影象病例讨论

脊柱与四肢骨关节慢性病损手法治疗前后影像学检查病例分析thecaseanalysisoftheimageologicalexaminationbeforeandaftermassagetreatmentswhicharethechronicdiseasesofthespineandlimbsoftheosteoarticular 广西中医药大学附属瑞康医院韦贵康RuiKangHospitalAffiliatedtoGuangxiUniversityofChineseMedicineWeiGuikang 我们在深入研究脊柱与四肢骨关节慢性病损手法治疗过程中 合理使用影像学 X线 CT MRI 检查 作为检查常规 对提高诊断准确率及提高疗效很有帮助 现将一些典型的病例分折如下 Whileweareresearchingthetreatmenttothechronicdiseasesofthespineandlimbsoftheosteoarticular it shelpfulforustouseimageologicalexamination X rays CT MRI reasonablytoincreasetheaccuracyrateofdiagnosisandtherapy Nowwesharesometypicalexamplesforyou 微屈前推法 园筒整复法治疗颈曲变直病例 例1 吳X 男 31岁 颈僵痛伴眩晕半年 x线片提示 颈曲变直 手法治疗2天1次 5次后颈僵痛眩晕消失 x线片检查颈曲有改善 Example1 Mr Wu male 31yearsold hehadalreadyfelttheneckstiffandpainanddizzinessforhalfayear X raysreported thecurveoftheneckbecamestraightened Heacceptedthemassageonceintwodays After5times hefeltbetterandthesymptomdisappeared X raysreportedthatthecurveoftheneckbecamebetter 颈曲变直手法治疗后改善Afterthemassage thecurveoftheneckbecamebetter 治疗前beforethetreatment 治疗后afterthetreatment 例2 李x 女33岁 颈痛伴上肢麻痛3个月 x线片提示 颈曲变直 手法治疗2天1次 4次后颈痛伴上肢麻痛消失 x线片检查颈曲有改善 Example2 Mrs Li female 33yearsold shehadalreadyfelttheneckpainandupperlimbsnumbfor3months X raysreported thecurveoftheneckbecamestraightened Sheacceptedthemassageonceintwodays After4times shefeltbetterandthesymptomdisappeared X raysreportedthatthecurveoftheneckbecamebetter 治疗前beforethetreatment 治疗后afterthetreatment 按语 1 40岁以前颈椎疾病伴有颈曲变直 通过手法 练功等方法 颈曲有不同程庋恢复 有利了临床症的消除或缓解 Note 1 Ifyouhavesomediseasesaboutcervicalvertebrawiththecurveoftheneckstraightenedbefore40yearsold wecanusemassage practiceandsoontorecoverthecurveoftheneck Throughthisway thesymptomscanbeeliminatedorrelieved 2 中年老年人 不强求颈曲恢复 应进行综后分析 对因治疗 2 Themiddleandtheolddon tneedtorecoverthecurveoftheneck theyshouldanalyzesyntheticallyandthenchoosetherightwayfortreatment 俯卧均衡牵引架 自制专利产品 加手法治疗 症状伴有腰曲变直 或脊柱侧弯畸形 或骨盆两侧不等高随着症状消除或改善 复查x线片原异常者得到相应改善 Prostratebalancedtractionframe homemadepatentproduct withmassagecanbeused Thecurveoflumbarbecomestraightened thelateralbendingofspinebecomeabnormalorthebothsidesofpelvisbecomedifferent Whilethosesymptomswereeliminatedorrelieved theytookX raysanditreportedthatthepatientsbecamebetterthanbefore 提法 左右摆法 腰曲治疗前Thecurveoflumbarbeforethetreatment 腰曲治疗后Thecurveoflumbarafterthetreatment 治疗前后beforeandafterthetreatment 动态推拉法 摆动整复法 侧弯治疗前thelateralbendingbeforethetreatment 侧弯治疗后thelateralbendingafterthetreatment 闭孔小治疗前obturatorformamenbeforethetreatment 闭孔小治疗后obturatorformamenafterthetreatment 手法治疗髋关节半脱位 顺向牽拉 反向复位 如患下肢外旋变长 采用下肢外展外旋 屈曲内收内旋伸直 Themassagetreatscoxaesubluxation Followthedirectiontopull reversethedirectiontorestoration Ifthelegsexternalrotationbecomelong weshouldadoptabductionandexternalrotation flexionadductionandinternalrotationandtostraightenit 髋半脱治疗前coxaesubluxationbeforethetreatment 