黄疸后遗症是新生儿时期发生高胆红素血症从而对大脑造成损害所致的临床后遗症,扭转痉挛作为黄疸后遗症的远期神经系统并发症较为罕见,对于该病的具体治疗方案报道较少。本案例报道1例黄疸后遗症引起的扭转痉挛的病例,患者紧张时头颈不自主向右扭转,伴有肌张力障碍和步态异常,通过予以药物、理疗、光照疗法等综合康复治疗后,症状较前缓解,为该病的临床治疗提供了新的思路。Sequelae of jaundice is a clinical sequela that arises from hyperbilirubinemia during the neonatal period, leading to cerebral impairment. Torsion spasms, a rare neurological complication of sequelae of jaundice, have been infrequently reported, and there is a paucity of literature addressing treatment options for this condition. In this case, we present a case of torsion spasm resulting from sequelae of jaundice, in which the patient exhibited involuntary right-sided rotation of the head and neck during tension, accompanied by dystonia and impaired gait. The symptoms were mitigated following a comprehensive rehabilitation treatment approach that incorporated medication, physical therapy, and light therapy, offering a novel approach for the clinical management of this condition.
膝关节置换手术产生的创伤刺激常使患者术后承受着中到重度疼痛,这不仅使患者术后体验不佳,疼痛应激还会加重机体的内环境紊乱,对患者的术后康复产生不利的影响。现在多模式镇痛理念越来越多被应用到术后镇痛中,即将多种不同机制的镇痛药物和镇痛方法进行合理有效的结合,发挥最佳的镇痛效应。布比卡因脂质体作为一种具有稳定性和长效性特点的新型缓释局麻药在术后多模式镇痛中得到越来越多的应用,尤其是应用在膝关节置换术后镇痛。文章综述了布比卡因脂质体应用于膝关节置换手术后镇痛的应用进展情况。The traumatic stimulus produced by knee replacement surgery often causes patients to suffer from moderate to severe pain after surgery, which not only makes the patient’s postoperative experience poor, but also aggravates the internal environmental disorders of the body, which adversely affects the patient’s postoperative recovery. Nowadays, the concept of multimodal analgesia is more and more often applied to postoperative analgesia, which is to reasonably and effectively combine multiple analgesic drugs and analgesic methods with different mechanisms to exert the best analgesic effect. Liposomal bupivacaine, as a new type of sustained-release local anesthetic with stability and long-acting characteristics, has been increasingly used in postoperative multimodal analgesia, especially in postoperative analgesia after knee arthroplasty. This article reviews the progress of liposomal bupivacaine application for postoperative analgesia after knee replacement surgery.
过敏性紫癜(Henoch-Schönlein purpura, HSP)又称为IgA血管炎,是由IgA免疫复合物沉积介导的全身性小血管炎。HSP以儿童最常见,成人较为少见。临床上以皮肤紫癜最多见,可伴有关节、胃肠道及肾脏等各系统症状。当腹部症状先于紫癜出现时,易被缺乏相关经验的临床医生误诊为急腹症、急性阑尾炎、消化道出血等疾病。现报道1例以腹部症状为主的成人混合型HSP,目的在于提高临床医生对HSP的诊治水平,避免延误患者的诊治。Henoch-Schönlein purpura (HSP), also known as IgA vasculitis, is a systemic small vasculitis mediated by IgA immune complex deposition. HSP is most common in children and less common in adults. The most common clinical skin purpura, can be accompanied by joint, gastrointestinal and kidney and other system symptoms. When the abdominal symptoms appear before purpura, it is easy to be misdiagnosed as acute abdomen, acute appendicitis, gastrointestinal bleeding and other diseases by clinicians who lack relevant experience. A case of adult mixed HSP with abdominal symptoms was reported in order to improve the diagnosis and treatment of HSP by clinicians and avoid delay in diagnosis and treatment.
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