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目的 探讨金尔伦治疗急性重型颅脑损伤患者的疗效和安全性。方法 13 1名急性重型颅脑伤病人随机分成金尔伦治疗组 (n =62 )和对照组 (n =69) ,观察治疗早期病人GCS评分变化和远期疗效。结果 金尔伦组患者GCS评分在用药后第 5d开始明显优于对照组 (P <0 0 5 ) ;金尔伦组病死率 2 4 2 % ,对照组病死率 5 0 7% ,两组相比有显著性差异 (P <0 0 1)。结论 金尔伦可以降低急性重型颅脑外伤病人颅内压的升高幅度 ,缩短昏迷时间 ,降低伤残率 ,促进病人神经功能恢复 ,改善预后。 相似文献
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金尔伦(盐酸纳洛酮)治疗急性重型脑外伤的临床研究 总被引:52,自引:0,他引:52
目的:探讨金尔伦(盐酸纳洛酮)在急性重颅脑外伤中的运用效果及其机制,方法:146列急性重型颅脑损伤病人随机分成金洋伦治疗组(n=75)和对照组(n=71),观察治疗早期病人生命体征,颅内压,头颅CT变化和远期疗效,以及治疗前后血,脑脊液中β-内肽变化情况,结果,金尔伦治疗组早期病人呼吸循环较快恢复稳定,呼吸异异常(29.3%),心律异常(30.7%),及伤后1周颅内压显著升高(20%)和重度脑水肿者(20%)均较对照组明显减少(P<0.01),金尔伦组1周后意识;转清醒率(54.7%)及伤后3个月恢复良好率(42.7%),显著高于对照组(P<0.05),重残及死亡率(37.3%)明显减少(P<0.05),金尔伦组病人β-内啡肽下降程度及速度较对照组显著加快(P<0.01),结论:金尔伦可以降低急性重型颅脑外伤病人颅内压的升高幅度,缩短昏迷时间,降低伤残率,促进病人神经功能恢复,改善预后,其机制可能是拮工抑制伤后β-内啡肽的释放。 相似文献
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金尔伦(盐酸纳洛酮)治疗急性中、重型脑外伤的神经电生理研究 总被引:19,自引:0,他引:19
目的:通过诱发电位(EP)监测,探讨金尔伦(盐酸纳洛酮)治疗急性中,重型脑外伤的疗效,方法:对40例急性中,重型脑外伤患者者随机,双盲治疗,前3天剂量为每日0.3mg/kg,后7天剂量为4.8mg/日,于用药前,用药后30分钟,24小时,72小时,120小时监测正中神经短潜伏期体感诱发电位(SLSEP)和脑干听觉诱发电位(BAEP),揭盲后分为金尔伦治疗组和对照组,对金氽伦治疗组与对照组诱发电位进行统计学分析,结果:金尔伦治疗级SLSEP的N13-N20峰间潜伏期(N13-N20IPL)及BAEP的I-V波峰间潜伏期(I-VIPL)在用药手均较对组缩短且有显著性差异,P<0.05,结论,诱发电位监测结果表明,金尔伦能有效改善急性脑外伤患者异常的神经网络生理指标,对于急性中,重型脑外伤有明显的治疗作用。 相似文献
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川芎嗪早期治疗急性颅脑损伤的临床观察 总被引:1,自引:0,他引:1
目的探讨早期应用川芎嗪治疗急性中、重型颅脑损伤的临床疗效和用药安全性。方法127例符合研究条件的急性中、重型颅脑损伤患者,随机分为川芎嗪治疗组和常规治疗组进行前瞻性研究。观察治疗期间不同时期GCS评分的变化,治疗结束后及康复期GOS评分。结果川芎嗪治疗组和对照组GCS评分在治疗第1天和第3天无显著性差异(P〉0.05),3d内死亡率亦无显著性差异(P〈0.05)。治疗结束后和3个月随访均进行GOS评分,治疗组明显优于对照组(P〈0.05)。随访结束后评定死亡率,治疗组死亡7例(10.9%,7/64),对照组死亡16例(254%,16/63),两组间有显著性差异(P〈0.05)。结论早期应用川芎嗪能明显降低急性中、重型颅脑损伤患者死亡率,改善预后,治疗过程中未见明显的毒副作用。 相似文献
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司来吉兰添加治疗帕金森病临床疗效评价 总被引:5,自引:0,他引:5
目的:观察司来吉兰添加治疗帕金森病的临床疗效及安全性。方法:采用随机双盲安慰剂对照方法,在复方多巴治疗的基础上添加国产司来吉兰治疗40例帕金森病患,分为司来吉兰治疗组和安慰剂对照组,疗程8周。采用改良的Webster评分量表评估药物疗效并观察不良反应。结果:司来吉兰治疗组治疗前后自身对照Webster评分有明显改善(P<0.05或P<0.01),安慰剂对照组于治疗后第4,6周差异有显性意义(P<0.05或P<0.01),司来吉兰组疗效优于安慰剂组(P<0.01),司来吉兰组患治疗的总有效率为80%,与安慰剂组(40%)比较差异有显性意义(P<0.01)。司来吉兰组患药物不良反应轻微。结论:司来吉兰是一种安全有效 的抗帕金森病辅助药物。 相似文献
