脑电图、经颅多普勒超声检查及焦虑量表与难以分类原发性头痛关系

目的探析脑电图（EEG）、经颅多普勒超声（TCD）及焦虑量表（HAMA）与难以分类原发性头痛的关系。方法入选该院2010年6月-2014年6月收治的难以分类的原发性头痛患者141例,发作时进行EEG、TCD及汉密尔顿焦虑量表（HAMA）检查,分析脑电图异常、血流速度异常及HAMA的关系。结果脑血流速度异常率为68.1%（96/141）,脑电活动异常率为32.6%（46/141）,可能焦虑和焦虑患者发生率为62.4%（88/141）;无论TCD检查脑血流速度情况如何,EEG正常和异常患者HAMA量表评分无差异（P〉0.05）;无论EEG检查脑电情况如何,TCD正常和异常患者HAMA量表评分无差异（P〉0.05）。结论难以分类原发性头痛患者中62.4%存在焦虑障碍的精神、心理疾患,故治疗时不应忽视精神和心理疾病的治疗。     

CCVI患者局部脑血流量及血流动力学改变的临床研究

目的观察慢性脑血管功能不全（CCVI）患者局部脑血流量（rCBF）及脑血流动力学改变。方法对20例经头颅CT或MRI检查证实无脑组织结构异常、临床确诊为CCVI患者行SPECT显像及经颅多普勒超声（TCD）检查，分别测定rCBF、局部脑血流量降低百分比、脑动脉的平均血流速度（MV）、脑动脉搏动指数（PI）。对照组为年龄、性别相匹配的正常者。结果20例CCVI患者中，95％（19／20）患者出现rCBF减少，主要灌注降低区为额叶、颞叶、顶叶、基底节。80％（16／20）患者大脑前动脉、大脑中动脉血流速度加快。结论对CCVI患者进行rCBF及TCD检测，有助于观察病变部位脑血流量及血流动力学变化，对其临床早期诊断和治疗有着重要意义。早期脑血流量变化可提示患者预后，为选择合理治疗方案提供客观依据。     

脑电图与经颅多普勒对椎基底动脉供血不足的诊断

目的:探讨联合运用脑电图(EEG)与经颅多普勒(TCD)对椎基底动脉供血不足(VBI)的诊断价值.方法:对VBI患者79例进行EEG、TCD检查.结果:EEG异常率为37.97%(30/79),TCD异常率为93.67%(74/79).结论:提示患者存在动脉粥样硬化,脑供血不足.EEG与TCD联合检查可作为VBI病因诊断、观察治疗效果的客观辅助依据.     

脑电图对缺血性脑卒中患者的临床应用

目的：探讨脑电图（EEG）对缺血性脑卒中的临床应用。方法：采用EEG-8128型EEG描记仪,对76例脑缺血性脑卒中患者和对照组65例进行EEG检测。结果：缺血性脑卒中组76例患者中,EEG轻度异常26例（34.21%）,中度异常11例（14.47%）,重度异常5例（6.58%）,痫样放电5例（6.58%）,边缘EEG7例（9.21%）,与对照组比较,EEG中度和中度以上异常有显著差异（P〈0.05）。47例异常EEG中,急性期31例（65.96%）,恢复期8例（17.02%）;后遗症期9例（19.15%）。结论：脑电图对缺血性脑卒中的早期诊断、疗效和脑功能监测有重要的临床意义;对缺血性脑卒中后血管性痴呆和癫痫的发生有诊断价值,并可为临床预防和治疗提供依据。     

66例安定依赖患者脑电图特征分析

目的探讨长期服用安定药对大脑生理功能的影响。方法对66例因睡眠障碍服用安定药半年以上的患者（药物组）、66例同样有睡眠障碍但未服用安定药患者（对照组）为脑电图检测对象,所有数据进行统计学处理。结果药物组EEG异常率78.8%,高于对照组（57.6%）,两组EEG异常率差异有统计学意义（χ2=13.58,P〈0.05）：药物组中＂α活动慢化＂、＂θ波及θ活动增多＂异常波明显高于对照组,药物组有12例（18.1%）出现了纺锤样波和8例（12.1%）出现K复合波,而对照组没有;且EEG异常程度跟服药时间长短有关：服药时间长,EEG异常程度相对就大。结论长期服用安定药对脑神经细胞生理功能有一定影响性,时间愈长,影响愈严重。     

