伽玛刀治疗大脑镰旁脑膜瘤98例临床分析

目的 研究伽玛刀治疗肿瘤最大径＜30 mm的大脑镰旁脑膜瘤的效果.方法 对2002年8月～2010年7月肿瘤最大径＜30 mm的98例大脑镰旁脑膜瘤患者进行伽玛刀治疗.肿瘤最大径＜10 mm 51例、10～＜20 mm36例、20～＜30 mm 11例,伽玛刀治疗处方剂量为26～32 Gy,50％的等剂量线包绕.结果 随访98例,随访23～81个月（平均52个月）.肿瘤消肖失37例,肿瘤缩小41例,肿瘤无变化14例,肿瘤继续增大6例.肿瘤生长控制率为93.9％（92/98）,其中肿瘤最大径＜20 mm的肿瘤控制率达96.6％（84/87）.出现肿瘤周围脑水肿反应17例.结论 伽玛刀治疗大脑镰旁脑膜瘤安全有效,肿瘤最大径＜20 mm为最佳.     

Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS

We report on oxygenation changes noninvasively recorded by multichannel continuous-wave near infrared spectroscopy (CW-NIRS) during endovascular neuroradiologic interventions requiring temporary balloon occlusion of arteries supplying the cerebral circulation. Digital subtraction angiography (DSA) provides reference data on the site, timing, and effectiveness of the flow stagnation as well as on the amount and direction of collateral circulation. This setting allows us to relate CW-NIRS findings to brain specific perfusion changes. We focused our analysis on the transition from normal perfusion to vessel occlusion, i.e., before hypoxia becomes clinically apparent. The localization of the maximal response correlated either with the core (occlusion of the middle cerebral artery) or with the watershed areas (occlusion of the internal carotid artery) of the respective vascular territories. In one patient with clinically and angiographically confirmed insufficient collateral flow during carotid artery occlusion, the total hemoglobin concentration became significantly asymmetric, with decreased values in the ipsilateral watershed area and contralaterally increased values. Multichannel CW-NIRS monitoring might serve as an objective and early predictive marker of critical perfusion changes during interventions—to prevent hypoxic damage of the brain. It also might provide valuable human reference data on oxygenation changes as they typically occur during acute stroke.     

前列地尔在急性脑梗死并发脑心综合征中的应用价值

目的观察使用前列地尔治疗急性脑梗死并发脑心综合征的临床效果。方法选取2011-04—2014-07收治的急性脑梗死并发脑心综合征患者130例,随机分为对照组与观察组,对照组实施常规治疗,在此基础上观察组联合前列地尔进行治疗,对比2组患者临床疗效。结果观察组治疗后神经系统及心脏损伤总有效率均明显高于对照组,治疗后2组高敏C反应蛋白、肌钙蛋白指标水平均显著降低,且观察组降低程度更为明显,差异均有统计学意义(P0.05)。结论使用前列地尔治疗急性脑梗死并发脑心综合征,能够有效降低各项相关指标,缓解神经、心脏方面临床症状,显著提高临床疗效,具有进一步推广价值。     

高血压性脑出血患者的护理体会

探讨高血压性脑出血术前、术后的护理经验及有效的护理措施。脑出血最常见的原因为高血压和动脉硬化。大多发生于50岁以上，但年轻人患高血压病者也可并发脑出血。其中男性多于女性，临床上以头疼、眩晕、呕吐、三偏征为其主要表现，由于此病有较高的致残率和病死率，因此，及时有效的治疗和科学护理对提高本病的治疗效果有着重要意义。     

