链霉素治疗三叉神经痛的临床观察

我科从 1 997年至今用链霉素治疗三叉神经痛 ,现将随访 1年 ,有完整病史资料的 1 3 6例患者总结如下。　　作者单位 :6460 0 0四川省泸州医学院附属医院口腔外科　　一、材料和方法1 .临床资料 :病例选择标准 :①所有病例都曾服用卡马西平或苯妥英钠 1年以上 ,最长者达 2 0年 ,用药后镇痛效果差 ,副反应重。②患者有明显的前驱症状 ,典型的三叉神经痛表现 ;③排除颅内占位性病变。 1 3 6例患者中有 4 6例曾行甘油注射 ,1 2例无水乙醇注射 ,8例射频治疗 ,拔牙 4 0例 ,半月神经节微血管剥离术 3例。 1 3 6例患者中 ,男 58例 ,女78例 ,年龄 :3 …     

硫酸链霉素治疗三叉神经痛作用机理的实验研究

目的 观察硫酸链霉素局部注射对三叉神经分支的组织学影响。方法 应用大耳白哆局部注射链霉系，通过光、电镜观察其三叉神经的病理改变。结果 动物局部注射链霉素后，三叉神经的神经纤维发生空泡变性、炎细胞浸润，严重者发生坏死。结论 链霉素治疗三叉神经痛的机制，可能是通过破坏神经纤维髓鞘，抑制其产生异位冲动，从而达到临床治疗的效果。     

硫酸链霉素治疗三叉神经痛作用机理的实验研究

目的观察硫酸链霉素局部注射对三叉神经分支的组织学影响。方法应用大耳白兔局部注射链霉素，通过光、电镜观察其三叉神经的病理改变。结果动物局部注射链霉素后，三叉神经的神经纤维发生空泡变性、炎细胞浸润，严重者发生坏死。结论链霉素治疗三叉神经痛的机制，可能是通过破坏神经纤维髓鞘，抑制其产生异位冲动，从而达到临床治疗的效果。     

复方美兰注射液封闭三叉神经痛板机点的临床观察

美兰以往多用于手术前瘘管内注入,以便手术中容易识别。此外美兰还具有破坏末梢神经髓质的作用,利用这一特性,在板机点局部封闭美兰,破坏末梢神经髓质,达到触动板机点而不诱发疼痛的目的。药物配制与使用方法: 配制:美兰 0.2g     

氟化氨银溶液对根面龋作用效果的短期临床观察

本文在外体研究的基础上，对２１３颗患牙骨质或根部牙本质浅龋的牙齿涂３８％氟化氨银溶液及２％氟化钠溶液进行治疗。６个月后复查，进行３８％氟化氨银溶液对根面龋作用效果的短期临床观察。结果表明，３８％Ａｇ（ＮＨ３）２Ｆ溶液抑制根面龋发展、促进其再矿化的效果明显优于２％ＮａＦ的溶液。     

拔牙断根遗留的临床观察

作者总结1995年1月至2000年3月我科门诊拔牙术中所发生的断根遗留37例,并进行近远期动态观察,为临床处理断根提供资料。     

阿霉素神经干注射治疗三叉神经痛的临床的临床观察

作者根据神经轴浆逆行传递原理，在直视下解剖分离三叉神经分支，用阿霉素行三叉神经干内注射治疗三叉神经痛４２例。全部病例在术后２４小时内症状消失，经３－１８个月随防，近期疗效满意，此方法为治疗三叉神经痛提供了一种安全、可靠、简便易行的途径。     

颌骨病变骨腔刮治术对原发性三叉神经痛的治疗（附516例报告）

原发性三叉神经痛是口腔颌面外科临床最常见的一种神经疾患，至今病因仍不明确。本文通过对５１６例原发性三叉神经痛患者，采用板机点追踪定位后，再行颌骨病变骨腔刮治术进行治疗，并将骨腔内容物送病理切片检查、细菌培养和观察手术疗效，同时对该病的病因进行初步探讨。     

三叉神经痛脱髓鞘改变的电镜观察

自１９８６年以来，对５例三叉神经痛患者术中撕脱的神经根，进行了电子显微镜观察。按照Ｐｏｐｐｅｎ的方法行三叉神经周围支撕脱术，将取得的标本按常规制备，电子显微镜下观察。４例发现有严重的退行性变，髓鞘增厚、正常结构不清、松解、断裂甚至呈圆形或半圆形向内突起，有时几乎占据整个轴浆部。轴浆呈退行性变，局部空泡形成，线粒体结构不清。本文根据实验结果，结合文献对三叉神经痛的病因进行了分析。     

Evaluation of the effects of occlusal splint,trigger point injection and arthrocentesis in the treatment of internal derangement patients with myofascial pain disorders

Purpose

In temporomandibular disorders (TMDs), unless splints are effective, combined therapies are performed. The aim of this study is to show the effectiveness of the local anaesthethic injections (trigger point injections) to the masticatory muscles.