半脱治疗后coxaesubluxationafterthetreatment 髌骨上移或下移测量法 髌股角测量法 正常值100 110 小于100 为髌骨下移 大于110 为髌骨上移 髌骨下移手法一一收紧法髌骨上移手法一一放松法Thewaytomeasurepatellatomoveupordown Themethodsofpatellofemoralangle thenormalrangeis100 110 Below100 isaspatellatomovedown above110 isaspatellatomoveup Themassagetotreatpatellatomovedowniscalled一一TighteningMethodThemassagetotreatpatellatomoveupiscalled一一RelaxationMethod 正常髌股角thenormalpatellofemoralangle 髌骨上移patellatomoveup 髌骨正常与下移thenormalpatellaandpatellatomovedown 误诊误用手法 针灸治疗无效 手术后手法外烫中药治疗 完全康复病例 张某 女 12岁 颈痛3个月 当地手法 针灸法疗3个月无效 来诊MRI检查为脊膜瘤 后手术治疗 术后行走失稳 两于发胀 采用手法 外烫中药 半年后完全康复 1年观察 完全康复 Previously thepatientacceptedthewrongdiagnosis wrongmassageandacupuncturewithnoeffect AfterthesurgeryweusedmassageandheatingwithChineseherbalmedicineastreatment Finallythepatientwascured MissZhang female 12yearsold shehadalreadyfelttheneckpainfor3months Andthemassageandacupuncturedidn tmakeeffectforher MRIreportedthatitwasspinalmeningioma Thensheacceptedthesurgery Afterthesurgeryshewalkedoutofbalanceandherhandsfeltswollen SoweusedmassageandheatingwithChineseherbalmedicineastreatment Afterhalfayearshewascured Andweobservedherayear shewastotallycured 手术前beforethesurgery 正位hemangioma 横切transection 术后即照 行走稍失稳 两手有些账thepicturewasrightafterthesurgery shewalkedoutofbalanceandherhandsfeltswollen 术后横切afterthesurgerytransection 术后手法加中药外烫 半年后MRI复查afterthesurgery sheusedmassageandheatingwithChineseherbalmedicineastreatment AfterhalfayearshetookMRI 手法后横切afterthemassagetransection 手术后3年 各症全消除 能正常参加学校体育活动 复查X线片Afterthesurgery3years allthesymptomsweredisappeared Shecouldtakepartinactivities ThiswasthepictureofX rays 误诊误用手法病例 例1 陈某 女 65岁 背痛2年 曾按一般背痛治疗无效 后MRI捡查为胸9椎体血管瘤手术治疗而愈 Theexampleofthewrongdiagnosisandwrongmassage Example1 Mrs Chen female 65yearsold backpain2years Shehadalreadyacceptedsometreatmentsbuthadnoeffect MRIreportedthatitwasthe9ththoracicvertebrahemangioma Afterthesurgeryshewascured 胸椎体血管癅thoracicvertebrahemangioma 椎体血管瘤centrumhemangioma 例2 陈某 女 35岁 腰痛2年半 曾按腰椎间突出症采用手法 针灸 理疗等治疗无效 后MRI捡查为腰椎管脊膜瘤手术治疗而愈 Example2 Mrs Chen female 35yearsold loinpaintwoandahalfyears Shehadalreadyacceptedmassage acupuncture physiotherapyandsoonforprolapseofthelumbarintervertebraldisci Buthadnoeffect MRIreportedthatitwaslumbarspinalmeningioma Afterthesurgeryshewascured 脊膜瘤spinalmeningioma 讨论 1 脊柱与四肢骨关节病损的诊治 要重视并合理选用影象学 X线 cT MRI 检查 这对诊断 鉴别诊断与治疗方法的选用有重要意义 Discuss1 Thetreatmentsforspineandlimbsoftheosteoarticularshouldvalueandchooseimageologicalexamination X rays CT MRI reasonably It ssignificantforustodiagnose differentialdiagnosisandchoosetherapeuticmethods 2 脊柱与四肢骨关节病损手法治疗 要重视结构改变 采用一些针对性手法 收到良好效果 但结构异常存在易留隐患 病情容易复发 2 Whenwetakemassageforspineandlimbsoftheosteoarticular weshouldvaluethechangeofthestructureandusesometargetedapproaches Itwillgetbetterresults Buttheabnormalstructurewillexisthiddendangerandtheillnesseasilyreappears 3 脊柱与四肢骨