挫伤性晶状体半脱位继发青光眼的临床治疗

目的探讨挫伤性晶状体半脱位继发青光眼的临床治疗效果。方法回顾性分析12例晶状体半脱位继发青光眼的临床资料和治疗方法。结果 12例患者经药物和手术治疗后,眼压恢复正常,视力有不同程度提高。结论根据青光眼的不同眼部体征,采用不同的治疗方法如药物治疗、前房穿刺放液、单纯小梁切除术或联合手术,取得了较好的治疗效果,眼压得到有效控制,视力提高,病情稳定。     

慢性寰枢关节旋转固定或脱位复位前后寰枕关节影像学变化

目的:总结慢性寰枢关节旋转固定或脱位患者的寰枕关节在寰枢旋转或脱位复位前后的影像学改变。方法:回顾性分析2004年9月~2019年6月间因寰枢关节旋转固定或脱位在我院诊治的患者40例,男19例,女21例,年龄5~17岁,平均11.2±2.8岁,病程2~36个月,平均6.0±5.7个月,随访时间3~18个月,平均5.7±3.1个月。其中A类(3例),寰枢关节旋转固定;B类(36例),寰枢关节旋转固定性脱位(其中B1类10例,一侧寰椎侧块前脱位,另一侧原位;B2类21例,一侧寰椎侧块前脱位,另一侧后脱位;B3类5例,双侧寰椎侧块不对称前脱位);C类(1例),寰枢关节旋转固定性脱位合并寰枕关节反向脱位。A类病例中1例牵引治愈、2例做了Halovest外固定下寰枢间植骨融合术;36例B类和1例C类患者都做了寰枢复位内固定植骨术。利用CT轴位、矢状位和冠状位影像,观察治疗前后寰枕关节面对合情况和关节间隙的变化。结果:大部分寰枢关节旋转固定或脱位患者寰枕关节出现不同程度的反向旋转移位、对合异常的现象,不同分类间其旋转程度有差异,寰枢关节旋转复位后,寰枕关节的旋转和关节面的对合关系也有不同程度改善。复位前、后都有寰枕关节自发骨性融合的现象。本次治疗前寰枕关节的情况:(1)除1例A类、3例B1类和5例B3类病例的寰枕关节对合正常外;其余病例的寰枕关节都有不同程度的旋转移位,对合不正常;1例C类双侧寰枕关节脱位;(2)2例出现寰枕关节自发融合,B1类和B3类各有1例。剩余38例经过治疗寰枢关节旋转矫正后寰枕关节的情况:(1)22例寰枕关节正常(包括A类3例,B1类6例,B2类10例和B3类3例);(2)寰枕关节自发骨性融合8例(包括B1类1例,B2类6例和B3类1例);(3)寰枕关节残留旋转移位、对合不正常4例(包括B2类3例,C类1例);(4)寰枕关节间隙变窄、模糊4例(包括B1类和B2类各2例)。结论:大部分A类和B1类患者以及全部B2类患者在治疗前出现寰枕关节反向旋转移位,其中个别B类患者在治疗前有寰枕关节自发融合的现象。复位后A类、B1类和B3类患者的寰枕关节恢复正常对合关系,但B类患者中有近一半出现寰枕关节对合不正常、关节间隙狭窄模糊、关节自发融合等不良问题,多见于B2类病例。     

关节镜技术在青少年急性髌骨脱位治疗中的应用

目的:介绍关节镜下微创手术治疗急性髌骨脱位的技术及疗效。方法:2002年5月~2012年6月应用关节镜技术对23例急性髌骨脱位患者进行了关节镜下微创手术治疗,技术要点为关节镜下髌外侧支持带松解,内侧支持带紧缩缝合。患者年龄13(13±19)岁,病程2(2±14)天,随访时间8(3±18)个月。手术前后采用Lysholm评分对膝关节功能进行评定。结果:患者无1例复发脱位。手术前Lysholm评分为55分,手术后提高至90分。结论:关节镜技术既显示了微创优势,同时又对不同程度的髌骨脱住皆获得了满意治疗效果。     

推拿治疗大学生颈肩部肌肉劳损

目的观察推拿治疗大学生颈肩部肌肉劳损的临床效果。方法将200例患者随机分为治疗组和对照组,各100例。治疗组采用整体施术和局部施术进行治疗,整体施术手法包括推、滚、按揉、点、弹拨、拿、拔伸、叩击等,局部施术手法是在患者局部肌肉群进行对症治疗。对照组采用拔罐法对颈肩部肌肉劳损患者进行治疗。观察2组临床治疗效果。结果 2组临床疗效比较,治疗组总有效率94%,高于对照组的53%,2组比较,P〈0.05。结论推拿治疗颈肩部肌肉劳损能够缓解颈肩部肌肉痉挛状态,恢复颈部活动度,减轻颈肩部疼痛。     

