微创颅内血肿清除术早期治疗重症高血压脑出血的临床观察

目的 探讨微创颅内血肿清除术治疗重症高血压性脑出血的治疗效果.方法 采用对比研究的方法,观察微创颅内血肿清除术与内科保守治疗重症高血压性脑出血患者的疗效.结果 治疗组血肿清除率大部分在75%～90%之间,治疗组的病死率为16.1%,明显低于对照组的41.5%(P＜0.05).结论 微创颅内血肿清除术简便安全、定位准确,早期进行该手术,对防止血肿压迫脑组织的不可逆损害,降低病死率,提高生存质量都有积极的意义,是治疗重症高血压性脑出血的一种较好的方法.     

微创穿刺术治疗脑出血后颅内血肿临床分析

目的分析微创穿刺术治疗脑出血颅内血肿的临床疗效。方法脑出血患者128例随机分为对照组和观察组各64例,对照组实施内科保守治疗,观察组采用颅内血肿微创穿刺清除术。观察比较2组疗效、并发症发生率。结果术后2周观察组总有效率81.3%,大于对照组的46.9%,差异有统计学意义(P0.05);2组消化道出血、肺部感染、尿路感染、脑疝形成并发症发生率差异无统计学意义(P0.05),观察组再出血、肾衰竭、电解质紊乱发生率低于对照组,差异有统计学意义(P0.05)。结论微创穿刺术对比传统内科保守治疗疗效较好,可有效降低患者病死率、减少并发症的发生,且操作简单值得推广。     

颅内血肿微创清除术治疗高血压脑出血与内科保守治疗对照分析

目的 探讨CT定位颅内血肿微创清除术治疗高血压脑出血的临床疗效.方法 将216例高血压脑出血患者按治疗方法的不同,分为颅内血肿微创清除术组(手术组)120例和内科保守治疗组(保守组)96例,两组患者给予常规治疗,包括吸氧、保持呼吸道通畅,降颅压,调整血压,预防感染、消化道出血、肾功能衰竭等并发症,维持水电解质平衡等.手术组另外行颅内血肿微创清除术.比较观察两组的临床疗效、并发症发生率及死亡率.结果 手术组疗效明显优于对照组(P<0.001),手术组并发症发生率和死亡率比对照组明显减少(P<0.01).结论 采用CT定位颅内血肿微创清除术治疗高血压脑出血,明显提高基本治愈率,有效降低并发症发生率和病死率.     

微创颅内血肿清除术治疗高血压性脑出血的临床研究

目的评价微创颅内血肿清除术治疗高血压性脑出血的疗效。方法对67例中、重症高血压性脑出血患者随机分为2组:A组(微创治疗组)33例,B组(保守治疗组)34例,A组采用微创技术清除血肿,B组单纯行保守治疗,并分别观察2组的临床疗效。结果(1)A组有效率(63.6%)及显效率(39.4%)均明显高于B组(35.3%,20.6%)(P<0.05),而A组病死率(27.3%)明显小于B组(55.5%)(P<0.01);(2)A组血肿消失速度[(15.1±3.4)d]明显快于B组[(35.3±5.2)d](P≤0.01);(3)治疗前、后15d A组神经功能缺损明显快于B组(P≤0.05)。结论微创颅内血肿清除术治疗高血压性脑出血较单纯保守治疗效果好,且能明显提高有效率、降低病死率及缩短患者血肿消失时间,促进患者神经功能的恢复。     

微创颅内血肿清除术治疗高血压脑出血60例临床分析

目的 探讨微创颅内血肿清除术治疗高血压脑出血的临床疗效.方法 将90例高血压脑出血患者随机分组,治疗组行微创颅内血肿清除术,对照组行常规的内科保守治疗.结果 治疗组患者病死率、并发症发生率均显著降低.结论 微创颅内血肿清除术治疗高血压脑出血能够显著降低患者病死率及致残率,提高生存质量,是一种安全有效的方法 .     

