YL-1型颅内血肿粉碎仪对高血压脑出血的微创治疗

目的探讨微创治疗高血压脑出血的临床效果。方法根据CT定位，使用YL-1型颅内血肿粉碎仪对颅内血肿碎吸引流。结果治疗36例，存活出院34例，死亡2例。结论微创治疗高血压脑出血，操作简便、安全，疗效好，费用低，是对高血压脑出血治疗的有效的治疗方法。     

原发性肝癌破裂出血的临床分析(附76例报告)

目的探讨原发性肝癌破裂出血的诊疗。方法回顾性分析1990-2004年我院76例资料完整的原发性肝癌破裂出血患者的诊断和治疗。结果76例患者均有急性上腹部疼痛和急性腹膜炎表现，影像学检查和腹腔穿刺均阳性。76例中非手术治疗34例，占44．7％，12例死亡（占非手术治疗的35．3％）；手术治疗42例，占54．3％。6例死亡（占手术治疗的14．3％）。结论病史、影像学检查和腹腔穿刺在原发性肝癌破裂出血的诊断中起重要作用。治疗根据患者的具体情况而采取保守治疗或缝扎止血、手术肝切除、肝动脉结扎等手术治疗方法。     

小脑后下动脉动脉瘤的诊断和治疗

目的探讨小脑后下动脉动脉瘤的临床特征、诊断、鉴别诊断和治疗。方法回顾性分析12例小脑后下动脉瘤的临床表现、影像学特征、手术效果及诊治过程中存在的相关问题。结果12例中有11例因动脉瘤破裂出血而发病,单纯第四脑室出血4例,全脑室系统出血2例,小脑半球出血3例,小脑蚓部伴第四脑室出血1例,侧脑室伴第三脑室出血1例,以后颅窝占位病变表现1例。8例术前行DSA检查明确诊断,4例术中明确诊断。12例均行后颅窝开颅显微手术治疗,其中动脉瘤颈夹闭9例,孤立切除2例,动脉瘤加固术1例,术后2例因脑积水加重行脑室-腹腔分流术。12例中除1例术后留有轻偏瘫外,其余11例恢复良好。结论小脑后下动脉瘤多以第四脑室出血发病,少数以小脑半球或蚓部出血发病,及早治疗效果满意。手术方式应尽量夹闭动脉瘤颈,对于小脑后下动脉末端动脉瘤,可以采用孤立切除术。     

支气管肺癌伴其它部位多原发癌的影像诊断(附25例报告)

经病理确诊的527例原发性支气管肺癌(PBC)(1972～1987)中,PBC伴其它部位多原发癌(MPC)25例(4.7％)。其中双原发肺癌(DPBC)、12例(2.3％),PBC伴消化道癌6例(1.14％)。25例中共有原发癌灶52个,其中2例为3原发癌;同期组6例(其中DPBC 4例),后期组19例(其中14例间隔3年以上,内2例分别间隔14年及25年)。组织类型相同者8例,不同者4例。 25例MPC特点如下:1.55岁以上20例(80％);2.24例(96％)第2原发癌为1980年后发现;3.第2原发癌为肺癌者23例(92％);4.双原发肺癌12例(48％)。上述特点说明80年代老年人中MPC,尤其是肺癌发病率增高。 本文着重对第2原发肺癌的影像学表现和鉴别诊断进行讨论。     

Primary malignant melanoma: a rare cause of mediastinal mass

A case of primary malignant melanoma in the mediastinum presenting as recurrent laryngeal nerve palsy is reported. Tissue biopsy at mediastinotomy yielded a diagnosis of malignant melanoma. The mass was fixed to the left aspect of the trachea and to the upper border of the left main bronchus and could not be removed surgically. Further extensive clinical and radiological investigations revealed no evidence of tumor elsewhere in the body.     

