Background:cicatricial deformation in child burn of hand often leads to severe squaelae.According to different causes of disease,different plastic surgery were adopted.The key of operation lies in skin repairing,articulation dealing,and thumb correcting,which aim is to resume normal longitudinal and transverse arce,holding and clenching ability.Objective:To investigate plastic surgery treatment on cicatricial deformation in child burn of hand.Unit:first People‘s Hospital of Yancheng City.Subjects:34 cases of burn were investigated including 23 males,11 females,aged 5-12 years old.Cicatricial reason:deep degree Ⅱ burn,19 cases;degree Ⅲ burn 11 cases;electric injury,4 cases.Scar type:hypertrophic scar,21 cases,areophic scar,13 cases.portion:dorsum of hand,22 cases,palm,12 cases.Time from healing to dealing:within 6 months,9 cases,within 1 year,8 cases,1-2 years,13 cases,over 3 years,4 cases.Intervention:Before operation,hypertrophic scar and adhesive web-space were cleaned with soap solution,1:5000 bromogeramine,30 min per time,twice a day.Anesthesia:general anesthesia to simple cicatricial contracture,scar removing,relaxing and free graft were adopted,full split thickness graft of palm,intermediate split thickness graft of dorsum of hand.To severe contracture,besides complete removing and full and intermediate split thickness graft,repairing of extensor tendon and articulate surgery,proximal finger joint was fixed at functional position when function couldn‘t be resumed.Tourniquet was used routinely,great saphenous venous and dorsal cutancous branch of radioulnar nerve avoiding exposing extensor tendon,fixed with plaster support and kirschner pins for some cases.Direct skin flap was used after incision and relaxing in 19 cases,skin flap graft was combined with repair in 15 cases.To scar contracture of part between thumb and index finger,because soft tissue had a good condition in this part,“Z”plastic operation was adopted for linar scar,local transfering of dorsal skin flap i 5 cases.To slight false web-space and adhesion,“Z”plastic operation was adopted,“M”or “T” skin flap repair to severe deformation and reconstructing of web-space with free skin graft when necessary.Result:Following up for 3-6 months,hand function recovered completely,improved obviously in 12 cases,no obvious effect was found in cases of deep burn.Conclusion:Different plastic surgery has an obvious effect on child hand bur,but the recovery of function needed long and effective rehabilitation therapy.
Objective: To observe therapeutic effect in the near future of the operation of vertebrascope in route of retreat to treat lumbar disc protrusion and complications.Method: According to symptoms,signs,myelography and CTM results to determine protrusion interspace and side type,applied the operation of vertebrascope in route of retreat to treat lumbar disc protrusion and perform functional exercises.Results: 86 patients were followed up,and within these patients,58 appeared excellent (67%),25 appeared good (29%),2 appeared not bad (2%),and 1 appeared bad (1%).Conclusion: The technology has many advantages,such as little wound,little hemorrhage,little pain and fast restoration,which provide advantageous conditions for early functional exercises after operation.
Backgroung:Etiology of fasciitis is that fasciitis in acute phase isn‘t cured timely or completely.Adhesion,hypertrophy,nodes and cords appear that pull peripheral tissue leading to local aching pain,spasm soft tissue,cervical intervertebral friction,and hyperosteogeny and protrusion of cervical intervertebal disc in the end,After that,a serie of clinical symptoms appear.Acupuncture,massage,physical therapy and adhesive plaster for external application are often used clinically,but therapeutic course is long.Objective: To investigate therapeutic effect of microacupuncture on chronic fasciitis at neck ad back.Unit: People‘s Hospital of Hebei.Subjects:80 cases of chronic fasciitis at neck and back from 1999 to 2002 were investigated to which modified needle was adopted,including 34 males,46 females,aged from 29-74 years old with disease courses from 2 months to 20 years.68 cases at shoulder and back,12 cases at lumbar region.Intervention: Microneedle was made from needle (Huatuobrand) that was grindded at oil whetstone,needle tip changed into flat blade,sterilized and prepaired for use,after routine sterilization,microneedle was stabbed longitudinally and swiftly into aching region,then separating,lifting and thrusting.When the sound that muscle fiber was cut was heared,cupping jar was used by Sanhuo.2-3 points were selected for each time,twice a week,4 weeks as a therapeutic course.Main prognosis index and result: Recovery:local pain dissappeared,nodes and cords disappeared or shrank,no touching pain,48 cases,60%;Effective:Focal pain alleviated,nodes or cords reduced,focal touching pain alleviated,32 cases,40%.Total effective rate was 100%.Conclusion: Microneedle therapy on chronic fasciitis could obviously alleviate pain.Because of the small size,microneedle therapy was fit for the weak or thin muscle tissue,but not for thicker muscle tissue.
