骨科
词汇介绍
拓展阅读
解析
intermittent 英 /ɪntə'mɪtənt/ 美 /ˌɪntərˈmɪtənt/
释义 adj. 间歇的,断断续续的
例句 It and reversing current different is not to be, but with a anode intermittently stop, because the intermittent power supply current interrupted, cathode potential with time periodically change. 它与换向电流所不同的是不把镀件作阳极,而是间歇地停止供电,由于间歇中断电流,阴极电位随时间周期性地变化。
claudication 英 /,klɔːdɪ'keɪʃ(ə)n/
释义 n. [医] 跛行;跛
例句 The symptoms of claudication can be mimicked by many other conditions which cause pain in the legs such as arthritis and nerve problems (neuropathy). 许多其它导致腿部疼痛的情形也可能产生跛行症状,例如关节炎和神经疾病(神经病变)。
概述
概述与定义
间歇性跛行是下肢缺血性疾病的一个临床表现,患者从开始走路,或走了一段 路程以后就会出现单侧或双侧腿痛,下肢麻木无力,以至跛行,但休息片刻后,症状可以很快缓解或消失,仍可继续行走,再走一段时间后,上述过程和状态再度出现。
病理及病生理基础
神经源性间歇性跛行及脊髓源性间歇性跛行在病理基础上有着基本的相同点,与以下几个方面有关,即发育性椎管狭窄,脊柱骨关节病所致的骨质增生,椎板肥厚,小关节肥大,多节段的椎间盘突出,黄韧带肥厚,后纵韧带骨化,强直性脊柱炎后期的脊柱僵直和韧带骨化,脊柱节段性不稳等等有关
临床表现
间歇性跛行在脊柱脊髓疾患中是一种十分常见的症状,主要表现为在直立或行走时,下肢出现逐渐加重的疼痛、麻木、乏力、沉重感等不同的感觉,以至于不得不改变站立的姿势或停止行走,而蹲下或以其他某种姿势休息片刻,症状可以减轻或消失,而再度继续行走或站立,将再次出现上述症状而被迫再次休息。有时由于病情的发展,其行走的距离逐渐缩短,由于本症状以腰椎疾患所致为多,故往往易主观诊断为腰部疾患。
鉴别诊断
虽然多种疾病均可表现为间歇性跛行的症状,但不同的疾病有不同的特点,通过仔细的追问病史及必要的体格检查,结合相应的影像学检查,大多可做出正确的诊断,从而避免治疗上的失误,仅仅依靠一种诊断手段,利用一个诊断标准,来进行全面而确切的病因和病理诊断是不现实的,只有充分利用各种可能的手段将临床资料与各种影像学检查结合起来,才能全面而正确地做出诊断。
治疗方法
对严重的神经源性间歇性跛行病人,经保守治疗无效或加重的可考虑手术。腰椎椎管狭窄症的手术方式有很多,如全椎板切除根管减压术,经椎板间孔减压棘间韧带重建术,节段性扩大减压术,扩大的半侧椎板切除术,开窗潜行减压术,椎管内扩大减压术,治疗侧隐窝狭窄的小切口开窗侧隐窝扩大成形术。
监督运动治疗和血运重建治疗间歇性跛行: 随机对照试验的网络Meta分析
发表时间:2019-02-12
影响指数:9.5
作者: Athanasios Saratzis
期刊:JACC Cardiovasc Interv
Multiple trials have compared the efficacy and effectiveness of SET, PTA, and best medical therapy (BMT) using a plethora of different designs. The vast majority of trials consisted of treatment arms directly comparing therapeutic modality with another. Previous systematic syntheses of published research have suggested that SET may be superior to BMT or early PTA. The most recent meta-analyses have suggested that SET combined with PTA may be the optimal initial treatment strategy. These meta-analyses, however, mostly included studies with head-to-head comparisons between 2 specific treatment arms (e.g., PTA vs. SET) or used an approach that did not allow the inclusion and direct comparison of all potential treatments in the context of IC. Using this approach to perform a synthesis of the available research means that a significant body of evidence may have been overlooked. Furthermore, previous meta-analytic attempts in this area have not included all available QoL assessments in their reporting, because various different tools have been used in claudication trials across the years.
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