腰痛的物理检查

腰椎间盘突出与其它腰痛病的鉴别诊断是骨科和物理康复科、中医骨伤科经常遇到的问题,尽管目前有CT,MRI等现代诊断手段,对诊断腰椎间盘突出符合率很高,但因设备复杂,费用昂贵,不可能普及。物理检查因其简便易行,在腰痛的诊断方面仍被广泛采用。对于理疗康复工作者来说,认真全面正确的物理检查可有助于了解腰部的功能状态,肌肉软组织的异常,神经受刺激的状况,既可获得进一步鉴别诊断的线索,又可为非手术治疗提供依据。我们统计了腰椎间盘突出症,腰肌劳损和腰椎骨关节病三种腰痛病的16项临床物理检查的阳     

浅谈肝脏的物理诊断

肝脏病的诊断方法,目前虽有肝功能化验、肝脏超声波检查、同位素肝功能检查和肝脏扫描,以及肝脏血管和胆管造影等检查方法,但肝脏物理诊断仍是所有检查方法中最方便和最重要的检查方法,许多肝脏疾病通过详细了解病史和认真地物理检查,是可以得出初步诊断的。因此肝脏物理检查是我们临床工作中必须掌握的基本功之一。     

骨科护士关爱技能培训效果观察

目的:探讨对骨科护士实施关爱技能培训的临床效果。方法:对30名骨科护士进行关爱技能培训,培训前后采用关爱能力评价(CAI)量表评价护士关爱能力,培训后护士将护理关爱技能运用到临床护理中,培训前后采用住院患者满意率调查表对30例骨科住院患者进行调查,评价比较患者满意度差异。结果:培训后,骨科临床护士CAI评分明显高于培训前(P0.01),并且患者满意率亦明显高于培训前(P0.01)。结论:实施护理关爱技能培训有助于帮助护士提高临床护理关爱能力,提高患者满意度。     

下腰痛的检查

腰痛是骨科临床常见症状,许多疾病都可出现腰痛,明确什么原因引起的腰痛,才能确定诊断,为此阐述一下下腰痛的检查物理检查脊柱视诊:充分暴露检查部位,观察脊柱的生理弧度.如视腰椎平直,即生理弧度减退,可能为腰痛腰肌痉挛的结果.例如急性腰扭伤、脊柱炎症、腰椎间盘突出症等.如视腰椎生理弧度增加,也是病态     

骨科护理中康复锻炼的应用研究

骨科护理中康复锻炼是影响骨科病人恢复速度与程度的重要因素。本文通过对骨科护理中康复锻炼的重要性进行研究,指出在康复锻炼中所存在的思想、医护配合、技能培训、提高素质方面的不足,提出康复锻炼中护理活动开展与质量提高对策。     

快速康复在骨科术后患者中的临床应用进展

正二十世纪以来,骨科在众学科当中的学术地位和社会需求度在日益上升,骨科临床医学的飞速发展也给骨科护理学科带来巨大的挑战。基于此现象,骨科护理学科需要有先进的理念引领和充实才能保证学科建设的不断完善,在骨科临床工作中,医疗和护理相辅相成,不可分割。发达国家的骨科护士除了负责骨科专科护理外,还承担着许多常规非手术治疗。随着骨科专业分工的精细和技术的不断提高,骨科临床护理工作亦日显重要。伴随着知识、技能、理念的飞速发展,     

规范化培训对骨科新护士综合能力的效果评价

目的 探讨规范化培训对骨科新护士综合能力的临床应用效果评价。方法 选取骨科新入职的、护理工作时间在半年以内的20名护理人员作为研究对象,对新护士进行骨科规范化培训3月,所有培训对象均完成各项培训内容,观察护理人员培训前后护理服务工作质量、专科基础理论知识和基本操作技能的掌握程度,评价骨科康复技能、护理用具和护理仪器的使用情况。结果 经过规范化的培训后,新护士的护理服务工作质量、骨科基础理论知识和基本操作技能的掌握均有大程度的提高;骨科康复技能和护理用具、仪器使用考核成绩比较,培训后明显优于培训前(P<0.05)。结论 规范化的培训有助于骨科新护士综合能力的提高,为护理专业的发展提供临床参考。     

