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71.
目的 探讨斜方肌肌电图在检测肌萎缩侧索硬化(ALS)延髓部下运动神经元损害中的价值.方法 对100例ALS患者、80例颈椎病患者和100名健康志愿者进行斜方肌肌电图检测,AKS组和颈椎病组同时进行胸锁乳突肌、第一骨间肌、腹直肌、胫前肌肌电图检测,比较3组肌电图的差异.颈椎病组中43例患者进行手术前后斜方肌肌电图比较.结果 ALS组中,病程≤8个月的患者斜方肌肌电图自发电位的出现率高于病程>8个月者[分别为21/30(70%)和28/70(40%),X~2=7.56,P=0.004];斜方肌肌电图与胸锁乳突肌肌电图异常率比较差异无统计学意义.ALS组[波幅(1086.9±152.6)μV,时限(17.2±6.5)ms,多相波23.6%±3.4%]与对照组[波幅(606.7±82.7)μV,时限(11.6±1.8)ms,多相波12.8%±2.2%;q=9.27、4.57、4.12,均P<0.01]、ALS组与颈椎病组[术前,波幅(615.7±90.3)μV,时限(12.1±2.0)ms,多相波13.5%±2.4%]间运动单位动作电位(MUAP)各参数比较,差异有统计学意义(q=8.32、4.25、4.23,均P<0.01).颈椎病患者手术前后斜方肌肌电图MUAP各参数无明显变化,5例术后发现少量自发电位.结论 斜方肌肌电图可作为检测ALS延髓部下运动神经元损害的辅助手段,特别是早期可见自发电位增多. 1.6±1.8)ms,多相波12.8%±2.2%;q=9.27、4.57、4.12,均P<0.01]、ALS组与颈椎病组[术前,波幅(615.7±90.3)μV,时限(12.1±2.0)ms,多相波13.5%±2.4%]间运动单位动作电位(MUAP)各参数比较,差异有统计学意义(q=8.32、4.25、4.23,均P< .01).颈椎病患者手术前后斜方肌肌电图MUAP各参数无明显变化,5例术后发现少量自发电位.结论 斜方肌肌电图可作为检测ALS延髓部下运动神经元损害的辅助手段,特别是早期可见自发电位增多. 1.6±1.8)ms,多相波12.8%±2.2%;q=9.27、4.57、4.12,均P<0.01]、ALS组与颈椎病组[术前,波幅(615.7±90.3)μV,时限(12.1± 相似文献
72.
Satoshi Kawaguchi Keiko Horigome Hideki Yajima Takashi Oda Yuichiro Kii Mitsunori Yoshimoto Tsuneo Takebayashi Toshihiko Yamashita 《European spine journal》2010,19(6):901-906
To determine the role of percutaneous vertebroplasty (PVP) in bone formation and the union of vertebral pseudarthrosis, we
analyzed 14 patients with an average follow-up duration of 21 months. Evaluation methods included back pain (visual analog
scale: VAS), wedge angle, dynamic mobility, radiographic remodeling including callus and spur formation, and union status.
The Student's t test was used for statistical analysis and a probability of less than 0.05 was determined as a significant difference. Back
pain improved in all 14 patients with a VAS score of 57.8 ± 23.5 mm (average ± standard deviation) preoperatively and 14.7 ± 16.4 mm
at the final follow-up (P < 0.001). The wedge angle decreased from 21.6° ± 8.3° (average ± standard deviation) preoperatively to 13.2° ± 6.9° at the
final follow-up (P < 0.001). Callus formation was seen in four patients. Bony spurs were seen in the affected vertebra in preoperative radiographs
in all patients, and were further developed to a solidified form during follow up after PVP. Dynamic mobility of the affected
vertebrae was 6.9 ± 2.9 mm preoperatively, which decreased to 1.1° ± 0.7° at the final follow-up (P < 0.001). Notably, all patients showed the dynamic vertebral mobility of 2 mm or less. Nevertheless, only two patients exhibited
the dynamic vertebral mobility of 0 mm at the final follow-up, which is referred to as bone union. These findings indicate
that PVP serves as a mechanical stabilizer for vertebral pseudarthrosis, which leads to immediate pain relief and segmental
bony responses. 相似文献
73.
