腰椎间盘突出是临床常见疾病,部分病人可通过保守治疗缓解症状,甚至在没有治疗干预情况下,出现突出髓核的自发吸收现象.目前有关腰椎间盘突出自吸收的相关病例已有报道,但极短时间自吸收病例较少,我科于 2017 年发现 1 例 9 天内腰椎间盘突出自吸收病例,现报道如下.

带状疱疹是疼痛科的常见疾病,在韩国2011年其发病率为10.4/1000人,随着年龄的增加发病率升高,60岁以上人群年发病率达22.4/1000人[1].胸背部是带状疱疹最常累及的区域,占总病例数的50％～70％ [2],大多数病人受累皮区的疱疹通常伴随疼痛.急性期带状疱疹性神经痛是指带状疱疹病程小于1月的神经痛,严重的急性期带状疱疹性神经痛影响病人日常活动及睡眠,需要大量镇痛药物的使用,如果早期不能得到良好的诊治,则可发展为更顽固的带状疱疹后神经痛 [3].

目的:观察超声引导下星状神经节阻滞联合低剂量糖皮质激素治疗急性期贝尔面瘫(Bell palsy)的疗效及安全性.方法:2016年11月至2018年1月收治的急性期贝尔面瘫病人60例,按随机数字表法分为2组(n=30):常规剂量糖皮质激素组(S组)和星状神经节阻滞(stellate ganglion block,SGB)联合低剂量糖皮质激素组(T组),在治疗第1、2、3、4周采用House-Brackmann(H-B)面神经功能分级评估疗效,记录T组病人颜面部红外热成像变化和治疗中两组出现的不良反应,并评价治疗3月后两组优秀率、总良好率.结果:T组在治疗第1、2、3、4周H-B分级明显优于S组(P<0.05).T组所有阻滞病人红外热成像示阻滞侧颜面皮温较对侧明显升高,T组出现2例喉返神经阻滞.3个月后随访,T组优秀率、总良好率为73.33％、93.33％,明显优于S组优秀率、总良好率46.67％、73.33％(P<0.05).结论:超声引导下星状神经节阻滞联合低剂量糖皮质激素可减少糖皮质激素用量,是一种治疗急性期贝尔面瘫安全有效的方法.

Objective To observe the effects of linear polarized near infrared light irradiation (Superlizer, SL) in the treatment of patients with pressure ulcer of stage Ⅱ, and explore the proper treatment parameters.Methods Fifty patients with pressure ulcer of stage Ⅱ according to National Pressure Ulcer Advisory Panel (NPUAP) were randomly divided into 70％ power group and 100％ power group, 25 cases in each group.The cure rate, effective rate and average wound healing time were observed in the two groups.Results The effective rate and cure rate were 78.4％ (29/37 wound numbers) and 51.4％ (19/37 wound numbers) respectively in 70％ power group, which were obviously lower than 92.5％ (37/40 wound numbers) and 65.0％ (26/40 wound numbers) in 100％ power group.The average healing time (17.5±2.2) d in 70％ power group was significantly longer than that of 100％ power group (14.9±2.3) d.Conclusion The effects of linear polarized near infrared light irradiation with B probe 100％ power are better than 70％ power in the treatment of pressure ulcer of stageⅡ, and its average healing time is shorter.