新生儿高胆红素血症患儿脑电图和脑干听觉诱发电位变化的评价

目的评价新生儿高胆红素血症（简称高胆）脑电图（EEG）、脑干听觉诱发电位（BAEP）的变化。方法对126高胆患儿进行EEG、BAEP检测,并与对照组（30名健康新生儿）进行比较。结果EEG异常率47.62%,主要表现为：变化性缺乏、弥漫性低电压、爆发性抑制、短暂性波幅或频率不对称;BAEP异常率71.43%,2组比较,Ⅰ波、Ⅲ波、Ⅴ波PL显著延长,差异有统计学意义（P〈0.05）;EEG异常者BAEP均异常,EEG正常者BAEP有23.81%异常。结论⑴高胆患儿伴有脑功能异常,EEG与BAEP均可反映脑功能异常改变但非同步,BAEP临床应用价值较EEG为显著;⑵短期内EEG、BAEP无好转,提示脑功能恢复可能需要较长时间,BAEP合并EEG异常,后遗症发生率越高;⑶血清间接胆红素与EEG、BAEP异常程度及预后有直接关系。新生儿EEG、BA-EP可作为高胆早期判断病情和预后的一种有效、方便的检查手段。     

对急性CO中毒后迟发性脑病脑电图的观察及其临床意义探讨

目的 观察脑电图（EEG）在急性一氧化碳中毒后迟发性脑病（DEACMP）患者中异常表现并探讨EEG在预后判断中的临床意义.方法 对48例DEACMP患者临床各期进行EEG检查并对异常EEG进行分析.结果 患者EEG异常率高达100%.EEG的异常主要表现为α慢化或消失,弥漫性中高幅θ,δ波,以额或额颞部最明显,呈持续性或较长程出现,昏迷时间越长其EEG异常率越高,病情越重,其改变越明显,并随病情好转逐渐恢复.结论 EEG对DEACMP早期诊断和预后评估有重要的临床意义.     

探讨儿童脑电图儿童病毒性脑炎的早期诊断和预后评估方面临床研究

目的探讨脑电图在儿童病毒性脑炎的早期诊断和预后评估方面临床研究价值。方法对115例儿童病毒性脑炎患者的脑电图和临床资料进行全面分析研究：97例为脑电图异常,异常率为84.34%。轻度异常51例（44.34%）,中、重度异常46例（40%）。结果治疗2-4周后,脑电图恢复正常81例,未恢复正常11例：轻度异常1例,中度异常6例,4例有明显的意识障碍,1例有经常发作性脑电图异常改变。脑电图异常改变表现为弥漫性慢波,α波节律减弱,或以θ波为主,其中一部分患儿有局限性异常脑电图表现。结论脑电图作为一种检查手段,脑电图异常改变与临床症状、大脑脑实质损伤的严重程度成正向关系,因此脑电图对儿童病毒性脑炎的早期诊断和临床预后评估有着非常重要的正相关性。     

荣脑通络益智汤治疗慢性脑供血不足的应用效果分析

目的:研究慢性脑供血不足患者实施荣脑通络益智汤治疗的应用效果。方法:选择74例我院慢性脑供血不足患者,纳入时间为2017年8月至2018年8月,采用随机数字表法将其分为实验组与参照组,每组均37例。其中参照组采用氟桂利嗪治疗,实验组行荣脑通络益智汤治疗,对比2组患者治疗前后血流动力学相关指标、药物不良反应及临床疗效。结果:治疗前2组患者血流动力学相关指标无差异(P0.05),与参照组相比,治疗后实验组高切全血粘度、低切全血粘度、纤维蛋白原、红细胞聚集指数、红细胞变形指数较低,实验组血浆粘度水平高于参照组,实验组慢性脑供血不足临床疗效(94.59%)与参照组(75.68%)相比较高,实验组恶心、震颤、口干等药物不良反应发生率(5.41%)明显低于参照组(27.03%),组间差异性较大(P0.05)。结论:慢性脑供血不足患者通过荣脑通络益智汤治疗需效果显著,能改善患者血流动力学指标,应予以临床推广。     

