顽固性跟痛症手术治疗体会

目的 探讨顽固性跟痛症的诊断、手术方法 、操作要点,并对治疗结果 进行总结.方法 对33例(41只跟痛足)因顽固性跟痛症要求并给予手术治疗的患者,分清病因、明确病变部位,给予手术治疗,并依据跟痛症状缓解情况及患足行走功能进行疗效评定.结果 33例患者术后随访6～12(8±4)个月,优30例38只,良3例3只,优良率为100%(33/33).结论 顽固性跟痛症由多种原因所致,针对病因,采用手术治疗顽固性跟痛症的效果确切.但术前必须熟练掌握诊断标准,详细问诊,认真触诊,仔细辨别,正确诊断;术中认真观察,综合手术;术后做好引流、抗炎等治疗措施,才能保证手术质量及治疗效果.     

顽固性跟痛症手术治疗58例疗效观察

顽固性跟痛症是一种常见的、难以有效治愈的病症,其确切病因尚不清楚。大多数病人经口服药物及局部封闭注射治疗或理疗均短期有效,药效过后仍然疼痛。我院外科近年对反复发作的顽固性跟痛症患者采取手术治疗,现报告如下。1临床资料1·1一般资料共对反复发作的顽固性跟痛症患者5     

自拟腰痛散治疗腰椎间盘突出症150例疗效观察

椎间盘突出症是腰腿痛的主要病因之一.目前,本病的治疗方法可分为保守治疗和手术治疗两大类,其中需要手术治疗的仅占10％～15％,大部分患者均经保守治疗而好转或痊愈[1].在众多的保守治疗方案中,中医药成为医治本病的首选方案[2].我们于2004年9月-2010年11月应用自拟腰痛散内服外敷治疗腰椎间盘突出症取得显著临床疗效,现总结报告如下.     

跟痛症预防保健措施的研究进展

跟痛症作为临床常见病,多发生于中老年人以及肥胖人群,临床症状以足跟跖面疼痛为主,且疼痛位置表现为红、肿、热、痛,直接影响患者机体健康及生活质量。近几年,我国跟痛症的患病率呈现日渐升高趋势,该病的病因较为复杂,可能与足底跖腱膜病变、跟骨病变、跟垫病变等存在密切关系,但常规西医治疗的效果并不理想。中医认为该病是由外感与内伤引起,且中医治疗方式较多,包含针灸、熏洗、中药、手法等,均存在各自优势及理论依据。除此之外,尽早开展有效的预防保健措施,可有效控制病情发展,为改善预后及生活质量提供保障。因此展开综述,分析跟痛症的病因以及疾病的预防保健措施,以期为患者康复提供保障。     

保守治疗腰椎间盘突出症1720例疗效观察

目的?探讨保守治疗腰椎间盘突出症的临床疗效.方法?将该院1720例腰椎间盘突出症患者随机的分为对照组和实验组两组,实验组患者采取多种保守方法进行治疗,对照组患者采取手术方法进行治疗,比较两组患者的治疗效果.结果?实验组和对照组的总有效率没有明显差异,但保守疗法治疗腰椎间盘突出症创伤小、副作用少,比较安全.结论?保守方法治疗腰椎间盘突出症较为安全、有效,值得在临床上推广应用开来.     

小针刀为主综合治疗跟痛症临床观察

跟痛症是指多种慢性疾患所引起的跟骨周围的慢性劳损且以疼痛及行走困难为主的病症,常伴有跟骨结节部骨刺形成,是骨科临床常见病、多发病,治疗方法很多但效果多不满意,笔者1999-2009年采取以小针刀为主的方法治疗跟痛症取得比较满意的疗效,现报告如下.     

中西医结合治疗跟痛症

目的?观察中西医结合治疗跟痛症的疗效.方法?回顾性分析了该院自2010年1月—2011年1月门诊跟痛症患者118例.随机分为两组,治疗组66例和对照组52.结果?治疗后两组疗效比较,治疗组总有效率为91.2%,对照组为69.8%.结论?中西医结合治疗跟痛症简单有效.     

