疏血通注射液治疗脑梗死的临床观察(附50例报告)

目的观察疏血通注射液治疗脑梗死的临床疗效及其对血液流变学的影响。方法将100例脑梗死患者随机分为治疗组50例和对照组50例,在常规治疗基础上分别给予疏血通注射液和丹参注射液治疗。结果治疗组的显效率为70.0%,而对照组的显效率为34.0%,两者比较差异有统计学意义(P<0.01);治疗组的总有效率为86.0%,显著优于对照组的60.0%(P<0.01);治疗组在降低全血低切黏度、全血高切黏度、血浆高切黏度和血细胞比积等方面均明显优于对照组(P<0.05或P<0.01)。结论疏血通注射液是治疗脑梗死有效的中成药物,且能明显改善血液流变学指标。     

丹芪通脉胶囊治疗脑梗死的临床观察

目的 观察丹芪通脉胶囊治疗脑梗死的临床疗效.方法 将180例脑梗死随机分为两组,108例为丹芪通脉胶囊治疗组,72例为常规西医治疗的对照组,30 d为1个疗程.观察比较两组病例临床疗效、血液流变学指标及血脂变化.结果 治疗组治疗后全血黏度、血浆黏度、红细胞比容、血脂均有显著改变,且优于对照组(P<0.05).治疗组总有效率为93.52%,对照组总有效率为 80.56%.治疗组优于对照组(P<0.05).结论 丹芪通脉胶囊治疗脑梗死治愈率高,后遗症少.     

开窍活血方治疗急性脑梗死临床观察

目的观察开窍活血方治疗急性脑梗死的临床疗效。方法将确诊的急性脑梗死患者随机分为两组,每组75例,对照组采用常规治疗,治疗组在西医常规治疗基础上加用开窍活血中药。两组疗程均为30d。结果治疗组总有效率为88.0%,明显优于对照组的74.7%(P<0.05)。两组治疗后全血黏度、血浆黏度、纤维蛋白原水平均较治疗前有统计学意义(P<0.05或P<0.01),治疗组与对照组治疗后比较也有统计学意义(P<0.05或P<0.01)。结论开窍活血方有降低血液黏稠度的作用。     

大黄保留灌肠治疗急性大面积脑梗死伴意识障碍的临床疗效观察

目的探讨大黄保留灌肠治疗急性大面积脑梗死伴意识障碍的临床疗效。方法发病24 h内,头颅CT或MRI确诊大面积脑梗死60例,按随机数字表法分为治疗组和对照组各30例。对照组治疗遵循《中国脑血管病防治指南》原则,予西医常规治疗;治疗组在西医常规治疗基础上加用中药生大黄60 g煎水灌肠,隔日1次,14 d后统计疗效。结果治疗组显效21例,有效8例,无效1例,对照组显效10例,有效11例,无效9例,治疗组疗效优于对照组(Z=2.117,P0.05)。结论急性大面积脑梗死伴意识障碍在常规治疗基础上予以大黄保留灌肠治疗,效果确切,值得在临床上推广应用。     

祛痰通腑颗粒治疗以痰瘀腑实型为主急性脑梗死的临床研究

目的 观察祛痰通腑颗粒治疗以痰瘀腑实型为主急性脑梗死的临床疗效.方法 150例急性脑梗死患者随机分为两组,两组常规给予抗血小板聚集、改善循环、神经保护治疗.治疗组(75例)用祛痰通腑颗粒治疗;对照组(75例)用舒血宁注射液治疗.结果 治疗组显效率和总有效率均优于对照组(P<0.05);中医证候积分优于对照组(P<0.05),改善神经功能及降低血液流变学各项指标均优于对照组(P<0.05).结论 祛痰通腑颗粒用于以痰瘀腑实型为主急性脑梗死的疗效显著且无毒副反应,是一种治疗脑梗死安全有效的药物.     