So-Ra Baek Jae-Young Lim Jung Jae Lee Ki Woong Kim Nam-Jong Paik 《Archives of gerontology and geriatrics》2010,51(3):e46
The aim of this study is to estimate the prevalence of musculoskeletal (MSK) pain in the upper extremities (UE), low back, and lower extremities (LE) in an elderly population, and to identify related factors. In this cross-sectional cohort study, 1118 Korean elderly subjects were randomly selected from residents aged ≥65 years living in an urban city of Korea. The study data included presence of MSK pain, educational levels, activity levels over a 24 h, monthly income, body mass indices and presence of depression. Estimated age- and gender-standardized prevalences of UE, low back, and LE pain were 62.6%, 72.6%, and 45.7%, respectively. The prevalence of LE pain increased with age, whereas those of UE pain and back pain did not. By multivariate analysis, a female gender and a low income were found to be significantly associated with pain at all sites, and obesity was related with low back and LE pain. Furthermore, an uneducated state was found to be associated with LE pain, and major depressive disorder to be obviously related to UE and LE pain. MSK pain was identified to be a common problem in the elderly Korean population, and a female gender was consistently associated with MSK pain. 相似文献
74.
经皮激光汽化减压联合臭氧髓核氧化术治疗椎间盘源性腰痛的效果观察 总被引:1,自引:0,他引:1
目的 探讨经皮激光汽化减压联合臭氧髓核氧化术治疗椎间盘源性腰痛的临床疗效.方法 应用医用半导体激光和医用臭氧,在X线引导下采用18G穿刺针经皮穿刺至髓核区,然后由穿刺针导入600μm光导纤维,用脉冲式激光切割、汽化髓核,以每个椎间盘800~1000J切割、汽化,再向椎间盘注入浓度为60μg/ml臭氧约5~8ml,共治疗74例95节腰椎间盘.结果 按照MACNAB标准评定,74例患者术后随访5~36个月,优64例,良6例,可4例,差0例,优良率94.6%.结论 经皮激光汽化减压联合臭氧髓核氧化术治疗椎间盘源性腰痛,疗效佳,操作简便,创伤小,安全性高,恢复快. 相似文献
75.
目的探讨锁骨下静脉置管两种回血方法的安全性及实用性。方法将120例锁骨下静脉置管患者随机分为两组,观察组60例,采用将输注0.9%生理盐水的输液器调节开关放置于毛菲式滴管以下5cm处,向上牵拉关闭状态的调节器1cm,观察锁骨下静脉置管管腔回血。对照组60例,采用5ml注射器回抽管腔内回血,见到回血后使用配置的肝素盐水脉冲式封管。结果实验组回血率高于对照组、外露管腔可视回血量均衡4±2cm,护理操作时间≤36s,导管感染率降低(P〈0.05)。结论使用输液器调节开关负压原理回血法较注射器回血法外露管腔可视回血量均衡,护理操作快速、简单,避免因管腔内回血量过多污染输液装置而增加导管感染率,提高了护理工作的安全性、有效性,具有临床实用价值。 相似文献
76.
Summary Bone health is generally not considered in patients who present with chronic back pain. Nonetheless, bone health and back
pain share common genetic and environmental correlates suggesting a co-dependence. Evidence exists for a relationship between
back pain and impaired bone health. Here we present the evidence, theoretic framework and clinical relevance.
Bone health and back pain are important determinants of musculoskeletal health. Back pain experienced in youth is a risk factor
for future back pain, while suboptimal bone health during development increases the risk of skeletal fragility in later life.