微创手术治疗跟痛症临床疗效分析

目的：探讨微创手术治疗老年性跟痛症的临床疗效。方法对2009年7月至2012年7月三年间来我院接受手术治疗的69例跟痛症患者的手术疗效进行分析。根据Maryland评分患者均＜50分，其中31例（微创组）患者接受了微创骨赘切除、跖腱膜止点松解、滑囊切除手术，跟骨减压。38例（开放组）接受开放式手术。结果69例患者中有53例得到回访，其中微创组疗效为优为23例，良2例，有效0例，无效0例。开放性手术组疗效为优23例，良3例，有效2例，差0例。25例为微创组，28例为开放性手术组。结论微创手术治疗跟痛症与开放性手术治疗相比，两者都能很好的治疗和缓解患者足部疼痛，但是微创手术具有创伤小，恢复快，手术瘢痕较小等优点。     

跟腱不完全断裂5例分析

目的本文通过总结5例跟痛症患者在临床进行针刀治疗后,出现自发性的跟腱断裂现象,来进一步分析研究跟痛症的病因病理以及与Haglund(哈格隆德)综合征的关系,用以证明针刀疗法对跟痛症的治疗是安全有效的。方法对多年来笔者在临床上应用针刀疗法治疗的大量跟痛症患者,在做针刀治疗之前先进行拍片和临床检查,然后对已确诊的Haglund(哈格隆德)综合征患者进行术后追踪随访。结果在为期3年的追踪随访过程中,发现了5例患者在末次针刀治疗后3个月~1年,分别出现了单侧跟腱不完全断裂的情况,断裂部位均在腱腹交界处。结论跟腱断裂与针刀治疗无关,与Haglund(哈格隆德)综合征及一些其他因素有一定的联系,提示针刀疗法安全及可靠。     

健康教育在腰椎间盘突出症患者中的作用

目的了懈腰椎间盘突出症的病因及影响因素，探讨健康教育在腰椎间盘突出症患者中的作用。方法选取2003年至2005年12月收治的100例腰椎闯盘突出症患者和2006年1月至2008年1月收治的100例患者分别作为对照组和试验组，试验组采用发放健康教育宣传单，出院后跟踪电话随访，对照组使用常规护理措施，分别对两组患者保守治疗与手术治疗的复发半及保守治疗手术率进行比较。结果两组患者分别在保守治疗复发率、保守治疗手术卒及手术治疗复发，牢进行对比，差异均有统计学意义。结论实施健康教育能使腰椎间盘突出症患者早日康复，减少复发，提高生活质量。     

单纯腓肠肌腱膜滑移术治疗慢性顽固性足跟痛

目的 探讨利用单一切口行腓肠肌腱膜滑移术治疗慢性顽固性足跟痛的可行性。方法 回顾分析已经治疗的11例慢性顽固性足跟疼痛的患者,其中女性8例,男性3例, 年龄40～72岁,平均56.3岁。术前均进行各种保守治疗,疗程6个月以上,最长疗程13个月。本文作者采用单一切口行腓肠肌腱膜滑移术进行治疗。手术当日就进行功能锻炼,患者足跟疼痛明显减轻,1月后行走基本正常。结果 11例患者都获得随访,效果明显。 手术前VAS评分,4～6分9例,7～10分2例。手术后VAS评分均为3分以下,1月后行走正常。结论 单一切口行 腓肠肌腱膜滑移术治疗慢性顽固性足跟痛,手术简单,疗效确切,值得推广。     

