红花注射液预防屈指肌腱损伤术后肌腱粘连的临床观察

目的评价红花注射液预防肌腱粘连的疗效。方法 60例屈指肌腱损伤患者,随机分成红花注射液组和迪康生物膜组,肌腱吻合术后分别应用红花注射液喷涂和生物膜包裹预防肌腱粘连。观察术后4周和8周肌腱总主动活动度及屈指肌腱肌力的变化。结果 60例患者创口均I期愈合,术后4周红花注射液组肌腱总主活动度优于对照组(P<0.05),术后8周肌腱总主活动度差异无统计学意义(P>0.05),术后指抓屈力量2组比较差异无统计学意义(P>0.05)。结论红花注射液可应用于预防屈指肌腱损伤术后肌腱粘连。     

益气温阳—养阴解痉中药治疗中风偏瘫肢体痉挛随机平行对照研究

[目的]观察益气温阳,养阴解痉中药治疗中风偏瘫肢体痉挛疗效。[方法]使用随机平行对照方法,将30例住院及门诊患者按诊顺序号方法分为两组。对照组15例巴氯芬,5mg/次,1次/d,口服。治疗组15例益气温阳,养阴解痉(黄芪、党参、白芍、石斛、桂枝、桑枝、地龙、甘草等),1剂/d,水煎400m L,早晚温服。两组均连续治疗28d为1疗程。观测临床症状、血液生化指标、《Barthel氏ADL指数法》评分、不良反应。治疗1疗程,判定疗效。[结果]治疗组痉挛疗效显效4例,有效9例,无效2例,总有效率86.70%。对照组显效3例,有效8例,无效4例,总有效率73.33%。治疗组疗效优于对照组(P0.05)。Bathel指数变化治疗组优于对照组(P0.01)[结论]益气温阳,养阴解痉中药治疗中风偏瘫肢体痉挛效果显著,值得推广。     

The biceps tendons: From the top and from the bottom

The biceps brachii muscle, which inserts proximally onto the scapula and distally onto the forearm, has several tendons with numerous anatomic peculiarities, which render their sonographic examination highly variable. Proximally, the tendon of the short head of the biceps inserts onto the coracoid process and that of the long head on the superior aspect of the glenoid. The distal biceps tendon is bifurcated, and it generally inserts on the radial tuberosity, around which it rolls during pronation/supination. There is a third distal structure, the Lacertus fibrosus, an aponeurosis that branches off from the medial aspect of the tendon, crossing the median artery and median nerve, and inserting on the superficial aponeurosis of the flexor muscles. The sonographic examination of these tendons focuses on nine separate zones of interest: the glenoid insertion of the long head, its extension to the upper pole of the humeral head, the rotator interval, the reflection to the upper bicipital groove, the bicipital groove, the upper myotendinous junction, the lower myotendinous junction, the distal tendon(s), and the inferior enthesis. Because of their morphological and topographical characteristics, the biceps tendons are subject to a variety of lesions, some of which are frequently misdiagnosed on the basis of clinical findings. Ultrasound plays an important role in detecting and characterizing these lesions. Proper examination of the biceps (the distal portion in particular) is a difficult task that cannot be improvised.     

手部动力支具在多区肌腱损伤修复术后的应用

【】目的：探讨手部动力支具在多区肌腱修复术后的临床应用效果。方法：选取2016年6月～2018年6月我院收治的81例肌腱损伤患者,采用随机数表法分为支具治疗组45例和对照组36例,分别予安装手部动力支具功能锻炼及常规治疗,患指肌腱修复后功能用TAM[总主动活动度测定法(total active movement,TAM)]评定。结果：随访3个月,支具组综合优良率为87.9％,对照组综合优良率为63.9％ ,两组间差异有显著性意义(P<0．05);支具治疗组二次松解手术率明显低于常规治疗组,组间数据对比差异显著(X₂=3.854,p=0.048),且未发生不良反应。结论：手部动力支具能较明显地减轻肌腱修复术后粘连的发生,降低二次手术的几率,由此可见手部动力支具在在肌腱修复术后的康复治疗是安全有效的。