动脉超选择化疗治疗恶性脑肿瘤(附32例报告)

目的观察对恶性脑肿瘤采用超选择脑动脉插管灌注化疗药物的临床疗效和预后。方法对32例经组织学确诊和化疗药敏试验的恶性脑肿瘤，采用超选择脑动脉灌注卡氮芥(BCNU)、替尼泊甙(VM26)、长春新碱(VCR)、嘧啶亚硝脲(ACNU)，同时应用甘露醇、尼膜同(NIM)，观察药物反应及近期疗效。结果32例经多疗程化疗后，1年存活率达87．5％(28／32)，2年存活率为68．7％(22／32)，全部患者均无眼部症状及严重的神经毒性反应。结论应用超选择脑动脉化疗法治疗恶性脑肿瘤，其患者存活率较单纯颈内动脉灌注化疗及外周静脉化疗高、并发症少；体外化疗药物敏感试验可助于化疗方案的合理制定，提高颅内恶性肿瘤患者的远期存活率。     

中药蒙药结合治疗颈腰腿痛64例

颈、腰、腿痛是一组脊柱、神经根和软组织疾病的总称 ,属中医“痹证”范畴。笔者从 2 0 0 0年 1月～ 6月应用中药蒙药结合治疗本病 64例 ,取得了较满意的效果 ,现报告如下。一般资料本组中男性 1 2例 ,女性 52例 ;年龄 2 5～ 70岁 ;其中颈椎病 32例 ,风湿性关节炎 1 4例 ,骨质增生 8例 ,腰椎间盘突出症 4例 ,肥大性脊柱炎 4例 ,肩周炎 2例。治疗方法根据不同的病变部位、不同的疾病采用不同的手法按摩施治。外敷自制止痛膏 :羌活、防风、芫花、当归、乳香、没药、川乌、草乌、巴日斯塔布 (蒙 )、乌那干吐古来草 (蒙 )、比拉皮 (蒙 )等 2…     

脑血管畸形破裂致颅内血肿的急诊治疗

目的 探讨126例脑血管畸形破裂致颅内血肿急诊治疗的方法。方法 对9a来所收治的126例脑血管畸形病人的急诊治疗及注意事项进行分析。治疗方法为颅内血肿清除 血管畸形切除（80例），脑室外引流（13例），保守治疗（24例），治疗注意事项，力争畸形团全切，止血彻底；脑室外引流应保持通畅，可给予尿激酶冲洗，禁负压引流；有脑疝形成可能及时手术。结果 手术组73例血管畸形团全部切除，3例残留，死亡5例，脑室外引流31例，死亡7例，结论 脑血管畸形破裂出血病死率和致残率高，及时正确处理可减少其发生。     

冬季兰州市高校教室热环境调查

为研究冬季大学生上课期间的室内热环境和热舒适状况,对兰州市某高校22间教室的室内空气干球温度、相对湿度、风速等热环境参数进行了现场测试,同时以问卷方式对ASHRAE的7级热舒适指标进行了调查。结果表明,84.8%的学生对室内19.7℃的平均温度表示接受,热中性温度为19.3℃,所期望的温度为20.8℃;80%的人感到舒适的温度范围为18.2～22.2℃,该结果的上、下限均比ASHRAE推荐的80%人群可接受温度为21～24℃的要求低约2℃。不同地区的室内人体热感觉存在差异,该研究结果可为兰州室内环境的控制和制定合适的教室内热环境标准提供参考。     

显微手术治疗颅内动脉瘤168例疗效分析

目的通过对168例颅内动脉瘤的显微手术治疗,以探讨手术时机、手术技巧对术后疗效的影响.方法对来我科首诊的经CT、DSA确诊为颅内动脉瘤的患者,力争在72 h内(由外院转诊已错过急性期者均在两周后)经翼点入路开颅行显微手术夹闭动脉瘤.结果 168例中,治愈139例(82.7%)、好转11例(6.5%)、植物生存3例(1.8%)、死亡15例(8.9%).结论颅内动脉瘤破裂引起 SAH,经CT、DSA确诊后应争取早期手术.选择最佳手术时机、手术入路、熟练掌握显微操作技术及显微解剖知识是手术成功的关键.     

