目的 比较单纯手法复位和手法复位合并口服抗眩晕药治疗良性阵发性位置性眩晕（BPPV）的短期和长期疗效。 方法 将2004年1月－2011年6月期间收治的236例BPPV患者随机分为两组，对照组112例采用单纯手法复位，观察组124例在手法复位基础上配合口服抗眩晕药治疗，两组均于1周和3个月后复查，并随访观察1年，且比较其疗效。 结果 观察随访1年后，对照组总治愈率92.86% (104/112），观察组治愈率为93.54%（116/124），两者比较差异无统计学意义。 结论 单纯手法复位和手法复位合并口服抗眩晕药治疗BPPV其疗效相当，但可作为BPPV患者的首选治疗方法。Objective To evaluate the short-term and long-term effect of canalith repositioning procedures with or without anti-vertigo drugs on benign paroxysmal positional vertigo (BPPV). Methods A total of 236 cases of BPPV that were treated with particle repositioning maneuver with medicine treatment from January 2004 to June 2011. The patients were divided into control group (112 patients, underwent canalith repositioning procedures) and observation group (124 patients, underwent canalith repositioning procedures with medication of anti-vertigo drugs). The two groups were reappraised after one week and three months respectively, and the follow-up duration was one year. Results The success rate was 92.86% (104/112) in the control group and 93.55%(116/124) in the observation group one year after the treatment. The difference between the two groups was not significant. Conclusion The effect of canalith repositioning procedures with or without anti-vertigo drugs on BPPV does not differ much from each other.
目的:观察手法复位配合针刺治疗腰椎间盘突出症的疗效。方法:将239例确诊为腰椎间盘突出症的患者随机分为治疗组和对照组，其中治疗组120例，采用手法复位配合针刺治疗，对照组119例，采用针刺治疗。并分别观察两组患者症状评分变化和疗程。结果:治疗组总显效率85.83%，对照组72.27%（Plt;0.05）。治疗组痊愈率53.33%，对照组36.13%（Plt;0.05）。治疗组显效病例，达到显效时所需的治疗时间为12.60±3.39天，对照组为16.85±4.15天（Plt;0.05）。结论:手法复位配合针刺治疗腰椎间盘突出症优于针刺治疗。
Objective To investigate the efficiency of manual reduction combined with uni-lateral percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF). Methods Between May 2005 and May 2009, the manual reduction combined with uni-lateral PKP was appl ied to treat 42 patients with OVCF (group A), and the simple uni-lateral PKP was appl ied to treat 43 patients with OVCF (group B) at the same period. The visual analogue scale (VAS), the vertebral height, and the Cobb angle were determined before operation, and at 3 days and 6 months after operation. Ingroup A, there were 6 males and 36 females aged 59-93 years (76.5 years on average) with an average disease duration of 7 days (range, 3 hours to 21 days); 27 segments of thoracic vertebrae and 31 segments of lumbar vertebrae were involved, including 15 segments at mild degree, 38 segments at moderate degree, and 5 segments at severe degree according to degree classification system of compression fractures of Zoarski and Peh. In group B, there were 9 males and 34 females aged 54-82 years (75.3 years on average) with an average disease duration of 7 days (range, 1 hour to 20 days); 26 segments of thoracic vertebrae and 35 segments of lumbar vertebrae were involved, including 21 segments at mild degree, 36 segments at moderate degree, and 4 segments at severe degree according to degree classification system of compression fractures of Zoarski and Peh. There were no significant difference (P gt; 0.05) in sex, age, affected site, degree, and disease duration between 2 groups. Results There was no significant difference (P gt; 0.05) in operative time, blood loss, or injected cement volume between 2 groups. No serious compl ication or death occurred in 2 groups. Cement leakage was observed in 4 cases (9.5%) of group A and in 5 cases (11.6%) of group B. The VAS scores after operation significantly decreased in 2 groups (P lt; 0.01). At 3 days and 6 months after operation, the VAS scores in group A were significantly lower than those in group B (P lt; 0.05). The postoperative compression rates of affected vertebral body in 2 groups significantly decreased (P lt; 0.01). The compression rates of affected vertebral body at 3 days and 6 months after operation, and the height recovery rate at 3 days after operation in group A were superior to those in groupB (P lt; 0.05). The postoperative Cobb angles in 2 groups were significantly diminished (P lt; 0.01). The Cobb angles at 3 days and 6 months after operation, and the recovery rate at 3 days after operation in group A were superior to those in group B (P lt; 0.05). Conclusion The cl inical efficiency of the manual reduction combined with uni-lateral PKP is superior to that of simple uni-lateral PKP in treatment of severe OVCF.