《临床物理诊断手册》一书已由天津科技出版社出版

物理检查是临床医师必须掌握的基本功,它可作为诊治疾病的线索和根据,也是医生掌握病情变化和诊治疾病的手段。们临床物理诊断手册》一书重点介绍一般物理检查的方法及常见病理征的临床意义,同时对有关物理检查的技巧及病理征的发生机制等也作了简要介绍。内容较全面,是一本实用的临床物理工具书。该书可供临床医师及医学院校师生使用。购者可与天津科技出版社张自忠路189号（邮编;300020）罗仙先同志联系。每册15.00元,大32开。《临床物理诊断手册》一书已由天津科技出版社出版~~     

高频超声在腹外疝诊断中的应用

腹外疝是外科最常见的疾病之一,将高频超声应用于腹外疝的诊断为临床提供了一项除以往物理检查之外的非常实用的诊断方法。本研究通过对127例腹外疝患者的声像图进行回顾性分析,旨在评价高频超声在腹外疝诊断中的应用价值,并探讨不同类型腹外疝的临床病理类型及其声像图特点。     

专业集中规范培训对提高骨科新护士综合能力的效果

目的探讨专业集中规范培训对提高骨科新护士综合能力的效果。方法选取2012—2013年入职于陕西省人民医院的骨科新护士20名,分两期进行骨科专业集中规范培训,每期10名,每期培训时间1个月,比较新护士培训前后综合理论和技能、专科基础理论知识和基本操作技能、骨科康复技能、护理用具以及仪器使用的情况。结果专业集中规范培训后,新护士的综合理论和技能、骨科基础理论知识和基本操作技能的掌握均有较大程度提高;骨科康复技能、护理用具和仪器使用考核成绩,培训前后比较,差异有统计学意义(P0.001)。结论专业集中规范培训有助于骨科新护士综合能力的提高,为骨科护理专业的发展提供临床参考。     

Orthopedic pitfalls in the ED: slipped capital femoral epiphysis

Slipped capital femoral epiphysis (SCFE), though a relatively common disorder, is frequently missed on initial presentation. Symptoms can be vague, the physical examination unrevealing, and radiographic abnormalities subtle. Prompt diagnosis of SCFE is important, however, to improve clinical outcome. The emergency physician needs to remain vigilant for this diagnosis to avoid this orthopedic pitfall. This article examines the clinical presentation, diagnostic techniques, and management options applicable to the emergency physician in the treatment of SCFE.     

Examination and treatment of a patient with hypermobility syndrome

BACKGROUND AND PURPOSE: The purpose of this case report is to present the patient examination, evaluation/diagnosis/prognosis, intervention, and outcome of a patient with hypermobility syndrome (HMS). Hypermobility syndrome has been widely recognized in the rheumatology literature, but it has seldom been discussed in the orthopedic literature and has only recently been described in the physical therapy literature. The signs and symptoms of HMS are common among patients seen in orthopedic physical therapy clinics; however, the underlying HMS may be overlooked while treating individual joints or tissues causing pain. CSE DESCRIPTION: The patient was a 28-year-old woman with complaints of chronic, multiple-joint pain. After years without a diagnosis, a rheumatologist had recently diagnosed underlying HMS. OUTCOMES: Following intervention that emphasized patient education and activity modification, the patient's complaints decreased. DISCUSSION: Recognition of HMS underlying common orthopedic problems may facilitate appropriate patient education and management.     

Treatment of Pernicious Anemia

An orthopedic examination should be performed along with the routine physical examination, and history taking should include pertinent questions relating to orthopedic ailments. The author discusses the signs and symptoms which will lead to a cursory but adequate examination of the musculoskeletal system and points out the elementary principles which will prevent the physician's overlooking an orthopedic defect.     

