成人声嘶的诊断与治疗

声嘶通常是指发声音色异常,可能表现为嗓音伴有过大呼吸声,音色不自然、粗哑、刺耳、颤抖、沉闷以及微弱,或是声音音调的过高或者过低.尽管在家庭医生看来声嘶是经常出现的一种症状,可是统计的发病率却与真实情况很不相符.     

诊断性抗结核治疗5例

目的 讨论诊断性抗结核治疗和范围，观察期限，过治问题。方法，对本院１９９７年按正规抗结核治疗的肺结核新病例中诊断有疑问的，作全程观察后，部分作更正诊断。结果 有效２例，误治２例、排除活动性肺结核１例。结论：诊断性抗结核治疗的观察期限２至５个月不等，此类病例的过（误）治在５０％以上。     

黄色肉芽肿性肾盂肾炎的诊断与治疗——附1例报告

本报告的目的旨在结合具体病例,进一步探讨黄色肉芽肿性肾盂肾炎的诊断与治疗方法.     

减压性骨坏死1例报告

1　临床资料徐某 ,男 ,5 0岁 ,某桥梁工程公司潜水工 ,作业工龄 2 2年 ,潜水深度一般为 10～ 3 0ｍ ,连续工作时间约 2～ 6ｈ/ｄ ,工作地点无减压设备 ,潜水后未按减压程序出水。 1996年在连续初潜水工作 10多个小时后出现“急性减压病” ,经高压氧等治疗后好转。以后一直脱离潜水作业至今 ,但一直感头昏、乏力、四肢关节痛、站立不稳 ,尤其以髋关节为重 ,伴记忆力减退 ,近 1年上述情况加重。检查 :患者神清合作 ,Ｐ70次 /ｍｉｎ ,ＢＰ12 0 /80ｍｍＨｇ ,发育正常 ,营养中等 ,面色略红 ,双手臂可见数个约 0 5～ 1ｃｍ大小脂血栓 ,心肺无明…     

显微镜及支撑喉镜下声带自体脂肪填充术治疗声门闭合不良的研究

目的：评估显微镜及支撑喉镜下声带自体脂肪填充术治疗声门闭合不良的效果。方法：选取本院10例声门闭合不良患者作为研究对象，均在显微镜及支撑喉镜下声带自体脂肪填充术治疗，术后行嗓音声学检查及喉镜检查，对比术前指标，分析治疗效果。结果：治疗后G、R、B、A均低于治疗前，差异具有统计学意义（P<0.05）。结果显示，治疗后10例患者的基频微扰、振幅微扰、NNE均低于治疗前，谐噪比、MPT高于治疗前，差异具有统计学意义（P<0.05）。治疗后10例患者发音时两声带突间的宽度高于治疗前，差异具有统计学意义（P<0.05）。结论：显微镜及支撑喉镜下声带自体脂肪填充术治疗声门闭合不良可获得良好疗效，可帮助患者获得满意的发音效果。     

环杓关节半脱位21例临床分析

目的 提高对环杓关节半脱位的诊断和治疗的认识.方法 分析21例环杓关节半脱位的症状体征;所有患者均在表面麻醉下行环杓关节拔动复位术,同时服类固醇素和消炎痛2周.随访1-5年.结果 患者症状为气管插管拔管后出现声嘶,检查见声带固定,声带突高低不一.伤后一个月内就诊治疗20例,拔动复位后杓部对称,声门闭合良好,嗓音恢复正常.1例伤后4个月就诊者,多次拔动失败后,行甲状软骨板成形术Ⅰ型,嗓音得以改善.结论 病史及纤维喉镜检查可早期诊断环杓关节半脱位.关节复位术是首选治疗方法.类固醇激素及消炎痛在治疗中有重要的辅助作用.     

延迟性脾破裂的诊断与治疗

延迟性脾破裂的诊断与治疗安徽省广德县邱村医院２４２２２７殷世学腹部闭合性损伤中的脾破裂大多在腹部外伤４８小时后才出现症状，是脾脏外伤的一种特殊类型，约占脾破裂的１５％，因隐匿期的表现颇不一致，往往给及时诊断和治疗带来一定的困难。而一旦出现症状，病情发...     

针药并用治疗周围性面瘫80例

周围性面瘫是指茎乳突孔或以下部位面神经的急性化脓性炎症所致的急性周围性面神经瘫痪。本病可发于任何年龄，一年四季均可发病，但以春秋两季发病率最高，本病好发年龄20～40岁，男性多于女性，以口角歪斜，眼睑闭合不全，不能鼓腮、吹气等为主症。笔者从2005年至今采用针药并用治疗周围性面瘫80例获得满意疗效。     

Mitral valve prolapse and sudden death: a case report

Mitral valve prolapse (MVP) is a common disorder that, in general, has a good prognosis. Rare occasions of sudden death have been reported in patients with MVP and it is presumed that the basis of sudden death is arrhythmias. We report a case of a 47 years old men affected by MVP complicated by ventricular arrhythmias and sinoatrial block; who died suddenly from ventricular tachycardia. The pathophysiology and risk factors of sudden cardiac death in MVP are discussed.     

