CT引导下硬膜囊前间隙置管注入胶原酶治疗腰椎间盘突出症

胶原酶溶解术,治疗腰椎间盘突出症,有盘内注射和盘外注射。前是将胶原酶注射到突出的椎间盘内;后是将胶原酶注射到突出的椎间盘周围,其注射方法要求高,操作复杂,而且容易损伤硬脊膜、蛛网膜和神经根,并有脊髓损伤的危险。作探索一种盘外注射新入路,就是在CT引导下,经骶裂孔硬膜囊前问隙置管,注入胶原酶。1998年6月至1999年5月,共治疗85例,现报告如下。     

侧入法盘外注射胶原酶治疗80例腰椎间盘突出症

腰椎间盘突出症是一种常见的腰腿疼痛疾病。好发于３０～５０岁。目前国内外治疗主要有（１）保守治疗;（２）手术治疗;（３）胶原酶盘外或盘内注射治疗。现将我院１９９８年９～１２月８０例腰椎间盘突出症患者采用侧入法盘外注射胶原酶治疗报告如下。１临床资料１．１...     

臭氧结合胶原酶治疗腰椎间盘突出症的疗效观察及护理

目的 探讨盘内注射臭氧盘外注射胶原酶相结合的方法治疗腰椎间盘突出症的疗效观察及护理.方法 随机将腰椎间盘突出症病人分为盘内注射臭氧结合盘外注射胶原酶治疗组(观察组)和单纯胶原酶治疗组(对照组),2组病人均给予心理护理、术前、术后指导,但观察组特别注重术后合理的功能锻炼.结果 1月和1年观察组与对照组比较,疗效差异有显著意义(p＜0.05).结论 盘内注射臭氧结合盘外注射胶原酶治疗腰椎间盘突出症,较单纯胶原酶治疗疗效更显著,患者恢复快,特别对不具备开展腰椎间盘突出症手术条件的医院,更具价值.臭氧结合胶原酶氧治疗腰椎间盘突出症是一种有效的非手术疗法,值得临床推广应用.     

盘外分次联合盘内单次注射胶原酶溶核术

目的 :探讨盘外分次注射联合盘内单次注射小剂量胶原酶治疗腰椎间盘突出症的效果。方法 :30例以根性腰腿痛为主要表现的腰椎间盘突出症患者。在X线引导下 ,穿刺针经患侧小关节内侧缘或椎板外切迹进入硬膜外侧间隙 ,另一根针从后外侧入路至椎间盘内。确定针尖位置后 ,向硬膜外腔缓慢注入胶原酶 4 0 0IU/ 2ml,共 3次 ,每次相隔 30分钟 ,同时向椎间盘内一次性注入胶原酶 4 0 0IU / 1ml。结果 :溶核后根性症状在 1～ 2周内改善 ,在 1、2、4和 8周的显效率分别为 16 .7%、4 3.3%、5 3.3%和 6 6 .7%。 10例 1年后复查CT ,有 7例显示椎间盘缩小 ,其中 2例腰椎间盘突出物消失。结论 :在硬膜外侧间隙分次注射 ,联合椎间盘内单次注射小剂量胶原酶的方法治疗腰椎间盘突出症有较好的效果     

靶点射频联合盘内小剂量胶原酶注射治疗腰椎间盘突出症

【目的】观察靶点射频联合盘内小剂量胶原酶注射治疗腰椎间盘突出症的疗效。【方法12005年8月至2010年2月本院对236例腰椎间盘突出症采用突出物靶点射频联合盘内小剂量胶原酶注射法治疗,结合患者影像诊断资料（X线、CT、MRI）,根据突出物形态及脊柱腰段解剖特点设计合适的穿刺路径进行射频和注药治疗并观察疗效。【结果】术后2周优良率为66．5％（157／236）,术后3个月优良率为88．1％（208／236）。术后3个月复查CT者197例,其中突出物缩小或消失171例,占全部复查病例86．8％。【结论】靶点射频联合盘内小剂量胶原酶注射治疗腰椎间盘突出症可以达到良好的效果。     

胶原酶溶解术治疗腰椎间盘突出症的护理

胶原酶溶解术是目前治疗腰椎间盘突出症新的、有效的方法 ,但要取得良好效果 ,围手术期的心理、生理护理是一重要因素 ,我科采用本方法治疗腰椎间盘突出症患者 34例 ,疗效满意 ,现将术前的心理疏导、手术体位的训练及术后饮食、疼痛、功能锻炼等护理重点作如下介绍。1　一般资料1.1　临床资料　我科于 1998年 10月～ 1999年 4月 ,用胶原酶溶解术治疗腰椎间盘突症状 34例 ,男 2 1例 ,女 13例 ;最小年龄 2 5岁 ,最大年龄 6 5岁 ,平均 34 .6岁 ;病史为 3月～ 8年 ,平均为 6 .4月。其中盘内注射 31例 ,盘外注射 3例 ,术后跟踪观察 2个月 ,治疗效…     

胶原酶盘内注射联合开窗减压治疗腰椎间盘突出症

1998年4月～2 0 0 2年1 2月,作者使用胶原酶盘内注射联合纤维环开窗减压治疗腰椎间盘突出症37例,获得满意疗效,现报告如下。1　临床资料本组腰椎间盘突出症患者91例中男5 2例,女39例。91例随机分为3组,A组(对照1组)2 2例,B组(对照2组) 32例,C组(治疗组) 37例。91例均有明确的症状体征,经CT或MR确诊,无过敏体质、椎管骨性狭窄或椎间盘钙化、黄韧带肥厚等治疗禁忌证。治疗方法:A组采用传统盘内注射疗法[1 ] ,B组采用传统盘外注射疗法[2 ] 。C组术前建立静脉通路,DXM 1 0mg静脉滴注。患者侧卧于C型臂台上,先于病变椎间盘间隙行硬膜外穿刺…     