破裂大脑中动脉动脉瘤的显微手术治疗

目的探讨破裂大脑中动脉动脉瘤的诊断、显微手术治疗及其疗效。方法回顾性分析显微手术治疗的70例破裂大脑中动脉动脉瘤患者的临床资料。64例患者术前进行了头颅3D-CTA或/和DSA检查,6例仅行头颅CT检查。结果 70例患者中,67例行动脉瘤夹闭术,3例行动脉瘤包裹术。术后随访3月～2年,按GOS评分,5分57例,4分5例,3分5例,2分1例,1分2例;60例患者行3D-CTA或/和DSA复查,未见动脉瘤复发,其中1例行包裹术的患者动脉瘤无明显增大。结论破裂大脑中动脉动脉瘤应尽早采取显微手术治疗,以有效改善预后;术中多普勒超声的使用能为手术提供帮助。     

疏血通联合银杏达莫治疗急性脑梗死疗效分析

目的观察疏血通联合银杏达莫治疗急性脑梗死患者的临床疗效。方法按标准选择急性脑梗死患者84例,随机分为治疗组和对照组,每组各42例。治疗组给予疏血通联合银杏达莫治疗,对照组给予银杏达莫治疗,疗程均为14 d.观察2组临床疗效及血脂、凝血指标等的变化。结果治疗组临床疗效优于对照组（P〈0.05）,血脂、凝血指标均有明显改善（P〈0.05）。结论疏血通联合银杏达莫治疗急性脑梗死疗效确切,且安全性好。     

Complementary Acupuncture Treatment Increases Cerebral Metabolism in Patients with Parkinson's Disease

We used positron emission tomography (PET) and the 18-flourodeoxyglucose tracer to study cerebral effects of complementary acupuncture in Parkinson's disease. Five patients received scalp-acupuncture and Madopa, while the other five had Madopa only. PET scans before and after 5 weeks of complementary acupuncture treatment show increased glucose metabolisms in parietal, temporal, occipital lobes, the thalamus, and the cerebellum in the light-diseased hemisphere, and in parietal and occipital lobes of the severe-diseased hemisphere. No changes were observed in the Madopa-only group. Acupuncture in combination with Madopa may improve cerebral glucose metabolism in Parkinson's disease.     

急性心源性肺水肿临床疗效与X线胸片的相关性分析

目的研究急性心源性肺水肿治疗效果和X线胸片表现之间的关系,为临床评估疗效提供帮助。方法由2名有经验的放射科医师采用盲法回顾性分析48例急性心源性肺水肿患者治疗前后的X线胸片好转率,所得的数据做χ2检验,并用Kappa检验对2人评判的结果做一致性分析。结果医师甲、乙所得的结论均为:急性心源性肺水肿临床治疗后好转者,X线胸片好转率的差异有统计学意义(P<0.05)。甲乙医师间阅片的一致性分析差异有统计学意义(P<0.05),说明甲乙2名医师对治疗前后X线表现好转与否的诊断结果有较好的一致性。讨论急性心源性肺水肿治疗过程中复查X线胸片,是评估临床疗效的一种有效的方法 。     

间苯三酚联合缩宫素对需引产分娩的初产妇产程进展和分娩结局的影响

目的 探讨间苯三酚联合缩宫素应用对于需引产分娩的初产妇产程进展、产妇及新生儿分娩结局的影响.方法 选取2019年1月至2020年12月在合肥市第三人民医院需引产分娩的足月单胎初产妇60例,采用随机数字表法分为观察组与对照组,每组30例,对照组单用缩宫素治疗,观察组应用缩宫素联合间苯三酚治疗,收集产妇的产程进展、产后出血量、宫颈或阴道裂伤发生率、产时羊水Ⅲ度发生率、阴道分娩率和新生儿Apgar评分等,并对两组数据进行比较.结果 观察组第一产程、总产程时间分别为(407.9±125.4)min、(450.5±131.0)min,均显著短于对照组的(663.3±218.2)min、(722.1±223.4)min(P<0.05).两组阴道分娩率、产后出血量、宫颈或阴道裂伤发生率、产时羊水Ⅲ度发生率的差异无统计学意义(P>0.05).结论 间苯三酚联合缩宫素静滴,可缩短产程,且不影响母婴安全.