高血压脑出血所致脑水肿的外科治疗

目的 对比三种不同的治疗方法对高血压脑出血后脑水肿的控制。方法 39例高血压脑出血病人依照病人所接受的治疗方法分为三组：11例以药物治疗(A组)．15例以立体定向抽吸加尿激酶治疗(B组)，13例以开颅手术去除血肿(C组)。利用头颅CT扫描影像来测量血肿及脑水肿的体积：血肿体积系于手术前(发病1—3天内)测量，而脑水肿体积则于脑出血后每隔5—7天测量1次。以统计学方法比较三组病例的血肿及最大水肿体积的不同，藉以评估三种治疗的疗效。结果 病人脑水肿最严重的时间是在脑出血后5—15天。最大水肿体积与血肿体积呈现高度相关性(P＜0．05)。计算最大水肿体积与血肿体积的比值，三组分别为：A组3．280，B组0．745及C组0．863．A组数值明显比B、C两组大，有统计学上的差异性(P＜0．05)。结论 以立体定向法及传统开颅手术治疗高血压脑出血，皆可明显减轻继发性脑水肿，而前者更具有微创手术的优点，有利于深部脑出血的治疗。     

有机磷中毒的脑CT表现

目的：通过对有机磷杀虫药中毒病人进行颅脑CT检查，观察、分析有机磷杀虫药中毒病人的脑部CT表现。方法：通过对83例有机磷杀虫药中毒病人进行颅脑CT扫描，观察病人的CT表现并对其进行诊断，对脑部异常患者进行随访。结果：83例患者中64％的患者有脑部异常表现，其中10％的病人有基底节及丘脑对称性或不对称性散在的出血，54％的病人急性期表现为脑水肿，随访脑部有脑萎缩、脑软化等CT表现。结论：对有机磷杀虫药中毒病人进行颅脑CT检查，是减少病人后遗症发生及判断预后具有重要的意义。     

Laparoscopic cholecystectomy: Imaging of complications and normal postoperative CT appearance

Six patients underwent imaging studies to evaluate complications related to laparoscopic cholecystectomy. In addition, computed tomography (CT) of the abdomen and pelvis was performed on six patients 3–5 days after uncomplicated laparoscopic cholecystectomy in order to further clarify the normal postoperative CT appearance in these patients. Complications included ureteral laceration with periureteric hematoma and ureteroperitoneal fistula, hepatic artery pseudoaneurysm, hepatic laceration, retained common bile duct stone, bile leak, and biloma of the abdominal wall. At 3–5 days following uncomplicated laparoscopic cholecystectomy, typical CT findings include fluid density in the gallbladder fossa, a very small amount of pelvic fluid, and small densities within the subcutaneous fat at the expected sites of trocar insertion.     

Intra-operative epidural morphine,fentanyl, and droperidol for control of pain after spinal surgery A prospective,randomized, placebo-controlled,and double-blind trial

Summary The present study was conducted to investigate the analgesic effects of intra-operatively administered epidural morphine in patients undergoing surgery for lumbar disc disease.Three treatment groups were constituted: one with 5,0 mg morphine and 2,5 mg dehydrobenzperidol (DHB) in 10 ml physiological saline, one with 5,0 mg morphine and 0,1 mg fentanyl in the same amount of saline, and one placebo group with saline only. The test solution was injected epidurally via catheter after haemostasis and before closure of the wound. Sixty eight patients were randomly assigned to each of the three groups and subjected to a double-blind evaluation.In the morphine/fentanyl and morphine/droperidol groups, significantly better analgesia was found as compared to the placebo group. No significant difference was found between the morphine/fentanyl and morphine/droperidol groups considering side effects of therapy, as well as duration and quality of analgesia. The side effects in the treatment groups were only slight and not significantly different from the placebo group. It was shown that additional epidural fentanyl offers no significant improvement of postoperative analgesia. No significant reduction of adverse effects could be found in the morphine/droperidol group compared to the morphine/fentanyl group.In conclusion, the intra-operative epidural application of morphine is a safe, effective and simple method for achieving sufficient analgesia in the first 24 hours after lumbar spinal surgery for disc disease.     

