腹部卒中

腹腔内血管自发性破裂，是一种比较罕见的急腹症，误诊率高，死亡率高，近年国内报道的病例增多。收集国内外文献，对本病的病因、临床表现、诊断依据及治疗进行综述。     

卒中应激性高血糖与糖尿病并发卒中的鉴别诊断研究

目的 :探讨糖化血红蛋白和糖化血清蛋白在卒中应激性高血糖与糖尿病并发卒中的鉴别诊断中的作用。方法 :通过测定卒中伴高血糖患者血液中的糖化血红蛋白和糖化血清蛋白水平 ,判断这种血糖升高的原因是应激性高血糖还是糖尿病并发卒中。结果 :2 4例脑出血伴高血糖的患者中 ,应激性高血糖 11例 ,糖尿病并发卒中 13例 ;38例脑梗死伴高血糖的患者中 ,应激性高血糖 8例 ,糖尿病伴发卒中 30例。结论 :糖化血红蛋白和糖化血清蛋白鉴别应激性高血糖与糖尿病并发卒中方法可靠 ,值得推广。     

脑卒中后抑郁症的分析

目的 分析脑卒中后患者抑郁症的发生率及发生的相关因素.方法 对196例脑卒中的患者用CT或MRI确定诊断,并用SDS、NFA、ADL进行评定,统计分析抑郁症的发生率及与医学、心理等方面的关系.结果 抑郁症发生率为35.7%.发生的相关因素有:神经功能缺损程度、卒中部位等.结论 脑卒中后抑郁症是生物、心理因素协同作用所致,在临床工作中常见.     

High altitude-induced pituitary apoplexy

Sudden ascent to high altitudes beyond 2,438 m can cause life-threatening complications such as acute mountain sickness and high altitude cerebral and pulmonary oedema. We present a case of pituitary apoplexy in a young man who ascended to high altitude gradually, after proper acclimatisation. He developed headache, nausea, vomiting and persistent hypotension. Magnetic resonance imaging revealed an enlarged pituitary gland with haemorrhage. His hormonal estimation showed acute adrenal insufficiency due to corticotropin deficiency. The patient responded well to conservative medical management with hormonal replacement therapy. This is most likely the first reported case of high altitude-induced pituitary apoplexy in the literature.     

脑卒中后抑郁症的分析

目的 分析脑卒中后患者抑郁症的发生率及发生的相关因素.方法 对196例脑卒中的患者用CT或MRI确定诊断,并用SDS、NFA、ADL进行评定,统计分析抑郁症的发生率及与医学、心理等方面的关系.结果 抑郁症发生率为35.7%.发生的相关因素有:神经功能缺损程度、卒中部位等.结论 脑卒中后抑郁症是生物、心理因素协同作用所致,在临床工作中常见.     

Pituitary apoplexy associated with ptosis

Pituitary tumours are the most common sellar masses, frequently presenting with visual impairment and endocrine abnormalities. Two cases of pituitary tumour presenting with ptosis are reported.     

中风后抑郁症发病机制探讨

通过探讨中风后抑郁症的发病机制 ,认为情志内伤是其重要病因 ,脏腑虚衰是其病理基础 ,气郁、痰瘀、正虚是其病理变化     

Clinical significance of pituitary apoplexy

A retrospective analysis of 280 cases of pituitary adenoma operated on over a period of 10 years from 1985-94 revealed 15 cases (5.3%) presenting with apoplexy, though there were 48 cases in which haemorrhage in pituitary adenoma was confirmed at operation. In the apoplectic group all but one had abrupt onset of severe headache. Seven of these 15 patients had diminution of vision and ocular motility defects were detected in 5 patients. There were 5 patients of amenorrhoea/galactorrhoea syndrome and 2 had acromegalic features. In the remaining 8 patients retrospective analysis failed to reveal any conclusive evidence of pituitary dysfunction. Trans-sphenoidal surgery was performed in 9 cases and the rest had transcranial surgery. Visual acuity loss improved in most of the affected patients, residual ocular motility defects were mild. Urgent trans-sphenoidal surgery to decompress the expanding mass seems to be the preferred mode of surgery.     

Ophthalmic manifestations of pituitary apoplexy

A case of pituitary apoplexy which occurred in a patient with prolactinoma is reported. The signs and symptoms on presentation were headache, loss of vision, sixth-nerve palsy, subarachnoid haemorrhage and fever. Physicians are alerted to the necessity of prompt and accurate diagnosis in this condition to allow urgent decompression of the anterior visual pathways.     

Pituitary apoplexy after stimulation tests.

Pituitary apoplexy occurs after infarction of a non-neoplastic pituitary or sudden expansion of an adenoma following haemorrhage or infarction. It usually occurs spontaneously but can follow a number of causes including pituitary stimulation tests. Since this complication is potentially life-threatening, the benefits of subjecting patients who might have pituitary tumours to such tests should be considered.