DSA对老年性颈内动脉重度狭窄或闭塞患者侧支循环的应用价值

Objective To investigate the diagnostic value of aortocranial DSA in collateral circulation in elderly patients with serious stenosis or occlusion of the internal carotid artery. Methods Twenty-three elderly patients with serious stenosis or occlusion of the internal carotid artery, admitted to our hospital from August 2008 to July 2010, were chosen; their DSA findings and prognoses were retrospectively analyzed. Results Of these 23 patients, the collateral circulation was seen in 18(78.3%), including compensations from anterior communicating artery (n=16), posterior communicating artery (n=6), anterior together with posterior communicating artery (n=3), anterior choroidal artery (n=5),meningina artery between anterior cerebral artery and posterior cerebral artery (n=5), meningina artery between posterior cerebral artery and middle cerebral artery (n=4), ophthalmic artery (n=15), blood vessel between posterior cerebral artery and superior cerebellar artery (n=3), and blood vessel among superior cerebellar artery, anterior inferior cerebellar artery and posterior inferior cerebellar artery (n=2); after conservative treatment and long time follow-up (1 to 22 months with a mean of 11.2 moths),disappearance of clinical symptoms and no recurrence were found in these 18 patients. Five patients were noted without compensatory collateral circulation: the 2 paralysis patients could not take care of themselves even with the improvement of myodynamia from grade 0 to grade Ⅲ; the 2 patients with disturbance of consciousness showed no recovery and died from lung infection; the left 1 patient was having aphasia. Conclusion DSA can accurately define ways and compensative ability of collateral circulation in elderly patients with serious stenosis or occlusion of the internal carotidartery, which can put forward reliable evidences for their treatments and prognoses.     

亚低温治疗对脑出血患者预后的影响

目的探讨亚低温治疗对脑出血患者预后的影响。方法将176例脑出血患者随机分为观察组和对照组,对照组给予脑出血常规治疗,观察组在对照组基础上加用亚低温治疗。观察比较两组患者治疗前、治疗后神经功能缺损评分(SSS评分)及血肿、水肿体积的改变情况;比较两组临床疗效。结果治疗后两组SSS评分较治疗前均有显著下降(P<0.001),但观察组降低的幅度大于对照组(P均<0.01);观察组血肿体积较对照组小(P<0.001);观察组脑水肿体积较对照组减轻(P<0.001);观察组的临床疗效优于对照组(P<0.05)。结论亚低温治疗脑出血可明显改善神经功能缺损程度,改善预后。     

脑脊液置换治疗蛛网膜下腔出血的疗效分析

目的分析不同量脑脊液置换治疗蛛网膜下腔出血(SAH)的效果。方法将102例蛛网膜下腔出血患者根据是否行脑脊液置换及置换量的多少分为少量置换组(A组,n=36)、大量置换组(B组,n=36)及一般治疗组(C组,n=30),置换组除了给予一般治疗组同样的治疗方法外,通过简易腰穿法,以不同量生理盐水缓慢置换脑脊液,A组10~30 ml/次,B组40~70 ml/次。结果置换组平均头痛缓解时间显著缩短(P<0.01),大量置换组较少量置换组平均头痛缓解时间缩短更显著(P<0.05);大量置换组脑血管痉挛及脑积水发生率均显著低于一般治疗组(P<0.05)。结论早期简易腰穿脑脊液置换治疗SAH可以缩短患者头痛时间,大量脑脊液置换不仅可以更有效缩短头痛时间,还可以减少其脑积水、脑血管痉挛并发症。     

糖化血红蛋白检测在急性脑梗塞中的应用价值

目的　探讨糖化血红蛋白 (GHb)在急性脑梗塞 (ACI)中的应用价值。方法　回顾性分析 15 5例空腹血糖增高的ACI患者的GHb与神经功能缺损程度、梗塞灶大小与预后的关系。结果　在 15 5例空腹血糖增高的ACI患者中GHb正常 61例 (Ⅰ组 ) ,GHb轻度增高者 63例 (Ⅱ组 ) ,GHb明显升高者 3 1例 (Ⅲ组 ) ,三组患者的神经功能缺损程度、梗塞灶大小及急性期预后比较差异有高度显著性 (P均 <0 .0 1)。结论　GHb可作为观察空腹血糖增高的ACI患者的病情和估计预后的指标之一 ,对指导治疗有重要临床意义。     