Background:clinical rehabilitation of unstable lumbar vertebrae in an important part of mordern rehabilitation medicine.Because of its plentiful contents,rapid developing,comprehensive using of methods,it has been paid more and more attention to.Objective:To investigate effect of rehabilitation nursing on prognosis of unstable lumbar vertabrae in bed.Unit:people‘s Hospital of Anyang City.Subjects:112 cases of unstable lumbar vertebrae were investigated,including 70 cases of spinal injury(62.5%),most of which were incomplete injury,38 cases of retrograde affection (34.0%),others 4 cases (3.5%).Interventions:(1)rehabilitation of muscle:Grouped exercises were directed to shoulder,elbow,wrist,hip,knee and ankle joints.Both active and passive exercises of each group took 200 times of flexing and extending,3-4 groups each day and increased successively;If patients couldn‘t coordinate or needed a larger amount,CPM and special OT,PT rehabilitation were given suplementarily:①upper part of body and head were elevated with both arms bracing and hip on bed.②both lower limbs extended backward in turn,with knee joint extending.③upper part of body and head were elevated without upper limbs bracing.④both lower limbs stable.⑤“swallow”movement.⑥upper and lower part turned over at the same time,combined with abdominal muscles exercise.Exercises varied with each individual,amount increased gradually.(3) Rehabilitation training of detrusor urinae and sphinctor of anus:before defectation,massaging of abdomen for 5-10min,hot water was drunk 15 min before defectation.Actively contracting detrusor usinae and sphinctor of anus,100 times pergroup,3-4groups every day.Rubbing anus sliphtly,15-30s,1-2 times every day.(4)Rehabilitation of complications:turning over once every 2h.Massage of sacrococcygeal region,sacroiliac region and calcaneus,15-20 min.Irrigation of bladder with furacilin(1:5000).Cleaning of perineum with bromogeramine.Results: In 2 cases of panplegia,patients could do simple activities with the help of wheel-chair;In 77 cases of incomplete pletia,muscle strength recovered to grade Ⅳ-Ⅴ.Besides 2 cases of panplegia,all cases achieved self-dependence of daily living.Conclusion:Rehabilitation nursing of nustable lumbar vertebrae in bed could accelerate the clinical rehabilitation and shorten therapeutic course.
Background:Defecation of patients with rectal carcinoma after operation cannot be controlled freely,which brings patients many mental burdens.Cocolyster operation can improve obviously the symptom.Objective.To explore the effect of cocolyster on defecation function of patients with diagnosed rectal carcinoma.Unit:Fifth People‘s Hospital of Shenyang.Subjects:90 patients with rectal carcinoma,47 males and 43 females,aged 29-66 years old.The patients were divided randomly into three groups,30 cases in each group of A,B and C.Intervention.Colostomy was used in both groups to train relieving themselves.After three weeks of operation,suitable 38 warm water 500-1000 ml was poured into intestinal cavity through water collector and catheter which nomally inserted 15-20 cm.Them the patients should be told to mix uniformly water and excrement by proper activities and excreted.The speed of enema should not be too fast to avoid intestinal colic,generally 15-20 minutes.Once intestinal colic occurred,the pouring was paused,then rubbed abdomen 5-10 minutes,continued pouring when abdominal pain relieved.A group choosed the defecation time when the patient was healthy and poured regularly,once per day,continuously for 12 days.b group oured regularly when getting up and evening,continously for 14 days.C group was as control group.Results:The defecation habit of A and b group could be controlled freely and the patients hadn‘t excrement and peripheral dermatitis of artificial anus.Involuntary defecation times of A group decreases 20%.Involuntory defecation times of b group decreased 20%.c group was not poured.Defecation times of each day:>5 times accounted for 40%,3-4 times accounted for 30%,1-2 times accounted for 30%.Meanwhile involuntary defecation times accounted for 50%.Peripheral dermatitis of artificial anus accounted for 19%.Conclusion:Using cocolyster can train regular peristalsis of intestinal tract,make the patient have same defecation habit and involuntary defecation times decrease.It also eliminates peripheral dermatitis of fistula,relieves the mental burdens and improves life quality of patients.
Background:Deep burn of hands can cause severe dysfunction.Early plerosis to the hands will play an important role to the functional exercise and the recovery.Objective:To observe the effect of early treatment of deep burn of hands to the functional reservation and prevention of scar proliferation.Unit:Department of Burn,People‘s Hospital of Gansu Province.Subjects: 1118 burned patients were recruited during December of 1998 to December of 2001.In them 252 patients were complicated with burn of hands,in which 129 hands were deep burns (96 males and 33 females,aged from 1 to 67,most of them were yound).The causes of burns were flame burn,scald by hot fluid,electric burn,chemical burn and hot crush injuries.Intervention:Excise the eschar of 59 hands with burns of deep Ⅱ to superficial Ⅲ and 21 hands with burn of Ⅲ degree.Perform dermatoplasty of local skin flap,abdominal flap,dorsolateral flap of index finger,reticular thin flaps with pedical containing subdermal vessels and fascial flaps to the 15 hands with injuries of tendons,bones and joints;Cut off granular wound surface and transplant large piece of intermediate split thickness skin graft and full split thickness skin graft to 5 hands;transplant postage stamp-shaped razor-thin graft or intermediate split thickness skin graft to 14 hands.Results:In the 129 hands,103 hands could keep the functios in maximal degrees 1-2 weeks after burning,most of them could begin to move after taking out stitches and could care themselves in the end.After 4-5 weeks,the hands with deep Ⅱ burn could recovery functions after dressing change,new skin excision,transplantation of large piece of intermediate of full split thickness skin graft,All of Hands Could resume the functions.In 14 patients with transplantation of stamp-shaped skin flaps on granular wound surfaces of hands‘ bank and fingers,the contracture were prominent and claw hands were formed in the late phase.11 hands of mixed burns of deep Ⅱ and Ⅲ were self-healed after repeated dressing change,proliferative scars appeared 4-5 weeks after burn.Although local medication and active and passive training,the hands were still with dysfunctions and take operative plerosis in late phase.Conclusion:Deep burn of hands should be treated with corresponding methods 1-2 weeks after the burning,which could reserve the functions,decrease mutilation rate and prevent contracture of scars in greatest degrees.
