腰椎间盘突出症患者术前心理状态及社会支持的调查

目的研究腰椎间盘突出症患者术前心理状态及社会支持的关系。方法应用社会支持评定量表、自我评定焦虑量表和自我评定抑郁自评量表对40例腰椎间盘突出症患者进行术前调查。结果①自我评定焦虑自评量表的评分高于常模(P<0.05);②自我评定抑郁量表的评分高于常模(P<0.05);③通过相关分析可以看出本组患者的自我评定焦虑量表、自我评定抑郁量表与社会支持评定量表呈负相关(P<0.05)。结论本组腰椎间盘突出症患者存在明显的焦虑与抑郁情绪;社会支持差者焦虑、抑郁程度重,其发生受多种因素的影响。     

CT导引下腰椎间盘造影的技术应用

目的：探讨CT导引下对腰椎间盘造影的作用和CT操作技术。材料与方法：用300mg/ml欧乃派克对27例患者49例椎间盘经CT检查证实为腰椎间盘突出的进行穿刺造影，包括L45椎间盘22例，L5-S1椎间盘27例，穿刺时病人俯卧位。结果：穿刺成功率100％，22例患者39例椎闻盘注射造影荆引起疼痛，6例患者10例椎间盘注射造影剂时引起道疼痛，77.8％的病人确诊疼痛来源。本组无并发症。结论：CT导引下对腰椎间盘造影术是诊断腰腿痛痛源的好方法。     

硬膜外间隙注药配合牵引治疗腰椎间盘突出症

目的观察硬膜外间隙注药配合牵引治疗腰椎间盘突出症。方法162例经体查，X线、CT、MRI摄片确诊为腰椎间盘突出症。硬膜外间隙注入利多卡因lmg／kg与强的松龙lmg／kg的混合液10ml，注药1次／7d，3次为一疗程。并行牵引4h／d。结果疗效优良率94．4％。结论此疗效确切。     

视网膜母细胞瘤临床误诊36例分析

视网膜母细胞瘤（retinoblastoma，Rb）是婴幼儿最常见的眼内恶性肿瘤，对视力和生命有严重的威胁。现将我院1985年7月～2005年7月收治的36例临床诊断为Rb而行眼球摘除，病理诊断为非Rb的病例进行临床分析。     

正脊加调盆手法治疗腰椎间盘突出症临床观察

腰椎间盘突出症是临床常见病，尤以中老年患者多见。2004年以来，笔者以正脊加调盆手法治疗本病95例，并与采用腰部微波热疗法进行对照观察，现报告如下。     

Effect comparison between sacral blocking and massage combined with traction on protrusion of lumbar intervertebral disc

Background:Epidural injection is an important method in treatment of protrusion of lumbar intervertebral disc.Especially in the recent decade sacral injection is adopted more and more often.Objective:To compare the clinical effects of sacral blocking and massage combined with traction.Unit:Yinhe Hospital of Beijing.Subjects:290 outpatients with grade Ⅱ of ASAI were selected from May,1994 to July,2000.Patients were randomly divided into observation group(n=145)and control group(n=145).Sacral blocking was adopted in observation group and 80 males and 65 females aged 20-78(mean:46.4)years old were included with disease course 3 days to 30 years.Massage combined with treaction was adopted in control group and 74 males and 71 females aged 22-74(mean:44.9)years oled were inmcluded with disease course 2 days to 10 years.Interention:Sacral blocking:Operation was according to sacral blocking and druge(dexamethasone injection,2 mg;0.75% bupivavaine hydrochloride,5 ml;saline,50ml) were injected slowly after success of puncture.Patient rested for 0.5h after injection and left treatment room if no adverse effects occurred.Massage combined with traction:Massage was adopted after traction to every patients.(1)Massage:Patient was seated at square stool and lower limbs separated naturally with same width of shoulders.Doctors sit behind patient.First,thubs of both hands were pressed on projecting part near spinous process(pressing points were selected according to different projecting part).Flexing and extending forward and backward were taken at the same time and extent was ddecided addording to patients‘ maximal endurable degree,5-10 timmes.Upper part of body was turned 45 degrees to left and right.Massage was still taken to affected part,3-t times.(2)Traction:Pelvis was extracted with general physical therapy and massage table.Supine position,chest and treaction bandage were fixed,tractiron wheel was turned slowly until patient felt comfortable with maximal endurance as limit(traction force,20-40kg),After extracting for 5 minutes,massagee switch was turned on to take rolling massage to bck and both lower libmbs.Traction force was increased every5 minutes and limit was still according to patient‘s maximal endurance,30 minutes for every time,once a day and ten times as a therapeutic course.Cohclusion:Effect of sacral blocking on protrusion of lumbar intervertebral disc was positive and fewer therapeutic time were needed.Massage combined with traction was also effective,safe and no adverse effects wer observed,but more therapeutic times were neeeded and inconveinient.     

