2022年医学专题—影象病例讨论.ppt

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(bngl)分析the case analysis of the imageological examination before and after massage treatments which are the chronic diseases of the spine and limbs of the osteoarticular,广西中医药大学附属(fsh)瑞康医院 韦贵康RuiKang Hospital Affiliated to Guangxi University of Chinese Medicine Wei Gui kang,第一页，共四十三页。,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(chnggu)，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：While we are researching the treatment to the chronic diseases of the spine and limbs of the osteoarticular,its helpful for us to use imageological examination(X-rays,CT,MRI)reasonably to increase the accuracy rate of diagnosis and therapy.Now we share some typical examples for you:,第二页，共四十三页。,微屈前推法、园筒整复法治疗(zhlio)颈曲变直病例,第三页，共四十三页。,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(jinch)颈曲有改善。Example 1:Mr.Wu,male,31years old,he had already felt the neck stiff and pain and dizziness for half a year.X-rays reported:the curve of the neck became straightened.He accepted the massage once in two days.After 5 times,he felt better and the symptom disappeared.X-rays reported that the curve of the neck became better.,第四页，共四十三页。,颈曲变直手法治疗(zhlio)后改善After the massage,the curve of the neck became better,治疗(zhlio)前before the treatment,治疗(zhlio)后after the treatment,第五页，共四十三页。,例2、李x，女33岁，颈痛伴上肢麻痛3个月，x线片提示(tsh)：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。Example 2:Mrs.Li,female,33years old,she had already felt the neck pain and upper limbs numb for 3 months.X-rays reported:the curve of the neck became straightened.She accepted the massage once in two days.After 4 times,she felt better and the symptom disappeared.X-rays reported that the curve of the neck became better.,第六页，共四十三页。,治疗(zhlio)前before the treatment,治疗(zhlio)后after the treatment,第七页，共四十三页。,按语：1、40岁以前颈椎疾病伴有颈曲变直，通过手法、练功(lin gng)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、If you have some diseases about cervical vertebra with the curve of the neck straightened before 40 years old,we can use massage、practice and so on to recover the curve of the neck.Through this way,the symptoms can be eliminated or relieved.,第八页，共四十三页。,2、中年老年人，不强求颈曲恢复(huf)，应进行综后分析，对因治疗。2、The middle and the old dont need to recover the curve of the neck,they should analyze synthetically and then choose the right way for treatment.,第九页，共四十三页。,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(gpn)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。Prostrate balanced traction frame(homemade patent product)with massage can be used:The curve of lumbar become straightened、the lateral bending of spine become abnormal or the both sides of pelvis become different.While those symptoms were eliminated or relieved,they took X-rays and it reported that the patients became better than before.,第十页，共四十三页。,第十一页，共四十三页。,提法(t f),第十二页，共四十三页。,左右(zuyu)摆法,第十三页，共四十三页。,腰曲治疗(zhlio)前The curve of lumbar before the treatment,腰曲治疗(zhlio)后The curve of lumbar after the treatment,第十四页，共四十三页。,治疗(zhlio)前后 before and after the treatment,第十五页，共四十三页。,动态(dngti)推拉法,第十六页，共四十三页。,摆动(bidng)整复法,第十七页，共四十三页。,侧弯治疗(zhlio)前the lateral bending before the treatment,侧弯治疗(zhlio)后the lateral bending after the treatment,第十八页，共四十三页。,第十九页，共四十三页。,闭孔小治疗(zhlio)前obturator formamen before the treatment,闭孔小治疗(zhlio)后obturator formamen after the treatment,第二十页，共四十三页。,手法治疗髋关节半脱位(tu wi)：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。The massage treats coxae subluxation:Follow the direction to pull、reverse the direction to restoration.If the legs external rotation become long,we should adopt abduction and external rotation、flexion adduction and internal rotation and to straighten it.,第二十一页，共四十三页。,髋半脱治疗(zhlio)前coxae subluxation before the treatment,第二十二页，共四十三页。,半脱治疗(zhlio)后coxae subluxation after the treatment,第二十三页，共四十三页。,髌骨(bng)上移或下移测量法：髌股角测量 法，正常值100110，小于100为 髌骨(bng)下移，大于110 为髌骨(bng)上移。髌骨下移手法一一收紧法 髌骨上移手法一一放松法The way to measure patella to move up or down:The methods of patellofemoral angle,the normal range is 100110.Below 100 is as patella to move down,above 110 is as patella to move up.The massage to treat patella to move down is called 一一Tightening Method The massage to treat patella to move up is called 一一Relaxation Method,第二十四页，共四十三页。,正常(zhngchng)髌股角the normal patellofemoral angle,第二十五页，共四十三页。,髌骨(bng)上移patella to move up,第二十六页，共四十三页。,髌骨(bng)正常与下移the normal patella and patella to move down,第二十七页，共四十三页。,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(jinch)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,the patient accepted the wrong diagnosis、wrong massage and acupuncture with no effect.After the surgery we used massage and heating with Chinese herbal medicine as treatment.Finally the patient was cured.Miss Zhang,female,12years old,she had already felt the neck pain for 3 months.And the massage and acupuncture didnt make effect for her.MRI reported that it was spinal meningioma.Then she accepted the surgery.After the surgery she walked out of balance and her hands felt swollen.So we used massage and heating with Chinese herbal medicine as treatment.After half a year she was cure