随着生物医学模式向生物心理社会医学模式转变，仅以发病率、患病率、病死率作为反映临床治疗和卫生预防措施的效果存在一定的局限性，人们越来越多地以生存质量（quality of life,QOL)作为终点指标。特别对于肿瘤等严重危及生命但尚不能完全治愈的疾病，许多患者宁愿有一个短时间但高质量的生命，不愿痛苦地、低质量地活着。国内外对实体瘤的QOL研究较多，但对血液系统肿瘤和白血病、淋巴瘤等的研究较少，文章对QOL的概念、评价方法和在血液系统肿瘤中的应用作一介绍，并介绍FACT－G量表在国内的应用情况。
目的：探讨颅内肿瘤患者术前生存质量及其影响因素。方法：采用诺丁汉健康调查表（Nottingham health poofite,NHP)对89例CT、MRI诊断颅内肿瘤患者的生存质量进行评价研究。结果：颅内肿瘤患者术前生存质量的损坏程度与颅内肿瘤的大小之间没有线性关系，颅内肿瘤的体积＞25ml比≤25ml者生存质量差，颅内肿瘤位于右侧半球的患者比位于右侧半球的患者生存质量要差，肿瘤位于幕下者比幕上者生存质量更差，恶性程度高的颅内肿瘤患者显示了较差的生存质量。结论：对颅内肿瘤患者术前生存质量进行估计评价时，不仅要考虑社会、医学因素，还应考虑到肿瘤的位置、大小和恶性程度对术前生存质量的影响。
Background:It is significant how to reserve residual myodynamia of parients with spinal cord injury,increase the ability of self-care and make them return to the family and society.We adopted kinesitherapy to treat 35 patients with spinal cord injury and reported the results as follows.Objective:To observe the effect of kinesitherapy on the treatment of spinal cord injury.Unit:Orthopaedics Hospital of Jincheng City of Shanxi.Subjects:35 patients with spinal cord injury during January of 1999 to 2001,31 males and 4 females,aged from 16 to 71,with mean age of 35.2.The causes of wound 4 of crash wound,2 of falling wound,26 of road accident and 3 of other wounds.The site of injuries:7 in cervical vertebra,14 in thoracic spine,12 in lumbarvertebrae(T12-L1-4) and 2 in multiple segments.The courses were from 40 days to 5 years.Standard lesion degrees of ASIA92: 6 of grade A,8 of grade B,18 of grade C and 3 of grade D.Intervention:The kinesitherapy were taken in 4 stages:(1)Stage of lying in bed:exercise in bed,training motion of joints and stretching exercise mainly.(2) Stage of wheel chair:train muscles of pectoral girdle,biceps and triceps muscle of arm to increase myodynamia of upper limb.(3) Stage of standing:standing training,standing on bed from 30° to 90° to resolve postural hypotension from long-term bed,and train iliopsoas muscles,gluteus muscles,muscles of lumber and back and quadriceps of femoris.(4) Stage of walking:use proper braces according to the myodynamia until remedial walking and functional walking were achieved step by step.All the training were taken once a day.for 45 minutes per time,5 times per week and 1 course for 3 months.Results:Evaluate the effect of functional independence and rehabilitation of patients with standard by Specification of diagnosis and treatment of China Rehabilitation Medicine.Before therapy,there were non of grade 1,non of grade 2,1 of grade 3,1 of grae 4,8 of grade 5,12 of grade 6,13 of grade 7.After therapy,there were 2 of grade 1,3 of grade 2,10 of grade 3,7 of grade 4,5 of grade 5,5 of grade 6,3 of grade 7.Conclusion:Kinesitherapy could enhance the force of all the muscles which could still be used,improve the ability of residual myodynamia and functional ability and in crease the residual functions.
Objective:To study changes and significance of endothelin (ET) in rat cerebral concussion.Methods 80 Wistar male rats were used for animal model of cerebral concussion,which were sacrificed on 1,3,7,14 and 30 days after injury and the brain tissue were taken off.The expression of ET was studied in the course of cerebral concussion by means of immunohistochemistry.Results:Typical clinical manifestation was observed in the 100g group in which the pathological changes included cerebral vascular constriction and dilatation,congestion and edema of cerebral tissue,neuronal degeneration,necrosis,and obviously decreased even disappeared Nissl bodies.Increased expression of ET was observed on the first day,the positive area was seen in the plasma of endothelial cells in cerebral cortex,hippocampus,cerebellum and thalamus.ET expression peak occurred on the 7th day,the positive area was also found in the plasma of Purkinje cells in the cerebellum.Decreased ET expression was found on 14th day and returned to normal level on the 30th day.Conclusion:The main pathological changes of cerebral concussion contained blood circulation disorder,and degeneration and necrosis of substantial cells.ET was involved n the brain tissue injury during the pathological process of cerebral concussion and might be related to regulation of cerebral vascular reaction,and neuron degeneration and necrosis.
