磁刺激运动诱发电位在腰椎间盘突出所致的腰骶神经根病变中的应用研究

在35例有L5和／或S1神经根损害表现的腰椎间盘突出患者腰椎区进行磁刺激运动诱发电位（MEP）检查，测定、记录胫前肌、展肌和小趾展肌MEP的起始潜伏期（OL）。结果显示，35例中至少有一条总侧肌肉MEP异常33例（94．3％）。在L4－5椎间盘突出中，以胫前肌的MEP异常为主；在L5－S1椎间盘突出中，以小趾展肌的MEP异常为主。表明腰椎区MEP检查对腰椎间盘突出所致的腰骶神经根病变较为敏感，可为临床诊断提供可靠依据并有助于定位诊断。     

针剥治疗腰骶棘间韧带劳损

腰防林间韧带劳损引起的下腰痛，目前的各种常规疗法，疗效常不确切。三年来我们在受针剥疗法治疗其它较组织损伤后遗症的启发下，试用外剥疗法治疗腰优棘间韧带劳损，取得了满意的疗效。临床资料共治疗病例109例，女69例，男40例。年龄20～50岁。病史最短3个月，最长23年。治疗方法患者俯卧位，腹部置一小枕，术区常现消毒，术者带手套，左手拇指尖紧指LSS；棘间，右手持外（长13cm，粗Zmm的克氏针，尾端打成扁平状，头部磨成扁刃状），沿棘间正中刺入，刀口线与棘间韧带纤维走行方向一致，深度约为3～4cm，以不穿过黄韧带为度，进外部位…     

骶管冲击疗法治疗根性腰腿痛

作者自１９８８年１０月至１９９５年１０月采用骶管冲击疗法共治疗根性腰腿痛患者１１６例，报告如下。临床资料１．一般资料：本组１１６例，男８７例，女２９例；年龄２３～６１岁；病程３周～８年；发病诱因：腰部长期负重７６例，轻体力工作有明确腰扭伤者２０例，无明显外伤而发病１１例，陈旧性腰椎骨折后发病９例。２．诊断依据及病例选择：具有下列典型体征：（１）椎间隙旁有局限性压痛并向同侧下肢放射。（２）神经根紧张试验阳性（屈颈试验，直腿抬高及加强试验）。（３）脊神经根的定位症状：出现范围局限的感觉障碍区及相对应…     

强直性脊柱炎骶髂关节CT和常规X线片检查的评估（附60例报告）

对６０例强直性脊柱炎患行骶髂行骶髂关节ＣＴ及常规Ｘ线片检查对照，结果表明，ＣＴ明显优于Ｘ线检查，ＣＴ能清晰显示关节间隙，提高关节面软骨下囊变、骨皮质中断、锯齿状改变的检出率，不仅能发现ＡＳ骶髂关节的早期改变，而且有利于较准确定级，Ⅰ～Ⅱ级骶髂关节炎ＣＴ检查比Ｘ线敏感一个级别，有利于早期诊断，此外，骶、髂骨的脱钙，下腰椎小关节硬化也是比较敏感的ＣＴ指标。     

多功能电脑三维快速牵引加液体刀骶管疗法治疗腰椎间盘突出症66例临床疗效观察

目的 观察多功能电脑三维快速牵引加液体刀骶管疗法对腰椎闻盘突出症的疗效。方法对66例采用多功能电咕三维快速牵引后再施以骶管滴注的临床治疗。结果 该治疗的总有效率为95．4％(63／66)，治愈率达60．6％(40／66)。结论 多功能电脑三维快速牵引加液体刀骶管疗法是非手术治疗腰椎间盘突出症的有效方法，能快速解除患者的疼痛，值得临床推广。     

右位心合并巨大血管瘤1例

患儿 女，出生6d。因呼吸急促3d入院。孕40^ 1周，剖宫产娩出，出生体重3550g，Apgar 1、5 min评分均9分(皮肤颜色扣1分)。其母胎盘黏连，产后大出血。人院查体：R48次／分，足月新生儿，反应可，呼吸急促，点头样呼吸，口周微绀。面部双颊可见树枝状紫红色毛细血管扩张，压之褪色，不高起皮面。背部自颈部至骶尾部可见一宽5cm的巨大血管瘤，颜色暗红，不高起皮面，表面光滑，压之部分褪色。三凹征( )，胸廓两侧对称，双肺呼吸音粗，无罗音。心尖搏动位于第四肋间右锁骨中线内2cm处，无震撼，     