儿童孤独症213例病例分析

目的：探讨孤独症的病因、发病机制和诊断。方法：对213例孤独症患儿进行生物学因素（妊娠史，出生史，家庭史，抽搐史）、家庭因素（父母性格，家庭教育情况），病历主诉和辅助检查（脑CT／MRI，EEG，BAEP、SPECT）的研究分析。结果：孤独症病例在生物学因素（妊娠史，出生史，家族史，抽搐史）上的异常情况十分普遍，病历主诉以语言发育障碍为主，脑部的CT／MRI，EEG，BAEP，SPECT辅助检查中，SPECT异常检出率高，主要表现为左侧大脑血流灌注降低，血流异常的部位主要是颞叶、额叶和边缘系统（海马回，扣带回等）。结论：妊娠史、出生史、家族史、抽搐史的异常和孤独症的发病有密切关系，以语言发育迟缓为主诉的儿童病例应考虑孤独症的可能。脑SPECT呈血流灌注降低，对诊断孤独症有一定帮助。     

易筋经操结合脑电仿生仪治疗脑供血不足疗效观察

目的观察中医推拿功法易筋经操结合脑电仿生电刺激仪治疗脑供血不足的临床疗效。方法脑供血不足患者67人,按照随机数字表法分为治疗组34例和对照组33例。对照组常规进行脑电仿生电刺激仪治疗,治疗组在脑电仿生电刺激仪治疗同时进行中医推拿功法的易筋经操锻炼,每周5d,每日1次,每次练习两遍,疗程为六周。治疗前后进行比较,并进行组间对比。结果治疗组的有效率达到94．1％,显效率高于对照组,差异有统计学意义（P〈O．05）。结论中医推拿功法易筋经作为温和的体育锻炼,结合脑电仿生刺激仪协同治疗脑供血不足具有更好的治疗效果,安全可靠价廉便捷应该值得推广。     

脑循环治疗仪治疗椎一基底动脉供血不足眩晕的效果观察

目的观察脑循环治疗仪治疗椎一基底动脉供血不足眩晕的临床疗效。方法 90例基底动脉供血不足眩晕的患者,采用脑循环治疗仪进行治疗。结果经过治疗后分别于3 d、5 d和1周进行效果评价,总有效率达93%。结论脑循环治疗仪治疗仪可改善椎-基底动脉供血不足眩晕症状。     

Clinical evaluation of SPECT in cerebrovascular disease

In 131 patients with cerebrovascular disease, regional cerebral blood flow was determined by 123I-IMP (N-isopropyl (123I)-iodoamphetamine) or 99mTc-HM-PAO (99mTc (d, l)-hexamethyl propyleneamine oxime) SPECT and findings were compared with those of X-CT or MRI. The perfusion deficit detected by SPECT was larger than the deficit by X-CT or MRI in every cases. The perfusion deficit area was more clearly demonstrated by SPECT than by X-CT or MRI in patients with acute cerebral infarction. The hypoperfusion area determined by 123I-IMP SPECT was wider than that by 99mTc-HM-PAO SPECT. The crossed cerebellar diaschisis was observed in 56 out of 131 cases (43%). The results of operation were quantitatively evaluated by 123I-IMP SPECT in 25 patients.     