预注氟芬合剂对琥珀胆碱肌颤的临床观察

目的 观察氟芬合剂对琥珀胆碱肌颤及气管插管条件的影响。方法 随机将48例口腔颌面部手术病人分为三组，均用1％氯胺酮，γ－羟丁酸钠诱导。观察组分别在给予氟芬合剂后2min和5min后再给予琥珀胆碱，观察肌颤及气管插管条件，另一组为对照组直接给予琥珀胆碱静脉推注。结果 对照组与观察组比较，观察组肌颤程度明显减轻（P＜0．05）；两观察组之间比较，氟芬合剂预注5min后肌颤减轻更为明显（P＜0．01）。三组气管插管条件无显著差异。结论 预注氟芬合剂能显著减轻琥珀胆碱肌颤程度，以预注氟芬合剂5min后效果为佳。     

胰岛素和高渗糖局部应用治疗阿弗他溃疡疗效观察

目的：观察胰岛素与高渗糖局部应用治疗阿弗他溃疡的临床疗效。方法：对48例复发频繁的阿弗他溃疡患者分为治疗组24例和对照组24例。治疗组应用胰岛素注射液和50%的高渗葡萄糖注射液及2%的利多卡因注射液混合后局部涂搽。对照组常规使用碘甘油和利多卡因注射液混合后局部涂搽。结果：治疗组平均愈合时间为4.2d,治疗组有效率（87.5%）,明显高于对照组（12.5%）（P＆lt;0.01）。结论：胰岛素和高渗糖能快速促进严重的复发频繁的阿弗他溃疡的愈合。     

老年人原发性三叉神经痛得宝松局部注射治疗效果评价

目的:探讨得宝松(复方倍他米松)局部注射治疗老年人原发性三叉神经痛的临床效果,为三叉神经痛提供新的治疗方法。方法:原发性三叉神经痛患者30例,根据疼痛范围行相应神经支局部注射,每个注射点注入得宝松灭菌混悬注射液0.5ml。治疗后3个月内定期复诊,随访时间3年,使用视觉模拟评分法评定患者疼痛程度和治疗效果。结果:30例患者治疗后1个月内三叉神经痛症状有不同程度的减轻,VAS评分疗效优、良、中者分别为43.3%、46.7%和10.0%,治疗后3年VAS评分疗效优、良、中、差者分别为33.3%、40.0%、16.7%和10.0%,3年内复发率为10.0%,平均复发时间分别为26个月,治疗后VAS评分与治疗前相比有显著性差异。患者治疗后无明显感觉降低。结论:得宝松局部注射治疗三叉神经痛方法简单,有效率高,复发率低,无明显毒副作用,是一种安全有效的治疗方法。     

封闭疗法结合咬合板治疗颞下颌关节紊乱综合征器质性破坏类的临床观察

采用封闭疗法结合咬合板治疗颞下颌关节紊乱综合征器质性破坏类患者５２例，男１２例，女４０例，年龄１４～７３岁，平均４０岁。关节下腔注射地塞米松和利多卡因混合液，根据病因选用前方调位咬合板或稳定型咬合板，治疗６个月后显效４６例（８８．５％）、有效６例（１１．５％），Ｘ经片示原骨质破坏处有修复出现，认为封闭与咬合板相结合是针对症状和病因的综合治疗方法，该方法治疗效果明显，无不良反应，有普及应用价值。     

Clinical response to local delivery of tetracycline in relation to overall and local periodontal conditions

Abstract The purpose of this study was to determine the clinical response to local delivery of tetracycline in relation to clinical and microbiological conditions of the other teeth. 4 deep pockets were monitored in 19 subjects with multiple deep periodontal lesions and high counts of P. gingivalis. In 9 patients (XT) only 2 of the selected lesions were treated by placement of tetracycline fibers (Actisite®). while the rest of the dentition was left untreated. In the other 10 patients, all teeth were supragingivally scaled and then treated by application of polymeric tetracycline HCl containing fibers, the whole dentition was subject to full mouth scaling and root planing, and the patients rinsed with 0.2% chlorhexidine (FT). A significant reduction in mean PPD was observed in all treated sites after two months. This reduction was maintained over the following 4 months. The magnitude of the effect was significantly greater in the FT group (1.74 mm) than in the LT group (0.88 mm). The mean attachment level changes were similar after 2 months in locally and fully treated subjects. A tendency of relapse was noted for treated sites in LT patients from month 2 to 6. A level of statistical significance was not reached for this effect. Data from measurements recorded at 6 sites around all teeth in the full mouth treated patients were analyzed using multiple linear regression. This analysis showed local changes in PPD and AL were significantly and strongly correlated with the baseline value of the respective parameter at the same site. In addition, more pocket depth reduction was noted if a site was not bleeding on probing at 6 months, if the location of a site was not approximal and if the tooth was not a second molar. Sites located on second molars showed also less AL gain than sites located on other teeth. Smokers showed significantly less reduction in PPD and significantly less AL gain. Furthermore, if subjects had a high % of pockets deeper than 4 mm at baseline they showed significantly less attachment gain.     

Trismus after injection of local anesthetic.

Persistent pain at the site of injection is the most common complication of local anesthesia in the oral cavity. The complication of trismus after local anesthetic injection is rare and may be prevented by the use of short needles for maxillary posterior injections, and by the avoidance of multiple injections in a short period time. Once trismus develops, its progression to chronic hypomobility and fibrous ankylosis may be prevented by the early institution of treatment consisting of heat, analgesics, muscle relaxants, and exercises.