寰椎后桥的X线诊断和临床意义

目的探讨寰椎后桥的临床意义,以提高对寰椎后桥的认识。方法回顾2009年1月至2012年10月期间24例寰椎后桥患者,并分析其成因及临床症状。结果在24例患者中,单纯性寰椎后桥10例．伴骨质增生或椎间盘病变14例;仅有头颈部不适者4例,外伤检查发现1例,发作性眩晕或上肢无力麻木者19例。结论寰椎后桥可以作为颈性眩晕的病因之一,应引起影像科医生及临床医生的重视。     

通心络胶囊佐治后循环缺血性眩晕和预防复发的疗效观察

目的观察通心络佐治后循环缺血性眩晕(PCIV)的临床疗效和对眩晕复发的预防作用。方法将126例PCIV患者随机分为2组,在常规治疗基础上,治疗组和对照组分别口服通心络和甲磺酸倍他司汀治疗,疗程均为15 d,比较2组临床疗效和治疗前后经颅多普勒超声指标,以及药物不良反应、血压、肝功能、肾功能情况。在出院的患者中选择90例随机分为3组(各30例),分别给予小剂量通心络、敏使朗预防治疗以及无药物治疗,观察3年内眩晕的复发情况。结果治疗组痊愈率、总有效率明显高于对照组(P<0.05,P<0.01)。治疗组在改善椎—基动脉的平均血流速度、降低动脉指数和血管阻力指数、频谱图改善等方面明显优于对照组(P均<0.05)。不良反应2组比较差异无统计学意义(P>0.05),且治疗后血压、肝肾功能无变化。在随访观察的3年中,眩晕复发率通心络预防治疗组<对照组<空白对照组(P<0.05,P<0.01)。结论通心络在佐治PCIV和预防眩晕复发方面均有良好效果。     

中医对脊柱相关疾病中眩晕与腰痛的认识

脊柱相关疾病是指颈、胸、腰椎的骨关节、椎间盘及椎周围软组织遭受损伤或退行性改变，在一定诱因条件下发生脊柱小关节错位、椎间盘突出、韧带钙化或骨质增生，直接或间接对神经根、椎管内外血管、脊髓或交感神经等产生刺激或压迫，导致脊椎损伤疾患以外的多系统症状和体征的疾病。本文将对眩晕和腰痛从中医的病因病理、与经络的关系、治疗方法等方面做一综述。     

Assessing vestibular function: which tests, when?

Vertigo and dizziness are common complaints encountered in clinical practice. The patient’s history and a thorough otoneurological evaluation are essential for identifying the specific pathology behind the patient’s complaints. If the patient reports an illusion of movement (vertigo), this most likely indicates an imbalance within the vestibular system. A sensation of rotatory movement together with a spontaneous nystagmus suggests a lesion involving the semicircular canals, while an illusion of linear movement indicates a disturbance of the otoliths. Nystagmus of central origin or caused by a peripheral vestibular lesion can usually be distinguished by other features in the history or on clinical examination. While peripheral vestibular lesions usually lead to a mixed horizontal-torsional or vertical-torsional nystagmus, a pure vertical or pure torsional nystagmus is always caused by a central lesion. With simple bedside tests such as head-shaking nystagmus and rapid head impulses deficits in labyrinthine function can clearly be detected. For a more thorough investigation of vestibular function at the level of individual semicircular canals and the otoliths, modern techniques are now available such as three-dimensional eye movement vector analysis for the evaluation of individual semicircular canal function, measurement of the subjective visual vertical for utricular, and click-evoked myogenic potentials for saccular testing. Received: 3 October 1999/Accepted: 7 December 1999     

补肾活血法在老年病治疗中的运用

目的:探讨老年病的基本病机和治疗方法.方法:分析老年病基本病因病机及几种常见老年病的病理基础、临床治疗用药.结果:补肾活血法对老年病有很好的治疗效果.结论:肾虚血瘀是老年病的病理基础,补肾活血法当贯穿老年病治疗过程的始终.     