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金尔伦治疗急性颅脑损伤全国多中心随机双盲临床研究总结会议暨金尔伦首届神经外科专家委员会成立大会于 2 0 0 0年 12月 18日至 12月 2 2日在海南省三亚市亚龙湾举行。参加会议的有金尔伦治疗急性颅脑损伤全国多中心随机双盲临床研究全国十八个研究中心代表及新闻界、公证处代表共 40余人。会议由中华神经外科学会副主任委员、中华神经外科杂志副总编罗其中教授主持。研究协作组代表、北京天坛医院赵元立博士向大会报告了双盲研究结果。研究协作组代表、上海长征医院江基尧教授向大会做了金尔伦临床应用基础报告。中华神经外科学会主任委员… 相似文献
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盐酸纳洛酮治疗大鼠急性颅脑损伤的药效学观察 总被引:10,自引:0,他引:10
目的观察盐酸纳洛酮(金尔伦)在大鼠急性颅脑损伤实验模型中促进神经功能恢复的治疗作用,并做量效分析。方法SD大鼠250只,采用Feenly自由落体撞击法建立颅脑损伤模型,随机分成六组,于损伤后30min开始给药。前四组每天分别给予金尔伦0.3mg/kg、1mg/kg、3mg/kg和9mg/kg腹腔注射;阳性对照组:给予胞磷胆碱钠2mg/只腹腔注射;阴性对照组:给予0.5ml/只生理盐水腹腔注射。每天进行MNSS神经功能评分,最长疗程为14d。伤后2d和4d每组随机取8只大鼠,通过干—湿重法计算脑组织的含水量。结果金尔伦治疗组大鼠的神经功能恢复情况明显优于其他两组(P<0.01)。金尔伦1、3、9mg/kg三组的情况优于0.3mg/kg组(P<0.05),而这三组之间没有显著性差异(P>0.05)。金尔伦治疗组大鼠的脑含水量明显低于对照组(P<0.05);金尔伦内部各实验组之间,0.3mg/kg组的脑含水量高于其他三组(P<0.05),其他三组之间无显著性差异(P>0.05)。结论金尔伦能够降低大鼠急性颅脑损伤后的脑水肿,对大鼠的神经功能恢复有明显的促进作用,并在一定范围内随着剂量的增加效果更显著。 相似文献
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金尔伦(盐酸纳洛酮)治疗急性重症脑外伤的临床观察 总被引:32,自引:0,他引:32
目的:针对重度颅脑外伤后血浆,脑脊液和脑区内源性阿片肽,特别是β-内啡肽明显升高,应用金尔伦(盐酸纳洛酮)探讨对重症颅脑外伤的临床疗效,方法选择GCS5-8分患者30例每天应用金尔伦4.8毫克,随机以30例同等伤情未用金尔伦药物治疗病例为对照组,观察意识觉醒,血液流变学及临床征象,结果,觉醒天数缩短,外伤后脑血管痉 发生率,血液粘滞度降低,致残率减少,结论:金尔伦对于内源性阿片肽引起的生理功能的应激性疾病起效快,作用可靠,其使用安全,治疗过程中未见有毒副作用。 相似文献
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马小强 《癫癎与神经电生理学杂志》2016,(2):87-90
目的:观察利培酮对颅脑损伤所致精神障碍患者精神病量表、神经功能及生存品质(QOL)的影响。方法:98例颅脑损伤患者中65例伴有精神障碍,将其随机分为观察组(33例)及对照组(32例),另外33例不伴精神障碍患者作为空白组。所有患者入院后根据病情行临床常规治疗。其中观察组使用利培酮及对照组使用舒必利对症处理伴发精神障碍。观察对比所有患者治疗前及治疗后第2、4、8周时的神经功能缺损评定量表(NIHSS)评分、简明精神病量表(BPRS)评分及日常生活能力量表(ADL)评分,以判断患者神经功能恢复情况、治疗效果及QOL。结果:观察组与对照组治疗前NIHSS、BPRS评分均高于空白组,ADL评分低于空白组(P<0.05),而两组间比较差异无统计学意义(P>0.05)。3组患者经治疗后,NIHSS、BPRS评分均随着时间推移逐渐下降,ADL评分均有所上升,且治疗后第2、4、8周与同组治疗前比较,差异均存在显著意义(P<0.05);观察组与对照组比较,治疗后第2周NIHSS、BPRS评分差异无统计学意义(P>0.05),而治疗后第4、8周观察组NIHSS、BPRS评分明显低于对照组,ADL评分明显高于对照组(P<0.05);且治疗后第8周,观察组的NIHSS、BPRS、ADL评分几乎接近空白组,差异无统计学意义(P>0.05)。结论:利培酮对颅脑损伤所致精神障碍患者具有良好疗效,能促进患者神经功能的恢复,降低精神病评分,改善患者的QOL。 相似文献
