中医药非手术方法治疗腰椎间盘突出症研究进展

腰间盘突出症是骨科的常见病,随着人们的生活方式改变和人口的老龄化,该病发病率逐年上升。中医药在腰椎间盘突出症的治疗上方法众多,也具有较好的临床效果,且作用效果持久,有一定的临床价值。本文主要对当下中医非手术方法治疗腰间盘突出症的方法,进行梳理分析整合综述,以期为临床治疗提供参考。     

格列美脲联合甘精胰岛素治疗老年糖尿病效果观察

目的探讨格列美脲联合甘精胰岛素治疗老年糖尿病的临床效果。方法选取该院2016年3月—2018年3月间收治的老年糖尿病患者110例作为临床研究对象,根据用药方案差异分为研究组(n=55)及对照组(n=55)。对照组采取甘精胰岛素治疗,研究组在该基础上联合格列美脲治疗,比较两组患者治疗效果。结果经过治疗,两组患者FBG、2 h PG以及HbAlc水平明显下降,但对照组水平要高于研究组(P0.05);经过治疗后,两组患者IRI水平均有所下降,但对照组水平要高于研究组(P0.05)。结论格列美脲联合甘精胰岛素治疗老年糖尿病可进一步控制病情发展,让患者保持血糖稳定。     

不同碘营养水平对育龄妇女甲状腺功能的影响

Objective To study the effects of different level of iodine nutrition on the thyroid function in women of reproductive age. Methods A total of 100 (50 from each) women of reproductive age but not pregnant were collected from iodine deficient and adequate areas. The questionnaire was obtained individually with items concerning personal history of thyroid diseases, goiters and category of edible salt and drinking water based on the project design. The household salt and drinking water were collected for measuring iodine content, and blood samples were obtained for TSH, FT4 and FT3 testing. Results The coverage of iodized salt and the median level of urinary iodine in iodine deficient women(72.0% and 95.5 μg/L) were obviously lower than that in iodine sufficient women(100.0% and 167.4 μg/L, χ2=16.28, U = 632.00, P < 0.01). Median level of serum TSH in iodine deficient women (2.56 m U/L) appeared in an increasing tendency compared to the iodine sufficient women (1.88 mU/L), but there was no significance (U=990.50, P > 0.05). Serum FT4 mean level in iodine deficient women [(14.7±2.0) pmol/L]was lower than that in iodine sufficient women[(17.0±3.8)pmoI/L, t=3.76, P<0.01]. There was no difference in serum FT3 between two group women[(5.1±1.4), (4.8±0.5)pmoI/L, t = 1.59, P > 0.05]; but FT3/FT4 ratio in iodine deficient women(0.33±0.04) was markedly higher than that in the iodine sufficient women(0.30±0.04, t=3.13, P<0.01). The percentage of thyroid dysfunction in iodine deficient women[20.0% (10/50)]was higher compared with the iodine sufficient women[8.0%(4/50)], but without significance(χ2=2.99, P>0.05). Conclusions Iodine deficiency is a primary cause leading to hypothyroid in women of reproductive age. Long term of iodized salt usage is an efficient way to correct iodine deficiency.     

恶性肿瘤患者经内镜逆行胰胆管造影术后高淀粉酶血症和胰腺炎的临床观察

目的 分析EKCP术后并发急性胰腺炎和高淀粉酶血症对恶性肿瘤患者的影响.方法 观察恶性肿瘤患者ERCP术后淀粉酶变化,观察诊断及治疗性EPCP术后并发症的不同.结果 恶性肿瘤组患者术后6h淀粉酶水平明显高于对照组,24h后无明显差异;恶性肿瘤患者术后并发症多见于诊断性操作,且诊断性ERCP术后并发症的发生率53.8%,明显高于对照组12.5%.结论 恶性肿瘤患者行ERCP术,并不增加胰腺炎的严重程度,有效的胆胰管引流可能降低术后并发症发生的风险.     

金属钛夹在消化道息肉高频电凝电切术的应用评价

目的 探讨金属钛夹在消化道息肉高频电凝电切术中的应用价值与安全性评价.方法 2009年6月至2011年6月对253例直径大于0.5 cm的消化道息肉患者进行金属钛夹联合高频电凝电切术治疗.对于山田Ⅲ型、Ⅳ型息肉先用钛夹钳夹蒂根部后进行高频电凝电切术,对于山田Ⅰ型、Ⅱ型息肉先进行黏膜下注射,息肉隆起后行高频电凝电切术,再用钛夹夹闭创面.结果 253例共312枚息肉,切除307枚,使用钛夹344枚,成功率98.4％.所有病例术中、术后未见出血及穿孔等并发症.结论 对消化道息肉应用金属钛夹联合高频电凝电切术是一种操作简便、安全性高、疗效好的治疗方法,可以有效防止出血、穿孔等并发症的发生.     

