腰椎间盘切除术临床治疗体会

腰椎间盘突出症经非手术治疗无效后常需手术治疗.小切口椎间盘切除术具有创伤小、并发症少、康复快等优点.本组对67例小切口椎间盘切除术治疗的腰椎间盘突出症患者术后平均2.86年的随访,予以回顾性分析.     

Crucial questions for physiotherapy in Finland.

When planning for health services, questions of production and distribution as well as cost and quality are key issues for health planners and decision makers. The lack of available objective data often makes this work difficult. This paper presents recent efforts in Finland to improve the collection of information needed for planning in the field of physiotherapy.     

Occupational exposure to carcinogens in Finland.

Finland has kept a registry on the manufacture and use of carcinogenic agents involving occupational exposure since 1979. Employers must report annually to the labor safety authorities the employees who have been exposed to carcinogens and provide information on carcinogenic agents produced, used, or formed. Out of 131 substances or groups of agents listed as carcinogenic, occupational exposure to 78 of them was reported in 1987. About half of the agents reported were used or produced in industry and half were handled on a laboratory scale. About 15,000 employees from 1,700 work departments were reported to the registry; 17% of them were women. The number of workers reported in 1987 accounted for 0.6% of the total work force. It has been estimated that at least 60,000 workers are exposed annually to carcinogens in Finland. The three most prevalent exposures--hexavalent chromium compounds, nickel and its inorganic compounds, and asbestos--accounted for over 60% of all exposed workers; only five carcinogenic chemicals were produced in Finland in 1987.     

Social group and mortality in Finland.

Morality rates for various social groups within the population of Finland were compared, using 179 919 death certificates for the period 1969-72. Morality was generally lowest in the highest social groups and highest among unskilled workers. Male mortality from coronary heart disease was also high among lower salaried employees. In the less developed area of northern Finland, female mortality from coronary heart disease and vascular lesions of the central nervous system was highest among the agricultural population. Cancer of the breast, cancer of the intestine, and suicides among women were apparently concentrated in the higher classes. Life table analysis showed that the social group differences in life expectancy at birth could be as great as 7.2 years. It is considered indispensable for a national health policy to improve on the recording of occupational data and to give regularly the occupation of the deceased when publishing mortality rates.     

Quality of contraceptive services in Finland.

OBJECTIVE: To investigate whether the quality of contraceptive services in Finland varies by the type of care provider. DESIGN: A cross sectional questionnaire survey. PARTICIPANTS: A random sample of 3000 Finnish women aged 18-44 years (response rate 74%) in 1994. RESULTS: Almost all women (94%) had used contraception at some time and 75% were current users. Although self care was common (29% had obtained their latest method outside the health services), 83% had sometimes used the health services for contraception. For their last visit, 55% of women had chosen a health centre (a publicly administered and funded health service), and 33% a private unit. In the health centre, the care provider was usually a general practitioner or a public health nurse, whereas in private care the providers were gynaecologists. Women who used private care were more likely to be from higher social classes and urban areas. After adjustment for a women's background, the two groups were similar for most indicators of the quality of care, but access to care and woman's experiences of treatment were better with private care. CONCLUSIONS: In terms of availability and choices the current system of contraceptive services in Finland is adequate. It is not always an integral part of municipal primary health care, and many women prefer private care for gynaecological services; this may case problems of comprehensiveness and equality of care.     

Mother's education and perinatal problems in Finland.

This study using nationwide data expands a previous study from one area in Finland. The purpose was to study how perinatal problems (mortality, short gestation, low birthweight and low Apgar scores) vary by mother's social class, which is measured by level of education. Outcomes of all births in the 1987 Medical Birth Register were linked to the 1988 National Education Register with gives the estimated number of years of completed education. In unadjusted analyses, the lowest educational groups (less than 9 years) had the worst results for outcomes other than neonatal mortality. Results in the two highest educational groups (greater than or equal to 13 and 12 years of education) were similar and if anything, better in the second highest group. Excluding twins and adjusting for confounding variables (age, parity, county, urbanization of residence) by logistic regression analysis did not alter the results much. Adjustment for possible mechanisms correlated with social class (marital status, smoking, time of first antenatal visit) decreased the higher occurrence of low birthweight infants in the low educational groups. Reported previous miscarriages were more common in the higher educational groups. Based on the available background characteristics one would expect to have found the usual social gradient in perinatal problems to have persisted between the two highest educational groups. Further studies on factors causing the plateau in the gradient between these groups might be useful.     

Alcohol-related problems among adolescent suicides in Finland.

We studied 106 adolescent suicides out of a total nationwide population of 1397 suicides. Forty-four (42%) of these 13-22-year-old victims were classified as having suffered either a DSM-III-R alcohol use disorder or diagnostically subthreshold alcohol misuse according to retrospective evaluation using the Michigan Alcoholism Screening Test (MAST). These victims were found to differ from the other adolescent suicides in several characteristics: they were more likely to have comorbid categorical DSM-III-R disorders, antisocial behaviour, disturbed family backgrounds, precipitating life-events as stressors and severe psychosocial impairment. In addition, they also had a greater tendency to be alcohol-intoxicated at the time of the suicidal act, which tended to occur during weekends, suggesting that drinking in itself, and its weekly pattern, each contributed to the completion of their suicides.     

