出口梗阻性便秘手术的护理体会

目的：总结直肠前突及直肠黏膜脱垂患者手术护理体会，进一步提高患者的护理质量。方法．28例用手按压阴道后壁排出粪便，多数患者长期服用导泻药物以协助排便。结果：对本组38例直肠前突和直肠黏膜脱垂患者经过积极的手术治疗和实施护理措施，大便排出困难均明显得到改善，临床症状消失，减轻了患者的痛苦，取得了良好效果，33例患者每日排便1次，有3例为每日排便2次，2例每2—3天排便1次。避免了并发症，使患者尽快的康复。结论：对直肠前突和直肠黏膜脱垂患者实施的本护理措施是有效的，提高了临床治愈率。缩短了患者住院时间，使他们早日康复。     

口腔颌面部血管瘤综合治疗疗效评价

目的:对血管瘤综合治疗的不同方法进行疗效评价。方法:对160例血管瘤患者进行统计,其中外科手术治疗60例,平阳霉素硬化治疗33例;鱼肝油酸钠硬化治疗27例,采用瘤周环扎和瘤内缝扎硬化治疗20例,冷冻治疗7例,激光治疗13例,结果:治疗后3~8年随访观察,单纯手术组治愈率为83.3%;非手术组中,平阳霉素硬化治疗、鱼肝油酸钠硬化治疗、瘤周环扎和瘤内缝扎硬化治疗、冷冻治疗、激光治疗治愈率分别为60.6%,44.4%,65.0%,28.6%,23.0%。手术治疗组与非手术治疗组间存在显著性差异(P<0.05)。结论:手术治疗是目前治疗口腔颌面部血管瘤理想、有效的主要方法,非手术治疗也可作为综合治疗血管瘤的辅助手段。     

骶管与硬膜外阻滞治疗腰椎间盘突出症疗效对比研究

目的 研究骶管阻滞与硬膜外阻滞治疗腰椎间盘突出症临床应用价值,并对骶管阻滞的技术操作及适应证和禁忌证进行探讨.方法 腰椎间盘突出症患者120例采用骶管阻滞(骶管组),于骶管腔注入(曲安奈德40 mg、维生素B1 100 mg、维生素B12 1 mg、2%利多卡因100 mg,用0.9%氯化钠稀释为20～30 ml),2周1次,3次为1个疗程.并与硬膜外阻滞治疗腰椎间盘突出症患者120例(硬膜外组)的疗效进行对比观察.结果 一次性穿刺成功率骶管组为93.3%(112/120),硬膜外组为82.5%(99/120),两组比较差异有统计学意义(P<0.05).治疗后骶管组、硬膜外组优良率分别为85.0%(102/120)、93.3%(112/120),差异无统计学意义(P>0.05);可差率分别为15.0%(18/120)、6.7%(8/120),差异有统计学意义(P<0.05).结论 骶管阻滞和硬膜外阻滞均为治疗腰椎间盘突出症的有效疗法,能较快解除神经根压迫症状和强迫体位.而骶管阻滞较硬膜外阻滞操作简单、安全性较高.     

The relationship between static and dynamic occlusion in 14-17-year-old school children

This study investigated the relationship between static and dynamic occlusion in school children. A total of 447 subjects, within an age range of 14-17 years with no history of orthodontic treatment or trauma to the teeth were included in this study. Static occlusion was determined for both incisal and molar relationship. Dynamic occlusion was determined in lateral and protrusive movements of the mandible. The majority of the subjects had class I static occlusion for both incisor and molar relationship (45 and 54%, respectively). Canine-guided occlusion was the dominant type of dynamic occlusion (57%) and most of the subjects had no posterior contact in protrusive movement (78%). There was an association between canine guidance with class II static occlusion. Statistically, a significant relationship was found between the dynamic and static occlusion of the incisor (P < 0.001) but not with the molar (P > 0.05).     

