腰椎间盘突出症临床诊疗的经验探讨

腰椎间盘突出症（LDH）是临床上引起腰腿痛最常见的一种疾病,尽管腰腿痛的病因很多,但腰椎间盘突出症在腰腿痛中占有举足轻重的地位已得到公认。据目前的统计资料表明,腰椎间盘突出症病人约占门诊腰腿痛患者的15%左右,占住院腰腿痛患者的40%左右,美国每年约有200万人患有此症,我国有80%的成年人均有不同程度、不同原因的腰腿痛,这其中20%左右被诊断为腰椎间盘突出症。而且,随着人们生活节奏的加快,腰椎间盘突出症的发病率正在逐年增高,严重影响了人们的正常工作状态及生活质量。     

补肾健脾通络汤治疗骨质疏松症临床观察

目的探讨补肾健脾通络汤治疗骨质疏松症的临床效果。方法选取2017年3月—2018年3月收治的98例骨质疏松症患者,利用随机数字表法分为2组,各49例。对照组采用益肾健骨片+钙尔奇片治疗,在此基础上,观察组加用补肾健脾汤治疗,对比2组临床疗效、骨密度、疼痛情况及中医证候积分。结果观察组治疗总有效率(95. 92%)较对照组(79. 59%)高,差异有统计学意义(P 0. 05);治疗前,2组患者骨密度、VAS评分及中医证候积分对比,差异无统计学意义(P 0. 05);治疗后,2组患者骨密度均升高,且观察组[(0. 79±0. 25) g/cm2]较对照组[(0. 70±0. 18) g/cm2]高,差异有统计学意义(P 0. 05);治疗后,2组患者VAS评分及中医证候积分均降低,且观察组[(2. 19±0. 26)分、(4. 67±0. 95)分]较对照组[(3. 24±0. 31)分、(8. 23±1. 12)分]低,差异有统计学意义(P 0. 05)。结论补肾健脾通络汤治疗骨质疏松症可有效提升临床疗效,提升骨密度,减轻患者疼痛,改善其中医证候。     

脊髓型颈椎病MRI-T2WI高信号与临床预后分析

目的 探讨脊髓型颈椎病(CSM)患者MRI-T_2加权像高信号与临床效果的联系.方法 将66例行颈椎前路椎间盘摘除减压、植骨和内固定手术的脊髓型颈椎病患者分为A组30例MRI T_1/T_2表现为等/等,B组36例MRI MRI T_1/T_2表现为等/高.所有病例于术前1周采用MRI检查和JOA评分.分别比较手术前、手术后6个月、手术后1年两组病人的JOA评分、改善率是否有差异.结果 所有患者均随访12～38月,平均21月.A、B两组在手术前和手术后的JOA评分和改善率无显著性差异(P>0.05).结论 MRI-T_2加权像高信号与患者的预后无明显相关性,有高信号患者同样可有良好的临床预后,不能仅通过MRI-T_2加权像异常的高信号表现来判断患者的预后.

Abstract：

Objective To analyze the correlations between increased spinal cord signal intensity on magnetic resonance images (MRI) and the clinical prognosis of compressive cervical myelopathy. Methods Sixty-six patients with cervical spondylotic myelopathy underwent surgeries through the anterior approach.In all the patients, the diagnoses were established on the basis of both neurological examination and MRI findings that showed spinal cord compression. The patients were divided into two groups according to preoperative MRI, namely isointense MRI T_1/T_2 signal group and iso/hyperintense MRI T_1/T_2 group. The JOA scores of the patients were evaluated before and at 6 and 12 months after the operation. Results The patients were followed up for 12 to 38 months after the operation (mean 21 months), and no statistically significant difference were found in the pre- and postoperative JOA scores between the two groups (P>0.05). Conclusion The peoperative hyperintense signals on T_2 weighted MRI does not correlate to the prognosis of patients with compressive cervical myelopathy, who may also have favorable clinical outcomes after the operation.     

提拉旋转斜扳法治疗腰椎间盘突出症80例

目的 探讨采用提拉旋转斜扳法治疗腰椎间盘突出症的临床疗效.方法 采用提拉旋转斜扳法对80例腰椎间盘突出症患者进行治疗.结果 经治疗,81例患者的总有效率91.25％.结论 提拉旋转斜扳法治疗腰椎间盘突出症能够改善血液循环,促进炎症吸收和消退,缓解疼痛.     

两种不同术式治疗骸骨骨折的疗效观察

骸骨骨折临床常见,占全身骨折1.05%[1].我们于2005～2007年对我院收治的85例骸骨骨折患者进行了两种不同的治疗方法.并在手术后3个月和6个月分别按照Bristol[2]评分标准对膝关节的功能进行综合评定和比较,现报道如下.