自控镇痛缓解血栓闭塞性脉管炎患者的慢性疼痛症状

血栓闭塞性脉管炎是一种累及血管的炎症和慢性闭塞性疾病。虽治疗方法较多,但不够理想。经采用患者自控硬膜外镇痛(PCEA)方法治疗血栓闭塞性脉管炎疼痛,效果较好。     

特殊体位锁骨下静脉穿刺置管术在临床中的应用

锁骨下静脉穿刺置管在临床上广为应用,是测定中心静脉压和深静脉营养以及肿瘤化疗的重要手段之一。传统上在仰卧下穿刺置管,但因心衰或呼吸困难不能平卧的患者采用传统穿刺方法受到限制,特别是处于坐位或接近坐位的危重患者。为此,我们设计一种改良方法,2001～2003年底用于临床30例,效果较好,现报告如下。     

自控镇痛缓解血栓闭塞性脉管炎患者的慢性疼痛症状

血栓闭塞性脉管炎是一种累及血管的炎症和慢性闭塞性疾病。虽治疗方法较多，但不够理想。经采用患自控硬膜外镇痛（PCEA）方法治疗血栓闭塞性脉管炎疼痛，效果较好。     

星状神经节阻滞治疗面部顽固性疼痛1例

1 Case abstract Patient, male,68 years old,got obstinate facial pain 10 years ago after nerve block due to trigeminal neuralgia.Pain resulted in following dysfunction:facial asymmetry,atrophic left facial muscle was 1/2 size of right;Myodynamy decreased,only soft and semiliquid food could be taken and compensation of right muscle was needed;Pselaphesia and thalposis were lost and there was on feeling to water at 40 ℃ .Continuous facial pain led to unstable mood,diet decreasing,bad sleepness,light weight,bad facial impressions and mental disturbance at the end.Once took sedative analgesic drugs such as valium,but effect was unobvious.Diagnosis: left facial pain.According to case history,symptoms,block of left ganglion stellatum was adopted.Dorsal position,head hypsokinesis to expose neck, operator pushed common carotid artery towards external side, and inserted needle at cricoid cartilage level,between trachea and common carotid artery towards C7 transverse process,withdrew needle when feeling substance of bone, if no blood and brain fluid returned, injected 5 ml of 2% lidocaine.After withdrawing,Horner's syndrome and facial burning sensation at the same side often appeared,but complications from celostomea,numb of upper limb to dyspnea weren't found.One time every two days, 5 times as a therapeutic course,the interval was 2 weeks,and 3 therapeutic courses in total.Therapeutic effect was expressed by version analogue scale(VAS):Drew a thick line and divided it into 10 parts,0 indicated no pain,10 indicate severe pain.Patient drew at corresponding position to express his pain degree.Before treatment,VAS score was 7,after 1 therapeutic course decreased to 4,after 2 therapeutic courses,2～ 3,after 3 therapeutic courses it was 0～ 1.With the improvement of disease,atrophy of left facial muscle was also improved and closed to the size of right.pselaphesia and thalposis recovered,masticatory function improved,sleeplessness disappeared,other complications improved much.     

喉罩与气管插管在面神经微血管减压术中的应用比较

目的:比较喉罩(欧普乐)与气管插管在面神经微血管减压术(MVD)中应用的安全性和可靠性。方法:选择择期行面神经微血管减压术患者40例,随机分为喉罩组和气管插管组,每组20例。观察并且记录两组麻醉诱导前(T0)、置入喉罩或气管插管前(T1)、置入即刻(T2)、置入后3 m in(T3)、置入后5 min(T4)、取出喉罩或拔管时(T5)的SBP、DBP、HR、SPO2和呼吸末二氧化碳分压(PETCO2),以及两组拔喉罩和拔管期的不良反应及术后并发症。结果:两组T2、T3、T5的SBP、DBP、HR有统计学差异(P(0.05),SPO2和呼吸末二氧化碳分压(PETCO2)比较差异无统计学意义(P>0.05)。气管插管组并发症的发生率显著高于喉罩组。结论:MVD术中使用喉罩(欧普乐)全麻的方法具有安全性好、血流动力学平稳、并发症少的优点。     

小儿经鼻盲探气管内插管2例

2000年7月及2001年9月,我们对2例面、颈部瘢痕挛缩致颈部活动受限、Ⅲ度张口困难拟行瘢痕切除术患儿,应用经鼻盲探气管内插管全麻获得成功,报道如下.     

经皮微球囊压迫三叉神经半月节治疗三叉神经痛的研究进展

三叉神经痛(trigeminal neuralgia,TN)是一种顽固的颜面部疼痛,TN不仅能够引起患者不适,同时显著地降低患者生活质量。经皮微球囊压迫(Percutaneous Microballoon Compression,PMC)三叉神经半月节是治疗顽固性TN一种可供选择的有效方法,其治疗机制仍不十分清楚。由于该技术操作拥有自身优势,许多患者对PMC这项技术非常青睐。本文回顾近年来国外关于PMC治疗TN的应用效果、所产生的问题及PMC治疗TN的方法学、临床应用与研究的发展状况、问题及其展望予以综述。