Scurvy still exists in children: A case report

Background: Scurvy is one of the oldest diseases known to mankind. Although rare lately, the clinical suspicion arises in front of a precarious situation or deficient nutrition and food restriction secondary to a psychiatric condition, even in patients with non-specific complaints.We report the observation of a 6 -year- old boy, followed for autism since the age of 3 years and who was admitted for limping, hemorrhagic syndrome, arthritis and weakness. The diagnosis of child abuse was initially suspected but clinical and radiological abnormalities seen were characteristic of scurvy. Vitamin C level was undetectable. The child had an unbalanced diet.A favorable outcome was rapidly obtained following supplementation.Scurvy is rare, but it should be mentioned among children with psychiatric disorders, presenting with musculoskeletal manifestations or hemorrhagic syndrome.It is essential to prevent it by systematic dietary supplementation of vitamin C in children with eating difficulties.     

Behavioral treatment of transsexualism: a case report.

Patients who believe themselves to be transsexual seek only confirmation of their diagnosis so that they may proceed with their pre-chosen course of management: hormones and surgery. Their syntonic emotional set generates resistance to any other therapeutic direction. Despite this attitude, it is the therapist's responsibility to assess each case individually and to decide, with the patient, on realistic goals even if they be different from the original one. This case emphasizes this need since a probing history revealed underlying conflict and anxiety related to severe homophobia. With revelation of the homophobia, various behavioral techniques could be used therapeutically. These resulted in acceptance of lesbianism as a life style. Careful assessment of patients with self-diagnoses of transsexualism can sometimes uncover a different etiology to which appropriate therapy can be applied.     

人巴贝西虫病1例报告并文献复习

巴贝西虫病是一种由蜱虫叮咬或输血传播的巴贝虫属原虫寄生于哺乳动物红细胞内的人畜共患疾病。该病属于临床少见病,临床医生尚缺乏足够的认知,极易与疟疾等疾病混淆,造成漏诊、误诊,严重影响该疾病的预后。故将临床诊疗中遇见的1例人感染巴贝西虫病的临床诊治过程整理报告,并做相关文献复习,以供大家参考。     

假鼻疽伯克霍尔德菌致双髋慢性化脓性关节炎1例并文献回顾

58岁的老年男性患者,因"反复双髋疼痛20 d"入院。于当地医院多次行"双髋切开引流术"后转诊某院,于该院行分泌物、关节液培养结果示假鼻疽伯克霍尔德菌,先后采取抗菌药物治疗、换药、置管冲洗引流术等保守治疗均失败,复查双髋X线片示双髋关节已严重破坏,行双侧髋关节切除旷置与二期全髋关节置换术,同时予以敏感抗菌药物治疗。术后随访2年,关节功能恢复,未见感染复发。因此,在临床慢性化脓性关节炎治疗中,首先需要积极行细菌培养鉴定,选用敏感抗菌药物,其次需要严格把握手术适应证,针对骨与关节感染,应及时彻底清创灌洗引流,关节严重破坏或功能丧失者可行一二期关节置换。     

Micturition disturbances in multiple sclerosis: Diagnostic and treatment options

Disturbances of the bladder are a frequent occurrence in most patients with multiple sclerosis. This has a tremendous impact on the quality of life for these patients and needs to be addressed whenever the clinician works with patients who have multiple sclerosis. This article discusses the symptomatology of urogenital tract dysfunctions in this population and focuses on both diagnostic and treatment options.     

Prism adaptation treatment for spatial neglect post brain tumour removal: A case report

Purpose/aim:Spatial neglect is caused by damage to neural networks critical for spatial attention. Spatial neglect without proper treatment impedes rehabilitation outcomes. Prism adaptation treatment, a visuomotor protocol, has been used with stroke survivors with spatial neglect to improve function. This case report explored the feasibility and potential effects of prism adaptation treatment in an individual with spatial neglect after glioblastoma removal.MethodsFeasibility was designed and tested to include acceptability and implementation. Exploratory aim on the effectiveness of the intervention was determined using the Catherine Bergego Scale via the Kessler Foundation Neglect Assessment Process, star cancellation, line bisection and scene copying.ResultsThe patient reported favouring the treatment. Eight sessions, one session a day, were completed over two weeks. The patient’s spatial neglect symptoms reduced on all assessments.ConclusionPrism adaptation treatment was feasible and effective; however, further research is needed to understand the complete benefits of prism adaptation treatment in this population.     

Hypnotherapy as a treatment for vulvar vestibulitis syndrome: a case report

The effectiveness of hypnotherapy in alleviating pain has been demonstrated with several disorders and diseases involving acute and chronic pain. Although hypnosis has been suggested as treatment for dyspareunia resulting from vulvar vestibulitis syndrome (VVS), empirical data and case reports showing its effectiveness have been lacking. This article presents a case report on the use of hypnotherapy to treat a 26-year-old woman suffering from VVS. Psychotherapy consisted of twelve sessions, of which eight were devoted to hypnosis. The goal of hypnosis was to help the client decrease her anticipatory anxiety, create a positive association of pleasure with intercourse, and create a sense of control over her pain. Despite having persistent pain during intercourse for 3 years with several partners, she experienced no more pain following treatment, and remained pain free at a 12-month follow up.