Generally, bone health is not considered in patients with chronic back pain who do not demonstrate other well-recognised bone
health risk factors or associated conditions. Nonetheless, evidence suggests that back pain and impaired bone health share
common environmental and genetic correlates, indicating that bone health ought to be considered in the context of back pain
in otherwise healthy individuals. This review describes the likely mechanisms explaining the relationship between back pain
and impaired bone health, evidence concerning the relationship and suggestions for future research. A narrative literature
search was conducted using CINAHL, Medline, PubMed and Web of Science electronic databases. A history of back pain is associated
with decreased bone mineral density in adults, yet this tends to be site-specific. No studies were identified examining this
association in youth, yet the negative effects of childhood skeletal trauma and obesity on bone and spinal health provide
indirect evidence for an association. Further research is required to clarify the impact of back pain on bone health at different
lifespan stages using prospective cohort designs. 相似文献
77.
Back pain is the most common reason for using complementary therapies. This analysis of the trial evidence is aimed at determining
whether the evidence base for or against complementary therapies for back pain is getting stronger. Two series of systematic
reviews conducted with the same methodology 5 years apart were compared. The results suggest that the weight of the evidence
has increased between 2000 and 2005 for a number of interventions. The direction of the evidence, however, remained unchanged
for all but one therapy. We conclude that the value of complementary therapies in the management of back pain remains encouraging
but not fully convincing. 相似文献
78.
Objective
We estimated the number of Korean adults with back pain and evaluated population-based associated factors of back pain from a representative sample data from the Fourth Korea National Health and Nutrition Examination Survey.Methods
The number of Korean adults who experienced back pain (experienced patients), those who experienced back pain lasting for three or more months during the past year (chronic patients), and those who were currently suffering from back pain (current patients) were estimated by analyzing the data from the fourth Korea National Health and Nutrition Examination Survey conducted in 2007 using surveyfreq procedure of the SAS statistical package. Population-based odds ratios for being experienced, chronic, and current patient according to demographic (age and gender), socioeconomic (education and occupation), and lifestyle factors (smoking, drinking, and exercise) were estimated using surveylogistic procedure.Results
It was estimated that there were 5,554,256 (proportion, 15.4%; 95% CI, 4,809,466 - 6,299,046) experienced patients, 2,060,829 (5.7%; 1,557,413-2,564,246) chronic patients, and 3,084,188 (8.5%; 2,600,197 - 3,568,179) current patients among 36,107,225 Korean adults aged 20-89 years in 2007. Each of explanatory variables was significantly associated with at least one of the response variables for back pain.Conclusion
Based on our study results, further efforts to investigate epidemiology of back pain, to evaluate associated factors, and to improve treatment outcomes are needed. 相似文献79.
Murphy DR, Morris NJ. Transitional cell carcinoma of the ureter in a patient with buttock pain: a case report.This case reports on a patient with an unusual presentation of a rare tumor: urethral transitional cell carcinoma (TCC). Urethral TCC occurs in approximately 0.7% to 4.0% of patients who have had primary bladder cancer. The initial symptoms usually involve hematuria, with approximately a third of patients reporting flank area pain. Buttock pain and the absence of hematuria are uncommon with this disorder. The patient was initially suspected to have piriformis syndrome, but when he did not respond as expected to treatment, and because of his history of primary bladder cancer, further evaluation was undertaken and the diagnosis was made. The patient responded well to radiation and chemotherapy. Musculoskeletal physicians should be particularly suspicious of the presence of urethral TCC in a patient with a history of primary bladder cancer who reports low back or buttock pain, particularly if the patient does not respond quickly to treatment. 相似文献
80.
Beattie PF Nelson RM Michener LA Cammarata J Donley J 《Archives of physical medicine and rehabilitation》2008,89(2):269-274
Beattie PF, Nelson RM, Michener LA, Cammarata J, Donley J. Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective, case series study.