椎缘骨的临床X线诊断

椎缘骨的临床Ｘ线诊断周桂林椎缘骨（ｌｉｍｂｕｓｖｅｒｔｅｂｒａ）是由椎间盘内容物在椎体边缘与软骨板相连接处疝入到椎体内所致，在椎体边缘产生一个或一个以上三角形游离骨块［１，２］，又称椎前缘软骨结节（ａｎｔｅｒｉｏｒｍａｒｇｉｎａｌｃａｒｔｉｌａｇｉｎ...     

椎板后移回植的椎管扩大术治疗椎管狭窄症

作者报告棘突劈开、椎板后移回植的椎管扩大术治疗椎管狭窄症１８２例，使椎管容积扩大３４．８％，横径扩大３．８ｍｍ，矢径扩大６．１ｍｍ。随访２年９个月，优良率８６．６％，椎板愈合率９６．９％。本文探讨少数椎板迟延愈合的原因和预防措施，如斜切椎板、缝合固定和腰背筋膜与棘上韧带悬吊缝合等。术后卧床１０～１２周，用石膏型保护。作者认为本法能有效的预防术后脊柱不稳，顽固性腰痛等并发症。     

椎—基底动脉闭塞病理临床分析

本文以１６例椎－基底动脉闭塞的病理，临床资料为基础，探讨了病理与临床特点，椎－基底动脉闭塞以基底动脉中段多见，栓塞多于血栓，病变主要波及桥脑、枕叶、颞叶及丘脑。约半数病人并存基底节区梗塞。本组病理资料提示脑动脉粥样硬化是发病的重要条件，也是本病常见于老年人的病理基础。起病时常见的症状有眩晕、呕吐、偏侧或双侧肢体瘫痪，言语不清及突然意识不清等。病变过程中比较有特征体的体征有眼肌麻痹、眼球震颤、构音障     

椎─基底动脉闭塞病理临床分析（附16例尸解资料）

本文以１６例椎—基底动脉闭塞的病理、临床资料为基础，探讨了病理与临床特点。椎—基底动脉闭塞以基底动脉中段多见，栓塞多于血栓。病变主要波及桥脑、枕叶、颞叶及丘脑。约半数病人并存基底节区梗塞。本组病理资料提示脑动脉粥样硬化是发病的重要条件，也是本病常见于老年人的病理基础。起病时常见的症状有眩晕、呕吐、偏侧或双侧肢体瘫痪、言语不清及突然意识不清等。病变过程中比较有特征性的体征有眼肌麻痹、眼球震颤、构音障碍、双软腭提举力差、双侧肢体瘫痪、双侧病理反射阳性。ＣＴ对本病诊断的帮助不大。     

寰枢椎椎弓根钉固定治疗伸直型齿状突骨折合并寰枢关节半脱位

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.     

静注碳酸氢钠联合西比灵治疗眩晕50例临床观察

我院2001年2月～2003年10月试用静脉注射5％碳酸氢钠佐以口服西比灵治疗眩晕50例，获得良好效果，报告如下：     

倍他司汀治疗椎基底动脉供血不足的疗效观察

目的 观察倍他司汀治疗椎基底动脉供血不足的疗效及不良反应。方法 96例患者随机分成两组，治疗组49例，对照组47例。治疗组用倍他司汀治疗，对照组用曲克芦丁治疗，观察两组疗效。结果 治疗组有效率（95.9％）高于对照组（78.7％），有显著性差异（P〈0.05）。结论 倍他司汀注射液治疗椎基底动脉供血不足安全有效。     

抗结核药物引起肝损伤1例

患者女，77岁。因椎基底动脉供血不足、高血压入院。入院体检：神清，平卧位，皮肤及巩膜无黄染，浅表淋巴结未及肿大，BP160／110 mmHg，二肺呼吸音略粗，心率80次／分，齐，腹平软，肝脾肋下未及，移动性浊音阴性，双下肢浮肿阴性。给予活血化瘀及对症治疗，病情稳定。入院后2月余患者诉皮肤瘙痒，伴胃纳减退，当时未予重视，以后症状逐渐加重并出现皮肤黄染，[第一段]     

椎－基底动脉TIA的BAEP转颈试验研究

本文对５０例椎－基底动脉－过性脑缺血发作（ＶＢ·ＴＩＡ）患者于发作间歇期进行了脑干听觉诱发电位（ＢＡＥＰ）转颈试验的研究。结果表明：ＢＡＥＰ转颈试验后，ＶＢ·ＴＩＡ患者的ＢＡＥＰ异常率，由转颈前的４８％显著地增高到８０％（Ｐ＜０．００５）。其ＢＡＥＰ异常主要表现为ＰＬⅠ、ＰＬⅤ、ＩＰＬⅢ～Ⅴ的延长。相比之下，对照组转颈前后ＢＡＥＰ变化无显著性（Ｐ＞０．０５）。由此提示血液动力学因素在本病的发病机制中起着极为重要的作用。