早期半卧位预防腹部术后腰肌酸痛的探讨

目的：观察早期半卧位在预防腹部手术后由于被动体位引起的腰肌酸痛的效果。方法：100例患者随机分成2组，实验组患者全身麻醉腹部手术后果用早期半卧位或斜坡位（带气道插管者除外）。对照组患者按传统方法采用去枕平卧位。术后48h内进行观察比较。结果：实验组术后发生腰酸者2例，程度轻，于手术当日发生，次晨消失。对照组术后发生腰酸者12例，程度重，有2例诉腰酸痛难忍。结论：术后早期半卧位能有效预防体位不适而引起的腰肌酸痛。     

超激光疼痛治疗仪在颈后路手术后颈肩部疼痛中的临床应用

目的探讨超激光疼痛治疗仪在颈椎后路术后颈肩部疼痛中的临床应用效果。方法将2008年10月～2010年10月期间在我科行椎旁肌剥离颈椎后路手术的42例随机分为实验组和对照组,各21例。实验组术后2d第1次换药后,开始使用超激光疼痛治疗仪广泛照射双侧颈肩部,同时予以常规治疗（镇痛及适当功能锻炼）;对照组按常规治疗,比较两组患者治疗2W后及术后半年随访的颈肩部疼痛情况,疼痛评估采用YAS量化。结果实验组及对照组术后2W及半年颈肩部疼痛发病率无明显差别（P〉0．05）,实验组在术后2W及半年随访,颈肩部疼痛VAS评分均低于对照组（P〈0．05）。结论超激光疼痛治疗仪可减轻颈后路手术后颈肩部的疼痛。     

脊柱全麻术后卧位改良的效果分析

以往我科脊柱手术全身麻醉后均采用平卧位，但此体位患者往往出现头痛、头晕、咳嗽无力，主诉颈部肌肉有紧张或牵拉感、全身肌肉酸痛等不适，影响了患者的舒适度。针对上述由于脊柱全麻术后平卧位容易造成的不适症状，我科对此进行了脊柱全麻术后卧位的改良，由传统平卧位改良为30度的低半卧位，现报道如下。     

电针对缓解肩手综合征腕部水肿与疼痛疗效的观察

目的:探究电针对于中风后肩手综合征的腕部疼痛和肿胀的缓解作用.北京老年医院卒中病房确诊肩手综合征的14例病例.方法:根据参照江藤氏肩手综合征诊断标准对患者将14例病例分为两组,实验组给予康复训练配合电针治疗,对照组仅做康复训练.对两组患者的疼痛和水肿进行评价.结果:两组的病人的水肿和疼痛均有所改善(P＜0.05),实验组的效果优于对照组(P＜0.01).结论:电针配合康复训练对于治疗中风后肩手综合征是有效的方法.     

碳酸氢钠雾化吸入对全麻开胸术后患者排痰的影响

目的 探讨碳酸氢钠雾化吸入对全麻开胸术后患者排痰的影响.方法 将100例全麻开胸术后患者随机分为实验组和对照组,各50例.对照组采用庆大霉素8万U、α-糜蛋白酶4000 U、地塞米松5 mg加生理盐水20 ml雾化吸入,实验组在对照组雾化吸入液中加碳酸氢钠0.5 g,观察两组术后排痰效果和肺部并发症发生率.结果 实验组咳痰的容易程度、痰量及痰性状较对照组有显著改善（P〈0.05）,肺部并发症发生率明显低于对照组（P〈0.05）.结论 全麻开胸术后,采用常规雾化吸入加碳酸氢钠能更有效地促进术后排痰.     

