外伤性脊髓损伤的MRI表现与临床对照分析

目的评价MRI在脊髓损伤的临床应用价值。资料与方法回顾性分析66例脊髓损伤的临床及MRI表现，着重分析脊髓损伤的MRI征象与病理、临床的关系。结果MRI显示椎体压缩性骨折51例，椎间盘脱出2例，椎体骨折并椎问盘脱出5例；椎体部分性滑脱20例，完全性滑脱1例。显示脊髓完全性截断4例，部分性截断1例，脊髓受压4l例。62例脊髓连贯者59例显示脊髓信号异常。59例有完整的住院治疗记录，治疗后显示病情好转25例，症状无改善26例，死亡8例。结论MRI检查能明确脊髓有无损伤以及损伤的程度，有助于临床治疗措施的选择以及对预后的评估。     

先天性心脏病的MRI诊断

磁共振成像是一种无创伤,无辐射的新型影像学诊断方法。伴随着MRI技术的飞速发展,MRI已从形态学诊断发展到分子学诊断，扩大了MRI的应用范围。     

垂体脓肿的诊断和治疗(附4例报告)

垂体脓肿较为少见，自1985年1月至2004年12月．本院经手术确诊仅4例。现将其临床特点及治疗介绍如下。     

Efficacy of large decompressive craniectomy in severe traumatic brain injury

Objective： To investigate the role of large decompres- sive craniectomy （LDC） in the management of severe and very severe traumatic brain injury （TBI） and compare it with routine decompressive craniectomy （RDC）.
Methods： The clinical data of 263 patients with severe TBI （GCS~8） treated by either LDC or RDC in our department were studied retrospectively in this article. One hundred and thirty-five patients with severe TBI, including 54 patients with very severe TBI （GCS ≤ 5）, underwent LDC （LDC group）. The other 128 patients with severe TBI, including 49 patients with very severe TBI, underwent RDC （RDC group）. The treatment outcome and postoperative complications of the two treatment methods were compared and analyzed in a 6-month follow-up period.
Results： Ninety-six patients （71.7 %） obtained satisfactory treatment outcome in the LDC group, while only 75 cases （58.6 %） obtained satisfactory outcome in the RDC group （P〈 0.05）. Moreover, the efficacy of LDC in treating very severe TBI was higher than that of RDC （63.0 % vs. 36.7 %, P 〈 0.01）. The chance of reoperation due to refractory intracranial pressure （ICP） in the LDC group was significantly lower than that of the RDC group （P 〈 0.05）, while the incidences of delayed intracranial hematoma and subdural effusion were significantly higher than those of the RDC group （ P 〈 0.05）.
Conclusions： LDC is superior to RDC in improving the treatment outcome of severe TBI, especially the very severe ones. LDC can also efficiently reduce the chances of reoperation due to refractory ICP. However, it increases the incidences of delayed intracranial hematoma and contralateral subdural effusion.     

Surgery for posttraumatic syringomyelia： a retrospective study of seven patients

Objective： To analyze retrospectively the clinical symptoms, signs, radiological findings and results of treatment of posttraumatic syringomyelia. Methods： The data of 7 patients with posttraumatic syringomyelia confirmed by computerized tomography （CT） and magnetic resonance imaging （MRI） in our hospital between 1999 and 2004 were reviewed retrospectively. The patients underwent decompressive laminectomy or syringo-subarachnoid （S-S） shunting with microsurgery. Long-term follow-up was available （range： 13-65 months）. Results： The major dinical manifestations of posttraumatic syringomyelia usually included the onset of increasing signs and the development of new symptoms after an apparently stable period. The clinical symptoms included pain, sensory disturbance, weakness, and problems in autonomic nerves. Syrinx existed merely at the cervical level in 4 cases and extended downward to the thoracic levels in the other 3 cases. One case underwent decompressive laminectomy, 6 cases were treated by S-S shunting. During the early postoperative period, all the patients showed an improvement of symptoms of syrinx without major complication or death. The decreased size or collapse of the syrinx was demonstrated by postoperative MRI. Conclusions ： Posttraumatic syringomyelia is a disabling sequela of spinal cord injury, developing months to years after spinal injury. MRI is the standard diagnostic technique for syringomyelia. The patients with posttraunmtic syringomyelia combined with progressive neurological deterioration should be treated with operations. S-S shunting procedure is effective in some patients with posttraumatic syringomyelia. Decompressive procedure may be an alternative primary surgical treatment for patients with kyphosis and cord compression.     

桥小脑角脑膜瘤的手术治疗(附88例报告)

目的 探讨桥小脑角区脑膜瘤的手术治疗方法。方法 对近20年经手术治疗的88例桥小脑角质膜瘤进行回顾性分析。结果 肿瘤全部切除68例（全切率77．3％）,大部切除20例;术后死亡6例（死亡率6．8％）。60例随访6个月－11年,46例恢复良好,8例死亡,6例复发。结论 手术治疗是桥小脑角脑膜瘤的首选治疗方法。合理选择手术入路,术中妥善处理和保护血管、神经、脑干等,以及术后正确处理并发症,配合其他辅助治疗,是提高手术疗效和患者术后生活质量的关键。     

成人型胸内淋巴结结核22例X线分析

分析22例成人型胸内淋巴结结核,发现本病好发于35岁以下青壮年,尤以女性多见。胸部X线特点为:单侧肺门或(和)气管旁淋巴结肿大,右侧多于左侧;肺门肿大淋巴结呈椭圆形或圆形,密度均匀,边缘光滑或毛糙分叶状;气管旁淋巴结肿大表现为上纵隔呈平直或弧状增宽,密度均匀,边缘光滑。     

中药大型输液剂增液针、养阴针的临床和实验初步观察

我所自1979年起,开展对中药大型输液剂"增液针"和"养阴针"的研制,目前已从实验转到临床,对324例患者进行了临床治疗对照和实验观察,现将观察结果初步分析讨论如下:临床观察一、观察对象:本组324例中,年龄最小17岁,最大90岁,26～60岁者占73.76%;内科病人213例,外科病人11例;住院观察273例,门诊观察41     

参麦液抗心律失常作用及毒性研究

参麦液能对抗乌头碱所致的大鼠心动过速,预防给药显著延长上述心律失常出现的潜伏期,治疗给药可使动物恢复正常窦性心律,还可对抗垂体后叶素诱发大鼠心肌缺血时心电图变化,並降低氯仿引起小鼠室颤的发生率。小鼠静注参麦液的LD₅₀为23.42g/kg,家兔亚急性毒性试验无明显毒性反应,因此毒性低,静脉注射使用安全。