维生素B12足三里穴位注射治疗眩晕的临床疗效观察

目的 探讨维生素B12足三里穴位注射治疗眩晕的临床疗效.方法 2011年1月至2012年1月我科门诊治疗的150例眩晕症患者,随机分为观察组78例和对照组72例.对照组给予常规药物治疗,观察组在此基础上辅以足三里穴位注射维生素B12.结果 观察组总显效率为89.7％,对照组为63.9％,两组疗效差异有显著性(P＜0.05).结论 足三里穴位注射维生素B12治疗眩晕症可以明显减轻患者临床症状,方法简单,安全有效,值得推广.     

纳洛酮不同给药途径治疗眩晕110例疗效观察

目的观察应用纳洛酮不同给药途径治疗眩晕的临床疗效。方法将110例眩晕患者随机分为A组50例与B组60例。A组给予纳洛酮0．4mg加入10％葡萄糖20mL静脉注射,每日1次;B组给予纳洛酮0．4mg肌肉注射,每日1次。比较两组疗效。结果两组疗效差异无统计学意义。结论纳洛酮治疗眩晕疗效确切,起效快,安全可靠。     

水平半规管良性阵发性位置性眩晕的临床特点

目的 探讨水平半规管良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特点.方法 回顾性分析2003年8月至2010年12月诊治的239例水平半规管BPPV患者的临床表现.结果 水平半规管BPPV占同期全部BPPV患者的25.7％(239/931).平卧侧头试验见水平向地性眼震者197例,眼震的平均潜伏期为(0.88±0.72)s,持续时间(26.36±19.71)s;水平离地性眼震者42例,平均潜伏期(2.69±1.83)s,持续时间(53.48±43.12)s;其中39例眼震表现为水平略带扭转向上而非纯水平,占16.3％(39/239).离地组眼震潜伏期明显长于向地组(t=-6.33,P＜0.001),眼震持续时间亦明显长于向地组(t=-3.99,P＜0.001).水平向地性眼震者予以Barbecue翻滚法治疗,192例经(1.6±0.8)个循环复位成功;水平离地性眼震者经左右侧头训练后,40例眼震转化为向地性,经(1.9±0.8)个循环后复位成功.结论 水平半规管BPPV占同期BPPV的比例较预期高.水平向地性眼震患者可直接给予Barbecue翻滚法治疗,水平离地性眼震患者应先行左右侧头训练,再给予Barbecue翻滚法复位.     

Effects of Betahistine Metabolites on Frog Ampullar Receptors

Conclusion. Our technique can decrease the formation of retraction pockets and improve hearing function. The wheel-shaped cartilage-perichondrium composite graft (Wheel CPCG) can be considered a good material for a drum graft, and it is easy to insert a ventilation tube, in case of initial drum retraction. Objective. The purpose of this study was to introduce the novel surgical technique of a Wheel CPCG with one-stage ossiculoplasty to prevent a retraction pocket and subsequent cholesteatoma after intact canal wall tympanomastoidectomy. Patients and methods. A total of 47 patients were reviewed; 43 cases were selected for audiologic testing. The results of operations were evaluated by comparing preoperative and postoperative hearing results and postoperative drum findings. Results. A retraction pocket was observed in three cases (6.7%). Slight protrusion of partial ossicular replacement prosthesis (PORP) and lateral healing of drum was observed in one case each, and there were two cases of postoperative infection. The number of cases with an air–bone gap (ABG)<20 dB increased from 9 (23%) cases before operation, to 20 cases (51%) after operation. The ABG average statistically decreased from 30.0 dB to 24.0 dB, and the mean air conduction thresholds decreased from a preoperative level of 47.3 dB to a level of 35.7 dB.     

白芍木瓜汤治疗椎--基底动脉供血不足性眩晕

观察白芍木瓜汤治疗椎－基底动脉供血不足性眩晕的疗效。设白芍木瓜汤治疗组30例和尼莫地平片加维及路通片对照组26例,疗程均为1个月。结果治疗组有效率90．0％,对照组有效率76．9％,P＜0．05。提示白芍木瓜汤治疗椎－基底动脉供血不足性眩晕疗效显著。