福建省原发性肝癌遗传因素分析

为了探讨遗传因素与福建省原发性肝癌的关系,应用多种对照配对的病例对照研究方法,对100个原发性肝癌和200个对照家系进行了遗传流行病学分析。结果显示,原发性肝癌先证者一、二级亲属患病率明显高于对照组患病率,分离比为0.04146～0.08654,遗传度加权均值为63.52±4.22％。提示原发性肝癌系多基因遗传病,遗传易感性是原发性肝癌的危险因素之一,原发性肝癌的发生是遗传和环境多种因素共同作用的结果。     

脑瘫患儿脑干听觉诱发电位研究

本文采用日本光电公司生产的 MEB-5304K 诱发电位测定仪,对101名6月-14岁脑瘫患儿和40名正常儿测定了脑干听觉诱发电位(BAEP)。结果表明:给予80dBNHL,20Hz 刺激时 BAEP 异常率为45.54%,随刺激强度减小及刺激重复率增加,BAEP 阳性率提高。BAEP 改变与病情、病型及并发症有关。为脑瘫的发病机理及病理生理学研究提供神经电生理学依据。对脑瘫合并听力障碍者有助于及早选用助听装置,解决其听力障碍问题。     

脉络膜挫伤

回顾６４例外伤性脉络膜挫伤。多发于２０－３０岁的青年男性；最常见有拳击伤；临床主要表现为视力下降，眼底可见脉络膜出血灶及裂伤口，荧光眼底血和造影可帮助诊断。脉络膜挫伤多发生于黄斑部，其次为视乳头周围，多为单个，１－ＰＤ大小，脉络膜破裂的形态多为长弧形，脉络膜出血多为圆形；脉络膜破裂与出血常同时出现。     

Effects of Ethanol in an Experimental Model of Combined Traumatic Brain Injury and Hemorrhagic Shock

Objectives: Given that clinical and laboratory studies suggest that ethanol and hemorrhagic shock (HS) potentiate traumatic brain injury (TBI), the authors studied the effects of ethanol in a model of combined TBI and HS.
Methods: A controlled porcine model of combined TBI and HS was evaluated for the effect of ethanol on survival time, hemodynamic function, and cerebral tissue perfusion. Anesthetized swine (17–24 kg) were instrumented, splenectomized, and subjected to fluid percussion TBI with concurrent 25-mL/kg graded hemorrhage over 30 minutes. Two groups were studied: control ( n = 11) and ethanol ( n = 11). Ethanol, 3.5 g/kg intragastric, was given 100 minutes prior to TBI/HS. Systemic and cerebral physiologic and metabolic parameters were monitored for 2 hours without resuscitation. Regional cerebral blood flow (rCBF) and renal blood flow were measured with dye-labeled microspheres. Data were analyzed with 2-sample t-test and repeated-measures ANOVA.
Results: Ethanol levels at the time of injury were 162 ± 68 mg/dL. Average TBI was 2.65 ± 0.35 atm. Survival time was significantly shorter in the ethanol group (60 ± 27 min vs 94 ± 28 min, p = 0.011). The ethanol group had significantly lower mean arterial pressure, cerebral perfusion pressure, and cerebral venous
O₂ saturation in the postinjury period. Cerebral O₂ extraction ratios and cerebral venous lactate levels were significantly higher in the ethanol group. A trend toward lower postinjury rCBF in all brain regions was observed in the ethanol group.
Conclusion: In this TBI/HS model, ethanol administration decreased survival time, impaired the hemodynamic response, and worsened measures of cerebral tissue perfusion.     

Studies of the antagonistic effect of BQ-123 on cerebral vasospasm induced by intracisternal injection of endothelin-1 and subarachnoid hemorrhage

Cerebralvasospasm(CVS)remainsoneofthemajorcausesofseriousoutcomeinpatientswithsubarachnoidhemorrhage(SAH);however,themechanismofwhichisstillnotwellunderstood.Sofaralargenumberofputativespasmogenshavebeenproposedandoneofwhichisendothelins(ETs).ETs,akindofverypotentendogenousvasoconstrictorsubstancesknown[1],hasthreeiso-forms:ET-1,2and3,andET-1isthemostpo-tentvasoconstrictorofthem.lnrecentstudies,ET-lhasbeenproposedasamediatorofCVSfol-lowingSAH[2-4j.TheavailabilityofETantagonistprovided…