目的：總結我們對表現為麻痹性癡呆的晚期神經梅毒的診治經驗。方法：報道4例麻痹性癡呆病例，并復習相關文獻。結果和結論：麻痹性癡呆的臨床表現復雜多變，早期誤診率高；診斷主要根據臨床特點、血清學及腦脊液檢查綜合考慮；治療上仍首選水劑青霉素G。
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.
目的:探討被誤診為功能性精神障礙的麻痹性癡呆患者的臨床特點和診治要點。方法:回顧性分析10例被誤診為功能性精神障礙的麻痹性癡呆患者的臨床資料。結果:被誤診為功能性精神障礙的麻痹性癡呆均以精神癥狀為首發，多表現為精神病性癥狀、類躁狂、抑郁、類神經癥、人格的改變及進行性癡呆等不典型癥狀群，本研究顯示誤診率高達71.4%，誤診例次率以精神分裂癥最高（47.3%），其次為躁狂癥或躁狂狀態（37.5%）。抗精神病藥物能有效改善精神癥狀，青霉素驅梅能阻止病情進展使病情得到緩解，兩者缺一不可。結論:被誤診為功能性精神障礙的麻痹性癡呆均以精神癥狀為首發且癥狀不典型而易被誤診，早期鑒別診斷十分重要，抗精神病藥物和青霉素治療可以有效控制癥狀。
【摘要】 目的 觀察應用不同手術方法矯正麻風麻痹性下瞼外翻的療效。 方法 2006年10月-2009年11月，共收治麻風麻痹性下瞼外翻68例115眼，根據患者下瞼外翻程度和局部專科情況，分別采用顳肌移位+闊筋膜移位懸吊固定術（Johnson法），改良顳肌移位術，下瞼板縮短外眥韌帶懸吊固定術，眼輪匝肌島狀皮瓣，眼輪匝肌懸吊固定術以及絲線懸吊固定術矯正眼瞼外翻。 結果 68例115眼成功率98.9%，手術后由于下瞼外翻導致的各種合并癥明顯好轉。隨訪觀察4～11個月所有患者術后效果良好，無復發。 結論 麻風麻痹性下瞼外翻的手術治療應根據患者的不同情況選擇合適的手術方法，才能達到最佳的矯正效果。【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：觀察柴芩承氣湯治療重癥急性胰腺炎(SAP)并發麻痹性腸梗阻 (Paralytic Intestinal Obstruction)的療效。方法:依據納入和排除標準,選取四川大學華西醫院中西醫結合科收治的SAP患者40例,按1∶1比例隨機分成試驗組(20例)和對照組(20例),試驗組入院時即給予柴芩承氣湯灌腸治療,對照組使用安慰劑灌腸治療;兩組入院時基線資料差異無統計學意義(Pgt;005)，且兩組均給予相同常規西醫治療。觀察入院后其首次自行排便排氣時間,入院時、入院后第3天、第7天APACHEⅡ評分及住院病程。結果:入院后首次自行排便排氣時間試驗組（302±154）天,低于對照組（453±241）天;入院后第3天APACHEⅡ評分試驗組（925±184）分，低于對照組（1163±222）分;入院后第7天APACHEⅡ評分試驗組（624±247）分，低于對照組（881±325）分。住院時間試驗組（2453±426）天,低于對照組（3032±589）天。結論:早期應用柴芩承氣湯灌腸治療SAP并發麻痹性腸梗阻,可縮短麻痹性腸梗阻的持續時間及減輕其危害,減少住院病程。