盐酸氨溴索对老年乳房癌根治术后病人肺功能的保护作用

目的 :观察盐酸氨溴索对老年乳房癌术后病人肺功能的保护作用。 方法 :40例老年乳房癌病人随机平均分为术后未用盐酸氨溴索治疗组 ( A组 )和术后应用盐酸氨溴索治疗组 ( B组 ) ,比较两组 Pa O2 和 Pa CO2 的变化。结果 :Pa O2 值 B组明显高于 A组 ( P<0 .0 5 ) ,Pa CO2 值 A组明显高于 B组 ( P<0 .0 5 )。结论 :盐酸氨溴索对老年乳房癌术后病人的肺功能具有一定保护作用 ,建议老年乳房癌根治术病人术后常规应用盐酸氨溴索     

SMS201－995对大鼠急性胰腺炎致肺水肿的防治作用

胰腺炎性肺水肿与胰酶释放入血有关。生长抑素类似物（ＳＭＳ２０１－９９５）能有效地抑制胰腺的外分泌功能。５％牛磺胆酸钠经胰管注射诱发急付出血环死性胰腺炎，在此模型诱发前和同时分别皮下注射ＳＭＳ２０１－９９５２μｇ／ｋｇ体重并连续输入其生理盐水混合液（含ＳＭＳ２０１－９９５５μｇ·ｋｇ~（－１）·ｈ~（－１））３ｈ后：（１）能有效地降低血清淀粉酶和脂肪酶；（２）能使肺系数和肺血管外水量显著减少；（３）能明显改善胰肺组织学变化。结果表明ＳＭＳ２０１－９９５防治胰腺炎及其肺水肿有效，并为临床应用提供了理论依据。     

Metabolite 1H relaxation in normal and hyponatremic brain

Proton spin relaxation rate constants in normal and hyponatremic rat brain were measured to determine the sensitivity of metabolite relaxation properties to cytotoxic edema and to quantify metabolite concentration in normal and edematous brain. Relaxation rate constants for protons of water and spectral regions with dominant contributions from methyl protons of cholines (Cho), creatines (Cr), N-acetylaspartate (NA), and lactate (Lac), and for methylene protons of glutamate (Glu) were measured at 7 T. Changes in metabolite relaxation properties associated with cytotoxic edema were a decrease in the Cr longitudinal rate constant, from 0.63 ± 0.02 s^?1 (mean ± SE) in controls to 0.50 ± 0.03 s^?1 in edematous brain, and an increase in the transverse rate constant of NA from 5.3 ± 0.2 s^?1 in controls to 6.6 ± 0.3 s^?1 in edematous brain. Four hours after induction of hyponatremia, there was a 14% reduction in summed metabolite concentrations of Cho, Cr, and NA, and a 200% increase in Lac signal intensity. It is concluded that changes in both metabolite spin relaxation and detectable spin concentration accompany the cerebral pathology of cytotoxic edema complicated with secondary ischemia.     

阿托品对兔局部脑缺血Ca2+积累和细胞水肿的作用

阿托品对兔局部脑缺血Ｃａ２＋积累和细胞水肿的作用吕爱刚胡香杰贾丹辉张贵卿可君（河南医科大学药理学教研室，郑州４５００５２）阿托品（ａｔｒｏｐｉｎｅ，Ａｔｒ）为一典型的Ｍ受体阻断剂，近年研究表明它可以选择性对抗ＫＣｌ和ＣａＣｌ２对兔基底动脉收缩作用，其...     

百日咳菌液致大鼠脑水肿模型脑组织氧化还原酶变化的研究

应用组织化学方法对百日咳菌液所致大鼠急性感染性脑水肿脑组织内乳酸脱氢酶、琥珀酸脱氢酶、单胺氧化酶的活性进行研究，结果显示：注菌组与正常对照组比较，三种氧化还原酶在脑组织内均出现多个局灶性酶活性减弱区，内毒素预处理组比注菌组酶活性强，提示急性感染性脑水肿时，脑组织内三种氧化还原酶活性均减弱，内毒素预处理对脑水肿有保护作用。