全麻唤醒状态下切除脑功能区病变的手术前后护理

目的 分析并探讨全麻唤醒状态下切除脑功能区病变手术前后的护理配合要点。方法 对6例在全麻唤醒状态下行脑功能区病变切除手术的患者术前进行全面的评估、有效的心理护理及针对性的培训指导,手术后进行仔细的对比观察和功能锻炼,并做好并发症的防治和护理。结果 6例患者中,术后有1例出现癫痫发作和幻觉症状,经用药治疗后控制;1例出现运动性失语症状;有2例出现病变对侧肢体肌力较术前下降,经积极的康复锻炼,未出现护理并发症;其余均未出现明显的语言或肢体运动功能障碍,恢复良好,顺利出院。6例患者均在出院半年后随访,效果较满意。结论 术前充分的评估、有效的心理疏导和指令性语言训练及培训指导有助手术顺利进行,术后细致的观察和精心的护理可促进神经功能恢复,减少并发症发生。     

浅析幼儿头部CT扫描中的护理工作

由于幼儿特殊的生理及心理因素，对于他们的头部CT扫描一直是困扰CT诊断医生的一大难点。由于普通CT扫描时间长、部分幼儿不合作因而得不到一张能够达到诊断标准的CT图片，因而如何做好小儿头部CF扫描中的准备成为CT室护理工作的一个重点。我院CT室在长达十五年的工作中积累了一定的经验，现综述如下以供大家探讨。     

细菌性皮肤病

阴囊皮损细菌培养及药敏试验结果分析；脓肿性穿掘性头部毛囊周围炎1例；皮肤紫色着色性细菌病2例报告；皮肤炭疽1例报告；定性研究方法在肺结核病人发现研究中的应用。     

头皮癌切除后创面修复八例报告

头皮癌切除后创面修复八例报告安徽省池州地区医院（贵池市２４７１００）开大顺胡安贵发生于头皮的癌肿以鳞状上皮癌为多见，其次为基底细胞癌、汗腺癌、瘢痕癌等。我院１９８１～１９９３年收治头皮癌１２例，其中８例为鳞状上皮癌，经手术切除癌肿，采用转移皮瓣修复创...     

头颈部癌放疗前后甲状腺功能的观察

我们在1993年10月～1996年12月间对47例头颈部癌放疗前后患者血清T_3、T_4、TSH、rT_3放射免疫测定,观察甲状腺功能改变,现报告如下。 材料和方法 全部病人均为本科住院或门诊放疗病人。男28例,女19例,年龄18～73岁,平均51.2岁。其中鼻咽癌29例;喉癌10例;颈部转移癌5例;舌癌3例。选择本院门诊体检无甲状腺与全身性疾病的健康人30例为对照组。 患者放疗时,放射源为~(60)Co射线。放疗每周5次,甲状腺组织全部或部分在照射野内。总剂量为40～75Gy/4～8周。其中26例患者全部甲状腺组织受照射,甲状腺平均受量为58.7Gy,21例患者甲状腺组织部分受照射,甲状腺平均受量为56.4Gy。 在放疗前、后6月、12月、24月检测患者血清T_3、T_4、TSH、rT_3各一次,采用北方免疫试剂研究所提供的放免试剂盒,按说明书操作。     

冰帽头部低温治疗丘脑出血53例分析

丘脑出血约占全部脑出血的10％，发病部位靠近中线，紧邻下丘脑，临床上一般不选择手术治疗，其常见发病原因为高血压病，起病急，并发症多，死亡率高。我们使用冰帽头部低温治疗丘脑出血病人53例，疗效满意，特总结如下：     

头部电针透穴治疗抑郁症31例临床观察

(黑龙江省中医研究院.哈尔滨150036)抑郁症为情感障碍的一种,以持久的心境低落、睡眠障碍、悲观失望、甚则自杀为特点。目前除药物治疗外尚无特效疗法。笔者在长期临床实践中,采用头部电针透穴法治疗抑郁症31例,取得满意疗效,现总结如下。1临床资料1.1一般资料选择抑郁症的病人     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

留置套管针致头部皮肤破溃1例

头皮静脉输液是儿科0～2岁儿童常用的治疗方法,随着一次性静脉留置针已经广泛应用于临床,可以减少患儿穿刺次数,减轻患儿痛苦,保护穿刺静脉,提高工作效率.     

外伤性迟发性脑内血肿的微创手术治疗

外伤性迟发性脑内血肿(delayed traumatic intracranial hetatoma，DTICH)是头部外伤的极为严重的并发症，其发生率为1．37％～10％。自1998年以来，我们用血肿碎吸微创手术治疗29例，取得了较为满意的效果。报告如下：