123例慢性胰腺炎的临床分析

目的通过对慢性胰腺炎疾病的探讨和研究分析,了解其致病因、临床表现和并发症状等,以提高治疗效果。方法随机选取我院2007年1月到2012年1月内的123例慢性胰腺炎患者,对其产生疾病的原因、感染疾病后的身体反应以及并发症状进行研究和分析,并加以总结。结果我院研究表明,慢性胰腺炎的产生原因有多种,如饮酒过量、暴饮暴食等;患者主要有腹痛、恶心等症状;我院根据患者实际情况分别给予手术治疗和保守治疗的方法,123例患者均得到有效的治疗,恢复良好。结论慢性胰腺炎的诊断多采用影像仪器,致病因有多种,治疗方式主要有非手术治疗和手术治疗,在接受治疗后能得到及时的治愈和恢复。     

Achilles tendinitis in running athletes

Achilles tendinitis is an injury that commonly affects athletes in the running and jumping sports. It results from repetitive eccentric load-induced microtrauma that stresses the peritendinous structures causing inflammation. Achilles tendinitis may be classified histologically as peritendinitis, tendinosis, or partial tendon rupture. Training errors are frequently responsible for the onset of Achilles tendinitis. These include excessive running mileage and training intensity, hill running, running on hard or uneven surfaces, and wearing poorly designed running shoes. Biomechanical abnormalities that predispose to Achilles tendinitis include gastrocnemius-soleus muscle weakness or inflexibility and hindfoot malalignment with foot hyperpronation. The initial treatment should be conservative with relative rest, gastrocnemius-soleus rehabilitation, cryotherapy, heel lifts, nonsteroidal anti-inflammatory drugs, and correction of biomechanical abnormalities. Surgery is recommended only for persons with chronic symptoms who wish to continue running and have not benefited from conservative therapy.     

电子结肠镜检查致肠穿孔并发症的影响因素及对策

目的：对电子结肠镜检查导致肠穿孔并发症影响因素进行探讨，并提出有效的对策。方法：选取我院从2010年1月到2016年1月收治的行电子结肠镜检查，并出现消化道穿孔的4例病例作为研究对象，对其进行回顾性分析。结果：4例发生消化道穿孔的患者中，包括3例诊断性肠穿孔以及1例治疗性穿孔。其中3例为无痛肠镜检查，而1例为常规肠镜检查。结论：采用电子结肠镜检查导致肠穿孔的几率较低，治疗和患者年龄、有无肠道疾病史、肠穿孔后并发感染程度等有关，可以采用保守治疗的方式进行治疗。     

Pathogenesis and conservative treatment of glaucoma]

Glaucoma is a chronic disease which, if not treated, can lead to blindness. The reason for deterioration of function is neuropathia n. optici developed during the disease. Earlier increased ocular tension was considered to be the cause of neuropathia. By now we have realised that increased ocular tension (that above 21 Hgmm) in only one of the risk factors. The decay of optic nerve fibres is caused by circulatory failure on the one hand, and by the necrosis of ganglion cells on the other hand. In the conservative treatment of glaucoma pilocarpin was used earlier but nowdays the first place has been taken over by the group of betareceptor blockers, which are applied twice a day in the form of dropping. If this proves unsatisfactory, the treatment is complemented with carbonanhydrase inhibitor-drops 2-3 times daily. In certain cases this is followed by prostaglandin F2alfa analog drops once a day, dripped in the evening hours. Carboanhydrase inhibitor can be administered per oral as well: 1-2 times weekly. This latter cannot be given continuously: it is only a temporal solution for a few months in addition to other conservative therapy. Cholinerg drops can join in at any time of conservative treatment. The future method of conservative therapy is the combination of drops with varions effect, which decreases the frequency of daily drippings and enhances the efficacy of treatment.     

Surgical treatment of acute epididymitis

Epididymotomy was performed besides drug therapy in 61 patients suffering from acute epididymitis. Surgical intervention was indicated if the conservative therapy was not successful or the wall of the scrotum became fixed. Epididymotomy is carried out by longitudinal or multiple incision of the inflamed epididymis and by the drainage of the operative region. Significant advantage of the operation is the rapid recovery and the fact that the development of a not infrequently seen chronic epididymitis can be prevented by it. This not yet widely used method in Hungary is recommended for the treatment of the disease, on the basis of the favourable results of the postexaminations.     

