微血管减压术治疗三叉神经痛65例分析

三叉神经痛是一种严重的面部发作性、疼痛性疾病,原发性三叉神经痛与三叉神经根受血管压迫有关,经微血管减压术治疗可获得较好疗效。2002年7月-2009年7月,我们采用微血管减压术治疗三叉神经痛65例,疗效满意。现分析报告如下。     

锁孔乙状窦后入路显微血管减压术治疗原发性三叉神经痛(附23例报告)

目的探讨乙状窦后入路锁孔显微血管减压术治疗原发性三叉神经痛的手术方法、效果及并发症。方法 23例原发性三叉神经痛患者行显微血管减压术,采用乳突后发际内小切口,小骨窗开颅,显微镜下全程解剖三叉神经颅内段,寻找责任血管,将其从三叉神经入脑干区(REZ)分离,植入Teflon垫棉。观察术后效果和并发症发生情况。结果术中均发现明确的责任血管压迫三叉神经REZ区。23例中22例术后症状立即消失,1例无效。3例术后发生术侧面部麻木。随访1个月～2年无疼痛复发。结论乙状窦后入路锁孔显微血管减压术是治疗三叉神经痛安全且有效的方法,正确的手术方法是决定手术效果、减少并发症的重要因素。     

76例原发性三叉神经痛微血管减压术围术期的护理体会

原发性三叉神经痛（TN）是指在三叉神经分布区内闪电样反复发作的剧痛,而不伴三叉神经功能破坏的症状,又称痛性抽搐。微血管压迫是TN的主要原因,因此,微血管减压术是目前治疗TN的主要方法。我科2007—2009年采用微血管减压术治疗TN76例，     

三叉神经微血管减压术患者体位安置体会

三叉神经显微血管减压术是原发性三叉神经痛首选的手术方法,疗效可靠,可保留三叉神经功能,是目前治疗原发性三叉神经痛的最好方法[1].我院在2002年5月～2008年12月采用显微血管减压术治疗三叉神经痛150例,取得良好效果.由于手术体位的需要,若侧卧位安置时间过久,可能影响肢体循环,发生周围神经损伤、血管压迫、挤压伤等并发症[2].因此,手术体位的安置是此类手术的关键之一.通过对150例手术患者术后皮肤情况观察,患者术中体位摆放方面不断进行研究、改进,取得良好效果,现报告如下.     

颅内微血管减压的手术配合体会

微血管减压手术（microvascular decompression，MVD）治疗三叉神经痛、面肌痉挛等脑神经疾病是一项有效但具有挑战性的工作。作者所在的两院神经外科自2000年10月-2008年2月共完成613例微血管减压手术，围手术期的手术体位摆放及术中配合都对护理提出了很高的要求。通过对613例微血管减压术的配合，积累了一定的经验，现总结如下。     

三叉神经根减压术后疼痛复发再手术8例

1993～ 2 0 0 1年 ,我们对经乙状窦后进路三叉神经根显微血管减压术后疼痛复发 8例 ,再次从原进路手术行三叉神经根探查及治疗 ,全部治愈。1　临床资料1 1　一般情况　 8例中 ,男 3例 ,女 5例 ;年龄 4 5～80岁 ,平均 6 3 5岁。经外院手术后复发 6例 ,本院手术后复发 2例。三叉神经疼痛左侧 3例 ,右侧 5例 ;第Ⅱ支 2例 ,第Ⅲ支 3例 ,Ⅱ、Ⅲ支 3例。术后分别在半年、1年及 6年复发各 1例 ,3年复发 2例 ,5年复发 3例。1 2　治疗　 2 %利多卡因局麻下 ,取患侧乙状窦后原手术切口处进路入颅 ,作三叉神经根探查术。术中见三叉神经根与蛛网膜严重粘…     

三叉神经痛的诱发电位和动作电位研究及其机制探讨

对２０例三叉神经痛患者减压手术前后及８０名无三叉神经痛的正常人分别进行了三叉神经体感诱发电位（ＴＳＥＰ）检测，并对其中１２例在术中三叉神经减压前后进行了三叉神经动作电位（ＴＣＡＰ）测量，并就其结果的对比研究，确定ＴＳＥＰ的早期成分Ｐ３（或Ｎ３）属三叉神经诱发电位，而不是肌电位。认为Ｐ３（或Ｎ３）是三叉神经根及三叉神经脊束核的突触后的混合电位。对减压前后ＴＳＥＰ和ＴＣＡＰ的比较，推测原发性三叉神经痛     

乙状窦后入路血管减压术治疗原发三叉神经痛

原发三叉神经痛病因长期以来存在争议,治疗也比较困难。我科从1991年以来采用乙状窦后入路三叉神经根微血管减压术治疗原发三叉神经痛186例,取得满意效果。现报告如下:     

三叉神经痛的诱发电位和动作电位研究及其机制探讨

摘要对２０例三叉神经痛患者减压手术前后及８０名无三叉神经痛的正常人分别进行了三叉神经体感诱发电位（ＴＳＥＰ）检测，并对其中１２例在术中三叉神经减压前后进行了三叉神经动作电位（ＴＣＡＰ）测量，并就其结果的对比性研究，确定ＴＳＥＰ的早期成分Ｐ＿３（或Ｎ＿３）属三叉神经诱发电位，而不是肌电位。认为Ｐ＿３（或Ｎ＿３）是三叉神经根及三叉神经脊束核的突触前和突触后的混合电位。对减压前后ＴＳＥＰ和ＴＣＡＰ的比较，推测原发性三叉神经痛的发病部位在外周，而致痛机制在中枢。     

内镜辅助下三叉神经痛微血管减压手术56例

 原发性三叉神经痛是一种常见病,主要表现为短暂而剧烈的阵发性面部疼痛,可被三叉神经分布区内轻微的皮肤刺激“扳机点”所触发,给患者造成较大的痛苦^[1]。目前,颅内血管对三叉神经的压迫是导致三叉神经痛发作的主要原因已经被广大学者所接受^[2]。微血管减压手术是针对三叉神经痛的主要病因进行治疗,是原发性三叉神经痛的首选手术治疗方法^[3]。我科自2009-02至2012-05在神经内镜辅助下行三叉神经痛微血管减压治疗患者56例,取得良好效果。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.