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Tourniquet paralysis is an uncommon complication of surgery, and self-inflicted tourniquet paralysis has never been documented to our knowledge. We report a patient with bilateral self-induced tourniquet paralysis of the lower extremities, whose symptoms were initially attributed to an acute demyelinating sensorimotor polyneuropathy based on clinical presentation and electrodiagnostic study. After investigations failed to reveal a cause, he was found to have placed tourniquets on his legs because of a rare obsession with limb amputation known as apotemnophilia. Significant spontaneous partial resolution of clinical symptoms was noted after 6 weeks. Electrophysiologic evidence of segmental demyelination of multiple motor nerves localized to the same region may help to distinguish this condition from other forms of acute demyelinating polyneuropathy. 相似文献
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目的 探讨急性创伤性膈疝的发病机理 ,临床特征和处理方式。方法 回顾性分析2 6例急性创伤性膈疝的临床资料。结果 患者均为多发伤 ,有不同程度的呼吸困难 ,均行手术探查 ,膈肌修补。 2例术中死亡。 14例术后出现多器官功能障碍 ,其中 3例术后死于多器官衰竭。本组 2 1例存活。结论 外伤性膈疝早期诊断 ,及时手术 ,防治并发症可提高抢救成功率。 相似文献
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Desmond Bohn 《Pediatric surgery international》1987,2(6):336-340
Blood gas analysis can be used to reliably predict outcome in infants with congenital diaphragmatic hernia (CDH) both before and after surgical repair, providing these values are indexed to some measurement of alveolar ventilation. Until recently there has been difficulty in interpreting some of the published data because of differing sampling sites and the fact that ventilatory parameters, which have major influences on all blood gas values in this anomaly, were not included. Application of this information enables us to identify infants with similar degrees of severity of CDH in order to evaluate the efficacy of novel forms of therapy and to determine whether they represent a genuine advance in management where more conventional forms of treatment have failed. 相似文献
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Respiratory failure from pulmonary hypoplasia continues to be the major cause of death in newborn infants with diaphragmatic hernia. Recent investigations have suggested that postnatally induced pulmonary injury can result from excessive positive or negative intrathoracic pressure and contribute to the respiratory deterioration. Therefore, the method of thoracic drainage on the side of the diaphragmatic hernia is critical in controlling and maintaining normal intrathoracic pressure in both intrathoracic spaces. No chest tube or an ipsilateral chest tube connected to water seal, can result in either excessive negative or positive intrathoracic pressure and, therefore, both methods should be avoided. Recently, we employed a "balanced" intrathoracic drainage system which maintains the ipsilateral intrathoracic pressure within the normal physiologic range of +2 to -8 cm H2O regardless of the degree of pulmonary hypoplasia, presence of an ipsilateral pulmonary air leak, straining by the infant, or mechanical ventilation. This system is simple, requires no suction apparatus, and is easily assembled with equipment readily available within the hospital. This technique has been utilized in 18 newborn infants with diaphragmatic hernia and pulmonary hypoplasia. There have been no complications which specifically could be related to the balanced drainage system. 相似文献
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目的 :探讨体外膈肌起搏器配合药物治疗特发性面神经麻痹的疗效。方法 :治疗组在常规使用激素、血管扩张剂和神经营养药等治疗的基础上配合应用体外膈肌起搏器 ,治疗面神经麻痹 ,对照组单纯使用药物治疗 ,对照两组的治愈率、好转率和平均治疗时间和好转时间。结果 :治疗组 73例 ,治愈 6 2例 ,好转 5例 ,总有效率 92 % ;对照组 32例 ,治愈 2 3例 ,好转 5例 ,总有效率 81% ,两组差异有显著性。 (P <0 0 5)。结论 :应用体外膈肌起搏器配合药物治疗面神经麻痹治愈率高 ,疗程缩短 相似文献
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