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Clinical Analysis on Old Patients with Diabetes Concurrence Tuberculosis

目的:探讨糖尿病合并结核病的临床特征、诊断和治疗。方法:分析总结了49例老年糖尿病合并结核病患者的临床资料,同时与老年单纯肺结核患者进行了对比。结果:两组临床症状无显著性差异,糖尿病合并肺结核组干酪渗出性病灶要多于单纯肺结核组(Plt;0.05),中、下叶病灶要多于单纯肺结核组(Plt;0.01)。两组疗效无显著性差异(Pgt;0.05)。 结论: 糖尿病合并结核病应引起高度重视,正确诊断和及时处理是提高疗效重要手段。

The Clinical Investigation of the DeepPressed Pain Points Injection on the Refractory Cancer Pain

摘要:目的: 探讨深部痛点阻滞在治疗顽固性癌痛患者中的作用。 方法 : 将156例顽固性癌痛患者,随机分为深部痛点阻滞组及对照组,每组78例。深部痛点阻滞组根据疼痛部位,应用软组织外科学理论找出相应压痛点,给予痛点深部阻滞治疗;对照组找出压痛点但仅按三阶梯用药原则给予口服药物治疗。 结果 : 深部痛点阻滞组及对照组两组患者经治疗后疼痛控制均较理想(深部痛点阻滞组VAS13, 对照组VAS17),但是深部痛点阻滞组吗啡用量明显少于对照组(吗啡日平用量深部痛点阻滞组为335mg, 对照组为15287 mg)。便秘的发生率深部痛点阻滞组为5384%,对照组为7692%。 结论 : 深部痛点阻滞能较好的控制顽固性癌痛,同时可明显减少吗啡的用量,副作用相对发生要少。Abstract: Objective: To investigate the effect of the deeppressed pain points injection on the refractory cancer pain and provide reference for relieving the cancer pain. Methods : One hundred and fiftysix patients with refractory cancer pain were diagnosed by the soft tissue surgery,finding the pain point by pressing deeply,the patients with deeppressed pain points were divided into deeppressed pain points injection group and control group randomly, The patients in deeppressed pain points injection group were treated with deeppressed pain points injection; the patients in control group were treated with drugs according with the WHO analgesic ladder. Results : The patients in deeppressed pain points injection group got the same pain relief as those in control group (VAS 13 in deeppressed pain points injection group, 17 in control group ),but the daily dose of morphine in deeppressed pain points injection group was less than that incontrol group (morphine 335mg/day in deeppressed pain points injection group,15287mg/day in control group ) significantly. There was 5384% patients with constipation in deeppressed pain points injection group, 7692% in control group. Conclusion : The refractory cancer pain can be controlled effectively by the deeppressed pain point injection and the daily dose of morphine to control the cancer pain is decreased significantly. The side effect in deeppressed pain points injection group was less than that in control group.

玻璃体切割术后注入曲安奈德辅助治疗增生性 玻璃体视网膜病变的初步观察

Clinical Application of Radioknife for Skin Flap Decoherence in Operation of Breast Cancer

摘要:目的：探讨高频电刀在乳腺癌手术皮瓣游离中的临床应用及其功率大小对术后皮瓣坏死的影响。方法：回顾性分析2003年1月至2008年9月,在我院154例行乳腺癌改良根治术患者的临床资料,其中乳腺刀组（A组）37例,小功率电刀组（B组）60例,大功率电刀组（C组）57例,对比分析各组皮瓣坏死情况。结果：共发生皮瓣坏死35例,其中A组用乳腺刀游离皮瓣6例（6/37）,B组用小功率电刀（18～22W）游离皮瓣9例（9/60）,C组用大功率（≥28W）电刀游离皮瓣20例(20/57),B组与A组比较差异无显著意义(Ｐ＞005),C组与A、B组比较差异有显著意义(Ｐ＜005);而B、C组与A组比较,游离皮瓣时出血量明显减少,差异有显著性意义（Ｐ＜005）。结论：合理应用高频电刀游离皮瓣具有术中出血少,术后恢复快的优势,但若功率过高,则会增加皮瓣坏死率。Abstract: Objective: To Analyse influence of Skin Flap Necrosis after Operation of Breast Cancer with different power of radioknife. Methods：The clinical data of 154 breast cancer patients received surgery operation trea tment was analysed retrospectively, among them there are 37 patients operation with lancet (group A), there were 60 patients operation with littlepower radioknife (group B) and there were 57 patients operation with highpower radioknife (group C). Results：There were 35 cases (22.73％) suffured from skin flap necrosis among 154 breast cancer cases received surgery operation. There were 6 cases（6/37）in group A, 9 cases（9/60）in group B and 20 cases（20/57）in group C. Group B and group C has littler hemorrhage in operation compare with group C (Ｐ＜005) . Conclusion： Radioknife for skin flap decoherence in operation of breast cancer can decrease hemorrhage but highpower radioknife will increase necrosis of skin flap.