Die Elektroencephalographie in der Diagnostik der frühzeitigen Hirnschädigung durch Schwefelkohlenstoff

Summary A total of 250 workers employed in the production of rayon staple were followed up for a long period of time and their 344 EEG records analyzed and compared with those of a control group of 61 healthy controls and with EEG records of a group of 47 patients suffering from cerebral arteriosclerosis. CS₂ is considered to cause vascular encephalopathy.In workers exposed to CS₂ a high incidence of abnormal EEGs was found (33.2%) vs. healthy control group (6.60) (P<0.01). As for the type of EEG abnormality, in exposed workers episodic activity predominated (33.6%); diffuse abnormality was present in 29.6%. On the other hand, in patients with cerebral vascular disease focal abnormality was most frequent (46.8%); diffuse abnormality occurred in 29.8% and episodic activity in only 14.9%. Frequency of alpha activity was found to be lower in exposed workers than in healthy controls. Exposed workers tended to frequencies up to 10 c/s.The relation between EEG and neurological findings was analyzed. A direct dependence was not found but there were more cases with EEG abnormality than cases with a pathological clinical picture.The series of EEG specimens is presented demonstrating the development of EEG abnormalities in exposed workers.The episodic activity in exposed workers must account for the effect on mesodiencephalic structures, in all probability by the direct toxic (or pathological-metabolic) effect of CS₂. The diffuse abnormality could be the manifestation of the toxic cerebral changes or of the effect of the smallest diameter's vessels in CS₂ vasculoencephalopathy or of a combination of the two mechanisms. Slowing of alpha activity is considered to indicate a cerebral metabolic disorder due to CS₂.Electroencephalography is regarded to have a great importance not only in early diagnosis of the CS₂ effect on the central nervous system but also for further research.

     

SPECT follow-up of cerebral blood circulation after stroke]

rCBF SPECT investigations with 99mTc-HMPAO were performed in 22 completed ischemic stroke patients on average 2.5, 16.8 and 38.0 days after stroke onset. As control group, 12 neurologically healthy volunteers were examined with the same method. The overall sensitivity of the rCBF SPECT method in the detection of cerebral blood flow abnormalities was 91%, with a specificity of 83% and an accuracy of 88%. The rCBF study was highly effective, particularly in the acute phase of the disease. Regional increased tracer uptake or a false normal 99mTc-HMPAO distribution due to the developing hyperemia mostly complicated the rCBF image interpretations in the subacute period. In the chronic phase, the spatial resolution of the SPECT system limited the detection of the continuously retracted stroke lesions.     

驻渝某部离休老干部疾病谱及其健康需求调查

目的了解离休老干部的疾病谱及其健康需求。方法应用健康检查及调查表的形式对第三军医大学3所干休所承担保障的106例离休老干部的疾病谱及其健康需求进行调查分析。结果106例离休老干部疾病谱调查,主要疾病有慢性支气管炎、肺气肿、慢性心功能不全、脑供血不足、脑动脉硬化、冠心病、糖尿病、糖尿病肾病、高血脂、高血压、高尿酸血症、胆囊结石、胆囊炎、病窦综合征起搏器植入术后、前列腺增生、白内障、黄斑变性、癌症、慢性肠道疾病、慢性传染性疾病、耳疾和截瘫偏瘫等疾病,其中多数疾病的发病率均超过10%,且同时患2种以上疾病者达55例,占51.89%;同时患3种以上疾病者达26例,占24.53%。健康需求调查结果显示,离休老干部在定期体检、定期巡诊及疾病信息通报方面的需求程度较高,其次为饮食指导、锻炼指导及睡眠指导等。结论离休老干部患病率较高,应坚持定期体检,定期巡诊,坚持从生活、医疗方面给予他们积极关心和帮助,这对提高他们晚年的生活质量无疑具有积极的作用。     

Functional imaging (PET and SPECT) in epilepsy]