Cancer prevention trials in China and Finland.

Intervention studies are now viewed as a useful and necessary approach to understanding the relation between nutrition and cancer. Over 20 such studies have been initiated in the past 7 years. Foreign countries may be an attractive site for such investigations, mainly because of desirable population characteristics such as unusually high rates of the cancer being studied, low dietary intake of potential chemopreventive nutrients, stability of the population, and high compliance, and also because of favorable logistical aspects including existing medical, social, or governmental structures that facilitate delivery of the intervention, ongoing cancer registries for endpoint determination, and reduced cost. The three basic elements of an intervention trial, identification and recruitment of a study population, delivery of the intervention and assessment of compliance, and ascertainment of endpoints, are the same in a foreign country as in the United States, but there are a number of special considerations, most notably communication difficulties due to language differences and distance between collaborators, which complicate foreign trials both before and during implementation. The basic elements and status of ongoing trials in China and Finland are presented.     

Iron deficiency and dietary factors in Finland.

In connection with a multiphasic screening program carried out in Finland, over 7,000 persons participated in a dietary survey. The method was a diet history interview concerning food consumption and habits during the previous year. The mean intake of meat products was lower in anemic women (Hb less than 12.0 g/100 ml or PCV less than 36 vol%) than in the others and in the intake of liquid milk products was higher in the anemic women. The meat product intake was lower in anemic men (Hb less than 13.0 g/100 ml or PCV less than 41 vol %) than in other men, but the milk consumption of the groups was almost equal. The intake of meat products in iron-deficient women )serum iron less than 50 mu g/100 ml or TIBC larger than or equal to 400 mu g/100 ml) was lower and the intake of milk products higher than in the other women. The intake of meat products in iron-deficient men (serum iron less than 50 mu g/100 ml or TIBC larger than or equal to 400 mu g/100 ml) was lower than in the other men and the milk consumption was almost equal. The results support earlier studies that dietary habits are significant in the etiology of iron deficiency. In the light of this population study the intake of vitamin C also seems to influence iron metabolism.     

Ovarian cancer and occupational exposures in Finland.

BACKGROUND: No single occupational or environmental agent has been established as causing ovarian cancer, existing studies often being based on ecologic or proportional mortality data in which potential confounders related to reproductive history have not been taken into account. METHODS: This study linked 324 job titles of occupationally active Finnish women (n = 892,591) at 1970 census with incidence of ovarian cancer (Finnish Cancer Registry, 5,072 cases) during 1971-1995 (over 15 million person-years). The job titles were converted into indicators of exposure to 33 agents, using a national job-exposure matrix based on measurements and surveys (FINJEM). Poisson regression analyses were performed with stratification by birth cohort, follow-up period, and socioeconomic status, and adjusted for mean number of children, mean age at first delivery, and turnover rate for each job title. RESULTS: We found indications of elevated risks for aromatic hydrocarbon solvents (standardized incidence ratio 1.3 (95% CI 1.0-1.7), leather dust (1.4; 0.7-2.7), man-made vitreous fibers (1.3; 0.9-1.8), and high levels of asbestos (1.3; 0.9-1.8), and diesel (1.7; 0.7-4.1), and gasoline (1.5; 1.0-2.0) engine exhausts). Previously reported findings for hairdressers and women in the printing industry were supported in our data, but not for women in dry cleaning jobs. CONCLUSIONS: Given the various drawbacks in linkage studies and job-exposure matrices, the excesses found in this study need confirmation in individual-level studies.     

Childhood cancer and parental occupation in Finland.

A case-control study was conducted of the occupations of parents of children under 15 with diagnosed malignancies. The total series contained all childhood cancers cases reported to the Finnish Cancer Registry during the period 1959-75. The parental occupations, recorded at the time of pregnancy, were collected from maternity welfare centres. The cases were analysed as a singly group or as subgroups according to the diagnoses-brain tumours, leukaemia, and all other malignancies. The maternal occupations found more frequently among cases than controls included farmers' wives (1959-68 only), pharmacists, saleswomen, bakers, and factory work of an vehicle driving, machine repair, painting, and the work of men who gave an academic degree as their occupation. Some of these occupations involve possible exposure to harmful chemicals, although chance correlations cannot be excluded.     

平衡火罐联合针刺法治疗气滞血瘀型腰椎间盘突出症的临床研究

目的:研究平衡火罐联合针刺法治疗气滞血瘀型腰椎间盘突出症的临床效果.方法:选取2019年6月至2020年10月来院就诊的气滞血瘀型腰椎间盘突出症患者60例,随机分为对照组和实验组,对照组予普通火罐加针刺治疗,实验组予平衡火罐联合针刺治疗,干预2周,随访4周.比较了两组患者视觉模拟评分(visual analogue s...