Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

急性心肌梗死误诊8例分析

急性心肌梗死(AM／)约1／4．1／3病例缺乏典型症状。近年来由于症状不典型而导致误诊的病例有所增加。现将我院近年来收治的误诊病例报道如下。     

浅谈紫外线（UVC）消毒技术在处理医疗废水方面的应用

医疗机构排放废水是一类以含病毒、细菌等病原体微生物为主要污染物的特殊废水,若不经过处理直接排放环境,势必会对受纳水体造成污染,对人类健康构成危害。目前,处理医疗废水较为传统和普遍采用的方法为氯消毒法,然而近年来随着其消毒副产物—具有三致（致癌、致畸、致突变）的有机化合物不断被发现,其应用前景令人堪忧。人们利用紫外线杀菌消毒由来已久,近20年来,随着UV消毒法具有的不投加化学药剂、不增加水的嗅和味、不产生有毒有害的副产物、消毒速度快、效率高、设备操作简单、便于运行管理和实现自动化等优点不断被发现,这种消毒方法正逐渐得到广泛应用。本文从对紫外消毒设备的原理和构造、医疗机构排水特征等方面进行研究,阐述紫外消毒技术在处理医疗废水较传统消毒方法的优势,并提出相关建议。     

麦氏点小切口阑尾切除一针缝合术50例

阑尾炎为普外科常见病、多发病。我院2003—2004年共收治单纯性阑尾炎50例，行小切口切除一针缝合术，收到了满意的效果。     

28例极低出生体重儿喂养的护理

极低出生体重儿是指出生体重在1500克以下的新生儿。其护理的三大要素是保温、预防感染及喂养。喂养是保证婴儿获得足够营养的手段,对新生儿的存活起着重要作用。因为极低出生体重儿的各个脏器发育不完善,如喂养方法及开奶时间不当,不仅影响小儿的生长发育,而且还可造成疾病的发生,严     

硬膜外阻滞的镇静作用及其可能机制

目的 通过监测脑电双频指数和心率变异功率谱,评价硬膜外麻醉后对异丙酚镇静催眠剂量的影响,并探讨其可能的机制。方法 50例行全子宫切除病人,随机分为硬膜外利多卡因组（GE,n=15）;硬膜外盐水-静脉利多卡因组（GI=15）;硬膜外盐水-静脉盐水组（GC=20）。硬膜外或静脉给利多卡因 20 min后,连续输注异丙酚至神志消失并记录异丙酚用量。所有病人同时监测脑电双频谱（BIS）、心率变异高频功率谱（HF）、低频功率谱（LF）、心电图和血压。输注异丙酚前抽取桡动脉血 2ml,测定血浆利多卡因浓度。结果 病人意识消失时异丙酚用量分别为GE组（1.22±0.25）mg/kg;GI组（1.62±0.22）mg/kg;GC组（1.85±0.41）mg/kg（GE与GI和GC比,P<0.05）。GE组和 GI组血浆利多卡因浓度分别为 3.04 μg/ml和 2.45 μg/ml,无统计学差异。三组病人意识消失时BIS平均值分别为54.4、57.1、55.3。结论 硬膜外利多卡因阻滞可降低异丙酚用量约35％。其作用机制与利多卡因自硬膜外吸收后的中枢镇静作用无明显关系,而可能与硬膜外阻滞后间接引起中枢兴奋阈值降低有关。     

利培酮治疗精神分裂症临床观察

我们用利培酮治疗 6 0例精神分裂症 ,并进行临床观察 ,报告如下。1　对象和方法为我中心心理病房 2 0 0 1年住院患者 ,符合中国精神障碍分类与诊断标准第 3版精神分裂症诊断标准 ;入院前 2周均未服抗精神病药 ;阳性症状与阴性症状评定量表 (PANSS)总分≥ 5 5分 ;无器质性疾病。共 6 0例 ,男 2 9例 ,女 31例 ;年龄 16～ 6 0岁 ,平均 (2 8 6± 12 1)岁。利培酮以 1mg/d开始 ,逐步加至 2～ 8mg/d。观察 8周。不合并用其他抗精神病药或其他疗法。可合并抗胆碱药或苯二氮 艹卓 类药。采用PANSS和副反应量表 (TESS)评定疗效和不良反应。疗…     

长沙地区孕妇CMV感染状况及其临床追踪观察

研究了７７例长沙地区孕、产妇的宫颈排毒（ＣＭＶ）情况及母、婴的免疫状态，并对宫颈排毒及ＣＭＶ一ＩｇＭ阳性的母亲所生小孩进行临床追踪。结果显示：孕妇宫颈排毒率为４．５％，抗ＣＭＶ－ＩｇＧ和抗ＣＭＶ－ＩｇＭ阳性率分别为７７％和１３％，５９例脐血ＣＭＶ－ＩｇＭ阴性。宫颈排毒的３例其抗体检测抗ＣＭＶ－ＩｇＧ均阳性，抗ＣＭＶ－ＩｇＭ仅一例阳性。作者认为，对妊娠期活动性ＣＭＶ感染的诊断，仅检测抗ＣＭＶ－ＩｇＧ和抗ＣＭＶ－ＩｇＭ抗体滴度仍不足，尚须结合病毒分离和其它检测手段。