Background:Sodium β-esci is involved in Aesculus chinensis Bunge,Could increase the tension of veins,improve blood rheology making the blood flow faster,fasten the absorption of the edema around the cerebral infarction,and improves blood supply in the cerebral infarction and around it,and promote the recovery of brain function.Objective:To evaluate the effect of sodium β-escin on early rehabilitation of traumatic cerebral infarction.Unit:The 180th Hospital of PLA.Subjects:55 cases including 34 males and 21 females,aging 5-63 years(meanly 27.4 years),were contained in this study.Causes included traffic accident in 27 cases,falling injury in 16,pounding injury in 9,and craniotomy in 3.Hemiplegia of different levels was found in all cases,complete hemiplegia in 13,incomplete hemiplegia in 42,myodynamia I-Ⅳ.Accompanying aphasia was found in 6 cases.Diagnosis was cofirmed by cranial CT examination in all cases.Injuries were found in the basal ganglion in 35 cases,in the temporoparietal lobe in 12,in the occipital lobe in 6,and the frontal lobe in 2.No past history of hypertension or cardiovascular disease was found in any of the cases.All the subjects were randomly divided into test group (28 cases) and the controls(27 cases).There was no significant difference in age,location of the injury,injury time,seriousness,or functional disorder of the limbs between the two groups (P>0.05).Intervention:In the test group:Decompression withdrawing the bone flap was performed in two cases.Conservative treatment was performed in 26 cases,which contained (1) 25mg of sodium β-escin (provided by the Green Leaf Pharmaceutical Co,Yantai,Shandong) in 250ml of 5% glucose solution i.v.drop,once a day,15days a course,and (2) 125 ml of 20% mannitol i.v.drop,twice a day,which was gradually decreased till stopped in a week.In the controls:Decompression withdrawing the bone flap wasperformed in two cases.Conservative treatment was performed in 25 cases,which contained 91) 250 ml of 20% mannitol i.v.drop quickly,three times a day,which was gradually decreased to 125 ml,twice a day,then till stopped in another week.Other comprehensive treatments including using of vascular dilators i.e.low molecular dextran,compound Red sage root,nitrendipine injection etc,activators of the brain cells,nutrient supporting was same in the two groups.Patients in bothe groups received rehabilitation train in 24 hours after confirmed diagnosis according to the Rehabilitation rules of cerebrovascular diseases in the acute stage,made by the China Rehabilitation Center.Main Prognosis indexes:Limb motor functions of the patients before and after treatment was evaluated with the simple Fugl-Meyer Analysis(FMA).Activities of daily living (ADL) were evaluated with barthel index.Result:Conditions in the two groups before and after treatment were shown in table 1.Conclusion:Early use of sodium β-escin in treatment of cerebral infarction is beneficial for recovery of limb motor functions and ADL abilities and is beneficial for early rehabilitation of traumatic cerebral infarction.
Objective:To observe effects of meshed relaxing short incisions (MRSI) on the content of endothelin(ET) in rat tension skin flap,and to investigate the mechanism of meshed relaxing short incisions (MRSI) on wound healing process of tension skin flap.Method:We designed an experimental model to investigate the change of ET content caused by MRSI and observe the distribution of ET in rat skin flap tissue each period of wound healing.In the meantime,the immunohistochemistry and auto-image analysis were employed.Results:our results showed:(1) ET positive immunologic reaction granules involved in small vascular endothelial cell in rat skin flap tissue increased with prolonging of time within 3 days;(2)the content of ET in MRSI group were significant lower than that of hypertension group (P<0.05).Conclusion:The decrease of ET contents may be one of the causes that MRSI improves microcirculation of skin flap,and reduces edema and facilitates healing of skin flap.
Objective:To study on the CDKN2/P16 gene i primary osteosarcoma.Method:By using molecular biological methods that inclued genome DNA extraction from paraffined tissue and PCR-SSCP analysis technique,we studied alternations of CDKN2/P16 gene in 25 primary osteosareomas.Results:(1)The deletions frequency in differentiation degree of osteosarcomas was ①bone brood cell,16.7%;②cartilage brood cell,12.5%;③Fiber brood cell:20%,(P>0.05).(2)The deletion frequency in male patients was 17.6,female patients 12.5%,(P>0.05).(3)In early metastatic osteosarcomas the deletion rate was 33.3%,which was significantly higher than that of the control group with the rate of 10.5%(P<0.05).(4)The deletion rate was 16% and the mutations were not found.Conclusion:(1)The deletion rate was 16% and the mutations were not found.This suggests that the deletions of CDKN2/P16 gene were closely related to the genesis of primary osteosarcoma and that the main type of the alternation of CDKN2/P16 gene was deletion.(2) In early metastatic osteosaarcomas the deletion rate was 33.3%,which was significantly higher than that of the control group with the rate of 10.5%.This indicates to great extend that the deletions of CDKN2/P16 gene were closely related to the metastatic ability.(3)The deletions frequency had no significant relationship with differentiation degree of osteosarcomas,so was with the sex of the patient.
Objective:To observe the effect of physical factors and promotion canalization on closed injury of brain,Method:68 cases of closed injury of brain were given the comprehensive rehabilitation therapy with many physical factors and promoting canalization technique,Result:The patients‘ consciousnesses were significantly improved after treatment.The motorial function of hemiplegic limbs was distinctly improved(P<0.05).The balance functions were distinctly improved (P<0.001).The activities of daily living abilities were significantly improved (P<0.05).Conclusion:The physical factors and promoting canalization treatment on the closed injury of brain are functionally effective.