枕大孔区巨大硬膜外血肿1例报告

1　临床资料　患者 ,男 ,5 0岁。头部外伤后头痛、头晕、呕吐 18ｈ ,原发昏迷半小时由外院转入。伤后 2ｈ曾在当地医院行首次头颅ＣＴ检查诊为“左小脑挫裂伤伴出血、枕骨粉碎性骨折” ,行保守治疗 ,病情平稳。入院时查体 :神志清楚。ＧＣＳ 15分。左枕部软组织肿胀、触痛。双侧眼球见粗大水平眼震。颈略抵抗。余 (- )。伤后 18ｈ复查头颅ＣＴ与外院首次ＣＴ(图 1)表现相同。因疑诊枕大孔区硬膜外血肿 ,又进一步行头颅ＭＲＩ检查 (图 2、3)明确诊断 ,急诊在全麻下行颅后窝开颅减压、枕大孔区硬膜外血肿清除术。术中见 :枕大孔左外侧有暗红色…     

七叶皂苷钠在关节镜下膝关节手术中的应用研究

目的评价七叶皂苷钠在膝关节镜手术围手术期应用的临床疗效及安全性。方法选取膝关节镜手术患者86例（男49例，女37例）随机分组，围手术期分别应用七叶皂苷钠和生理盐水，检测术后VAS疼痛评分、膝关节活动度、关节肿胀、积液程度及药物不良反应。结果七叶皂苷钠组术后早期疼痛评分均较对照组明显降低，关节活动度增大，关节积液程度明显减少，七叶皂苷钠药物不良反应率高于对照组，但二组间差异无统计学意义。结论膝关节镜术后应用七叶皂苷钠可缓解患者疼痛，增大关节活动度，明显减少关节积液程度，其不良反应率低，具有良好的临床疗效和安全性。     

盐酸丁卡因胶浆用于男性患者导尿的临床观察

目的探讨盐酸丁卡因胶浆减轻男性导尿疼痛等的作用。方法100例男性患者,随机分为对照组和实验组。对照组使用导尿包内的石蜡油润滑导尿,实验组使用盐酸丁卡因胶浆替代石蜡油导尿。疼痛评分采用数字评分法。结果实验组导尿一次成功率高于对照组（P〈0．01）;实验组一次成功置管时间为（7±2）min,而对照组为（6±2）min。实验组操作时间虽比对照组长,但是实验组导尿时疼痛及拔管时疼痛评分远低于对照组（P〈0．01）,实验组导尿后血尿发生率也远低于对照组（P〈0．05）。实验组全麻患者麻醉苏醒期因尿管刺激而引起的烦躁低于对照组（P〈0．01）。结论男性患者导尿时使用盐酸丁卡因胶浆替代石蜡油能显著减轻患者的疼痛和不适,减少血尿发生率,并能显著减轻全麻患者麻醉苏醒期因尿管刺激而引起的烦躁。     

肩关节镜下治疗肩袖损伤的护理及康复253例总结

<正>1临床资料1.1一般资料本院运动医学科2005年12月~2010年6月的253例肩袖损伤患者,其中男性150例,女性103例,年龄12~82岁,平均42.6岁。1.2手术方法患者全身麻醉,手术体位为"沙滩椅"位,患肩常规消毒铺巾。常规后入路,前上入路,前外侧入路。后入路探查关节,确认肩袖损伤部位及范围,植入内排螺钉缝合肩袖,外排螺钉加强固定。术后患者外用支具保护。1.3结果     

麻醉体位干预应用于椎管内麻醉的疗效及对并发症影响分析

目的分析椎管内麻醉患者应用麻醉体位干预后效果。方法选取2018年1月~2019年6月收治的119例手术行椎管内麻醉患者,采用随机法进行分组,对照组59例患者给予常规围术期干预措施,观察组60例患者在对照组基础上增加麻醉体位干预措施,对比两组患者干预后疼痛、穿刺时间及术后并发症发生率。结果观察组患者穿刺准备时间及VAS评分均较对照组患者低,数据差异显著(P<0.05);观察组患者干预后一次性成功穿刺率高于对照组患者,穿刺后心率增快率及低颅压头痛率均低于对照组,数据差异显著(P<0.05)。结论麻醉体位能够有效提升椎管内麻醉患者一次性成功穿刺率,减轻麻醉时疼痛,减少术后低颅压头痛发生率、穿刺准备时间及穿刺后心率增快发生率。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.