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连续应用7.5%高渗盐水治疗重型颅脑损伤的临床观察 总被引:2,自引:0,他引:2
目的 探讨7.5%高渗盐水治疗重型颅脑损伤的效果及副作用。方法 将50例颅脑损伤患者随机分为高渗盐水治疗组(HTS组,26例)和甘露醇治疗组(M组,24例)。HTS组静脉滴注7.5%高渗盐水2ml/kg,M组静脉滴注甘露醇250ml,均为q8h,连续7d。用药前及用药后第1、3、7天测患者血电解质、渗透压和肾功能,用药前及用药后2周对患者进行GCS评分。结果 与用药前相比,用药后6h两组患者的平均动脉压、心率、呼吸均无统计学差异(P〉0.05),而HTS组患者中心静脉压在用药后明显升高(P〈0.05)。用药后第1、3、7天HTS组患者血K^+、Na^+、Cl^-、尿素氮、肌酐及血浆渗透压均无显著改变;M组血K^+、Na^+、Cl^-、肌酐及血浆渗透压无显著改变(P〉0.05),但用药后第7天尿素氮值较同期HTS组明显升高(P〈0.05)。用药2周后,两组患者GCS评分均有明显改善(P〈0.05)。结论 7.5%高渗盐水降低颅脑损伤引起的高颅内压是安全、有效的,连续使用效果好、副作用少。 相似文献
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Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults 总被引:9,自引:0,他引:9
Suominen S Helenius H Blomberg H Uutela A Koskenvuo M 《Journal of psychosomatic research》2001,50(2):77-86
A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health. 相似文献
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Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat. 相似文献
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Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system. 相似文献
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Aarsland D Kvaløy JT Andersen K Larsen JP Tang MX Lolk A Kragh-Sørensen P Marder K 《Journal of neurology》2007,254(1):38-45
Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated
with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim
of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of
age.
Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups
of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed
for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological
and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore
the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables.
Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to
develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased
relative effect of age on the time to develop dementia in PD cases compared with controls.
Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects
with PD.
Received in revised form: 22 December 2005 相似文献