锥颅穿刺术与开颅手术在脑出血治疗中的应用对比

目的评价锥颅穿刺术与开颅手术治疗脑出血的临床疗效。方法选取2011年6月至2012年12月我院收治的58例脑出血患者,按随机数字表将其分为对照组和观察组各29例。对照组行传统小骨窗开颅血肿清除术,观察组行锥颅穿刺抽吸引流血肿清除术。观察和比较两组手术情况、术后近期格拉斯哥预后评分(GOS)以及Barthel指数评定评分。结果在手术时间、拔管时间和住院时间上,观察组明显低于对照组,同样在复发率方面,观察组(10.34%)要低于对照组(17.24),差异具有统计学意义(P<0.05)。但在血肿清除率方面中,两组差异无统计学意义(P>0.05);与术前比,两组术后GOS短期预后评分都有所提高,其中观察组术后GOS短期预后评分为(13.12±4.54)分,显著高于对照组(P<0.05),术后GOS正常和轻度昏迷例数显著高于对照组(P<0.05),而重度昏迷和死亡频数显著低于对照组(P<0.05);同时在Barthel远期评分中观察组为(71.35±14.21)分,显著高于对照组(P<0.05);观察组Barthel优良率达82.76%,显著高于对照组(P<0.05)。结论锥颅穿刺抽吸引流血肿清除术具有手术时间短、操作简便等优点,能显著提高开颅手术治疗脑出血的短期和远期临床疗效,是治疗高血压脑出血的有效方法之一。     

小骨窗开颅血肿清除术治疗高血压脑出血的研究

目的:探讨小骨窗开颅血肿清除术治疗高血压脑出血的临床疗效.方法:收集高血压脑出血患者85例,其中采用小骨窗开颅血肿清除术者50例,传统大骨窗开颅治疗35例,对两组患者手术持续时间、术中出血量、平均住院时间、远期疗效等进行统计学分析.结果:试验组开颅窗3.00±0.05,对照组开颅窗8.00±0.05;试验组患者手术持续时间、术中出血量、平均住院时间、远期疗效方面均优于对照组.结论:与传统大骨窗开颅手术相比较,小骨窗开颅血肿清除术治疗高血压脑出血手术时间短、创伤小、术中出血量小,并且能够减短住院时间.     

小骨窗开颅血肿清除术与大骨瓣开颅血肿清除术治疗高血压脑出血疗效对比研究

目的：探讨小骨窗开颅血肿清除术与大骨瓣开颅血肿清除术在高血压脑出血中的临床疗效。方法选取高血压脑出血患者92例,随机分为小骨窗开颅手术组和大骨瓣开颅手术组,小骨窗开颅手术组采用小骨窗开颅血肿清除术,大骨瓣开颅手术组采用大骨瓣开颅血肿清除术,并对其临床治疗和症状改善情况进行比较和分析。结果与大骨瓣开颅手术组相比,小骨窗开颅手术组痊愈的比率和总的有效率均显著提高,可达50.00%及89.13%,手术时间和住院时间均明显缩短,仅为（0.89±0.12）h及（23.15±2.06）d,且术中输血量明显减少,仅为（80.21±35.79）ml,差异均具有统计学意义（P＜0.05）。结论小骨窗开颅血肿清除术对于高血压脑出血患者临床症状的改善和临床疗效的提高均具有积极的促进作用。     

小骨窗颅内血肿清除术治疗高血压性脑出血的临床疗效与安全性评价

目的探讨小骨窗颅内血肿清除术治疗高血压性脑出血的临床疗效,为其基本治疗提供临床参考。方法选择我院2009年2月～2013年4间收治的80例HCH患者为研究对象,依据手术方法的不同分为研究组和治疗组。研究组给予小骨窗颅内血肿清除术治疗,对照组则给予传统的开颅手术治疗。治疗后,评价两组的临床疗效相关的指标。结果研究组的血肿清除率（10．0％ vs 30．0％）、临床总有效率均优于对照组（90．0％US70．0％）。研究组的手术时间和住院时间分别为（1．27±0．08）h和（29±5）d,对照组则分别为（2．84 ±0．21）h和（21±4）d,两组差异具有统计学意义（P〈0．01）。在合并症和死亡率方面,研究组的发生率较低。结论小骨窗颅内血肿清除术能够有效清除高血压性脑出血患者的脑内血肿,降低患者的死亡率,较传统开颅术具有诸多优势,值得临床推广。     

