乙烯-乙烯醇共聚物的性能及其在介入栓塞领域的应用

介绍了乙烯-乙烯醇共聚物的结构与性能,综述了其在治疗脑动静脉畸形、脑动脉瘤及硬脑膜动静脉瘘等疾病的临床应用,并对产品的优缺点做了评述。     

脑动静脉畸形4例报告

目的探讨脑动静脉畸形（AVM）的临床特征、治疗方式的选择及操作技巧。方法回顾分析4例脑动静脉畸形患者的临床资料。结果右额脑动静脉畸形1例，左额脑动静脉畸形1例，右颞脑动静脉畸形1例，左颞脑动静脉畸形1例。其中1例为外伤后无意中发现，其余3例均以脑出血为首发表现。4例均经过手术治疗完全切除，均无任何后遗症。结论治疗AVM的基本目标是降低自发性出血的风险。对于已经出血的AVM可以积极手术治疗，对于无症状的巨大AVM，在条件允许的情况下手术切除仍是最根本的治疗方法。     

脑动静脉畸形Dyna CT和数字减影血管造影的图像融合

Dyna CT和数字减影血管造影(DSA)成像模态对脑动静脉畸形的诊断和治疗具有重要价值。三维Dyna CT可以提供动静脉畸形团的空间信息,而二维DSA可以提供判别动静脉的时间信息。为了同时显示动静脉及畸形团的位置关系,需要对这两种模态的图像进行融合。本文提出一种二维到三维反投影生长的方法,实现了二维DSA图像和三维Dyna CT图像的融合,从而可以在三维Dyna CT图像中直观地区分动静脉。实验结果表明,融合图像既能提供畸形团的空间位置信息,又能提供动静脉流向的时间信息,可以帮助医生更准确地诊断脑动静脉畸形以及进行手术规划。     

Onyx胶栓塞脑动静脉畸形31例

背景：在脑动静脉畸形的血管内栓塞治疗中,栓塞材料的选用在很大程度上决定血管内栓塞治疗的效果。Onyx胶是近年研制的一种新型液体栓塞剂,具有不粘管、弥散均匀及可控性好等优点。 目的：总结新型液态栓塞剂Onyx胶栓塞脑动静脉畸形31例的技术要点和临床疗效。 方法：应用Onyx胶栓塞脑动静脉畸形31例,均采用Seldinger技术在股动脉内置入6F动脉鞘,6F导引导管插入颈内动脉或椎动脉,Marathon微导管超选择进入畸形血管团内,采用“注胶-返流-停止-再注胶”技术长时间缓慢注射Onyx胶栓塞脑动静脉畸形。 结果与结论：栓塞后脑动静脉畸形闭塞40%~60% 8例,60%~90% 7例,90%以上(完全栓塞)16例。未能完全栓塞的15例中,4例接受手术治疗,其中3例痊愈,1例单侧肢体乏力,肌力Ⅳ级;6例患者术后辅以伽玛刀治疗,其中2例1年以后复查DSA显示脑动静脉畸形完全闭塞。提示Onyx可提高脑动静脉畸形的栓塞效果,但应正确采用栓塞技术和注意预防并发症。     

一种脑动静脉畸形的血流动力学集中参数模型及其应用

脑动静脉畸形（脑AVM）是脑血管系统中结构异常的动静脉短路血管组织,其所导致的异常脑循环血流动力学状态是造成脑AVM血管破裂出血和产生某些神经功能障碍以及严重的手术并发症的重要原因之～由于对脑血管内血流动力学参数的临床或实验测量十分困难,利用理论模型来研究脑AVM的血流动力学特征特有助于加深对其病理机理的认识,从而为脑AVM的临床治疗和诊断提供理论依据。本文提出一种改进的脑循环集中参数模型,对脑AvM的几种典型结构所引起的脑血流动力学变化作了分析,模型分析的结果表明,当AVM流量相对较小（300ml／min以下）…     

15例脑动静脉畸形的手术治疗

目的讨论手术切除治疗脑动静脉畸形（AVM）。方法回顾性分析我院自2006年5月～2009年12月间显微手术治疗的15例脑AVM。结果本组术后无死亡病例。术后1天内出现残腔血肿1例,占本组的6.7%,3天内局部脑肿胀2例,占本组的13.3%,以上3例均经加强脱水降颅压、控制血压等治疗而好转。术后患者无再次癫痫发作病例。其余12例（占本组的80.0%）恢复良好,复查DSA均显示脑动静脉畸形已全切除。本组15例随访DSA3年,均无脑动静脉畸形复发病例。结论开颅手术切除是治疗大中型脑AVM的有效手段。在治疗时,应该积极防治正常灌注压突破出血及其他并发症,通过精细的显微手术操作以获得更好的治疗效果。     