DSA对老年性颈内动脉重度狭窄或闭塞患者侧支循环的应用价值

Objective To investigate the diagnostic value of aortocranial DSA in collateral circulation in elderly patients with serious stenosis or occlusion of the internal carotid artery. Methods Twenty-three elderly patients with serious stenosis or occlusion of the internal carotid artery, admitted to our hospital from August 2008 to July 2010, were chosen; their DSA findings and prognoses were retrospectively analyzed. Results Of these 23 patients, the collateral circulation was seen in 18(78.3%), including compensations from anterior communicating artery (n=16), posterior communicating artery (n=6), anterior together with posterior communicating artery (n=3), anterior choroidal artery (n=5),meningina artery between anterior cerebral artery and posterior cerebral artery (n=5), meningina artery between posterior cerebral artery and middle cerebral artery (n=4), ophthalmic artery (n=15), blood vessel between posterior cerebral artery and superior cerebellar artery (n=3), and blood vessel among superior cerebellar artery, anterior inferior cerebellar artery and posterior inferior cerebellar artery (n=2); after conservative treatment and long time follow-up (1 to 22 months with a mean of 11.2 moths),disappearance of clinical symptoms and no recurrence were found in these 18 patients. Five patients were noted without compensatory collateral circulation: the 2 paralysis patients could not take care of themselves even with the improvement of myodynamia from grade 0 to grade Ⅲ; the 2 patients with disturbance of consciousness showed no recovery and died from lung infection; the left 1 patient was having aphasia. Conclusion DSA can accurately define ways and compensative ability of collateral circulation in elderly patients with serious stenosis or occlusion of the internal carotidartery, which can put forward reliable evidences for their treatments and prognoses.     

DSA对老年性颈内动脉重度狭窄或闭塞患者侧支循环的应用价值

目的 探讨DSA对老年性颈内动脉重度狭窄或闭塞患者侧支循环的诊断价值.方法 广西右江民族医学院附属医院神经内科自2008年8月至2010年7月收治一侧颈内动脉重度狭窄或闭塞的缺血性脑血管病患者23例,回顾性分析患者的DSA表现与预后.结果 DSA显示有充分侧支循环代偿18例(78.3%),其中前交通动脉代偿16例,后交通动脉代偿6例,前交通动脉和后交通动脉代偿3例,脉络膜前动脉代偿5例,大脑前动脉和大脑中动脉之间的软脑膜动脉代偿5例,大脑后动脉和大脑中动脉之间的软脑膜动脉代偿4例,眼动脉代偿15例,大脑后动脉与小脑上动脉之间吻合3例,小脑上动脉、小脑前下动脉和小脑后下动脉之间吻合2例;随访1～22个月,患者临床症状全部消失并未再复发.无侧支循环代偿5例,其中2例瘫痪患者肌力由0级恢复到Ⅲ级,生活无法自理;2例意识障碍没有恢复,因肺部感染而死亡;1例患者失语无法恢复.结论 DSA可以准确判断老年性颈内动脉重度狭窄或闭塞患者侧支循环的存在方式和代偿能力,为治疗方法的选择和预后的判断提供可靠依据.