Objective:To assess motor function quantitatively on children with cerebral palsy before and after wearing ankle foot orthopedic instruments.Method:Ankle foot orthopedic instruments were made by Dalian Prosthesis Factory.Children‘ motor function was assessed with self-made quantitative assessment scale according to the forth,fifth function area of motor assessment scale of children with cerebral palsy after one week of wearing orthopedic instruments.Result:In all 23 patients,orthopedic instruments proved effective in controlling leg muscular tension,correcting equines,genu recurvatum,talips valgus and talipes varus,keeping erect posture and modifying gait.Motor function assessed show significant difference before and one week after wearing orthopedic instruments (P<0.001).Conclusion:Ankle foot orthopedic instruments play a positive role in improving motor function of lower extremity in cerebral palsy patients.
Vitrificated indicates the high adhesion state of solution at extremely low temperature(-115℃)^.No ice crystals are formed when extracellular and intracellular solution is under state of vitrification,and hence eliminating mechanic injury and preserving activity of biological tissues.In 1980‘s,cryopreservation of mouse embrgos,red cells,rats ocytes,human monocytes was successfully performed^[2-4].After that,some researchers successfully preserved cornea and skin by vitrification^[5-8].In order to elucidate preservation of cells and tissues by vitrification and widen apply of vitrification,we investigate principle of vitrification,solution,devitrification and its application.
Background:Secondary head injury following severe head trauma is a main factor affecting prognosis,treatment for which is an effective measure in improving prognosis.It is indicated that hyperbaric oxygen can facilitate recovery of injured nerve cells.Objective:To investigate effect of hyperbaric oxygen plus naloxone in the treatment of severe head trauma.Unit:Daping Hospital,Third Military Medical University.Subjects:During February 1999 to December 2001,50 patients suffered from head trauma aged 11-60 years were randomly divided into two groups,treatment group (hyperbaric oxygen plus naloxone beyond routine management) and control group(routing treatment),each group having 25 patients.Injury causes included traffic accidents(n=17),and falling injury(n=8).there were no significant difference in age,sex,and injury causes between the two groups.Severe head injury was confirmed at admission with GCS score varying between 3-8(P>0.05).GCS score was used to evaluate patients before and after treatment.GCS and KPS behavior evaluation was performed 3-6 months after discharge.Intervention:Routine treatment consisted of craniotomy(n=17),antiinfection,maintenance of water and electrolyte balance and decompression of intracerebral pressure for extensive axon injury,and neuroactivator management.10 cases was dead (40%),5 showed favorable rehabilitation (20%),3 suffered from moderate disability (12%),5 from severe disability,2 lived a vegetarian life (8%).Comatose lasted for 14 days averagely.In treatment group,16 accepted craniotomy,and 9 suffered from extensive axon injury.Treatment groups received hyperbaric oxygen plus naloxone beyond routine treatment.Patients undergoing surgery were treated 48 hours without operation received hyperbaric oxygen 24 hours after admission.Method:Patients were placed in a large Hyperbaric oxygen cabin and oxygen was given for 35min×2.0 xygen was given with mask or head mask under 0.2 MPa and an interval of 10 min.Pressure increase and decrease lasted for about 45 min,once a day.10 days was a treatment course.5-2 treatment course were adopted in our study.8mg naloxone was administered during hyperbaric oxygen treatment,once a day.Result:7 cases were dead(28%),12 showed good recovery (48%),4 suffered from moderate disability (16%),2 from severe disability (8%).Comatose time lasted for about 9 days for all patients.Conclusion:Hyperbasic oxygen plus naloxone can decrease mortality,disability rate,and rehabilitation duration after severe head trauma.
Background:Clinical manifestation of magraine is periodical onset of fluctuating headache caused by dysfunction of nerve-vessel,which mechanism is still unclear.Objective: To evaluate therapeutic effect of hyperbaric oxygen on magraine.Unit:Central Hospital of Jinzhou City.Subjects: According to diagnosis standards formulated by 1998 International Headache association,64 cases magraine in neural department of central hospital of Jinzhou city were randomly divided into 2 groups.Treatment group:12 males,20 females,aged 18-50 (mean:34)years old with disease course 4 months to 20 years (mean:4.5 years).Control group:13 males,19 females,aged 16-48(mean:33)years old with disease course 3 months to 18 years(mean:5 years).There was no obvious difference at sex,age,conditon between 2 groups.Intervention:Control group:Buflomedil was used,0.1g,once a day,venous injection and 14 days as a therapeutic course.Control group:On base of drug therapy,hyperbaric oxygen chamber therapy was adopted,raising pressure for 30-35min,stabilized pressure for 40 min,reducing pressure for 20 min,therapy pressure 0.2 MPa,once a day,10 days as a therapeutic course.Main prognosis index:Control:no relapse of headache when treating;Marked:Headache alleviated,continuing time shortened obviously,onset times reduced over 60%;Effective:Headache alleveated and continuing time shortened,onset times reduced over 50%;Ineffective:above standards couldn‘t be achieved.Result: Comparison of therapeutic effects between two groups see table 1.Conclusion: Both combination of hyperbaric oxygen with drug and simple drug therapy could reduce onset frequency of magraine,but combination therapy was more effective,and could shorten effect-producing time.