腰椎间盘突出症非血管性双介入治疗28例临床分析

目的 提高经皮穿刺腰椎间盘髓核切吸术及胶原酶盘内注射术后各自疗效。方法 对28例腰椎间盘突出症病人行经皮穿刺腰椎间盘切吸术后再注射胶原酶于椎间盘内。结果 25例患者获得满意疗效。结论 经皮穿刺腰椎间盘髓核切吸术与胶原酶盘内注射双介入治疗腰椎间盘突出症，是一种微创，安全，有效的治疗方法。     

射频联合胶原酶盘内注射治疗腰椎间盘突出症的护理

目的探讨射频联合胶原酶盘内注射治疗腰椎间盘突出症的护理对策。方法总结120例腰椎间盘突出症患者采用射频联合胶原酶盘内注射手术前、手术中、手术后的护理经验。结果术后半年随访,临床治愈71例,显效36例,残留部分症状13例。结论术前良好的沟通、完善的准备,术中合理的医护配合及术后积极的健康宣教是手术成功的关键。     

盘内、外联合注射臭氧治疗腰椎间盘突出症

腰椎间盘突出症是脊柱外科最常见的疾病,目前治疗方法很多,本院自2006年11月至2010年11月采用盘内、外联合臭氧(O3)注射治疗腰椎间盘突出症共85例,初步疗效满意,现报告如下。1资料与方法1.1一般资料采用盘内、外联合臭氧注射治疗腰     

与1例失语病人的交流

语言在人类进化过程中已成为重要的交往工具和联络手段[1] 。脑梗死病人 ,由于大脑皮质语言功能区病损 ,发音肌肉瘫痪 ,使其说话、阅读和书写能力残缺 ,不能表达其思想 ,影响了人际间交往 ,给治疗、护理工作带来了很大困难。我院于 2 0 0 2年10月 9日收治 1例多发性脑梗死病人     

Faulty Assumptions Associated With the Use of Restraints With Children

TOPIC: The use of restraints in nursing and other professions has a long and troubling history, particularly in psychiatric settings. No research evidence has demonstrated restraints to be therapeutically effective. A number of faulty assumptions appear to support the continued practice of this unproven and potentially dangerous intervention. PURPOSE: To present and refute several faulty assumptions using the empirical literature and theory, and to discuss alternatives based on the developmental-ecological theoretical framework for responding to crises in children. SOURCES: Extant empirical literature. CONCLUSION: Alternatives to restraints must be investigated and developed to replace the current reactive, crisis-management orientation of practice.     

Bullous Eruption Associated With Dihydropyridines With Cross Reactivity

The spectrum of cutaneous eruptions associated with dihydropyridines is extensive, varying from exanthemas to severe adverse events. We report a case of bullous eruption, one month after starting nicardipine and lercanidipine. The same symptoms recurred few days after taking nitrendipine.     

Factors Associated With Self-Concept in Children With Asthma

PURPOSE: To investigate the relationship of demographic asthma, family, and child factors with self-concept in children with asthma. METHODS: Data were collected twice approximately 4 years apart from both the affected children and their mothers (N = 134) via interviews and self-report questionnaire. FINDINGS: Children who demonstrated more negative attitudes toward their illness, had less satisfaction with family relationships, and used more negative coping behaviors had the poorest self-concepts. Over time, the greatest improvement in self-concept occurred in children whose attitudes and satisfaction with family relationships improved and whose use of negative coping behaviors decreased. CONCLUSIONS: Results suggest that some children with asthma, especially girls with severe asthma, appear to be at risk for poor self-concept.     

Clinical Analysis of Chinese Patients With Rheumatoid Arthritis Treated With Leflunomide and Methotrexate Combined With Different Dosages of Glucocorticoid

ObjectiveTo analyze the safety of combined leflunomide (LEF), methotrexate (MTX), and glucocorticoid (GC) therapy, we investigated the adverse effects of such combination therapy in patients with early active rheumatoid arthritis (RA).MethodsTwo hundred sixty-six patients with RA who were receiving LEF and MTX therapy were randomly assigned to 3 groups, as follows: group 1 received no GC, group 2 received 7.5 mg prednisone, and group 3 received 15 mg prednisone. Adverse effects were analyzed using the χ² test at week 4 or the Fisher exact test at week 12.ResultsPatients in group 1 had a higher incidence of skin rash, oral ulcers, leukopenia, and liver damage than did those in groups 2 and 3 (all, P ≤ 0.05). However, the rates of osteoporosis, diabetes, hyperlipidemia, and hypertension in group 3 were statistically higher than in groups 1 and 2 (P ≤ 0.05).ConclusionIn the treatment of RA, the incidence of skin rash, liver dysfunction, and oral ulcers may be decreased with combination therapy using LEF, MTX, and 7.5 mg prednisone, and blood pressure, blood glucose concentration, and bone density are not increased. Most important, 7.5 mg prednisone was synergistic with LEF and MTX, and such combination therapy could be a useful option as initial treatment of early active RA.