在医院信息化建设中加强内部控制的几点做法

随着医院管理科学的发展,内部控制已经成为其中一个越来越重要的组成部分。假如一个医院的内部控制搞得不好,则很难说它的管理是高水准的,所以当前各医院都十分重视内部控制,尤其是在进     

颅神经血管压迫症的MR血管断层表现与微血管减压术疗效的相关性

Objective To explore the correlation of the operation effects of the miorovascular decompression(MVD) and the findings on magnetic resonance tomographic angiography(MRTA) in patients of neurovascular compression of the cranial nerves.Methods Two hundred and twenty three patients treated with the microvascular decompression were analyzed retrospectively.They were grouped and graded according to the vessel compression on the cranial nerves.The compression were grouped as none, moderate and severe, and the operation effects were graded as Ⅰ ( complete relief), Ⅱ ( partial relief) and Ⅲ ( no relief).The operation effects grades were correlated according to the compression groups by Kruskal-Wallis test and the operation effects between each two of the groups were compared using Nemenyi test.P < 0.05 was defined as statistic significant.Results Of the 53 cases of non-compression group, 31 cases were graded as Ⅰ , 13 cases were graded as Ⅱ and 9 cases were graded as Ⅲ, according to the operation-effects of the decompression.Of the 110 cases of moderate group,95 cases were grade as Ⅰ , 11 cases were graded as Ⅱ and 4 cases were graded as Ⅲ.Of the 60 cases of severe group, 48 cases were graded as Ⅰ, 7 cases were graded as Ⅱ and 5 cases were graded as Ⅲ.There were statistic significance among the three groups,where χ2= 16.84 and P <0.05.The mean rank of the non-compression, the moderate and the severe group was 134.21,102.37 and 110.4 ,respectively.The difference of the mean ranks between the non-compression group and the moderate group was 31.84, and between the non-compression and the severe group was 24.17, respectively, where P < 0.05 both.Conclusions There was close relationship between the findings on magnetic resonance tomographic angiography and the operation effects of the MVD.The operation effects of patients with moderate and severe vessel compression were much better than the non-compression group.MRTA is helpful for MVD surgical indication and its prognosis.     

颅神经血管压迫症的MR血管断层表现与微血管减压术疗效的相关性

Objective To explore the correlation of the operation effects of the miorovascular decompression(MVD) and the findings on magnetic resonance tomographic angiography(MRTA) in patients of neurovascular compression of the cranial nerves.Methods Two hundred and twenty three patients treated with the microvascular decompression were analyzed retrospectively.They were grouped and graded according to the vessel compression on the cranial nerves.The compression were grouped as none, moderate and severe, and the operation effects were graded as Ⅰ ( complete relief), Ⅱ ( partial relief) and Ⅲ ( no relief).The operation effects grades were correlated according to the compression groups by Kruskal-Wallis test and the operation effects between each two of the groups were compared using Nemenyi test.P < 0.05 was defined as statistic significant.Results Of the 53 cases of non-compression group, 31 cases were graded as Ⅰ , 13 cases were graded as Ⅱ and 9 cases were graded as Ⅲ, according to the operation-effects of the decompression.Of the 110 cases of moderate group,95 cases were grade as Ⅰ , 11 cases were graded as Ⅱ and 4 cases were graded as Ⅲ.Of the 60 cases of severe group, 48 cases were graded as Ⅰ, 7 cases were graded as Ⅱ and 5 cases were graded as Ⅲ.There were statistic significance among the three groups,where χ2= 16.84 and P <0.05.The mean rank of the non-compression, the moderate and the severe group was 134.21,102.37 and 110.4 ,respectively.The difference of the mean ranks between the non-compression group and the moderate group was 31.84, and between the non-compression and the severe group was 24.17, respectively, where P < 0.05 both.Conclusions There was close relationship between the findings on magnetic resonance tomographic angiography and the operation effects of the MVD.The operation effects of patients with moderate and severe vessel compression were much better than the non-compression group.MRTA is helpful for MVD surgical indication and its prognosis.     

高血压下壳核动脉易破裂出血的显微解剖研究

目的　为高血压性脑出血好发生于壳核的原因提供形态学依据。②方法　采用镜下解剖和脑血管铸形方法 ,对 5 0侧脑标本、5例脑血管铸形标本壳核动脉的形态学特点进行了观察。③结果　 5 0侧大脑半球共观察到 392支壳核动脉 ,平均每侧 (7.8± 2 .6 )支。 392支壳核动脉中 80 .6 %来源于大脑中动脉 ,17.9%来源于大脑前动脉 ,1.5 %来源于脉络膜前动脉。壳核动脉行程迂曲 ,在穿入壳核时尚形成弓状、环状弯曲 ,其直接形成直径 <0 .10mm分支情况亦明显高于基底核区其他结构的供血动脉 (χ2 =6 1.191,P <0 .0 1) ,且 76 .0 %的壳核动脉起于大脑中动脉分叉处 2 .0 0mm范围内。④结论　壳核动脉无论从起源、行程情况还是从其分支的发出形式上来讲 ,都与脑出血的发生具有密切关系。