三棱莪术散外敷治疗急性中央型腰椎间盘突出症52例

中央型腰椎间盘突出症是临床常见病、多发病。笔者自2002年7月～2004年7月，两年间用三棱莪术散外敷治疗急性中央型腰椎间盘突出症52例，收到了满意的疗效。现总结如下：     

腰椎病的7大症状

随着现代生活节奏的加快,腰椎间盘突出症逐渐成为了常见病。以往以年龄大的患者居多,而近年来以学生、电脑工作者、汽车司机及年轻"白领"居多,并有年轻化趋势。人的脊柱俗称脊梁,支撑人的骨架,由很多块椎骨组成。椎骨之间有一片富有弹性的软骨样衬垫,称为椎间盘。从胚胎到出生,这个衬垫到20年后达到发育高峰,以后开始走下坡路。这时人体椎间盘开始缩水,椎间盘逐渐变性,加之在日常生活中,经常受到挤压、牵拉、扭转等外力作用,很容易受伤,便出现纤维环破裂,即椎间盘突出。腰椎间盘突出的临床表现主要有大症状:腰背部疼痛。这种疼痛出现在腿痛之前,也可同时出现。疼痛主要在下腰部,一般是钝痛、刺痛或放射性疼痛。下肢放射性疼痛。在突出后期常表现为腿痛重于腰背痛或仅有腿痛。麻木及感觉异常。腰椎间盘突出后,可造成神经根接触区域的局部性压迫和牵扯性压迫,使神经根本身的纤维和血管受压而导致缺血缺氧,表现为麻木或患肢发凉。肌肉瘫痪。腰椎间盘突出物压迫神经根时间较长,可造成神经麻痹、肌肉瘫痪。间歇性跛行。行走时,椎管内受阻的椎静脉丛充血,加重了神经根的充血程度和脊髓血管的扩张,同时也加重了神经根的压迫而出现间歇性跛行及疼痛。脊柱姿势改变。腰椎间盘突出后约有90%以上的患者有不同程度的功能性脊柱侧凸,多数凸向患侧,少数凸向健侧,主要看突出物与神经根的关系。侧弯是减轻突出物对神经压迫的一种保护性措施。马尾综合征。表现为会阴区麻木、排便和排尿无力或不能控制。男性可出现阳痿。1234567     

腰椎间盘突出症患者围手术期心理护理体会

目的观察心理护理对椎间盘突出症患者围手术期配合程度及住院时间的影响。方法随机将确诊为腰椎间盘突出症且需手术治疗的60例患者均分为两组：观察组和对照组。观察组：术前针对不同患者的心理特点，为患者提供相关信息．以矫正患者的不正确认识，消除其不必要的忧虑和恐惧；术后则针对患者术后心理的变化通过多层次进行心理疏导。对照组：不采用针对性心理护理。结果观察组术中配合程度显著优于对照组（P〈0．01）；平均住院时间较对照组减少8&#177;1．41d（P〈0．01），具有显著的临床意义。结论对腰椎间盘突出症患者围手术期进行针对性心理护理可显著增强患者术中的配合．促进患者术后的恢复，缩短住院时间，减轻患者经济负担，节约医药资源，具有一定的I临床意义和实用价值，值得推广应心。