针刀定位结合三维立体操作用于临床体会.docVIP

针刀定位结合三维立体操作用于临床体会【摘要】对针刀治疗前的定位与治疗中的操作过程进行临床经验分析。针刀治疗是一种闭合性的微创手术治疗方法,治疗时在盲视下既要保证手术操作时的安全,又要取得很好的临床疗效,这与我们在治疗前的定位及操作时的三维立体感有直接关系。治疗前的准确定位,是建立在正确分析临床症状、体征、影像检查及正确诊断的基础之上,同时还需采用合适的定位方法。定位后的操作我们强调以三维立体感和两个金字塔结构来代替我们的眼睛。以扎实的解剖学基础结合医者的手感和患者及时反馈的针感,构建起两个三维立体的人体组织金字塔结构,行安全有效之术。? 【关键词】针刀;定位;操作;三维立体? 【中图分类号】R45 【文献标识码】A 【文章编号】1008-6455(2010)08-0001-02 The Clinical Experience of Location and 3-D operation of Acupotomology? Ge Hengqing Tang Minghan Yang Yongquan et al.? 【Abstract】Analysis of the clinical experience of location and operation of acupotomology. Acupotomy is one kind of closed operation with minimal invasion,and the management is done under blind visual state.Therefore,the safety and the efficiency are closely related to the per-location and the operation with three-dimensional sense. It is built on the correct analysis of clinical symptoms and signs, imaging and on the basis of a correct diagnosis that to make a accurate positioning. While the appropriate positioning methods is also very important.It is the 3-D sense and the two pyramid structure that we should take care of,and should regard it as our eyes during the operation.However,the solid foundation of anatomy is the key to establish the 3-D pyramid-liked structure of human body,as to as the needling sensation of patient and handle of operator.They are the important guarantee for the safety of acupotomy treatment.? 【Key words】acupotomology; location; operation; three-dimensional 针刀治疗是一种闭合性的微创手术治疗方法,治疗时在盲视下既要保证手术操作时的安全,又要取得很好的临床疗效,这给我们从事针刀治疗的医生带来了很大的难题,也是我们针刀医生一直追求的目标。根据我从事针刀治疗20多年,安全治疗患者10万多例的临床体会分析,针刀治疗时安全及取效与否,与我们在治疗前的定位及操作时的三维立体感有直接关系。? 1 定位? 1.1 定位的依据:针刀治疗讲究的是辨位论治,当机体某一部位发生病变出现临床症状、体征时,我们要结合影像学、检验等相关辅助检查手段给予明确诊断及鉴别诊断,并根据局部病变的解剖位置,周围血管、神经的毗邻关系,予以准确定位,进行针刀治疗。? 1.1.1 临床症状分析:根据患者主诉疼痛的性质,麻木的程度,活动不便,力量减弱及肌肉萎缩的部位进行初步临床症状分析。? 1.1.2 临床体征分析:根据患者临床症状的表现进行初步分析后,再进一步检查体征,结合影像学,确定患者的病变部位及性质,分析是否是我们针刀治疗的适应证。阳性体征是我们临床诊断的有力依据。每一个症状的发生都有其典型的阳性体征。特别是针刀治疗的适应证,其阳性体征尤为重要。如腰突症患者:罹椎压痛阳性,向突出的一侧下