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21.
颅内出血性椎动脉夹层的治疗 总被引:2,自引:0,他引:2
目的探讨颅内出血性椎动脉夹层的治疗方法。方法回顾分析了2000-2005年40例出血性颅内段椎动脉夹层的治疗。其中支架辅助的弹簧圈栓塞33例,夹层段动脉闭塞6例,夹层近端主干动脉闭塞1例。结果手术无死亡病例。术后随访1-46个月,平均16.3个月。发现夹层动脉通畅,无夹层再出血,无新发后循环梗死。1例支架辅助弹簧圈栓塞患者夹层复发,行补充填塞弹簧圈。结论血管内夹层近端闭塞以及夹层段动脉闭塞是治疗颅内出血性椎动脉夹层的经典术式。支架辅助的弹簧圈栓塞治疗保留了载瘤动脉,避免了术后对侧椎动脉血流负荷量的增加;减少了后循环缺血的危险,扩大了血管内治疗出血性椎动脉夹层的手术适应证。本组结果显示支架辅助弹簧圈栓塞术并未增加夹层再通以及穿支动脉闭塞。本组经验初步表明支架辅助的弹簧圈栓塞是治疗出血性颅内椎动脉夹层的合理选择之一。 相似文献
22.
Takuo Fujita Masaaki Fukase Takao Shimada Hironosuke Yamamoto 《Journal of bone and mineral metabolism》1992,10(1):37-40
In addition to estrogen widely used all over the world for the prevention of postmenopausal osteoporosis, calcitonin and vitamin
D derivatives are commonly employed to treat established osteoporosis at higher age in Japan. In order to critically assess
the usefulness of vitamin D derivatives and calcitonin alone or in combination on the advancement of vertebral deformity at
higher age, 32 osteoporotic patients with vertebral deformity with the mean age of 79 were randomly divided into 4 groups
with indistinguishable age and severity of the vertebral deformity. Group 1 served as the control without specific medications
for osteoporosis. Group 2 was treated with 10 units elcatonin (eel calcitonin derivative) injected intramuscularly twice a
week. Group 3 was given 0.75 to 1.5μg/day 1α (OH) vitamin D3 orally. Group 4 was given a combination of treatments used in Groups 2 and 3.
In the lateral X-ray film of the spine taken prior to the test and every 6 months thereafter, the shape of the vertebral body
T8 through L4 was monitored by measuring the anterior, central and posterior heights. Decrease of the vertebral height ratio; anterior
or middle height/posterior or adjacent intact posterior height, by more than 20% of the original value or from above to below
0.80 both appeared to be inhibited during administration of 1α (OH) vitamin D3. Such effect seems to be augmented by simultaneous administration of elcatonin. Actual decrease of vertebral height ratio
values and the per cent fall from the original value significantly less in Groups 3 and 4 than in Group 1. Development of
vertebral deformity assessed by the changes of the vertebral height thus appears to decrease during treatment with 1α (OH) vitamin D3 especially together with calcitonin in established osteoporosis. 相似文献
23.
椎动脉型颈椎病血浆内皮素变化 总被引:45,自引:0,他引:45
目的:通过观察内皮素(endothelinET)在椎动脉型颈椎病患者血浆中的变化,探讨其在该病中的病理学作用和意义。方法:用放射免疫方法分别对30例正常人和30例患者、20例椎动脉减压术患者术前和术后的血浆内皮素测定。结果:椎动脉型颈椎病患者血浆ET含量(119.46±58.65ng/l)明显高于正常对照组(38.34±14.33ng/l);20例手术患者术后ET含量(50.84±21.67ng/l)明显低于术前ET含量(139.34±52.56ng/l),经统计学t检验有显著性意义(P值<0.001)。结论:ET可能是椎动脉型颈椎病发病中的重要体液因素之一,探讨ET抗体和特异ET受体阻滞剂将为治疗该病提供新的启示。 相似文献
24.
D. Agnusdei G. Crepaldi G. Isaia G. Mazzuoli S. Ortolani M. Passeri L. Bufalino C. Gennari 《Calcified tissue international》1997,61(2):142-147
One hundred ninety-eight postmenopausal women (aged 50–65 years) with vertebral bone density (VBD) 1 SD below the mean value
for normal, age-matched, postmenopausal subjects were enrolled in six Italian centers and 134 completed 2 years of treatment.
All subjects were randomly allocated to a 2-year treatment with oral ipriflavone (200 mg t.i.d.) or a matching placebo, according
to a double-blind, parallel group design. All patients also received an oral daily calcium supplement of 1 g as calcium carbonate.
VBD and markers of bone turnover were measured at baseline, and every 6 months. A complete routine analysis of liver and kidney
functions along with hematological parameters were measured before and at the end of treatment period. The valid completers
analysis showed a significant increase of VBD in ipriflavone-treated women with average percent changes of +1.4 after 1 year,
and +1% at the end of treatment period (P < 0.05). The placebo group presented a significant decrease of VBD after 2 years of treatment (P < 0.05). The difference between treatments was significant (P < 0.01). The intention to treat analysis confirmed the significant decrease of VBD in the placebo group, with no changes
in ipriflavone-treated women. Skeletal ALP significantly decreased in ipriflavone-treated women (P < 0.05). Serum BGP and urine HOP/Cr showed a significant decrease only in ipriflavone-treated women, suggesting an inhibitory
effect on bone turnover rate. Adverse reactions, mainly gastrointestinal, occurred to a similar extent in the two treatment
groups. The evaluation of patients' compliance, assessed by residual tablets count, revealed a drug intake of more than 80%
after 2 years in 92.5% and 92.8% of patients treated with ipriflavone or placebo, respectively. This study demonstrates that
ipriflavone can prevent bone loss in postmenopausal women with low bone mass.