儿童期脑外动静脉畸形的CT评估价值

目的:分析儿童期脑外动静脉畸形的临床特点及计算机断层扫描（CT）影像表现,探讨CT增强检查对儿童期脑外动静脉畸形介入治疗前的评估价值。 方法:回顾性分析47例经数字减影血管造影确诊的儿童期脑外动静脉畸形患者的临床及CT影像资料,对部位、形态、边界、血管构筑和骨的侵犯等表现进行分析。 结果:病变位于胸壁1例,腹盆壁3例,四肢7例,口腔颌面部29例,耳部3例,眼眶1例,鼻部1例,头皮2例,伴有骨质受累5例。临床呈高流量的血管畸形表现,症状反复或进行性加重。特征性CT表现为强化的畸形血管团、粗大扭曲的引流静脉、增粗的供血动脉。 结论:CT增强检查能准确显示动静脉畸形的畸形血管团、大部分供血动脉及引流静脉,是介入治疗前的有效评估方法。     

脑动静脉畸形血流动力学的理论模型研究进展

脑动静脉畸形 (脑 AVM)可导致脑血流的异常分布 ,不正常的血流动力学状态是脑 AVM发生脑内出血和造成某些神经功能障碍以及严重的手术并发症的重要原因之一。由于脑血管内血流压力、流量等血流动力学参数测量技术的局限 ,一些学者借助于理论模型来分析脑 AVM的血流力学特征。本文介绍了国外关于脑 AVM血流动力学理论模型研究的进展 ,论述了各类模型的特点和缺陷以及进一步研究的思想路线。     

脑动静脉畸形脑血流 SPECT 显像及其临床相关因素

脑动静脉畸形脑血流ＳＰＥＣＴ显像及其临床相关因素为探讨脑动静脉畸形（ＡＶＭｓ）血液动力学变化及其与临床的关系，将健侧、病灶侧相应部位脑组织放射性计数值之差值除以该区域象素值（即象素总数），作为脑ＡＶＭｓ脑缺血指数，并与患者年龄、性别、临床症状和病变大...     

105例脑动静脉畸形并出血的外科治疗

目的探讨脑动静脉畸形及合并出血后外科治疗方法的选择。方法105例病人根据脑动静脉畸形的分级、出血的部位、出血量的大小及病人的状况等选择手术、栓塞或栓塞后手术等方法治疗。结果手术组60例,全切除55例,占92%;部分切除5例,占8%。血管内治疗40例,一次全部栓塞的15例,占37%;分次全部栓塞的18例,占45%;部分栓塞的7例,占18%。血管内治疗后手术5例,全切除3例,占60%;部分切除2例,占40%。治愈91例,治愈率为86%;好转6例,占6%;死亡8例,占8%。结论手术治疗和血管内治疗是目前治疗脑动静脉畸形并出血的有效方法。     

Level of functioning of siblings and parents of probands of varying degrees of retardation

A further analysis of already published data supports the position that retardates of low ability level less frequently have retarded siblings, retarded parents, and parents low in occupational level than do retardates higher in ability level. The analysis supports the position that there are two types of retarded individuals, persons retarded as a result of gene or chromosomal anomalies, brain injury, etc., who more frequently occur in the lower-level retardate group, and persons whose retardation represents polygenic segregation, who more frequently occur in the higher-level group.     

Modes of Inheritance of Errors of Refraction

Eighteen families in which both parents had refractions within the range of +4·0 D to −4·0 D and axial lengths seen in emmetropia (22·3-26·0 mm) showed coefficients of correlation of the order 0·5 indicative of polygenic inheritance. Such coefficients were seen for axial length (0·407) and for the cornea (0·487), but not for the lens (which is known to be yoked to the axial length). No such coefficients were seen in 19 families in which one of the parents had axial length outside the emmetropic range (nine families with long axes and 10 with short axes).

The pattern of polygenic inheritance for emmetropia (completely correlated optical components) and errors of refraction up to 4·0 D (inadequately correlated components: correlation ametropia) follows that seen in stature and other measurable characters. In contrast the high refractive errors with their abnormal axial lengths (component ametropia) are—like the extremes in stature—pathological anomalies with monofactorial inheritance.

     

Aspects of the problem of direct introduction of Standards of International Organizations

Editorial note. This article is published as part of a discussion. Particular issues of the article are disputable. First of all, this concerns the so-called “folder” method of introduction of international standards for medical devices to domestic medical practice (i.e., by direct translation of the standards and their publication as standardizing documents). Nevertheless, at least one of the problems, the problem of coordination between domestic state standards for medical devices and international recommendations of ISO and IEC, is undoubtedly of topical importance. Advancement of new health service legislation which is to be approved by law-makers will definitely introduce corrections into the present situation. The Editorial Board of Meditsinskaya Tekhnika believes this article will lessen these problems and to be welcomed by readers.