囊袋张力环在晶体半脱位白内障超声乳化术的临床应用观察

目的：评价张力环在晶体半脱位手术中的应用价值。方法对10例（10眼）晶体半脱位患者在白内障超声乳化术中植入囊袋张力环,随访3～6个月,测量视力,眼压,观察人工晶体位置。结果所有病例中,视力较前提高,人工晶体位正,无倾斜及偏位。结论囊袋张力环是晶体半脱位白内障超声乳化术的安全有效辅助器械,能够防止术后人工晶体偏位,降低术后并发症,有利于术后视功能的早期恢复。     

晶状体半脱位继发闭角型青光眼的临床分析

目的 回顾性分析晶状体半脱位继发青光眼的临床特点与治疗。方法 对13例（13只眼）晶状体半脱位继发闭角型青光眼患者，分别行YAG激光虹膜周边切除，小梁切除术，小梁切除术＋晶状体摘除＋玻璃体切割术（或＋人工晶体植入术），睫状体冷冻术，总结其临床表现特点与治疗效果。结果 晶状体半脱位继发闭角型青光眼临床表现类似急性闭角型青光眼；术后84．6％眼压控制正常范围；术后61．5％最佳矫正视力提高。结论晶体半脱位继发闭角型青光眼表现与急性闭角型青光眼相似，前房浅并深浅不均，眼压高，视力影响大是其特点；可根据患者前房、晶体及视力情况选择不同的治疗方案。     

针刺阳陵泉结合刺络拔罐治疗肩周炎的临床观察

目的：观察针刺阳陵泉结合刺络拔罐法治疗肩周炎的临床疗效。方法：将80例患者随机分为治疗组42例,对照组38例,治疗组采用针刺阳陵泉、痛点刺络拔罐,对照组采用针刺肩三针的方法。结果：治疗组与对照组比较具统计学意义(P<0.05)。结论：针刺阳陵泉结合刺络拔罐治疗肩周炎疗效显著。     

Functional Impact of Shoulder Taping in the Hemiplegic Upper Extremity

Few methods have been validated for treatment of the painful hemiplegic shoulder. Harness slings and other methods of support have traditionally been applied in an attempt to prevent pain and subluxation, but supports often lead to complications. This paper describes shoulder taping in a patient with right hemiplegia following a cerebrovascular accident and evaluates taping efficacy through measures of activities of daily living, range of motion, and pain before, during, and after treatment. Taping significantly reduced pain and relieved excessive tension on the involved structures. The positive outcome obtained in this patient, in conjunction with other case reports, suggests shoulder taping may be more useful than traditional immobilization methods in the treatment of hemiplegic shoulders.     

Shoulder Disorders Related to Work Organization and Other Occupational Factors among Supermarket Cashiers

Abstract

The study was designed to examine, in 210 supermarket cashiers, the cross-sectional relationships between shoulder disorders according to location and chronicity of pain as well as personal and occupational factors and store and workstation characteristics. The factors associated with shoulder disorders differed for the right and left sides. Age and psychological disorders were significant risk factors. Among occupational factors, duration of employment, job control, wage dependence on efficiency, exposure to cold, movements and postures such as stooping, working with arms above shoulder level and holding heavy loads in position, and using a laser scanner were associated with shoulder disorders, especially on the left. These results confirm the multi factorial origin of shoulder disorders, and show the importance of psychosocial work factors, movements and postures, and the laser scanner as occupational risk factors, and the need to consider right and left shoulder disorders in cashiers separately.     

Sonography as a Tool for Identifying Engaging Hill‐Sachs Lesions

Engaging Hill‐Sachs lesions can be a factor predictive of recurrent anterior shoulder instability, yet no method has been recognized as an effective means to predict engagement. We evaluated the ability of sonography to identify engaging Hill‐Sachs lesions by using a transaxillary approach and dynamic scanning. In patients with engaging lesions, there was an abrupt change in the contour of the humeral head when the shoulder was in 90° of abduction and 90° of external rotation. Sonography therefore has the potential to be a useful preoperative tool in determining which patients may benefit from a surgical repair that also addresses Hill‐Sachs lesions.