Correlation of intravesical prostatic protrusion with bladder outlet obstruction

OBJECTIVES: To determine the effect of intravesical protrusion of the prostate (IPP, graded I to III) on lower urinary tract function, by correlating it with the results of a pressure-flow study. PATIENTS AND METHODS: In a prospective study men (aged> 50 years) with lower urinary tract symptoms were initially evaluated as recommended by the International Consultation on Benign Prostatic Hyperplasia, together with the IPP and prostate volume, as measured by transabdominal ultrasonography. These variables were then correlated with the results from a pressure-flow study. RESULTS: The IPP was a statistically significant predictor (P < 0.001) of bladder outlet obstruction (BOO) compared with other variables in the initial evaluation. In all, 125 patients had significant BOO, defined as a BOO index of> 40. Of these men, 94 had grade III and 30 had grade I-II IPP. Seventy-five patients had a BOO index of < 40; 69 had grade I-II and six grade III IPP. In patients with BOO confirmed on the pressure-flow study, grade III IPP was associated with a higher BOO index than was grade I-II (P < 0.001). CONCLUSION: The IPP assessed by transabdominal ultrasonography is a better and more reliable predictor of BOO than the other variables assessed.     

腰椎间盘突出症微创手术

腰椎间盘突出症是一种常见病、多发病,是引起腰痛或腰腿痛的主要原因。腰椎间盘突出症除保守治疗和开放手术外,近年开展的微创介入手术治疗正逐渐被临床认识和应用。微创外科手术治疗腰椎间盘突出症具有疗效显著,损伤小,并发症少,术后恢复快等优点。正确认识腰椎间盘微创手术,严格适应证和熟练的操作技巧是取得良好疗效的关键。     

腰椎间盘突出症术后复发疼痛的治疗

为了有效治疗腰椎间盘突出症术后疼痛的复发,对１１ 例患者采用硬膜外注射皮质类固醇。所用药为０－５％利多卡因１０～１５ｍｌ,内含曲安缩松４０ｍｇ。每周１ 次,３ 次为１ 疗程。结果：随访３～４２ 个月,１０ 例疼痛消失,１ 例症状无改善。笔者认为对腰椎间盘突出症术后因外伤性蛛网膜炎,或神经根粘连导致的疼痛复发,硬膜外注射类固醇效果理想,且可避免再次手术。为避免曲安缩松引起的轻度脊膜增厚及粘连,可采用增大注射容量,冲淡药物浓度。     

Orthodontic camouflage treatment of skeletal class II malocclusion with severe maxillary dentoalveolar protrusion

This case report describes the orthodontic treatment of a 14-year-old male patient who presented with prognathic maxilla, severe dentoalveolar proclination, deepbite and retained deciduous tooth. We selected headgear and fixed appliance to correct malocclusion but cooperation towards headgear was found less during treatment. So we chose orthodontic camouflage treatment to correct dentoalveolar problems without altering the skeletal base relation. The final treatment results were good and patient had improvement in esthetic and function.     

腰椎间盘MRI或T2相变化与冯氏临床分型（四步腰型）关系的研究

目的探讨腰椎间盘突出症患者MRI T2相信号、性别、年龄、病程、临床分型之间的关系,验证冯氏临床分型与腰椎间盘MRI T2相信号变化的相关性。方法本研究收集102例腰椎间盘突出症患者的临床资料,根据腰椎间盘MRI T2相信号分3型,根据临床分型分为A、B两组,对患者性别、年龄、病程、腰型、腰椎间盘T2相信号变化,用医学统计软件spss13.0进行秩和检验和非参数相关性检验。结果1、MRI T2相信号与性别、年龄不相关;2、MRI T2相信号变化与临床分型密切相关,结论椎间盘T2相信号变化与临床分型有很强的相关性,但要结合临床综合判断,我们要重新认识椎间盘T2相信号变化的临床意义。     

腰椎后路椎间盘镜治疗腰椎间盘突出症82例疗效分析

目的：探讨后路椎间盘镜治疗腰椎间盘突出症（LDH）的手术技巧及其手术并发症的防治。方法：应用显微外科技术对82例LDH病人行手术治疗，术后采用Macnab标准评估疗效。结果：82例均随访3个月～1年，平均为5个月。疗效优69例（84％），良11例（13．4％），差2例（2．4％），优良率97．6％。术中出血60-250ml，平均120ml。手术时间50min～3h。结论：腰椎后路椎间盘镜手术减压充分、适应证宽、创伤小、出血少、术后恢复快。