神经内镜下经鼻蝶入路手术切除垂体腺瘤的临床观察

目的研究神经内镜结合磨钻切除垂体瘤的手术效果。方法应用神经内镜结合磨钻辅助下切除垂体瘤29例,回顾性分析病人的临床资料,总结手术疗效。结果肿瘤全切除19例(65.5%),近全切除8例(27.6%),部分切除2例(6.9%)。术后发生脑脊液漏4例,暂时性尿崩症25例,经积极处理后均治愈。术后3月随访,术后视力恢复正常15例(83.33%),视野缺损明显好转8例(80%),头痛缓解9例(81.82%)。术后3个月复查15例病人PRL水平由术前的(302.43±182.25)μg/L降至术后的(42.69±27.96)μg/L;6例病人GH水平由术前的(49.17±23.96)μg/L下降至术后的(14.53±6.09)μg/L,差异有统计学意义(P<0.05)。结论经鼻蝶神经内镜结合磨钻垂体瘤切除手术是一种安全、微创、有效的手术方式。     

间断区域非血循环技术在颅脑手术中出血控制作用的研究

目的寻找巨大AVM,颅底脑膜瘤,动脉瘤等术中可能有凶险出血的术中控制方法及视野清晰问题的解决方案。方法术侧颈动脉预置控制液囊,必要时短时阻断颈动脉,特殊需要时高压、低温液灌注,使同侧血管床暂时处在非血循环状态,快速进行止血操作(持续1~2min)。结果控制大出血确切有效;视野清晰,止血顺利;在失血量较大时,可快速补充血容量。结论颈动脉限时阻断与间断低温血代液灌注是术中大出血有效的应急措施,应用时机得当,兼顾肾功能的情况下是一项实用的新技术。     

钻孔负压引流治疗硬膜外血肿34例体会

我科自2002年1月-2007年12月，共收治颅脑损伤患者1747例，其中硬膜外血肿78例，行钻孔清除并负压引流治疗34例，效果良好，现报告如下。 1 临床资料     

神经内窥镜治疗梗阻性脑积水并发症分析

目的:分析神经内窥镜治疗梗阻性脑积水并发症情况。方法:应用神经内窥镜采取三脑室造瘘术,室间孔再通和/或透明隔造瘘术,房间隔再通术等手术方法治疗58例梗阻性脑积水,根据其治疗结果,重点分析并发症。结果:58例梗阻性脑积水手术,痊愈39例,好转15例,需处理并发症4例,其中3例处理后好转,1例治疗无效自动出院。结论:发热、气颅、术中脑室出血、皮质塌陷是主要并发症,脑压过低可致硬膜下积液或硬膜外血肿。     

从病理电生理及法学探讨脑震荡诊断标准

1．1脑震荡的诊断 在国内外教科书上均有较为一致的记载。基本内容为：①脑，尤其是脑干功能的一过性障碍。②现有客观辅助检查无明确的阳性发现。虽然有动物实验发现脑震荡模型动物脑有超微结构改变，但未在人体获得证实。且现有临床检查手段亦无法证实。③以一过性意识障碍(30min以内)、逆行性遗忘、脑外伤后综合征为其临床表现特征。     

局部复方低温液灌洗治疗脊髓损伤的实验与临床研究

目的探索低温、低温程度及时间和药物配方对脊髓损伤的作用。方法用Ａｌｅｎ法致伤家兔成截瘫模型，观察比较早期低温灌洗组与对照组在运动能力、局部光电镜下的病理变化。结果低温灌洗对损伤之脊髓有良好保护作用，临床应用结果与动物实验相符。结论复方低温液对脊髓损伤有确切的保护作用，低温以２～４℃为宜，低温时间以２０分钟为宜     

高血压性脑出血的临床分析

我院1996～2003年住院治疗高血压性脑出血病人352例，现报道如下：     

不同年龄脑出血大鼠海马齿状回神经干细胞增殖与分化差异的比较

BACKGROUND:Cerebral hemorrhage can activate the proliferation and differentiation of neural stem cells in the dentate gyrus of the hippocampus. Through continuous differentiation and proliferation, endogenous neural stem cells can gradually replace aging and damaged neurons, thus protecting the brain structure. OBJECTIVE:To compare the difference of the proliferation and differentiation of neural stem cells in the dentate gyrus of the hippocampus of rats with different ages. METHODS:Ninety-six adult rats and 96 aged rats were randomly divided into normal group (n=18 per group), sham operation group (n=12 per group) and cerebral hemorrhage group (model group, n=66 per group), respectively. Cerebral hemorrhage models were made in the two model groups in which, the rats were subjected to cerebral hemorrhage for 6, 24, 48, 72 hours and 7 days, respectively. Then, brain tissues were collected to measure brain water content. BrdU/NeuN and BrdU/GFAP double staining were performed at 3, 7, 14, 21, 28 days after surgery to calculate the number of positive cells. RESULTS AND CONCLUSION:For both adult and aged rats, the brain water content was significantly higher than that in the normal group and sham operation group (P < 0.05), while in the normal and sham operation groups, the brain water content was significantly lower in the aged rats than the adult rats (P  < 0.05). The number of bilateral BrdU-positive cells in the adult and aged model groups was significantly higher than that in the corresponding normal and sham operation groups (P  < 0.05), and moreover, the positive cell number at the hemorrhage side was significantly higher than that at the opposite side (P < 0.05). In addition, the number of BrdU-positive cells at the hemorrhage side in the adult rats was significantly higher than that in the aged rats at different time after cerebral hemorrhage (P  < 0.05). Results from immunohistochemical double staining showed that the BrdU/NeuN and BrdU/GFAP expression in the hippocampal dentate gyrus of adult rats with cerebral hemorrhage was significantly higher than that of normal adult rats. All these experimental results show that there are a few neural stem cells proliferating in the hippocampal dentate gyrus of normal rats, and the proliferation ability is stronger in the adult rats than the aged rats. Cerebral hemorrhage can significantly strengthen the proliferation of neural stem cells in the dentate gyrus in the adult rats compared with the aged rats.