Epilepsy is one of the most prevalent neurologic disorders and affects approximately 1% of the population. Most complex seizures arise from the temporal lobes and the condition of 20-30% of these patients is refractory to medication. Many can be rendered seizure free with surgery. Epilepsy surgery requires accurate identification of the site and extent of the epileptogenic area responsible for seizures. EEG is accepted as a gold standard, however only 50% of the patients are safely diagnosed. The need for invasive monitoring with possible hemorrhage or infection has been greatly reduced by the introduction of new technologies such as PET, SPECT and MRI in the clinical practice. MRI demonstrate morphologic changes in approximately 80% of patients with epilepsy. However, structural lesions may not always correlate with clinical, EEG and pathologic localization of epileptogenic foci. Seizures are associated with pronounced changes in regional cerebral blood flow. The real power of SPECT lies in the opportunity of ictal examinations, with a sensitivity ranging from 90 to 97%. Interictal PET studies using 18F-FDG measure regional glucose metabolism, have been investigated for their value as non-invasive focus-localizing techniques. These studies have sensitivity ranging from 80 to 85%. The benzodiazepine binding site that are associated with and modulate the activity of GABA receptors have been imaged by SPECT (using 123I-iomazenil) and PET (using 11C-Flumazenil). Combined measurements of benzodiazepine binding sites and perfusion/metabolism provide a more accurate visualization of epileptogenic site than perfusion or metabolism measurements alone. Functional imaging modalities (PET and SPECT) are highly important in the presurgical evaluation of patients with medically refractory complex partial seizures.     

Effect of intra-arterial chemotherapy of head and neck tumors on cerebral blood circulation]

A combination of Cisplatin and Epirubicin was administered through the external carotid artery system according to a standard protocol as preoperative or palliative therapy in 14 oral cancer patients. With the aim of clarifying the subacute side-effects of this chemotherapy on the intracerebral circulation, rCBF SPECT investigations with 99mTc-HMPAO were performed before and after the cytostatic treatment. The interval between SPECT studies was 24 (SD +/- 12) days. In concordance with the neurological condition, visual assessment of the rCBF SPECT reconstructed transversal slices revealed no perfusion abnormalities and no changes on the follow-up. No significant changes were found in the side activity ratios in 22 regions of each hemisphere (unpaired t-test) in the whole group of patients. It was concluded that within the investigated time interval this highly effective combination of cytostatics administered perfectly through the external carotid artery system causes no serious disturbances in the cerebral circulation in oral cancer cases.     

脑电图监测在新生儿缺氧缺血性脑病中的价值

目的:观察脑电图(EEG)监测在新生儿缺氧缺血性脑病(HIE)中的临床价值。方法:对45例HIE患儿进行EEG监测,并评价EEG结果与临床后遗症的关系。结果:EEG总异常率为62.2%,轻、中和重度异常率分别为28.9%、20.0%、13.3%,临床病情轻、中、重度HIE患儿EEG异常率为36.4%、80.0%、100.0%。EEG轻度异常者其临床后遗症发生率为7.7%,EEG中、重度异常者其发生率则为53.3%。结论:EEG异常率随着脑损伤程度的加重而增高,EEG异常程度越重则临床后遗症发生率越高。     

Renal complications of multiple myeloma

In connection with the analyses of 84 post-mortem examinations (47 men, 37 women, average age: 66.3 years) the author dealt with the renal complications of multiple myeloma. The signs of cylinder nephropathy, light-chain nephropathy, amyloidosis, nephrocalcinosis, urate nephropathy, acute renal insufficiency, renal vein thrombosis, acute and chronic pyelonephritis as well as the tumorous infiltration of the renal tissue have been sought for. The severity of the lesions were ranged into minimal, slight, moderate, and severe groups. On the basis of the semiquantitative morphological picture and the clinical data: 1. intact kidney (41 patients), 2. involvement of the kidney without azotemia (10 patients), 3. involvement of the kidney with azotemia (17 patients, serum creatinine level: greater than 177 mumol/l) and 4. renal involvement with chronic renal insufficiency associated with uremia (16 patients) were discerned. In the background of 33 cases (39%) with deteriorated renal function cylinder nephropathy was found most frequently (27 occasions) (32%). Every other complication occurred significantly less frequently e.g. amyloidosis or kappa-light-chain nephropathy occurred in 3 cases each.