目的：观察柴芩承气汤治疗重症急性胰腺炎(SAP)并发麻痹性肠梗阻 (Paralytic Intestinal Obstruction)的疗效。方法:依据纳入和排除标准,选取四川大学华西医院中西医结合科收治的SAP患者40例,按1∶1比例随机分成试验组(20例)和对照组(20例),试验组入院时即给予柴芩承气汤灌肠治疗,对照组使用安慰剂灌肠治疗;两组入院时基线资料差异无统计学意义(Pgt;005)，且两组均给予相同常规西医治疗。观察入院后其首次自行排便排气时间,入院时、入院后第3天、第7天APACHEⅡ评分及住院病程。结果:入院后首次自行排便排气时间试验组（302±154）天,低于对照组（453±241）天;入院后第3天APACHEⅡ评分试验组（925±184）分，低于对照组（1163±222）分;入院后第7天APACHEⅡ评分试验组（624±247）分，低于对照组（881±325）分。住院时间试验组（2453±426）天,低于对照组（3032±589）天。结论:早期应用柴芩承气汤灌肠治疗SAP并发麻痹性肠梗阻,可缩短麻痹性肠梗阻的持续时间及减轻其危害,减少住院病程。
目的:探讨被误诊为功能性精神障碍的麻痹性痴呆患者的临床特点和诊治要点。方法:回顾性分析10例被误诊为功能性精神障碍的麻痹性痴呆患者的临床资料。结果:被误诊为功能性精神障碍的麻痹性痴呆均以精神症状为首发，多表现为精神病性症状、类躁狂、抑郁、类神经症、人格的改变及进行性痴呆等不典型症状群，本研究显示误诊率高达71.4%，误诊例次率以精神分裂症最高（47.3%），其次为躁狂症或躁狂状态（37.5%）。抗精神病药物能有效改善精神症状，青霉素驱梅能阻止病情进展使病情得到缓解，两者缺一不可。结论:被误诊为功能性精神障碍的麻痹性痴呆均以精神症状为首发且症状不典型而易被误诊，早期鉴别诊断十分重要，抗精神病药物和青霉素治疗可以有效控制症状。
Objective To explore some operative problems of correcting paralytic scoliosis(PS) by using vertebral pedicle screwsrods system. Methods From May 2000 to May 2005, 18 patients with PS were corrected by screwsrods system which were made of titanium alloy.There were 10 males and 8 females, aging from 11 to 26 years. The primary disease included poliomyelitis in 13 patients and myelodysplasia (MS) in 5 patients (2 cases for second correction) with scoliosis of an average 85° Cobb angle (55-125°). The pelvic obliquity was found in all patients with an average 24° angle (355°).Of the 18 patients,3 cases were given perioperative halo-pelvic traction, 2 cases were given vertebral wedge osteotomy and correction and fixation, the other patients were purely underwent the treatment of pedicle screwrods system implants. Fusion segment at operation ranged from 6 to 15 sections, applied screws the most was 16,the fewest was 6. Results There were no wound infections and neurologic complications, all wounds healed by the first intention. Allscoliosis obtained obvious correction (P＜0.001), the correction rate averaged 52.95% (44%-81%); the majority of lumbar kyphosis and pelvic obliquity were apparently corrected. The average clinical follow-up (16 cases) was 21 months(6-36 months),there was no implants failure. One patient with MS had a worse Cobb magnitude, the other patients had no curve progression (P＞0.05). Conclusion The use of vertebral pedicle screwsrods fixation to multiple vertebral bodys and short segment fusion for PS, the treatment method is reliable and the outcome is satisfactory. While performing the correcting operative procedures, the spinal, pelvic and lower extremity deformities and functions should be all considered as a whole.
【摘要】 目的 观察应用不同手术方法矫正麻风麻痹性下睑外翻的疗效。 方法 2006年10月-2009年11月，共收治麻风麻痹性下睑外翻68例115眼，根据患者下睑外翻程度和局部专科情况，分别采用颞肌移位+阔筋膜移位悬吊固定术（Johnson法），改良颞肌移位术，下睑板缩短外眦韧带悬吊固定术，眼轮匝肌岛状皮瓣，眼轮匝肌悬吊固定术以及丝线悬吊固定术矫正眼睑外翻。 结果 68例115眼成功率98.9%，手术后由于下睑外翻导致的各种合并症明显好转。随访观察4～11个月所有患者术后效果良好，无复发。 结论 麻风麻痹性下睑外翻的手术治疗应根据患者的不同情况选择合适的手术方法，才能达到最佳的矫正效果。【Abstract】Objective To evaluate the clinical effect of different surgical methods to correct lower eyelid paralytic ectropion. Methods From October 2006 to November 2009, 68 cases (115 eyes) with lower eyelid paralytic ectropion induced by leprosy were treated in this department.According to the degree and local circumstance of different patients, some patients underwent temporalis muscle transfer (TMT) with the Johnson’s procedure, some patients underwent modified temporalis muscle transfer, and some patients underwent orbicularis oculi muscle island flap or uplifting the lower eyelids with orbicularis oculi muscle, silk, lateral canthal tendon. Results The achievement rate of 68 cases (115 eyes) was 98.9%.The complications resulted from lower eyelid ectropion were obviously improved.All the patients got good results followed up for 4 months to 11 months after operation and no recurrence was found. Conclusion To achieve the best effect of correcting lower eyelid paralytic ectropion, it is the key point to choose the suitable method according to the level and local circumstance.
目的：总结我们对表现为麻痹性痴呆的晚期神经梅毒的诊治经验。方法：报道4例麻痹性痴呆病例，并复习相关文献。结果和结论：麻痹性痴呆的临床表现复杂多变，早期误诊率高；诊断主要根据临床特点、血清学及脑脊液检查综合考虑；治疗上仍首选水剂青霉素G。