Application Status and Prospect of Bio-artificial Liver

Liver failure which can be caused by viral hepatitis,alcohol,drugs,metabolic diseases,autoimmune processes or other fac tors is the end stage of chronic liver disease.Although liver transplantation is currently considered to be the primary treatment measures of chronic liver disease.Due to donor shortages,surgical complications and immune rejection,cell therapy has been extensively studied.?Hepa tocyte transplantation and artificial liver have evolved into a simpler alternative to liver failure treatment.Artificial liver can be used as Liver replacement therapy in patients who were waiting for the liver transplantation with chronic liver disease.The ideal biological artificial liver must have the liver material metabolism,detoxification,synthesis and secretion and other functions.Nowadays bio-artificial liver has carried out a large number of clinical trials and get some progress.?This article is now discuss the status of bio-artificial liver and its re placement therapy prospects.     

T管拔除后胆瘘患者“三管”疗法的护理

目的：总结T管拔除致胆瘘患者行＂三管＂保守疗法的护理体会。方法：选取7例T管拔除致胆瘘患者作为研究对象,在T管拔除前后,经留置T管的窦道插入硬麻导管、普通导尿管、气囊导尿管,行胆瘘＂三管＂保守治疗,对患者进行恰当的护理措施,观察其效果。结果：本组7例患者采用＂三管＂疗法,经恰当的护理措施,均未经开腹手术,保守治疗成功。结论：胆瘘及时发现、早期正确处理,辅以得当的护理措施,可避免再次手术给患者生理心理带来的重创,＂三管＂保守疗法切实减轻患者各项负担,效果确切。     

Management of patients presenting with generalized musculoskeletal pain and a suspicion of Lyme disease

Lyme disease is caused by bacteria of the B. burgdorferi sensu lato complex, and can give polymorphic clinical manifestations that can affect several organs such as the skin, the central nervous system, or the joints. In recent years, patients’ associations and physicians have been supporting the hypothesis that this infection would manifest as chronic generalized musculoskeletal pain symptoms, named “chronic Lyme disease”. Fibromyalgia is a clinical presentation characterized by chronic generalized musculoskeletal pain with a major impact on quality of life and social and psychological functioning. We analyzed existing literature data on pain syndromes associated with Lyme disease (post-treatment Lyme disease syndrome) or tick bites (polymorphic symptoms after a tick bite). We also analyzed existing data on the diagnosis, pathophysiology, and treatment of fibromyalgia. Our review shows that post-treatment Lyme disease syndrome has characteristics very close to post-infectious fibromyalgia. On the other hand, patients presenting for Lyme disease screening because of chronic generalized musculoskeletal pain symptoms after a tick bite should also be screened for fibromyalgia to allow appropriate management. Antibiotics are not recommended here.     

Energy metabolism in acute and chronic renal failure

Energy metabolism was measured by indirect calorimetry in 86 patients with various forms of renal failure and in 24 control subjects. In patients with acute renal failure with sepsis, oxygen consumption, carbon dioxide production, and resting energy expenditure were increased (P less than 0.05). In other groups with renal failure (acute renal failure without sepsis, chronic renal failure with conservative treatment or hemodialysis, and severe untreated azotemia) these indices were not different from those of control subjects. Urea nitrogen appearance was decreased in patients with chronic renal failure undergoing conservative treatment, in those with severe untreated azotemia, and in hemodialysis patients (P less than 0.05). We conclude that renal failure has no influence on energy expenditure as long as septicemia is absent. Reduced urea nitrogen appearance rates in chronic renal failure are due to a reduced energy and protein intake. Wasting is a consequence of decreased food intake but not of hypermetabolism in chronic renal failure.