疗效进行比较,并分别于术后3、5和10 d以量角器测量关节活动度,比较两组患者的膝关节活动度.结果 总有效率治疗组为96.7%,对照组为83.3%.差异有显著意义(P<0.05).康复治疗后3、5和10 d膝关节活动度治疗组皆好于对照组,差异有显著意义(P<0.05).结论 膝关节置换术后使用810 nm半导体激光局部照射,可缓解局部疼痛,消除肿胀,松解粘连,改善关节活动度,是提高术后疗效的有效治疗方法.     

0.05%卤米松乳膏联合He-Ne激光照射治疗肛门湿疹的疗效观察

目的观察0.05%卤米松乳膏联合He-Ne激光照射治疗肛门湿疹的疗效、耐受性及不良反应。方法肛门湿疹患者186例,治疗组96例,每日将0.05%卤米松乳膏均匀涂在患处,再以波长632.8 mn、功率120 mW、光斑直径6 cm的He-Ne激光照射患处,每日照射1次,时间15～30 min。对照组90例,仅采用He-Ne激光治疗,方法同上。结果治疗组痊愈率98.9%,复发率2.1%;对照组痊愈率42.2%,复发率74.7%。两组疗效比较差异有显著意义（P〈0.01）。结论 0.05%卤米松乳膏联合He-Ne激光治疗肛门湿疹治愈率高,疗程短,复发率低,痛苦小。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.