玻璃酸钠液治疗颞下颌关节紊乱病的疗效观察

目的:探讨玻璃酸钠与利多卡因治疗颞下颌关节紊乱病(TMJID)的效果。方法:将62例患者随机分为治疗组36例和对照组26例,治疗组用玻璃酸钠注射液5mg加2%利多卡因0.5ml在颞颌关节上腔注射,对照组用2%利多卡因1ml在颞颌关节上腔注射。结果:治疗组总有效率为86.11%,对照组总有效率为50.00%,两组差异有统计学意义。结论:玻璃酸钠注射液关节腔注射治疗TMJID,可获得较好效果。

颞下颌关节镜治疗关节盘不可复性前移位的临床研究

目的评价应用颞下颌关节内镜手术治疗关节盘不可复性前移位所致张口受限的临床疗效。方法选取深圳大学第一附属医院口腔科2007～2009年保守治疗6个月以上无效,术前MRI检查发现关节盘出现不可复性前移位的关节内紊乱患者23名(28侧关节),局麻下进行行颞下颌关节镜手术治疗,采用关节上腔前后隐窝双通道手术(包括灌洗术、粘连松解术、关节盘盘前松解+盘复位术)。主客观评价资料视觉模拟疼痛指数评估(visual analogue pain score,VAS),张口度及MRI检查在术前和术后7,30和60d及以上收集分析,评价颞下颌关节镜手术的疗效。结果术后各时间段开口度与术前相比差异有显著性(P<0.01)。治疗后6个月最大张口度平均值由(20.4±4.5)mm改善至(38.9±3.2)mm较治疗前差异有显著性(P<0.01),视觉模拟疼痛指数评估(VAS),由术前的(56.4±9.9)改善至(9.2±2.7),差异有显著性(P=0.0023)。术前MRI检查所有患者均可见关节盘不可复性前移位,其中18侧(18/28,64%)关节可见关节盘变形,5侧(5/28,18%)关节腔内可见积液。术后60d复查MRI,发现14侧关节盘与术前相比位置明显改善,13侧关节盘与术前相比位置少许改善,1侧关节盘无改变。所有颞下颌关节镜手术过程顺利,术后无并发症的发生。结论该颞下颌关节镜手术是一种安全性高,创伤小,并能有效改善关节区疼痛和下颌运动受限的治疗方法,并且关节盘位置明显改善。与开放手术相比较拥有风险性小,并发症少,恢复快等优势,成功率高能有效治疗颞下颌关节盘不可复性前移位,前景光明,值得在临床进一步推广。

An Investigation into Disease Progression and the Correlation between Diabetes Mellitus and Hepatocellular Carcinoma

Diabetes mellitus has been associated with anincreased risk of hepatocellular carcinoma in recent studies ofpatients. At the same time, advanced hepatocellular carcinomaitself can cause glucose intolerance and can aggravate diabetes.Diabetes mellitus inducing hepatocellular carcinoma may resultin changes in the following aspects: dysfunction of organism,endocrine hormone balance and interactions, endothelins andso on. One way, diabetes mellitus may induce hepatocellularcarcinoma through the effects of chemotherapeutics and otheradjuvant drugs. This review outlines the relationship betweendiabetes mellitus and the risk of hepatocellular carcinoma as wellas treatments for hepatocellular carcinoma, which may be helpfulfor clinicians.