肺栓塞的下肢静脉超声表现

国外统计资料报道肺栓塞总的发病率为5％～24％，其中老年人高达49％。有献报道，美国每年死于肺栓塞达5万以上，是最常见的致命的肺部疾病。肺栓塞的栓子80～90％来源于下肢深静脉血栓。本对近期我院收治的6例肺栓塞患下肢静脉超声表现进行探讨。     

以发热、血尿、肺泡呼吸音减弱为特点的布氏菌病1例

1 临床资料 患者,男性,40岁,河北兴隆人,属于半农半牧区,有流产羊胎接触史.患者于2008年5月底出现午后高热、大汗,脱发,全身不适,乏力倦怠,食欲不振,牙龈肿胀,在当地医院予口服抗炎药物(具体不详)治疗3 d后牙龈肿胀消失.     

急慢性放射性肠炎32例临床研究

目的 通过对放射性肠炎的临床观察,分析急慢性放射性肠炎的病例特点及治疗效果.方法 对32例放射性肠炎进行回顾性分析,观察其病例特点,比较其治疗效果及预后.结果 23例急性放射性肠炎疗程短、疗效好,治疗有效率达95.6%,预后良好;9例慢性放射性肠炎疗程长,起效时间长,治疗有效率33.3%,预后不良.结论 放射性肠炎以预防为主,急性期治疗效果较好,若为慢性迟发型则治疗困难,预后不佳.     

不同碘营养水平对育龄妇女甲状腺功能的影响

Objective To study the effects of different level of iodine nutrition on the thyroid function in women of reproductive age. Methods A total of 100 (50 from each) women of reproductive age but not pregnant were collected from iodine deficient and adequate areas. The questionnaire was obtained individually with items concerning personal history of thyroid diseases, goiters and category of edible salt and drinking water based on the project design. The household salt and drinking water were collected for measuring iodine content, and blood samples were obtained for TSH, FT4 and FT3 testing. Results The coverage of iodized salt and the median level of urinary iodine in iodine deficient women(72.0% and 95.5 μg/L) were obviously lower than that in iodine sufficient women(100.0% and 167.4 μg/L, χ2=16.28, U = 632.00, P < 0.01). Median level of serum TSH in iodine deficient women (2.56 m U/L) appeared in an increasing tendency compared to the iodine sufficient women (1.88 mU/L), but there was no significance (U=990.50, P > 0.05). Serum FT4 mean level in iodine deficient women [(14.7±2.0) pmol/L]was lower than that in iodine sufficient women[(17.0±3.8)pmoI/L, t=3.76, P<0.01]. There was no difference in serum FT3 between two group women[(5.1±1.4), (4.8±0.5)pmoI/L, t = 1.59, P > 0.05]; but FT3/FT4 ratio in iodine deficient women(0.33±0.04) was markedly higher than that in the iodine sufficient women(0.30±0.04, t=3.13, P<0.01). The percentage of thyroid dysfunction in iodine deficient women[20.0% (10/50)]was higher compared with the iodine sufficient women[8.0%(4/50)], but without significance(χ2=2.99, P>0.05). Conclusions Iodine deficiency is a primary cause leading to hypothyroid in women of reproductive age. Long term of iodized salt usage is an efficient way to correct iodine deficiency.     

多层螺旋CT在预防上颌后牙手术致上颌窦瘘的临床价值

目的 探讨多层螺旋CT(MSCT)对上颌后牙疾病的测量、诊断在指导临床手术预防上颌窦瘘中的临床应用价值.方法 对45例上颌牙齿、上颌骨部位的容积数据进行后处理,重建出全景齿科图像和牙槽骨的矢状面和冠状曲面图像,与原始图像结合,进行测量、分析、诊断.结果 45例均能清晰显示上颌窦底的骨质密度、结构,牙齿、牙根、牙槽骨的形态及其与上颌窦的解剖关系.能清楚地描述病变的范围、骨质的破坏情况.准确的测量上颌窦底和上颌后牙牙根的距离,牙槽骨高度、宽度及上颌窦底骨质缺损大小.临床根据MSCT结果制定合理的上颌后牙手术方案,45例在拔牙、根管治疗及种植手术中均未发生上颌窦瘘.结论 MSCT重建图像可以立体、直观、清晰、全面地显示颌面部复杂的解剖结构,对临床医师在疾病的诊断,术前手术方案的制订中有重要的指导价值,在上颌后牙手术中预防上颌窦瘘起了非常重要的作用,MSCT可以作为上颌后牙手术的常规术前检查.