唐红运用中药内外合治糖尿病周围神经病变经验

介绍唐红主任医师治疗糖尿病周围神经病变的临床经验,主张运用中药内外合治,并自创活血化瘀之糖络宁外敷穴位。     

四肢开放性骨折延期内固定治疗的临床评价

目的评价四肢开放性骨折延期内固定治疗的临床疗效。方法收治四肢开放性骨折247例,其中129例(A组)118例(B组)均经清创后一期或延期缝合伤口、延期内固定。结果A组伤口软组织感染31例(24.0%),骨髓炎9例(7.0%),骨不愈合13例(10.1%);B组伤口软组织感染3例(2.5%),骨髓炎0例,骨不愈合2例(1.7%)。B组三种并发症均明显少于A组。结论针对开放性骨折,彻底清创后给予一期或延期伤口缝合、延期内固定,对降低伤口感染率及骨髓炎、骨不愈合的发生率有明显的降低,效果良好。     

中西医结合治疗慢性盆腔炎64例临床观察

目的:观察中西医结合治疗慢性盆腔炎的临床疗效。方法:121例病例随机分为两组。对照组57例采用单纯西药治疗;治疗组64例采用西药治疗的同时加用自拟中药消炎汤内服并配合中药保留灌肠治疗。7天为1个疗程,共治疗1~3个疗程。结果:治疗组痊愈48例,显效10例,有效4例,无效2例,总有效率为96.87%,对照组痊愈35例,显效8例,有效3例,无效11例,总有效率为80.70%。两组患者治疗后疗效比较有显著性差异(P<0.05)。结论:中西医结合治疗慢性盆腔炎具有很好的临床疗效,优于单纯西药治疗。     

吻合血管的骨移植与内固定

作者10年来为85例各种原因所致骨质大段缺损施行了吻合血管的骨移植。根据骨质缺损的部位、范围和形状并结合常用的几种吻合血管移植骨的解剖特点,作者对各部位骨缺损区的供、受骨端之间的固定方法作了较详细的经验介绍。     

Unusual approaches for insertion of the greenfield vena cava filter: the value of its approach through the jugulosubclavian junction

During the last four years, we have attempted 249 insertions of the Greenfield inferior vena cava filter using the right internal jugular vein. This approach was impossible in 31 patients (12.5%). Our first alternative was the insertion of the filter through the venous junction between the right internal jugular and right subclavian veins. If this latter technique was not possible we attempted the insertion of the Greenfield filter through the left internal jugular vein before using the retrograde femoral route which is associated with high morbidity. By these techniques we have been able to reduce the number of patients in whom it is impossible to achieve mechanical endocaval partial interruption to 2.4%.     

RAPID DOPPLER SCREENING TEST FOR INTERNAL CAROTID DISEASE

There is increasing evidence that only hemodynamically significant internal carotid lesions (of more than 50% diameter stenosis or occlusion) rather than minor lesions are the precursors of stroke. A Doppler test combining periorbital and direct audible interpretation of internal carotid Doppler signals was performed on 67 patients (134 internal carotids) and the results were compared with those from conventional biplane angiography. The test was 100% sensitive and had a positive predictive value of 91% for hemodynamically significant lesions. Negative predictive value for normal or less than 50% stenosis was 100%. Carotid bifurcation bruits were heard over only 25% of internal carotids with significant stenosis and nearly 60% of bruits were heard over internal carotids with minor disease. The equipment was portable and relatively inexpensive. The test could be performed by vascular technicians in less than 12 minutes with minimal patient discomfort, thus meeting most of the criteria for an ideal non-invasive screening test. (Aust NZ J Med 1986; 16: 481–485.)     

Pigmented macules on the palms and/or soles of Japanese subjects: influences of clinical severity and duration of illness.

We have suggested that pigmented macules on the palms and/or soles occur in response to various systemic diseases. In the present paper, we evaluated the influences of clinical severity and duration of illness in Japanese subjects. In males, cases who suffered from cerebral vascular accident (CVA) for long periods and/or severely tended to have numerous pigmented macules. In females, cases with CVA did not show any similar tendency. As the result of our prior and present studies, we conclude that underlying systemic disease itself can play a pivotal role in the development of pigmented macules on the palms and/or soles of Japanese subjects. We emphasize that such a pigmented macular eruption with characteristic clinical features is an important sign of internal disorders, including malignancy.     

闭塞性颅外段颈内动脉夹层经抗凝、抗血小板治疗再通：二例报告及文献复习

目的 探讨抗凝、抗血小板治疗颅外段颈内动脉夹层(eICAD)的疗效和安全性.方法 报道并分析我院治疗的2例闭塞性eICAD;Medline数据库检索关于颈内动脉夹层的文献,进行文献复习.结果 多数研究支持抗凝、抗血小板药物的经验性应用.约30%的闭塞性eICAD在起病8 d内再通,60%～80%在3个月内再通.治疗期间缺血性卒中复发或残死率在抗凝组为8.3%～14.3%,抗血小板组为7%～23.7%.结论 对存在抗凝禁忌证的eICAD患者抗血小板治疗可能有益;无禁忌证者建议及早抗凝治疗.