小剂量尿激酶联合低分子肝素治疗急性进展性脑梗死53临床分析

目的观察小剂量尿激酶联合低分子肝素治疗急性进展性脑梗死的临床疗效。方法将同期收治的106例急性进展性脑梗死患者随机分为观察组和对照组各53例,均予常规措施及低分子肝素治疗,在此基础上观察组予小剂量尿激酶治疗。14 d后观察两组神经功能缺损评分变化并据以判定临床疗效。结果观察组治愈12例、显效17例、有效16例、无效8例、总有效率（治愈＋显效＋有效）为84.9%,对照组分别为8、13、15、17例和67.9%,观察组总有效率显著高于对照组（P〈0.05）。结论小剂量尿激酶联合低分子肝素治疗急性进展性脑梗死能够明显提高临床疗效,值得临床借鉴。     

丹红注射液治疗急性脑梗死疗效观察

目的观察丹红注射液治疗急性脑梗死的临床疗效。方法将我院收治的60例急性脑梗死分为治疗组和对照组各30例,两组同在西医的常规治疗同时,治疗组应用丹红注射液,对照组应用灯盏花素注射液、血塞通注射液等药物。两组于治疗前后抽取静脉血,检测并比较治疗前后血液流变学指标变化情况。结果两组患者临床疗效间差异有统计学意义（P〈0．05）。两组患者治疗后全血黏度高切、低切、全血还原黏度、纤维蛋白原间差异均有统计学意义（P〈0．05）。结论丹红注射液治疗急性脑梗死有一定疗效。     

丹红注射液治疗急性脑梗死的临床研究

目的探讨丹红注射液治疗急性脑梗死患者的临床疗效。方法将136例急性脑梗死患者随机分为治疗组和对照组各68例。在常规治疗基础上对照组给予血塞通注射液,治疗组应用丹红注射液静滴治疗,两组均以2周为1个疗程。治疗前和治疗1个疗程后观察两组治疗前后神经功能缺损程度评分、临床疗效及血液流变学各指标。结果两组治疗后神经功能缺损评分间差异有统计学意义(P<0.01)。两组患者临床疗效间差异有统计学意义(P<0.01)。治疗组治疗前、后全血黏度(高切)、全血黏度(低切)、血浆黏度、纤维蛋白原间差异均有统计学意义(P<0.01);两组患者治疗后各项指标间差异亦有统计学意义(P<0.01)。两组患者在治疗期间未出现明显不良反应。结论丹红注射液可明显改善急性脑梗死患者的血液流变学参数和神经功能缺损。     

豁痰祛瘀通络法对急性缺血性中风患者预后的影响

目的探讨豁痰祛瘀通络法对急性缺血性中风患者预后的影响。方法选取66例急性缺血性中风辨证为痰瘀阻络型患者随机分为对照组（34例）和治疗组（32例）。对照组采用常规治疗,治疗组在常规治疗基础上给予豁痰祛瘀通络方法治疗,连续观察14d。比较两组治疗前后的中医证候积分、美国国立卫生研究院卒中量表（NIHSS）评分。结果两组治疗后中医证候积分、NIHSS评分均降低（P〈0．01）,且两组间比较差异有统计学意义（P〈0．05）。结论豁痰祛瘀通络法对急性缺血性中风有明显疗效。     

川芎嗪联合低分子肝素钙对肺心病急性发作期患者血液流变学影响

目的观察川芎嗪联合低分子肝素钙治疗肺心病急性发作期的临床疗效及血液流变学的影响。方法根据入院单双日对86例慢性肺心病急性发作期住院患者分成观察组和对照组,各43例。对照组给予常规综合治疗,观察组在常规治疗上输注川芎嗪注射液及皮下注射低分子肝素钙,疗程均为7 d,比较两组临床疗效和血液流变学变化。结果观察组显效31例,有效9例,无效3例,总有效率93.0%;对照组显效19例,有效11例,无效13例,总有效率69.8%。观察组疗效优于对照组（P〈0.05）,观察组血液流变学的全血高切黏度、全血低切黏度、血液黏度、红细胞压积等指标均显著降低,与对照组相比差异有统计学意义（P均〈0.05）;观察组与对照组用药前后凝血功能无明显差异（P〉0.05）。结论川芎嗪联合低分子肝素钙能快速改善慢性肺心病急性发作期患者血液流变学状况,纠正血液高凝状态,降低肺动脉高压,改善肺微循环和肺通气/血流比值,有效缓解临床症状,疗效显著。     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.