眼带状疱疹伴发葡萄膜炎的临床分析

首发为动眼神经麻痹的后交通脑动脉瘤患者不同手术时间的疗效观察

Clinical Observation of Atorvastatin in 70 Patients with Hyperlipidemia

目的：探讨阿托伐他汀治疗高脂血症患者的疗效分析。方法： 对70例确诊高脂血症的患者给予阿托伐他汀10 mg，每日一次，连服3个月，观察观察治疗前后的血脂、肝功能、肾功能,同时观察患者有无不良反应。结果：治疗3个月后,TC、TG、LDL-C均较治疗前显著下降(Plt;0.05),HDL-C较治疗前明显提高(Plt;0.05),TC、TG、LDL-C、HDL-C治疗3个月的总有效率分别是84.28%、74.6%、80%和62.26%,未见明显不良反应。结论：阿托伐他汀治疗高脂血症患者安全有效。

距骨骨折脱位32 例治疗

目的 探讨距骨骨折及距骨与周围关节脱位的处理方法。方法 1998年2月~2005年10月收治32例距骨骨折脱位。其中男23例，女9例；年龄19~56岁。车祸伤13例，坠落伤10例，压砸伤7例，扭伤2例。其中开放性损伤7例，伴同侧肢体或踝部骨折、韧带损伤10例，脾破裂1例。距骨颈骨折按Hawkins分类：Ⅰ型5例，Ⅱ型12例，Ⅲ型7例，Ⅳ型2例，距骨体骨折4例，距骨头骨折2例。伤后2~26 h进行治疗。手术切开复位者以2枚螺丝钉内固定，距骨体粉碎性骨折者行距下关节融合术。结果 32例均获随访6个月～7年，术后疗效按Kenwright 4级分类法评定，闭合性复位7例，优5例，良2例；切开复位内固定14例，优6例，良3例，可3例，差2例；开放性损伤7例，优1例，良2例，可2例，差2例；距下关节融合术4例，优1例，良2例，可1例。结论 距骨骨折或脱位后及时取得良好复位，恢复正确解剖关系对稳定足部非常重要，合理处理能最大限度恢复踝关节功能。

The Treatment of the Extensive Skin and Soft Tissue Avulsion Injury in Buttocks, Perineal Area and Lower Limbs

目的:回顾性分析臀会阴及下肢大面积皮肤软组织撕脱伤的治疗体会。方法:2005年1月至2007年6月,对8例臀会阴及下肢大面积皮肤软组织撕脱伤患者进行综合治疗。男4例,女4例,年龄4～48岁,平均26岁,病程1天～1月,平均2周。皮肤撕脱达体表总面积8%～20%。致伤原因:车祸伤7例,高坠伤1例。其中7例成人均上翻身床治疗,1例小孩床上自行翻身,6例由于创面距肛门较近或脊髓损伤不能控制大便而行结肠造瘘,通过造瘘口排便,创面愈合3月后行造瘘还纳术。所有患者均通过积极创面处理、肉芽新鲜后行刃厚植皮术而痊愈。结果:8例患者经过我们的综合治疗后伤口均愈合,随访6月后皮肤愈合良好。6例行结肠造瘘的患者中3例因骨盆骨折稳定于出院后3月左右行结肠造瘘还纳术,恢复肛门排便,3例伴有脊髓损伤患者而不能自行控制排便的患者在随访期间未行结肠造瘘还纳术。结论:臀会阴及下肢大面积皮肤软组织撕脱伤患者通过上翻身床,必要时行结肠造瘘,积极的创面处理及对症支持治疗能取得较好效果。

Microsurgical Treatment of Hypertension Brainstem Hemorrhage

目的:探讨高血压脑干出血的显微外科治疗的手术指征、手术技巧、效果和预后。方法: 回顾性分析21例高血压脑干出血患者的临床资料、手术方式、治疗效果及随访资料。结果:21例患者均于显微镜下清除血肿,无手术死亡,术中运用神经电生理监测。11例患者术后神经功能障碍得到改善,5例症状加重持续昏迷。5例术后死亡,术后随访6～18个月,9例生活基本能够自理,7例长期卧床。结论: 采用显微外科技术治疗高血压脑干出血,效果良好。