Abstract：

Objective To investigate the diagnostic value of aortocranial DSA in collateral circulation in elderly patients with serious stenosis or occlusion of the internal carotid artery. Methods Twenty-three elderly patients with serious stenosis or occlusion of the internal carotid artery, admitted to our hospital from August 2008 to July 2010, were chosen; their DSA findings and prognoses were retrospectively analyzed. Results Of these 23 patients, the collateral circulation was seen in 18(78.3%), including compensations from anterior communicating artery (n=16), posterior communicating artery (n=6), anterior together with posterior communicating artery (n=3), anterior choroidal artery (n=5),meningina artery between anterior cerebral artery and posterior cerebral artery (n=5), meningina artery between posterior cerebral artery and middle cerebral artery (n=4), ophthalmic artery (n=15), blood vessel between posterior cerebral artery and superior cerebellar artery (n=3), and blood vessel among superior cerebellar artery, anterior inferior cerebellar artery and posterior inferior cerebellar artery (n=2); after conservative treatment and long time follow-up (1 to 22 months with a mean of 11.2 moths),disappearance of clinical symptoms and no recurrence were found in these 18 patients. Five patients were noted without compensatory collateral circulation: the 2 paralysis patients could not take care of themselves even with the improvement of myodynamia from grade 0 to grade Ⅲ; the 2 patients with disturbance of consciousness showed no recovery and died from lung infection; the left 1 patient was having aphasia. Conclusion DSA can accurately define ways and compensative ability of collateral circulation in elderly patients with serious stenosis or occlusion of the internal carotidartery, which can put forward reliable evidences for their treatments and prognoses.     

维生素E辅助治疗癫痫患者的临床疗效及作用机制探讨

目的：探讨维生素E辅助治疗癫痫的临床疗效，并分析其作用机制。方法选择我院神经内科收治的140例癫痫患者作为研究对象，其中观察组70例采用常规癫痫药物联合维生素E治疗，对照组70例采用常规癫痫药物治疗，比较2组临床疗效，并分析其作用机制。结果观察组总有效率82.86％，明显高于对照组，差异有统计学意义（ P＜0.05）；观察组血浆T-Aoc水平较对照组明显增加，而MDA水平较对照组明显降低，差异均有统计学意义（P＜0.05）。结论维生素E辅助治疗癫痫患者具有显著疗效，改善体内自由基水平，保护脑组织，阻止神经元放电，值得临床推广和应用。     

血清神经元特异性烯醇酶检测在短暂性脑缺血发作中应用价值的探讨

目的 :探讨血清神经元特异性烯醇酶 (NSE)检测在短暂性脑缺血发作 (TIA)的应用价值。方法 :对 6 0例首次发作的颈内动脉系统TIA患者于起病后 4 8小时内用时间分辨荧光免疫分析法检测血清NSE含量 ,选取 5 0名健康成人作为正常对照组 ,分析NSE与年龄、性别、症状持续时间、头颅CT阳性责任病灶的关系 ,动态观察 1 2个月 ,比较血清NSE增高组与血清NSE正常组的脑梗死发生率。结果 :6 0例TIA患者中有 2 4例血清NSE增高 ,TIA患者血清NSE含量较正常对照组明显增高 (P <0 0 1 )。血清NSE增高与年龄、性别之间无统计学上的相关性 (P >0 0 5 ) ,与症状持续时间及头颅CT阳性责任病灶之间的关系密切 (P <0 0 1 )。血清NSE增高组在 1 2个月内的脑梗死发生率较血清NSE正常组明显增高 (P <0 0 1 )。结论 :血清NSE的检测可作为临床上诊断TIA的筛选指标之一 ,血清NSE增高是TIA患者近期内发展成为脑梗死的参考因素之一     

脑干血管病临床分析(附8例报告)

<正> 脑干血管病在脑血管病中较少见。头颅CT的应用使脑干血管病尤其是出血性病变的诊断有了更可靠的依据。现收集作了CT扫描的脑干血管病8例报告并分析如下: 例1,黄某某,男,75岁。于1988年12月13日早晨起床时发觉左侧肢体无力,站立不稳,伴头晕,轻头痛、恶心,     

急性脑血管病的脑脊液细胞学检查(附25例报告)

<正>作者对25例急性脑血管病病人的脑脊液进行细胞学检查,结果发现部分病例脑脊液细胞有不同程度的改变,认为脑脊液细胞学检查虽不能成为脑血管病的一个主要诊断手段,但仍有一定的临床参考价值。脑血管意外病人的脑脊液细胞部分可呈不同程度的改变,近几年来脑脊液细胞学检查的进展为脑血管病的脑脊液细胞研究提供了新的方法和资料.1989年7月份以来,我科对部分急