颈

Results Masses were located at the branch of common carotid artery,so the interval between external and internal carotid arteries was enlarged.Low echoic substantial masses with clearly boundary were found.The bigger masses always grew around carotid arteries.More color flow signals were detected in the masses and most were arterial flow.

结果 颈动脉体瘤肿块位于颈总动脉分叉处，颈内及颈外动脉间距增宽，瘤体常呈实质性低回声，边界清晰，较大瘤体常围绕血管生长；彩色多普勒超声显示肿瘤内丰富彩色血流信号，以动脉血流为主，能显示瘤体与颈动脉的关系。

Methods? 67 cases of extracranial carotid artery aneurysm were treated surgically from January 1986 to June 1997.Results? There were a mortality rate of 1.5%and a hemiparalysis rate of 4.5%.Conclus ion?

？ 总结了1986年1月~1997年6月期间收治颅外颈动脉瘤67例（70个，其中颈总动脉瘤10例，颈动脉分叉处动脉瘤53例（56个），颈内动脉瘤3例，颈外动脉瘤1例。

A special tribe called Kayan is known for wearing rings around their neck. Kayan women often say that their purpose for wearing the rings is cultural identity. The rings are rarely removed since they started wearing them around the age of five. The coiling and uncoiling is a long procedure. They are usually only removed to be replaced by a new or longer set of coils. To set the record straight, women do not suffocate if the rings are removed, though the muscles covered by them are weakened. Many women have removed the rings for medical examinations. Contrary to popular belief, the neck is not actually lengthened. Each coil is replaced with longer coils as the weight of the brass pushes the collar bone down and compresses the rib cage.

在清迈有一个少数民族称做Kayan族，当时为了逃难而来到泰国西北边界的媚洪顺，后来不知为何这支民族的妇女认为长颈才能显示出女人的美丽，因此她们从5岁起就在母亲的协助下在颈子上架起了铜圈，到了10岁开始每年再多加一圈直到25岁为止，到了25岁这些铜圈更可高达25圈重达5至10公斤；铜容易生绿锈，要时常擦拭，而且铜很沉，会将肩膀压塌，所谓的长颈并不是因为颈子变长，而是因为钢圈的重量长期压住锁骨和肋骨，使得脖子看起来变长了。

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

To pay attention to carry out effective cardiopulmonary resuscitation, hemostasis by compression and deep vein intubation rapidly in the initial stage of emergency. The carotid shunt tube plays an important role in severe carotid injury and re-establishment process. We use external jugular vein to transplant and re-establish,which are rung with artificial blood vessels for the long distance carotid injury and achieved the best result. We expose as fully as possible for the hepatic venae and the posthepatic post caval injury,and adopt effective methods to stop bleeding and repair. The application of blood shunt pump could raise the success rate for those severe patients. The self-double vastransplantation with both ends being all trousers-style one opening solve some problems such as there are no suitable caliber self-transplantation blood vessels and the artificial blood vessels are easy to occur obliteration for long-term and so on for the great or middle blood vessels.We use improved Fogarty duct and anterograde intubation to eliminate thrombus could eliminate thrombus effectively and avoid accessory injury for the deep vein injury and extensive thrombosis.

抢救初期要注意进行有效的心肺复苏、压迫止血和快速进行深静脉插管；颈动脉转流管在严重颈动脉损伤重建过程中有重要作用；对长距离颈动脉损伤用颈外静脉移植外环包人造血管重建，可取得最佳效果；对肝静脉及肝后下腔静脉损伤，要充分暴露，采用有效方法止血和修复，对病情极危重的凶险性出血者，血液转流泵的应用可提高成功率；对大、中血管损伤，两端均为裤式单开口自体双血管移植，解决了无适宜口径自体移植血管和应用人造血管远期易闭塞等问题；对深静脉损伤并广泛血栓形成者，应用改进的Fogarty导管和顺行插管取栓法，可有效取栓并避免了副损伤。

To pay attention to carry out effective cardiopulmonary resus-citation,hemostasis by compression and deep vein intubation rapidly in the initial stage of emergency.The carotid shunt tube plays an important role in severe carotid injury and re-establishment process.We use external jugular vein to transplant and re-establish,which are rungwith artificial blood vessels for the long distance carotid injury and achieved the best result.We expose as fully as possible for the hepatic venae and the posthepatic post caval injury,and adopt effective methods to stop bleeding and repair.The application of blood shunt pump could raise the success rate for those severe patients.The self-double vastransplantation with both ends being all trousers-style one opening solve some problems such as there are no suitable caliber self-transplantation blood vessels and the artificial blood vessels are easy to occur obliteration for long-term and so on for the great or middle blood vessels.We use improved Fogarty duct and anterograde intubation to eliminate thrombus could eliminate thrombus effectively and avoid accessory injury for the deep vein injury and extensive thrombosis.

