共焦显微镜在复发性角膜上皮糜烂综合征治疗中应用

目的：探讨共焦显微镜在指导长期配戴绷带式角膜接触镜治疗复发性角膜上皮糜烂综合征中的价值。

方法：随机选取2014-03/09就诊于我院36例36眼复发性角膜上皮糜烂综合征患者配戴绷带式角膜接触镜,观察戴镜前,戴镜后2、4、8、12wk眼部疼痛和刺激症状、角膜上皮愈合情况、共焦显微镜图像及不良反应情况。

结果：患者在配戴绷带式角膜接触镜后30min眼部的疼痛与刺激症状均得到不同程度缓解,完全缓解者26眼(72%),明显缓解者10眼(28%); 角膜上皮的平均愈合时间5.68±0.73d; 2、4、8、12wk时共焦显微镜下基底细胞形态、排列,上皮下神经纤维密度、走形日渐趋于正常; 临近角膜上皮基底细胞的前基质层炎细胞逐渐消退。观察期间未发现1例与配戴接触镜有关的并发症。

结论：共焦显微镜指导下绷带式角膜接触镜治疗复发性角膜上皮糜烂综合征可以避免过早摘镜,使基底膜与前弹力层紧密粘连,减少复发,是一种简便、安全、有效方法。     

Long-Term Management of Breast Cancer-Related Lymphedema after Intensive Decongestive Physiotherapy

Background Treatment of lymphedema is based on intensive decongestive physiotherapy followed by a long-term maintenance treatment. We analyzed the factors influencing lymphedema volume during maintenance treatment. Method Prospective cohort of 537 patients with secondary arm lymphedema were recruited in a single lymphology unit and followed for 12 months. Lymphedema volume was recorded prior to and at the end of intensive treatment, and at month 6 and month 12 follow-up visits. Multivariate models were fitted to analyze the respective role of the three components of complete decongestive therapy, i.e. manual lymph drainage, low stretch bandage, and elastic sleeve, on lymphedema volume during the 1-year maintenance phase therapy. Results Mean volume of lymphedema was 1,054 ± 633 ml prior and 647 ± 351 ml after intensive decongestive physiotherapy. During the 1-year maintenance phase therapy, the mean lymphedema volume slightly increased (84 ml—95% confidence interval [CI]: 56–113). Fifty-two percent of patients had their lymphedema volume increased above 10% from their value at the end of the intensive decongestive physiotherapy treatment phase. Non-compliance to low stretch bandage and elastic sleeve were risk factors for an increased lymphedema after 1-year of maintenance treatment (RR: 1.55 [95% CI: 1.3–1.76]; P < 0.0001 and RR: 1.61 (95% CI: 1.25–1.82); P = 0.002, respectively). Non-compliance to MLD was not a risk factor (RR: 0.99 [95% CI: 0.77–1.2]; P = 0.91). Conclusion During maintenance phase after intensive decongestive physiotherapy, compliance to the use of elastic sleeve and low stretch bandage should be required to stabilize lymphedema volume.     

Fractionation of the cataleptic bracing response in rats

In haloperidol-treated rats, bracing, i.e., resistance to displacement along a horizontal surface, was found to involve four components: gripping by the digits, extension by the limbs, stiffening of the body axis and arching the vertebral column towards the displacing force. Labyrinthectomy weakened the bracing of the forequarters as did application of a head bandage. Labyrinthectomy, when combined with head bandage, completely abolished all forequarter bracing responses. Neither manipulation affected the bracing responses of the hindquarters. The hindquarter bracing reaction was abolished by application of an abdominal bandage, which left most of the forequarter responses intact. Isolation of fore- and hindquarter bracing responses revealed that whereas gripping by the digits and extension by the limbs could occur independently in either part of the body, stiffening of the body axis and arching of the vertebral column originated in the hindquarters. However, although these latter components of bracing originate in the hindquarters, as evidenced by their abolition with application of an abdominal bandage, their recruitment into the anterior of the body only occurred when the bracing of the forequarters was unimpaired. Either labyrinthectomy or head bandage prevented stiffening and arching of the vertebral column from occurring in the forequarters, even though these procedures had no effect on the hindquarters. Labyrinthectomy, head bandage and abdominal bandage all fractionated the bracing response over a wide range of haloperidol dosages (0.5, 1.0, 2,5, 5,0 and 7.5 mg/kg).     

新型加压绷带在腰椎术后脑脊液漏病人中的临床应用

目的 探讨自行设计的新型加压绷带在腰椎术后脑脊液漏病人中的临床应用。方法 选取2021年4月至2022年4月我科腰椎术后脑脊液漏病人42例,应用随机数字表法分为观察组和对照组,每组21例。观察组脑脊液漏病人使用自行设计的新型加压绷带加压包扎治疗,对照组使用普通腹带加压包扎治疗。观察两组病人加压包扎护理耗时、引流管留置时间和加压包扎处的皮肤情况。结果 观察组加压包扎护理耗时和引流管留置时间均较对照组明显缩短［（1.12±0.24）分 vs. （6.74±1.43）分;（5.09±1.12） d vs. （7.18±1.16） d］,差异均有统计学意义（P＜0.001）。观察组加压包扎处皮肤无异常;对照组发生皮肤异常9例（42.86%）,其中红肿4例、水疱1例、破皮4例。结论 新型加压绷带有助于提高加压包扎的护理效果,缩短加压包扎护理耗时和引流管留置的时间,明显改善病人加压包扎处的皮肤状况,极大地降低了护理不良事件的发生,促进了病人术后的康复。     