目的 探讨阳性激发点推拿治疗对足底筋膜炎的临床疗效。 方法 对2011年3月－8月门诊确诊为足底筋膜炎的52例患者，采用随机方式分为治疗组和对照组各26例，治疗组采用阳性激发点推拿，对照组采用电针治疗。并对两组患者治疗5次后的即时疗效率、日本骨科学会（JOA）足底治疗疗效评分、每次治疗后的疼痛面谱量化评分、3个月随访疼痛复发率等疗效进行对照分析。 结果 治疗组和对照组经连续治疗5次后，其JOA足底治疗疗效评分分别为（91.32 ± 10.61）、（82.92 ± 13.61）分，总有效率分别为96.15%、80.77%，差异均有统计学意义（P＜0.05）。疼痛面谱量化评分，治疗组在第一次治疗后较对照组改善明显，差异有统计学意义（P＜0.05）。3个月后随访疼痛复发情况，治疗组复发人数较对照组少，差异有统计学意义（P＜0.05）。结论 阳性激发点推拿治疗法对改善足底筋膜炎引发的足底疼痛、步行不适等症状优于电针治疗法，值得临床推广运用。
ObjectiveTo study the feasibility of using propofol and remifentanil for reduction of shoulder joint dislocation in the conscious elderly patients, and compare its efficacy with brachial plexus block anesthesia. MethodsSeventy elderly patients (American Sociaty of Anesthesiologist physical statusⅠ-Ⅱ) who underwent shoulder dislocation reduction in our hospital between August 2011 and December 2013 were randomly divided into two groups, each group having 35 cases. Patients in group A received brachial plexus nerve block anesthesia downlink gimmick reset, while patients in group B received the use of remifentanil-propofol and lidocaine compound liquid intravenous drop infusion for anesthesia downlink manipulative reduction. After successful anesthesia, two groups of patients were treated with traction and foot pedal method (Hippocrates) to reset. We observed the two groups of patients in the process of reduction, and recorded their hemodynamic changes, reset time, discharge time, postoperative satisfaction, intra-operative memory, breathing forgotten (breathing interval was longer than 15 seconds) and visual analogue scale (VAS) scores, and then comparison was made between the two groups. ResultsPatients in both the two groups successfully completed manipulative reduction. Compared with group A, patients in group B had more stable hemodynamic indexes during the process of reduction, shorter reduction time, better anesthesia effect and higher postoperative satisfaction degree, and the differences were statistically significant (P<0.05). There was no significant difference in terms of time of leaving the operation room between the two groups (P>0.05). VAS score was higher in group A than that in group B (P<0.05). The occurrence of intra-operative memory amnesia and breathing forgotten phenomenon existed in part of the patients after operation in group B, but they did not occur in patients in group A. ConclusionRemifentanyl propofol-lidocaine compound fluid can be safely used in conscious elderly patients for shoulder joint dislocation reconstructive surgery, and it functions quickly with complete analgesia and stable hemodynamic indexes.
ObjectiveTo compare the effects of povidone iodine handwashing with brush and brush-free handwashing on the hand skin condition of nurses in operation room. MethodA random sampling method was used to choose 150 nurses from the operation room of a grade-3 class-A hospital as our study subjects from June 2013 to December 2014. They were randomly divided into control group and study group according to the random number table with 75 in each. The control group used the traditional povidone iodine handwashing with brush, while the study group applied brush-free handwashing method. Then, we compared the hand skin condition and disinfection effect of these two kinds of handwashing methods. ResultsThe control group had dry skin in 34 nurses (45.3%), dry desquamation in 9 (12.0%), tight feeling in 51 (68.0%), and allergy in 5 (6.7%). The study group had dry skin in 19 nurses (25.3%), dry desquamation in 0 (0.0%), tension in 21 (28.0%), and allergy in 0 (0.0%). The differences between the two groups were statistically significant (P<0.05). ConclusionsThe brush-free handwashing method is able to achieve the requirements of surgical hand disinfection, and can protect the skin of nurses in operation room.