Background: To deep burn of hand,Some adopted natural healing,some adopted removal of eschar,thin and intermediate thickness skin flap repairing,But after healing,proliferation and contracture of scar of pigmentation,obvious dryness,no brightness,had elasticity often appeared that would reduce tolerance of abrade and impair function and appearnce of fingers.Objective: To investigate the clinical effect of full thickness skin graft after removal of eschar on deep burn of hand.Unit:169th Hospital of PLA.Subjects: 36 cases of deep burn of hand were investigated including 28 males,8 females,aged 2-46 years old among which were 24 cases of flame burn,6 cases of scald,3 cases of acid burn,2 cases of alkali burn with 8 cases at both hands,3 cases at both palm and dorsum of hand.Intervention:(1)After 6-8d,when edema disappeared,routine therapy was adopted to circular eschar,relief incision;One day before operation,wet packing with antibiotics and bandaging was adopted to achieve relative asepsis circummstance.(2) 0.5 before operatioin,surface of wound was brushed completely,hibitane soaking for 30 min complex iodine sterilizing operation region.(3)Eschar was removed under tourniquet.Necrosed tissue was deleted completely,avoiding injuring vessels (if longe quantity of bone substance was exposed,transferred to other method;After complet hemostasis,wet packing with saline containing antibiotics for 10 min.(4) Full thickness skinflap was reilled to keep apporiate tension.After suture subcutaneous stasis of blood was irrigated;Skin flap was pressed with bits of ganze and compression bandage.Finger and wrist were fixed with plaster support.(5) Antibiotics was used systemicly;Operation part was elevated and stitches were removed after 10d.Movement was started from 15-20d,and increased successively.Result:Wound surface of all cases healed within 25d,survival rate of skin flap was over 95%.After 0.5-1 year of follow-up,no obvious proliferation and spasm of scar and dysfunction were found,outward appearance of hand,elasticity,brightness and abrade tolerance approached normal level.Conclusion: Early full thickness skin graft could promote healing of wound surface in deep burn of hand and decrease incidence of dysfunction leaded by proliferation and spasm of scar.
Background:Massotherapy was the main method adopted in treatment of semiluxation of articulatio atlantoepistrophica and traction was also used.An obvious effect was observed when two methods were combined.Objective:To observe effect of massotherapy combined with traction on semiluxation of articulatio atlantoepistrophica.Unit:Guilin Hospital of Traditional Chinese Medicine.Subjects:47 cases were in vestigated including 27 males,20 females.29 cases were 4-12 years old,2 cases were 12-18 years old,16 cases over 18 years old.Injury history was found in 28 cases,respiratory infection or tonsillitis in 6 cases,degenerative lesion of cervical vertebral or strain of cervical muscles in 7 cases,indefinite reasons in 6 cases with disease courses 1 day to 6 weeks.Pain of cervical muscles in 47 cases,complicated with headache in 39 cases,dizzingess in 40 cases;Tender point at cervical part in 47 cases,limit of motion in 41 cases;Tender point at cervical part in 47 cases,limit of motion in 41 cases,torticollis in 6 cases.films of orthophoria and lateral and C1,2 were taken in all cases.Asymmetry of inter-space of articulation atlantoepistrophica in 47 cases,abnormal physiological curvature in 8 cases,hyperosteogeny in 7 cases,complicated with fracture of spinous process of C1 in 1 case.Main prognosis index:Excellent:symptoms and signs disappeared,X-film showed,middle axis of articulatio allantoepistrophica coincided;Good:symptoms and signs disappeared a large part,middle axis of articulatio atlantoepistrophica didn‘t coincided,or paralleled,improved than before;Fair:symptoms and signs improved than before,and middle axis of articulatio atlantoepistrophica improved than before;Bad:no improvement.Result:Excellent,9 cases;Good,20 cases;Fair,16 cases;Bad,2 cases;Total Effective rate,96%.Conclusion;Massotherapy combined with traction on semiluxation of articulatio atlantoepistrophica had an obvious therapeutic effect.
Background:Urinay incontience is complication following benign hyperlasia of prostate undergo endoscopic removal.Due to internal imbalance of micturition mechanism mainly,such as incompetence of posterior urethra or unstable detrusor.Urinary incontinence causes not only physiological,psychological disorder,but also family and social problems.Objective:To observe effect of rehabilitation exercises on urinary function of urinary incontinence patients following per urethrakprostate operation.Unit:South-west Hospital,Third Military Medical University.Subjects:1525 male patients,aged 62-95 years old.Perurethra prostate electric technique,prostate holmium laser were done under peridural or general anesthesia.Urinary catheter was removed at 3-5 days after operation.There were 78 cases urinary incontinence after urinary catheter was taken out.After urodynamic study and culture of midstream urine,78 urinary incontinence were divided into:imminent urinary incontinence 48 cases,compression urinary incontinence 26 cases,real urinary incontinence 4 cases.Intervention:(1)To imminent urinary incontinence caused by infection,first strengthening anti-infection treatment,sensitive antibiotic was used.Sitz bath in potassium permanganate warm water patients were encouraged to drink more water and get liquid 1500-2000ml/d in case of no venous inflow,drink water once every 2-3h.Urinary mechanical douche was kept so as to lighten urinary irritation.Water intake should be reduced at night and in winter.(2) To precipitant urinary incontinence caused by unstable bladder.Patients should be guided whten they had urination consciousness,horizontal and genuflex position,deep breathed,relaxed abdominal muscle,constracted pelvic muscle and sphincter of anus,time of urination was delayed as for as possible.After urgent feeling decrease,went to toilet.With improvement of self-controlled ability of urination,went of toilet at fixed time.Patients were warned to tried their best to micturite once each hour.They should micturite at fixed time as far as possible,the time was prolonged to once every 3-4h.According to rehabilitation state of patients later finally biofeedback model was formed.Results: 14 urinary incontinence caused by inflammatory stimulus,remitted after 7-21d,normal micturition recovered after 1 month,9 cases.In 25 cases of urgent urinary incontinence,12 cases could control micturition,after 2 weeks,7 cases could control micturition after 1 month,other 6 cases could control micturition partly.In compression urinary incontinence patients,16 cases couldf control micturition after 1 month.10 Cases kept exercises after discharge,in those 8 cases could control micturition after 2-3 months,2 cases could control micturition at daytime.Two real urinary incontinence patients symptom was improvement.Conclusion: Rehabilitation exercises of urinary incontinence patients after per urethra prostate operation can improve their micturition function effectively.
