CT引导下肺结节定位针拖尾法定位联合胸腔镜肺段切除术治疗早期肺腺癌的临床效果

目的 探讨CT引导下肺结节定位针拖尾法定位联合胸腔镜肺段切除术治疗早期肺腺癌的临床效果。方法 选取110例早期肺腺癌患者,随机分为观察组(n=57)和对照组(n=53)。给予观察组CT引导下肺结节定位针拖尾法定位联合胸腔镜肺段切除术治疗,给予对照组常规CT引导定位联合胸腔镜肺段切除术治疗。比较两组患者的手术指标,手术前后的肺功能指标、肿瘤标志物、生存质量,以及手术并发症发生率。结果 观察组患者的定位时间、引流时间和术后住院天数短于对照组,一次定位准确率高于对照组(P<0.05),但两组的手术时间、术中出血量、引流量、淋巴结清扫数差异无统计学意义(P>0.05)。术后3个月,两组患者的最大自主通气量、第1秒用力呼气容积、用力肺活量、一氧化碳弥散量比较术前降低,但观察组上述肺功能指标优于对照组(P<0.05);两组患者生存质量各领域得分和总得分较术前升高(P<0.05),但两组生存质量各领域得分和总得分差异无统计学意义(P>0.05);手术前后两组患者的血清癌胚抗原、糖类抗原125、细胞角蛋白19片段抗原21-1、鳞状细胞癌抗原水平差异无统计学意义,两组患者手术并发症发生率差异亦无统计学意义(P>0.05)。结论 行胸腔镜肺段切除术治疗早期肺腺癌时,采用CT引导下肺结节定位针拖尾法定位有助于术前精准定位病灶,缩短术中定位时间和引流时间,对患者肺功能影响小,促进患者术后恢复。

复杂性后尿道狭窄尿道拖入直针吻合36例

目的：采用后尿道瘢痕切除前尿道游离后，拖入直针外翻吻合使尿道恢复通畅。方法：３６例患者均行腹会阴切口切除瘢痕组织，拖入前尿道采用自制直针外翻吻合。结果：术后３～４周出院，出院后需扩张２５例，占６９．４％，不需扩张１１例占３０．６％，经５～１０年随访效果良好。结论：复杂性后尿道狭窄采用瘢痕切除后直针外翻吻合疗效可靠，可推荐使用。

从络病辨治扽针治疗顽固性面瘫随机平行对照研究

[目的]观察扽针治疗顽固性面瘫疗效。[方法]使用随机平行对照方法,将46例门诊患者按就诊顺序编号简单随机分为两组。对照组23例主穴：患侧丝竹空、颧髎、翳风、风池、牵正、颊车、地仓、双侧太冲、合谷。配穴：眉毛不能上抬取阳白、头临泣;鼻唇沟变浅取迎香;下眼睑闭合不全取四白;人中沟变浅取人中。斜刺或平刺0.8~1.5寸。常规针刺,得气后适度深刺增强针感,以耐受为度。治疗组23例主穴：患侧丝竹空、颧髎、牵正（在面颊部,耳垂前0.5~1寸处）、翳风、风池、双侧太冲、合谷,用1.5~2寸28号不锈钢毫针针刺以上穴位,平补平泻,得气基础上适度深刺增强针感。扽针法,取3寸28号不锈钢毫针由颊车向地仓方向透刺2~2.5寸,同一方向捻转针柄直至不动,形成人为滞针,然后手持针柄向耳后方向小幅度牵拉数次,使患者局部产生酸胀感为度;配穴同对照组。治疗40d为1疗程。观测临床症状、面神经功能评分、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈17例,显效3例,有效2例,无效1例,总有效率95.65%;对照组痊愈8例,显效8例,有效4例,无效3例,总有效率86.95%;治疗组疗效优于对照组（P〈0.05）。[结论]扽针治疗顽固性面瘫,疗效满意,无严重不良反应,值得推广。

Evaluation of Therapeutic Effect of Maneuver-Dominated Method in 30 Cases of Cervical Spondylotic Myelopathy

Thirty cases of cervical spondylotic myelopathy (CSM) were treated by a maneuver-dominated non-surgical therapy. Eighteen cases were recovered to grade E according to the criteria set by the American Spinal Injury Association. The effect was definite. Indications and contraindications of the maneuver were proposed on the basis of the pathogenesis of CSM and the principles of this manual method.

Therapeutic Efficacy Observation on Combining Intermittent Traction with Warm Needling for Cervical Radiculopathy

Objective:To observe the clinical effect of combined intermittent traction with warm needling for cervical radiculopathy.Methods:A total of 100 cases with cervical radiculopathy were randomly allocated into an observation group and a control group.Cases in the observation group were treated with intermittent traction coupled with warm needling,whereas cases in the control group were treated with warm needling alone.The therapeutic efficacy was observed after 20-day treatment.Results:The markedly effective rate in total was 90.0%in the observation group,versus 78.0%in the control group,showing a statistically significant difference(P<0.05).Conclusion:Combining intermittent traction with warm needling is safe,convenient and significantly effective for cervical radiculopathy.It is worth further popularization in clinical practice.