الملخص
OBJECTIVE@#To compare the clinical effect on intestinal dysfunction of spinal cord injury (SCI) between the comprehensive therapy of moxibustion (moxibustion for opening the governor vessel and regulating the spirit) and rehabilitation training and the simple treatment with rehabilitation training.@*METHODS@#A total of 60 patients with intestinal dysfunction of SCI were randomized into a comprehensive therapy group and a rehabilitation group, 30 cases in each one (3 cases were dropped out in each group). On the base of the routine western medicine treatment and rehabilitation training, the bowel training and rectal function training were provided, once a day in the rehabilitation group. In the comprehensive therapy group, on the base of the treatment as the rehabilitation group, the moxibustion was exerted at Yaoyangguan (GV 3), Mingmen (GV 4), Zhiyang (GV 9), Dazhui (GV 14) and Baihui (GV 20), etc, once a day, 30 min each time. In both groups, the treatment for 4 weeks was as one course and 3 courses of treatment were required. Separately, before treatment, after 4, 8 and 12 weeks of treatment, the scores of neurogenic bowel dysfunction (NBD) and World Health Organization quality of life scale (WHOQOL-BREF) were observed and the clinical effect was evaluated after 12 weeks of treatment.@*RESULTS@#After treatment, the total effective rate was 88.9% (24/27) in the comprehensive therapy group, which was higher than 74.1% (20/27) in the rehabilitation group (<0.05). After 4, 8 and 12 weeks of treatment, NBD scores were all reduced obviously as compared with those before treatment in the two groups (all <0.01). After 8 and 12 weeks of treatment, NBD scores in the comprehensive therapy group were lower than the rehabilitation group (both <0.05). After 4, 8 and 12 weeks of treatment, the scores of all of the domains (psychology, physiology, social relations and environment) in WHOQOL-BREF were higher than those before treatment in the two groups (all <0.01). After 4 weeks of treatment, the scores in the psychology and physiology domains in the comprehensive therapy group were higher than the rehabilitation group (all <0.05). After 8 and 12 weeks of treatment, the scores of all of the domains in the comprehensive therapy group were higher than the rehabilitation group (all <0.05).@*CONCLUSION@#The comprehensive treatment of moxibustion and rehabilitation training achieves the better effect on intestinal dysfunction of SCI than the simple rehabilitation training and greatly improves the quality of life in SCI patients.
الموضوعات
Humans , Acupuncture Points , Moxibustion , Quality of Life , Spinal Cord Injuries , Therapeuticsالملخص
Objective To explore the surgical skills and efficacy of microsurgical excision of large acoustic neurinoma via the suboccipital retrosigmoid keyhole approach. Methods Fifty-nine patients with large acoustic neurinoma (≥3 cm) underwent microsurgical resection via suboccipital retrosigrmoid keyhole approach. The intraoperative position of the operative bed and angle of the microscope were adjusted to expose the tumors sufficiently. The duramater was sutured tightly and the bone flap was replaced and fixed. Results Of the 59 patients, 53 (89.8%) received a total resection of the tumors, and 6 (10.2%) subtotal resection. No patient died. The facial nerve was anatomically preserved in all the patients. Forty-five patients (76.3%) suffered from mild or moderate facial palsy after the surgery, and the symptoms were improved significantly after expectant treatment. Fifteen patients preserved partial hearing. No subcutaneous water accumulation or cerebrospinal fluid leakage occurred.Conclusion Microsurgery via suboccipital retrosigmoid keyhole approach is a favorable treatment for large acoustic neurinomas with low morbidity and mortality,which can effectively protect the function of the acoustic and facial nerves.