功能绷带治疗应力性骨折的随机三盲对照试验

目的 :观察某功能绷带对应力性骨折 (stressfracture ,SF)的治疗效果。设计 :为真实、客观地评价绷带治疗效果 ,采用随机三盲对照试验。研究地点 :中国陕西渭南地区。对象 :以整群抽样的方式选择某部两个步兵团参加 1998年度基础训练全体新兵中发生的SF战士。方法 :所有绷带事先随机分为相等的两组 ,即A绷带组、B绷带组 ,A、B两种绷带外观一样 ,患者、观察者、设计者均不知道何为试验绷带 ,何为对照绷带。单侧伤、双侧伤按就诊的先后顺序 ,发给对应编号的绷带 ,并填写《疗效观察登记表》。使用绷带的伤员必须日夜坚持包扎 ,除使用绷带不同外 ,两组其他措施完全一致。四周为一疗程 ,每周由观察人员随访一次。抽取部分伤员于治疗前后作骨闪烁成像 (ECT)检查各一次 ,观察骨质恢复情况。结果 :16 3例使用绷带的SF战士中 ,A组 12 8个部位 ,B组 12 3个部位。治疗四周后 ,A、B两组治疗后均较治疗前症状好转 ,但两组减轻程度无显著性差异。从ECT显示SF愈合情况看 ,两种绷带均未见明显效果。A、B两组的总有效率分别为 6 7 2 %、 75 % ,统计学检验未见显著性差异。结论 :由于战士受伤后不能得到及时休息 ,仍然带伤训练 ,运动量同治疗前变化不大 ,新的致伤因素仍然存在 ,可能是该绷带疗效不佳的主要原因     

弹性绷带对脑瘫患儿立位及步行功能的作用观察

目的:探讨弹性绷带的应用对脑瘫儿立位及步行功能的影响。方法:立位及步行功能异常的脑瘫患儿71例,随机分为矫正组50例和对照组21例,两组均采用以Bobath技术为主的综合康复治疗,矫正组同时据患儿情况配备弹性绷带进行训练。2组治疗前后用粗大运动功能评定量表(GMFM)对爬和跪、立位、步行等项进行功能评定。结果:治疗3个月后2组患儿GMFM得分较治疗前明显提高(P<0.001),矫正组得分高于对照组(P<0.05)。结论:配备弹性绷带并采用神经生理学疗法为主的综合康复治疗更有利于患儿立位及步行功能的提高。     

乳腺加压弹力绷带与自粘弹力绷带在乳腺病灶麦默通旋切术中的应用效果比较

目的 比较乳腺加压弹力绷带与自粘弹力绷带在乳腺病灶麦默通旋切术中的应用效果.方法 将2011年11月～2012年10月行乳腺病灶麦默通旋切术的230例患者按住院号末位奇偶数随机分为乳腺加压弹力绷带组（A组117例）与自粘弹力绷带组（B组113例）,比较两组术后24h血肿发生率、舒适度及绷带移位情况.结果 两组血肿发生率比较,差异无统计学意义（P＞0.05）.B组绷带移位发生率（23.9％）明显高于A组（0％）（P＜0.01）.A组舒适度明显优于B组（P＜0.01）.结论 乳腺加压弹力绷带应用于乳腺病灶麦默通旋切术中压迫止血的效果可靠,不移位,且佩戴舒适、简便易用.     

高分子石膏绷带固定骨折患者的临床护理

目的观察骨折患者使用高分子石膏绷带固定的临床应用。方法骨折患者66例分别采用高分子石膏绷带固定和传统石膏固定,比较石膏固化特点及舒适度护理特点。结果骨折患者使用高分子石膏绷带固定无一列发生过敏反应,嵌压或折断,而且固化时间短,愈合好。结论高分子石膏绷带固定较传统石膏固定坚固、轻便,固化时间短,透气、透X线,操作方便,无刺激和过敏反应,且利于骨折四肢的护理措施,促进愈合及功能的康复。     

高分子石膏绷带固定骨折患者的临床护理

目的观察骨折患者使用高分子石膏绷带固定的临床应用。方法骨折患者66例分别采用高分子石膏绷带固定和传统石膏固定,比较石膏固化特点及舒适度护理特点。结果骨折患者使用高分子石膏绷带固定无一列发生过敏反应,嵌压或折断,而且固化时间短,愈合好。结论高分子石膏绷带固定较传统石膏固定坚固、轻便,固化时间短,透气、透X线,操作方便,无刺激和过敏反应,且利于骨折四肢的护理措施,促进愈合及功能的康复。     

弹力绷带在胸壁结核清除术后的应用及管理

目的探讨弹力绷带在胸壁结核清除术后的应用效果。方法将156例胸壁结核病灶清除术后患者随机分为两组，观察组（80例）采用弹力绷带加普通胸带加压包扎，对照组（76例）采用普通胸带加压包扎，包扎时间均为3～4周，均采用标准化疗方案正规抗痨治疗6-9个月，比较两组的疗效。结果观察组与对照组的治愈率分别为97．50％和81．58％。皮下积液发生率分别为3．75％和18．42％，复发率分别为2．50％和18．42％。平均住院时间分别为（10．30±1．63）d和（13．50±l：77）d，平均住院费用为（10437．1±1016-4）元和（12034．0±1514．4）元，两组比较差异有统计学意义（P〈O．05）。结论普通胸带加弹力绷带应用于胸壁结核清除术后患者的效果显著，值得临床推广应用。