Received: 1 April 1996 / Accepted: 5 March 1997 相似文献
25.
P. Lips MD C. Cooper D. Agnusdei F. Caulin P. Egger O. Johnell J. A. Kanis U. Liberman H. Minne J. Reeve J. Y. Reginster M. C. de Vernejoul I. Wiklund 《Osteoporosis international》1997,7(1):36-38
The morbidity of osteoporosis is caused by fractures. Vertebral fractures lead to pain and disability and a decrease in quality of life. A Working Party of the European Foundation for Osteoporosis has developed a specific questionnaire for patients with established vertebral osteoporosis. This questionnaire is intended for use in clinical trials. The questionnaire consists of questions and visual analogue scales in the following domains: pain, activities of daily living, jobs around the house, mobility, leisure and social activities, general health perception and mood. The questionnaire has been translated from English into French, German, Italian, Hebrew, Swedish and Dutch. The questionnaire is currently being validated in a multicentre study involving patients with stable osteoporosis and control subjects. Preliminary results indicate that the reproducibility is sufficient and that the questionnaire is able to discriminate between patients with vertebral osteoporosis and control subjects. 相似文献
26.
Bone mineral “density” (BMD) measured by dual-energy X-ray absorptiometry (DEXA) does not represent the volumetric density (grams per cubic centimeter), but rather the areal density (grams per square centimeter). This distinction is important during growth. The purpose of this study was to measure vertebral dimensions in cadavers of young pigtail macaques (Macaca nemestrina), and to derive equations to predict the volumetric bone density from noninvasive measurements. We measured the areal bone density by DEXA, vertebral volume by underwater weighing, mineral content by ashing, dimensions of lumbar vertebrae by calipers, and dimensions of vertebrae by radiography. Somatometric measurements of the female lumbar vertebral bodies showed that the shape changed during growth. The bone mineral content from the densitometer correlated significantly with the ash weight (r = 0.99, error 8.7%). The correlation coefficient between the volumetric bone mineral density and areal BMD measurement was significant (r = 0.68, p < 0.0001) with a 9.5% error; this improved significantly to 0.82 (7.2% error) when the BMD was divided by the vertebral depth from the radiograph. Areal BMD showed a strong correlation with age (r = 0.82, p < 0.0001), with an average increase of 7.4%/year. In contrast, volumetric mineral density showed a weak relationship with age (r = 0.43, p < 0.01), for an average increase of 1.5%/year. When studying bone mineral density during growth, the differences between volumetric and areal bone mineral density should be taken into consideration. ( 相似文献
27.
Summary We observed a rare cerebrovascular anomaly in a patient with brain-stem infarction. Two right vertebral arteries arose from the subclavian artery and communicated directly with each other under the transverse foramen of the fourth cervical vertebra. The left vertebral artery consisted of a rudimentary artery that arose from the left subclavian artery, ran through the transverse foramen of the sixth cervical vertebra and then tapered down to disappear at the fourth/fifth cervical vertebrae, plus a second, accessory artery that arose from a branch of the left thyrocervical trunk, ran through the transverse foramen of the fifth cervical vertebra and tapered off to disappear at the first/second cervical vertebrae. 相似文献
28.
本文对300个寰椎的后桥和侧桥的存在情况作了观察。其中129个寰椎(43.0%)有后部分桥,22个寰椎(7.3%)有后完整桥;34个寰椎有侧部分桥(11.3%),16个寰椎(5.3%)有侧完整桥。经统计学检验,在左右侧后完整桥及左右侧侧完整桥间均无显著性差异。对寰椎横突孔、后弧孔及侧弧孔内径的测量显示,绝大部分后弧孔(92.0%)较同侧横突孔小,且右横突孔与右后弧孔间存在高度显著性差异(P<0.01)。此外,还测量了两种完整骨桥的宽度,探讨了狭小后弧孔对正常椎动脉机能的可能影响,分析了文献中关于寰椎桥的起源。 相似文献
29.
Candida albicans vertebral osteomyelitis is rare. Three cases are presented. Without antifungal treatment, they developed spinal collapse and neurological deterioration within 3–6 months from the onset of symptoms. There was a delay of 4.5 and 7.5 months between the onset of symptoms and surgery. All patients were managed with surgical debridement and reconstruction and 12-week fluconazole treatment. The neurological deficits resolved completely. The infection has not recurred clinically or radiologically at 5–6 years follow-up. Although rare, Candida should be suspected as a causative pathogen in cases of spinal osteomyelitis. Without treatment the disease is progressive. As soon as osteomyelitis is suspected, investigations with MRI and percutaneous biopsy should be performed followed by medical therapy. This may prevent the need for surgery. However, if vertebral collapse and spinal cord compression occurs, surgical debridement, fusion and stabilisation combined with antifungal medications can successfully eradicate the infection and resolve the neurological deficits. 相似文献
30.
用33例男性青年新鲜尸体的脊柱,自蛛网膜下腔灌入铸型造影剂.低温冷冻,横断各颈椎照X线片,测出C_3~C_7椎体、椎管、硬膜囊和脊髓的横、矢径平均值。取4例先做脊髓造影CT测量,再做铸型造影对比,证明33例标本测量数值可作为正常男性椎管及脊髓CT测量的标准参考数据。选20例X线片进行图像面积扫描,其中C_4与C_5脊髓与椎管的面积比例较小。 相似文献