微创治疗高血压脑出血的疗效及对神经功能早期康复的影响

目的探讨微创颅内血肿清除治疗高血压脑出血的临床疗效及对患者神经功能早期康复的影响。方法选择我院收治的85例高血压脑出血患者为研究对象,均接受脱水、神经营养药物等常规内科治疗,数字表格法将患者分为2组,对照组行传统骨瓣开颅血肿清除术,实验组则行微创颅内血肿清除术,比较2组治疗效果、并发症、治疗前后神经功能康复情况。结果实验组总有效率、并发症发生率分别为91.11%、13.33%,与对照组的75.00%、37.50%比较差异显著(P0.05)。2组术后1d、1周、2周神经功能缺损评分比较差异显著(P0.05)。随访6个月,2组ADL分级Ⅰ级比较差异显著(P0.05)。结论微创颅内血肿清除术治疗高血压脑出血疗效明显,能有效减少并发症,改善神经功能缺损症状,值得临床推广。     

微创颅内血肿清除术治疗脑出血的临床效果

目的分析应用微创颅内血肿清除术治疗脑出血(CH)的临床效果。方法选取180例高血压CH患者为研究对象,将其随机分为观察组和对照组,每组各90例。对照组给予内科保守治疗,观察组在对照组治疗的基础上给予微创颅内血肿清除术治疗。对2组的临床疗效和并发症的发病率以及治疗3个月后患者的各项生活质量评分进行观察和比较。结果2组的临床总有效率分别为96.7%和70.0%,观察组的临床总有效率显著高于对照组(P0.05),且观察组中基本治愈高于对照组(P0.05),有效或无效显著低于对照组(P0.05);观察组并发症发生率均显著低于对照组(P0.05);治疗后观察组的各项生活质量评分均显著高于对照组(P0.05)。结论应用微创颅内血肿清除术治疗CH的疗效优于内科保守治疗,可显著改善患者术后的生活质量并降低并发症的发病率。     

颅内血肿微创清除术治疗老年高血压脑出血的疗效

目的探讨颅内血肿微创清除术治疗老年高血压脑出血的疗效。方法以2011-02—2013-07我院收治的96例老年高血压脑出血患者为研究对象,分别进行颅内血肿微创清除术(微创组)和保守治疗手术(保守组),比较2组治疗前后的GCS、ADL评分,并记录并发症及死亡情况。结果 2组治疗前GCS、ADL评分差异无统计学意义(P0.05)。治疗结束后,2组GCS、ADL评分明显升高,且组间差异具有统计学意义(P0.05)。微创组48例,再次出血4例(8.33%),感染8例(16.67%),胃肠道出血6例(12.50%),高热3例(6.25%),死亡9例(18.75%);保守组48例,再次出血9例(18.75%),感染17例(35.42%),胃肠道出血13例(27.08%),高热8例(16.67%),死亡19例(39.58%)。以上差异均具有统计学意义(P0.05)。结论颅内血肿微创清除术在治疗老年高血压脑出血方面具有明显优势,能够有效改善患者生存质量,具有并发症少、病死率低的优点。     

微创颅内血肿清除术治疗高血压性脑出血临床分析

目的 观察应用微创颅内血肿清除术治疗高血压性脑出血的疗效.方法 将103例高血压性脑出血患者随机分成2组,分别采用微创颅内血肿清除术治疗和保守治疗,观察治疗后4周和6个月的临床疗效.结果 治疗4周后,A组治愈率和显效率均明显高于B组,病死率明显低于B组;治疗后6个月随访,A组重残发生率(23.9%)明显低于B组(37....     

微创穿刺颅内血肿清除术治疗高血压脑出血42例临床分析

目的探讨微创穿刺颅内血肿清除术治疗高血压脑出血的临床效果。方法随机将84例高血压脑出血患者分为2组,各42例。观察组实施微创穿刺血肿清除术,对照组给予传统内科药物治疗,分析对比2组的治疗效果。结果观察组总有效率85.7%,显著优于对照组的45.3%;治疗期间观察组再出血、电解质紊乱、消化道出血等并发症发生率为21.4%,显著少于对照组的40.5%;观察组死亡2例,对照组死亡6例。2组比较差异有统计学意义(P0.05)。结论与传统内科药物治疗比较,微创穿刺颅内血肿清除术治疗高血压脑出血,操作方法简单、总有效率高、治疗期间并发症发生率及病死率低,效果满意。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.