这个弧弧太神奇了,先左后右再左,最后没了


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送交者: 羽矢 于 2013-07-10, 23:40:53:

回答: 给肖锤喝个彩并报告羽矢 由 TGIF 于 2013-07-10, 21:33:39:

引用:
Bladder contractions were measured in response to scratching as well (Fig. 4). At the 6-month interval, when the patient believed he might be able to urinate in response to scratching the left L-5 dermatome, he was found to have bladder contractions > 15 cm H2O in response to scratching in the right L-5 dermatomal distribution but not on the left (surgical) side. By 12 months after surgery, he had contractions > 15 cm H2O in response to scratching the left L-5 dermatome (surgical side) but not in the contralateral L-5 distribution. By 18 and 24 months after surgery, his bladder contracted enough to raise pressure > 15 cm H2O when scratching on the control side (right L-5 dermatome) but not on the surgical side (left L-5).

术后6个月, 抓挠非手术侧皮区可引起膀胱收缩,但抓挠手术侧皮区不行。
术后12个月,抓挠 手术侧皮区可引起膀胱收缩,但抓挠非手术侧皮区不行。
术后12/18个月, 抓挠非手术侧皮区可引起膀胱收缩,但抓挠手术侧皮区不行。
术后3年,探查发现神经吻合处长成了神经瘤。

作者说,“今后的研究应谨慎阐释术后的一时改善”,明指“今后”暗指“以前”,包括肖的结果解释、Beaumont术后一年结果的解释不靠谱。

作者未引用Beaumont三名脊髓损伤患者失败案例,也未引用德国失败8例。前者情有可原,因为Beaumont本来就未发表。后者已多次发表摘要,未引用实不应当。德国8例与ACH这例相似,早期曾报道有所改善,但远期无反射弧、无改善,所以,如果引用了德国8例,这个结论就不好意思说了:It is impossible to draw broad conclusions about the efficacy of the procedure based on a single patient with no demonstrable benefit。




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