高血压脑出血锥颅血肿抽吸引流术与开颅血肿清除术的对比研究

目的 探讨高血压脑出血的合适手术方法,评估各个手术方法的临床疗效,为临床治疗提供依据.方法 分别采用大骨瓣开颅血肿清除术、锥颅血肿抽吸引流术治疗高血压脑出血共131例,其中开颅组64例常规开颅手术显微镜下清除血肿,锥颅组67例根据头CT选择血肿最大层面进行锥颅穿刺抽吸,尿激酶冲洗引流血肿.结果 锥颅组手术时间为(0.5±0.2)h,术后GCS评分锥颅组平均12.46±4.12,开颅组平均10.24±4.72,再出血率锥颅组13.43%(9/67),开颅组12.50%(8/64),锥颅组术后神经功能恢复率高于开颅组,植物生存及病死率低于开颅组,两组致残率接近.结论 早期锥颅穿刺抽吸引流术微创、操作简便、短时、安全有效,是治疗高血压脑出血的有效方法之一.     

锥颅穿刺术与开颅手术运用于脑出血治疗中的比较分析

目的：对比锥颅穿刺术与开颅手术在脑出血临床治疗中的效果。方法选取脑出血患者80例为研究对象,以随机数表抽取法分为穿刺组与开颅组,各40例,穿刺组患者给予锥颅穿刺术治疗,开颅组患者给予传统开颅手术治疗。对2组患者临床疗效和神经功能缺损评分进行观察对比。结果2组患者术前神经功能缺损评分对比差异无统计学意义;2组患者术后神经功能缺损评分均明显降低,但穿刺组术后神经功能缺损评分明显低于开颅组,穿刺组治疗总有效率明显高于开颅组,差异均有统计学意义（P＜0.05）。结论在脑出血患者临床治疗过程中,给予锥颅穿刺术治疗颅内血肿清除较为彻底、术后神经功能恢复良好的优势,对改善患者预后有重要意义,值得临床推广。     

高血压脑出血手术治疗方法的选择

高血压脑出血手术治疗方法的选择（８４３０００）新疆阿克苏农一师医院张玉亚李发吉张廷聪张海龙我院自１９９２～１９９７年收治的高血压脑出血在ＣＴ定位引导下采用手术治疗２６４例，其中锥颅穿刺置管注药抽吸术１４２例（以下简称锥颅穿刺术），小骨窗开颅血肿清除术...     

超早期锥颅抽吸引流术治疗大量脑出血68例

目的 观察锥颅抽吸引流术（锥颅术）用于超早期和大量脑出血（＞50ml)患者的安全性及疗效。方法 124例大量脑出血患者分为两组,分别采用锥颅术和骨窗开颅血肿清除术（开颅术）。结果 锥颅术没有显示较高的再出血发生率,却体现出较高的存活率和较优的总生活能力。结论 超早期锥颅术用于治疗大量脑出血患者安全可行、疗效肯定。     

锥颅术和开颅血肿清除术治疗脑出血65例对比分析

目的:探讨锥颅钻孔血肿抽吸外引流术(锥颅术)和开颅血肿清除术(开颅术)治疗脑出血的效果。方法:将65例高血压脑出血患者随机分为锥颅组和开颅组,其中锥颅组做锥颅术治疗,开颅组行开颅血肿清除术治疗,比较分析两组患者的手术方法、并发症和预后。结果:锥颅组患者在手术时间、住院时间方面明显短于开颅组(P<0.05),术后再出血发生率明显高于开颅组(P<0.05),颅内感染明显少于开颅组(P<0.05);而预后和并发症对比,两组无显著性差异(P>0.05)。结论:锥颅钻孔血肿抽吸外引流术是一种安全有效、时间短、操作简单的治疗脑出血的手术方式,但其术后再出血的发生率较开颅血肿清除术高。     

小骨窗开颅血肿清除术治疗脑出血60例的疗效观察

目的观察小骨窗开颅血肿清除术治疗脑出血的疗效。方法将120例脑出血患者用抽签法随机分为两组,观察组60例患者采用小骨窗开颅血肿清除术治疗,对照组60例采用传统开颅血肿清除术治疗,对比观察两组的平均手术时间、血肿消失时间、住院时间、再出血率及出院时日常生活能力（ADL）评分。结果观察组的手术时间、血肿消失时间、住院时间分别为（64．2±18．7）min、（3．6±1．2）d、（22．8±3．4）d,均明显短于对照组的（116．8±21．1）min、（5．7±1．8）d、（25．6±4．1）d（P＜0．01）;观察组的再出血率、病死率分别为18．33％（11/60）、6．67％（4/60）,对照组则分别为23．33％（14/60）、16．67％（10/60）,两组比较,差异无统计学意义（P＞0．05）;出院时观察组幸存者ADL评分明显优于对照组（P＜0．01）。结论小骨窗开颅血肿清除术具有创伤小、手术时间短、术后恢复快、病死率低的特点,是一种治疗脑出血的有效术式。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…