抢救初期要注意进行有效的心肺复苏、压迫止血和快速进行深静脉插管；颈动脉转流管在严重颈动脉损伤重建过程中有重要作用；对长距离颈动脉损伤用颈外静脉移植外环包人造血管重建，可取得最佳效果；对肝静脉及肝后下腔静脉损伤，要充分暴露，采用有效方法止血和修复，对病情极危重的凶险性出血者，血液转流泵的应用可提高成功率；对大、中血管损伤，两端均为裤式单开口自体双血管移植，解决了无适宜口径自体移植血管和应用人造血管远期易闭塞等问题；对深静脉损伤并广泛血栓形成者，应用改进的Fogarty导管和顺行插管取栓法，可有效取栓并避免了副损伤。

Methods There were 12 cases, 10 of them were corpse specimens, the other 2 were clinic cases. Firstly we dissociate the contralateral C7 root from the intervertebral foramen to its divisions, secondly we set up a tunnel between the cone and the anterior scalenus, thirdly we moved the C7 root to the gap between the thyroid and the opposite carotid theca through the mentioned tunnel, then we dissociate the injured brachial plexus extensively, lastly we anastomose the contralateral C7 and the injured inferior trunk.

尸解10例，临床应用2例，将健侧颈7神经近端游离至神经根孔，远端游离至前后股处，于前斜角肌后椎体前建立通道，将健侧颈7神经引导至患侧颈血管鞘和甲状腺间隙处，然后患侧行下干、内侧束、尺神经、及正中神经内侧头广泛游离，患侧屈肘屈肩关节后，将健侧颈7神经直接与患侧下干无张力下吻合。

1.Preliminary studys on the carotid artery parameters Detected by Intracavitary Convex Array ProbePurpose and SignificanceFinal results of The North American Symptomatic Carotid Endarterectomy Trial and the MRC European Carotid Surgery Trial displayed that carotid artery must be observed intimately when stegnosis degree is higher than 50%and it must have an operation or interventional therapy in time when stegnosis degree is higher than 70%.

1、腔内凸阵超声探头检测颈动脉参数的初步研究目的和意义北美有症状颈动脉内膜剥脱试验(The North American Symptomatic CarotidEndarterectomy Trial NASCET)和欧洲颈动脉手术试验(European Carotid SurgeryTrial，ECST)研究结果显示，当颈动脉狭窄程度超过50%时要密切观察病情变化，当狭窄程度超过70%时要及时手术或介入治疗，治疗后可大幅降低脑梗死的发生率。

We analyzed 77 cases of unilateral or bilateral carotid disease which were diagnosed by TCD and cerebral angiography reported by Lindegaard 1985.The ratio of compensative blood mean velocitywith carotid disease and the identical lateral middle cerebral arterial blood mean velocity－Vm/Vmca can be used as a medium for the analysis of 81(out of 154)laterals carotid pathological changes,which was reported by Lindegaard.

应用15例我科经TCD诊断并由MR、颈动脉双功B超或DSA证实的一侧颈内动脉狭窄或闭塞的病例，与Lindegaard〔2〕报道的77例经TCD和脑血管造影诊断的一侧或双侧颈动脉病变的病例进行分析，将颈动脉病变时代偿血流的平均流速Vm与同侧大脑中动脉平均流速Vmca的比值作为本组15例与Lindegaard的77例81侧颈动脉病变分析的桥梁。

The most popular during the Shang Dynasty was the "bird and beast" design,hu,(long-necked and small opening, deep-bellied with round base, some with overhanging handle),you (elliptic opening, deep-bellied with round base, has a lid and overhanging handle), lei (some round and some square, openings vary in size, short neck with square shoulders, deep bellied, with curling feet or round base, and has a lid), fou and the like are wine vessels, jue (deep-bellied, tri-pedestal, can be heated on top of fire, protruding grooves at the top for easy pouring), gu (the most common wine-drinking utensil, more often used in combination with jue, which is bigger, opening is shaped like a bugle, long neck, thin waist, tall curling feet), zh(similar to the zun in shape but smaller, some with lids), gong (oval belly, has an outer edge for flow of wine, short handles, bottom has curling feet, lid is in the shape of the head of a beast, some has an entire body like a wild animal, with small spoon as accessory), bei, zhen is to drink from.

尊（鼓腹、敞口、高颈，底有圈足，形制较多，商代以鸟兽形尊最为流行）、壶（长颈、敛口，有的有盖，深腹圆座，有的有提梁）、卣（椭圆口，深腹圆座，有盖和提梁）、罍（有圆形和方形，口大小不一，短颈方肩、深腹，圈足或圆底座，有盖）、缶等是盛酒的器具，爵（深腹、三足，可在火上加温，上端有伸出的沟槽以倒酒）、觚（最常用的饮酒器，多与爵相配使用，比爵小，口呈喇叭状，长颈、细腰、高圈足）、觯，觥（椭圆腹，有流酒的外沿和短提把，底为圈足，有兽头形盖，也有整体为兽形的，并附有小勺）、杯、盏是饮酒的器具。

Methods: Five patients with parkinsonism or dystonia were assigned to general anesthesia using an modified endotracheal tube.

本实验依照人体实验之相关规定进行，五位患有帕金森氏症或肌张力异常的病人接受神经立体定位手术。

If you can benefit from this book, it is our honour.

如果您能从本书获益，这将是我们的荣幸。