Objective To investigate effectiveness of rotator cuff repair with manipulation release and arthroscopic debridement for rotator cuff tear with shoulder stiffness. Methods A retrospectively study was performed on the data of 15 patients with rotator cuff tear combined with shoulder stiffness (stiff group) and 24 patients without stiffness (non-stiff group) between January 2014 and December 2015. The patients in the stiff group underwent arthroscopic rotator cuff repair with manipulation release and arthroscopic debridement while the patients in the non-stiff group only received arthroscopic rotator cuff repair. The patients in the stiff group were older than the patients in the non-stiff group, showing significant difference (P<0.05). There was no significant difference in gender, type of rotator cuff tear, side of rotator cuff tear, and combined with diabetes between 2 groups (P>0.05). The visual analogue scale (VAS) score, University of California Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM) were used to evaluate the effectiveness after operation. Results All incisions healed by first intention without any complication after operation. The patients were followed up 13-31 months in the stiff group (mean, 19.2 months) and 13-23 months in the non-stiff group (mean, 20.3 months). There was no significant difference in follow- up time between 2 groups (t=–0.573, P=0.570). The VAS score in the stiff group was higher than that in the non-stiff group before operation (t=–2.166, P=0.037); there was no significant difference between 2 groups at 3, 6, 12 months and last follow-up (P>0.05). The forward flexion and external rotation were significantly lower in the stiff group than those in the non-stiff group before operation and at 3 months after operation (P<0.05); there was no significant difference between 2 groups at 6, 12 months and last follow-up (P>0.05). At last follow-up, the internal rotation was beyond L3 level in 2 groups. The preoperative UCLA score was significant lower in the stiff group than that in the non-stiff group (P=0.037); but there was no significant difference in UCLA score at last follow-up between 2 groups (P=0.786). There was no significant difference in pre- and post-operative ASES scores between 2 groups (P>0.05). Conclusion Satisfactory effectiveness can be achieved in the patients with rotator cuff tear combined with shoulder stiffness after rotator cuff repair with manipulation release and arthroscopic debridement, although the patients with shoulder stiffness had slower postoperative recovery of ROM until 6 months after operation.
ObjectiveTo provide an overview of systematic reviews on the efficacy and safety of massage for the treatment of cervical spondylotic radiculopathy.MethodsCNKI, WanFang Data, VIP, CBM, PubMed, The Cochrane Library and EMbase databases were electronically searched to collect the systematic reviews on the efficacy and safety of massage for the treatment of cervical spondylotic radiculopathy from inception to December 30th, 2018. Two reviewers independently screened the literature and extracted the data, applied the AMSTAR2 scale to evaluate its methodological quality, and GRADE to evaluate the quality of the evidence.ResultsA total of 7 systematic reviews/meta-analysis were included. The AMSTAR2 scale evaluation showed that the quality of the included studies was extremely low. The GRADE evidence grading results showed that the quality of the VAS score outcome index of the two literatures was intermediate, and the quality of the OASCSR outcome index of one literature was intermediate. The quality of the remaining outcome indicators reported is low or very low.ConclusionThe available evidence shows that the efficacy and safety of manual treatment of cervical spondylotic radiculopathy is acceptable, but the overall methodological quality of the systematic review is extremely low, and the quality level of evidence is generally low. The future clinical trials and systematic reviews should be strictly followed. The scientific research design of the medical science provides high-quality evidence and provides reference for clinical practice.
ObjectiveTo evaluate mid-term effectiveness of manipulation under anesthesia combined with arthroscopic capsular release and subacromial debridement for primary frozen shoulder.MethodsBetween January 2013 and December 2017, 33 patients of primary frozen shoulder were treated with manipulation under anesthesia combined with 360° arthroscopic capsular release and subacromial debridement. There were 10 males and 23 females, aged from 37 to 65 years, with a mean age of 50.9 years. The affected shoulder on left side in 17 cases and on right side in 16 cases. The disease duration was 6-13 months (mean, 8.4 months). Before and after operation, the visual analogue scale (VAS) score was used to evaluate the shoulder joint pain, Constant score was used to evaluate the shoulder joint function, and the flexion, abduction, and external rotation of shoulder joint were recorded. The internal rotation function was assessed based on the vertebral plane that the thumb could reach after internal rotation of the affected shoulder joint (the rank of internal rotation vertebra). X-ray film was taken to measure the distance of the subacromial space.ResultsThere was no fracture or labrum tear in all patients, and all the incisions healed by first intention. All the 33 patients were followed up 20-31 months, with an average of 24.1 months. During the follow-up, there was no complication such as wound infection and nerve injury. At last follow-up, the range of motion of shoulder flexion, abduction, and external rotation, the rank of internal rotation vertebra, the VAS score, Constant score, and subacromial space were significantly improved when compared with preoperative ones (P<0.05).ConclusionManipulation under anesthesia combined with arthroscopic capsular release and subacromial debridement can achieve a good mid-term effectiveness without complication for primary frozen shoulder.