Objective:To explore the effect of rehabilitation through analysis the early enteral feeding on the prevention of enteral infection in severely burned patients.Method: A total of 22 Patients with severe burns were randomly divided into an early enteral feeding group (EF) and a delayed enteral feeding group (DF).The levels of serum endotoxin were detected in the members of both groups in 1,3,and 5 days.Result: The levels of serum endotoxin in severely burned patients were significantly higher than in normal subjects (P<0.01).The levels of serum endotoxin in the EF group were significantly lower than in the DF group (P<0.01).Conclusion:Early enteral feeding may decrease enterogenic infection and it helps the nutrition support,improve the patient resistance,facilitate the repair of damaged tissue,so it contributes to the rehabilitation of burned patients.
Background:The contraction deformity of hand proximal interphalangeal joint flexion often occurs after different injury of palmar digital skin,which has effections on hand functions in different extent (varying degrees) and brings many difficults to patients in their life and work.And marked effect are achieved when “X” plastic operation and postoperative recovery therapy are put into use.Objective:To investigate “X” plastic operation and curative effect of postoperative rehabilitative treatment of contraction deformity of hand proximal interphalangeal joint flexion.Unit:First Clinical Medical College of Harbin Medical Universkty.Subjects:4 patients,3 males and 1 females,all the deformity of six fingers were caused by deep trauma of hand skin,timely ranged from 0.5 to 8 years.Intervention:In the location of finger flexion contraction “X” incision was done across the joint,which reached deeply the surface of flexor aponeurosis and fully slacked contraction.After X-shaped incision,two side triangular flaps were formed,which should not be separated in order to prevent necrosis of tips.Two triangular flaps crisscrossed and were connected to finger flexion joint.One or two new surface of wound left over by proximal and distal ends of flaps can be done with free skin grafting of thick graft of thick faint graft.After operation the affected fingers were bandaged and fixed.The patients should be told passive flexion and extension of finger joint in early postoperative period and active floxion and extension in later period.The mobility should be refined to the range of joint sour and endurance.The child can be fixed for three months with plaster model or small splint according to the conditions and assigned with floxion and extension.Results: Flaps growed well after operation and all survived.Following up three cases half one year and founding that no one case recurred up to now ad the flaps were extending and the function of flexion and extension were good.Conclusion: Two side flaps caused by this operation can easily acrossly connect to the joint of flexion surface and can gradually extend with the flexion and extension of joint.It achieve marked effect that other operations cannot achieve.Early rehabilitative training after operation can not only add patients‘ confidence,make them fully realize the importance of practices,but also improve the early recovery of joint function.
Baskground:Ankylosis is the result of adhesion of knee extension apparatus that is often the complications of trauma of femoral shaft and knee.Because ankylosis will impair the flexion of knee joint,postoperational exercise is the key to rebuild flexing function of knee joint.Objective:To investigate therapeutic effect of rehabilitation treatment on ankylosis after relaxing and plastic operation of adhesion of knee extension apparatus.Unit:Yuanbaoshan Ore Hospital of Chifeng City.Subjects:38 cases of ankylosis were investigated including 29 males,9 females aged 23-58 (mean:36) years old,with disease course 7 months-5 years.All cases were given operation and after operation fixed with plaster,fixing time:58-142 (mean:94) days.Mobility of knee joint before operation:4 cases over 50°,7 cases over 40°,others 5°-30°(mean:24°0.x-ray showed:no deformity of space,atrophy of quadriceps muscle of thigh,bad mobility of patella.Relaxing and plastic operation of adhesion of knee extension apparatus was given to all cases.Intervention:Knee joint was fixed at maxium flexing degree with solichocnemic plaster.Skin blood should be paid attention to.24h after operation affected limb was layed on removable orthodontic applicance at daytime,passive movement of joint was adopted,with painlessness as discipline for flexing,normally 10°-80°,increased successively.Knee joint was fixed at flexion position at nighttime.Exercise,twice a day,2-3h every time.Active exercise was adopted in intervals of passive exercise:kicking toes,straight leg elevating,After 2 weeks of passive exercise and 3 weeks of active exercise,patients took simple activity active movement mainly.Combined physical therapy:hot compression,keeping for 3 months.Result:Follow-up survey 9 months-3years(mean:1 year and 4 months).motion range:60°-130°(mean:110°).Conclusion: Function exercises after relaxing and plastic operation of adhesion could promote self-repairing of articular cartilage,accelerate healing of articular cartilage and peripheral tissue and prevent adhesion.