骶神经调节治疗慢性排尿功能障碍的护理

目的 探讨骶神经调节治疗慢性排尿功能障碍的护理措施，为今后护理常规的制定提供依据。方法 回顾分析6例慢性排尿功能障碍病人接受骶神经调节治疗的护理资料。结果 6例骶神经调节测试病人中有5例的客观和或主观指标都改善了50％以上，其中2例接受了永久电极和可程控式骶神经调节器植入术后客观和或主观指标得到了显著改善。术前和术后病人心理稳定，能较好地配合治疗和护理。6例病人随访15～26个月，未发现明显不良反应和并发症。结论 术前积极的心理护理和充分的术前准备是保证骶神经调节治疗顺利进行的关键，术后康复指导和正确的护理是促进病人尽快康复，减少并发症发生的重要措施。     

剖宫产术后骶尾部压疮形成原因与护理

压疮或称褥疮,是由于局部组织长时间受压,血液循环障碍,局部持续缺血、缺氧、营养不良而致的软组织溃疡和坏死。压疮一旦发生,不仅降低患者的生活质量,增加患者痛苦,而且浪费大量的人力、物力,延长住院天数。我院在2005年1～6月施行剖宫产分娩的645例产妇中,术后发生骶尾部压疮Ⅰ期的患者8例。笔者对剖宫产术后压疮形成原因进行分析,总结护理经验,提高护理质量。现报道如下。     

Effect comparison between sacral blocking and massage combined with traction on protrusion of lumbar intervertebral disc

Background:Epidural injection is an important method in treatment of protrusion of lumbar intervertebral disc.Especially in the recent decade sacral injection is adopted more and more often.Objective:To compare the clinical effects of sacral blocking and massage combined with traction.Unit:Yinhe Hospital of Beijing.Subjects:290 outpatients with grade Ⅱ of ASAI were selected from May,1994 to July,2000.Patients were randomly divided into observation group(n=145)and control group(n=145).Sacral blocking was adopted in observation group and 80 males and 65 females aged 20-78(mean:46.4)years old were included with disease course 3 days to 30 years.Massage combined with treaction was adopted in control group and 74 males and 71 females aged 22-74(mean:44.9)years oled were inmcluded with disease course 2 days to 10 years.Interention:Sacral blocking:Operation was according to sacral blocking and druge(dexamethasone injection,2 mg;0.75% bupivavaine hydrochloride,5 ml;saline,50ml) were injected slowly after success of puncture.Patient rested for 0.5h after injection and left treatment room if no adverse effects occurred.Massage combined with traction:Massage was adopted after traction to every patients.(1)Massage:Patient was seated at square stool and lower limbs separated naturally with same width of shoulders.Doctors sit behind patient.First,thubs of both hands were pressed on projecting part near spinous process(pressing points were selected according to different projecting part).Flexing and extending forward and backward were taken at the same time and extent was ddecided addording to patients‘ maximal endurable degree,5-10 timmes.Upper part of body was turned 45 degrees to left and right.Massage was still taken to affected part,3-t times.(2)Traction:Pelvis was extracted with general physical therapy and massage table.Supine position,chest and treaction bandage were fixed,tractiron wheel was turned slowly until patient felt comfortable with maximal endurance as limit(traction force,20-40kg),After extracting for 5 minutes,massagee switch was turned on to take rolling massage to bck and both lower libmbs.Traction force was increased every5 minutes and limit was still according to patient‘s maximal endurance,30 minutes for every time,once a day and ten times as a therapeutic course.Cohclusion:Effect of sacral blocking on protrusion of lumbar intervertebral disc was positive and fewer therapeutic time were needed.Massage combined with traction was also effective,safe and no adverse effects wer observed,but more therapeutic times were neeeded and inconveinient.     

蜂毒中毒的社区急救(附5例报告)

蜂类有蜜蜂、黄蜂、大黄蜂、土蜂等,工蜂尾部有毒腺和蛰针,蛰针刺入人体后释放毒汁,可引起被蜂蛰伤者不同的中毒反应.