Acute finger injuries: part II. Fractures, dislocations, and thumb injuries

Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocation reduction is accomplished with careful traction. If successful, further treatment focuses on the concomitant soft tissue injury. Referral is needed for irreducible dislocations. Distal phalanx fractures are treated conservatively, and middle phalanx fractures can be treated if reduction is stable. Physicians usually can reduce metacarpal bone fractures, even if there is a large degree of angulation. An orthopedic or hand surgeon should treat finger injuries that are unstable or that have rotation. Collateral ligament injuries of the thumb should be examine with radiography before physical examination. Stable joint injuries can be treated with splinting or casting, although an orthopedic or hand surgeon should treat unstable joints.     

Anterior and posterior cruciate ligament injuries

Knee pain is a common complaint in the primary care setting, and ACL and PCL injuries are common causes of knee pain. Therefore, it is important for the primary care physician to be skilled in the diagnosis and initial management of these injuries and to be aware of potential associated knee injuries. By understanding the history, mechanism of injury, physical examination maneuvers, and imaging modalities related to ACL and PCL injuries, primary care physicians can prepare themselves to make an accurate diagnosis. Then they can counsel the patients on the available treatments, initiate conservative treatment if appropriate, and facilitate an effective referral to a primary care sports medicine physician or orthopedic surgeon.     

Orthopedic trauma: office management of major joint injury

Orthopedic injuries are common reasons for visits to primary care physicians. Careful history and physical examination with intelligent use of imaging technology will arrive at the correct diagnosis in most patients. Many conditions may be definitively managed by the office internist. Others maybe initially stabilized and referred to orthopedic surgeons for definitive care. Nondisplaced fractures, tendon injuries, sprains, and overuse syndromes are entities within the purview of the primary care physician. Familiarity and confidence with diagnosis and management of these conditions in the office is optimal for the care of the adult patient.     

Evaluation and management of the high-risk orthopedic emergency

Orthopedic injuries are frequently seen in the ED. Whereas the diagnosis and management of most of these injuries is straightforward, there are distinct pitfalls to avoid. The common theme among the high-risk "pitfall" injuries discussed in this article, besides a thorough patient history and careful physical examination with appropriate radiographs, is a high suspicion for the presence of these injuries. When the EP is knowledgeable about these orthopedic pitfalls, these injuries are much less likely to slip by in clinical practice.     

Physical examination of the knee

Regardless of whether knee pain is acute or chronic in presentation, the primary care physician must be confident and practiced in his or her musculoskeletal examination skills to perform a thorough assessment. Keeping in mind the types of problems that tend to occur in different age groups and in certain patient populations with particular risk factors, a preconceived differential diagnosis list should be present in the physician's mind. In most cases, the history and physical examination findings are sufficient to formulate a definitive diagnosis. Plain radiography (multiple views) and laboratory studies if indicated may narrow the differential. Advanced imaging studies will affirm the clinical findings. Referral may be necessary for surgical management, particularly in pediatric and unstable orthopedic cases (eg, suspected growth plate injury, compartment syndromes, displaced or intra-articular fractures). Consultation should always be readily available if questions arise on preliminary clinical work-up and management.     

医学影像管理系统在骨科疾病管理中的应用

目的 应用电子计算机建立医学影像管理系统,存储并分类管理骨科疾病的病例资料,为临床、科研和教学提供重要的数据资料.方法 基于中文Windows XP系统,应用Excel表格和Word对骨科疾病的病例文本、影像学资料、图片和音像资料进行分类及全程管理,并进行统计学分析.结果 通过管理系统,可以利用临床诊断或姓名随意调阅病例文本,查找相应病例影像学资料,并可对相同疾病的病例进行分类、对比和统计学分析,为临床治疗方法、护理技术的改进提供重要的数据.结论 医学影像管理系统的建立为骨科疾病的临床治疗、科研和教学提供了强大的支撑平台,具有广阔的应用空间.