Background:Blocking of cervical nerve ganglion is an effective method in treatment of cervical spondylopathy.Health education before and after operation could solve many nursing problems.Objective: To investigate effect of health education in treatment of cervical spondylopathy by blocking of nerve ganglion.Unit:Rongjun General Hospital of Shandong.Subjects:88 cases of cervical spondylopathy were diagnosed for cervical stifness,painess and numb of upper limbs,Including 61 males,27 females,aged 31-78 years old.Brachial plexus puling test and intervertebral foramen pulling test were both positive,and X-ray showed varying degrees of hyperosteogeny.Randomly divided into A group and B group.Intervention:A group:routine test and preparing before operation,answering questions asked;B group:reading case data,grasping condition,acknowledge of patients,mastering of information,and mental state,which was the base for health education.Health education varied with each individual.(1) Mental prepairing:Before blocking,besides answering requirement,the following must be explained:therapeutic method,aim,operational process,possible reaction,feelings in puncture and injection.It must be noted that patient shouldn‘t move body.(2)Position prepairing:To peridural anesthesia,patients were helped to exercise repeatedly embracing knees with two hands,flexing of head towards chest,flexing of knees towars abdomen.(3)Importance of determining “pressure pain point” which was often the location of lession.(4) Prevention of infection:Besides strict aseptic manipulation,patients were told to keep puncture position clean.(5) After treatment,patients were instructed to press back cervical vertebral joint,extending neck fully backward.Families were instructed massotherapy to prevent relapse.Result:Effect of pain relieving in two groups was satisfying,but increasing of blood pressure,speeding of pulse,hematoma at puncture portion appeared,in A group,11 cases in 45cases(24%),in B group 3 cases in 43 cases(7%).After 6 months of follow-up,9 cases relapsed in 45 cases(18%)in A group while in B group,2 cases relapsed in 43 cases(5%).All data was dealed with χ^2 test,there was obvious statistical significance(P<0.05).Conclusion:In treatment of cervical spondylopathy by ganglion blocking,effective education could make patient accept treatment physiologically and mentally,change behaviors harmful to health,achieve a healthy state of mind and body reducing relapse of disease.
Background:The clinical symptoms of disorders of temporomandibular joint,clicking of joint and dyscinesia of mandibular,which treatment ways are virious and its curative effect is different.Objective:To explore the effect of the ulotrasonic wave treatment of 116 patients with disorders of temporomandibular joint.Unit:Affiliated Second Hospital of Qiqihaer Medical College.Subject:116 patients with temporomandibular joint,47 males and 69 females,aged 14-70 years old,average 36 years old.Disease history recorded from 2 days to several months.Pathosenic parts:18 cases were bilateral,42 cases were dextral and 56 cases were left.Pathogenic factors included mental,traumatic and others factors.clinical stages:75 cases in dysfunction period of masseter (65 per cent),36 cases in disturbance period of structure of joint (31 per cent) and 5 cases in period of organic changes.Intervention:With CSL-I type ultrasonic wave treatment machine produced by Shanghai,frequency 800 kHz,diameter 3.5cm,we used the method of contact and movement,which adopted liquid paraffin as coupled agent.We told patients open mouth slightly and placed sound-head on the part of temporomandibular joint,0.75-1.0W/cm,once 10 minutes,once each day and 10 days as a treatment course.We can observe the effect after two courses of treatment,meantime adopt comprehensive treatment like rehabilitative therapy to eliminate causes of diseases.Main result measurements index:recovery:joint pain disappears,extent of opening mouth normal,snap disappears and figure of opening mouth abnormity disappears;improved:joint pain obviously alleviates,extent of opening mouth obviously improves and snap and figure of opening mouth alleviate;ineffective:no changes before and after treatment.Results:75 cases disorders of masseter function,75 cured (58 in one treatment course,17 in two treatment course),recovery rate 100 per cent;36 cases of disorders of joint structure,28 cured (18 in one treatment course,10 in two treatment course),recovery rate 77.78 per cent.8 cases improved (two treatment courses),total effective rater 100 per cent;5 cases of organic changes,4 cases improved (two treatment courses),1 case ineffective,total effective rate 80 per cent.Conclusion:The treatment of ultra wave of temporomandibular joint can alleviate pain and improve blood circulation,ralax contracted muscle,and improve injury recovery.
Objective:To study to therapeutic effectof reconstruction in improving trachea-esophagus vocalization after total laryngectomy.Method:We reviewed the reconstruction of vocalization with trachea-esophagus tunnel in 12 cases patients of total laryngectomy,i.e.a triangular mucous valve was made by incision of the posterior wall of the trachea with the correlative anterior wall of the esophagus made into a tunnel and the mucous valve would vocalize.Result:11 of the 12 cases obtained successful vocalization,counting for 91% of the total.Atresia of the vocalizing valve occurred in one case.Conclusion:Trachea-esophagus tunnel vocalization reconstruction has better therapeutic effect with good vocalization effect and fewer complications and easily performed.It avoided the shortcomings of necrosis and atresia of the vocalization valve and pharyngeal fistula formation,and the complexity of exchange of artificial vocalization tube again and again.