低分子肝素钙联合依达拉奉治疗进展性脑梗死的疗效分析

目的观察低分子肝素钙联合依达拉奉治疗进展性脑梗死的临床疗效。方法 80例进展性脑梗死患者随机分为联合组及对照组各40例,两组均给予常规治疗,联合组在上述治疗基础上给予低分子肝素钙联合依达拉奉治疗。结果联合组的总有效率明显高于对照组（P〈0.05）。治疗7d和14d后两组的神经功能缺损评分与治疗前比较均明显降低（P〈0.05）,且联合组分别与对照组比较,差异有统计学意义（P〈0.05）;治疗14d后,两组神经功能缺损评分与治疗7d后比较明显降低（P〈0.05）。结论低分子肝素钙联合依达拉奉治疗进展性脑梗死疗效确切,值得临床推广。     

纳洛酮与依达拉奉联合治疗急性脑梗死疗效观察

目的:现察纳洛嗣联合依达拉奉治疗急性脑梗患者的临床效果.方法:将82例急性脑梗死患者随机分治疗组42例与对照组例40例,对照组采用依达拉奉治疗,治疗组采用纳洛酮与依迭拉奉治疗,15天后比较治疗前后临床疗效及神经功能缺损评分(NDS).结果:治疗组有效率明显高于对照组(p<0.05),治疗组NDS减少程度高于对照组(p<0.05).结论:纳洛酮联合依达拉奉治疗急性脑梗死是安全有效地.     

依达拉奉与逐瘀活血中医方药联用治疗青中年进展性脑梗死疗效观察

目的:探讨依达拉奉与逐瘀活血中医方药联合治疗青中年进展性脑梗死的临床疗效.方法:将我科2010年1月～2012年6月青中年进展性脑梗死患者80例随机分为2组:观察组、对照组,每组各40例.两组均在常规治疗基础上,观察组应用依达拉奉和逐瘀活血中医方药,对照组应用依达拉奉,进行神经功能缺损评分并评价临床疗效.结果:观察组患者的神经功能缺损改善情况明显优于对照组(P＜0.05).结论:依达拉奉与逐瘀活血中医方药联用治疗青中年进展性脑梗死,可更有效终止病情进展,改善神经功能缺损,提高临床疗效.     

依达拉奉治疗急性脑梗死疗效观察

目的评价依达拉奉治疗急性脑梗死的临床疗效。方法将56例急性脑梗死患者随机分为对照组和治疗组,对照组给予常规治疗,治疗组除常规治疗外,加用依达拉奉30mg＋生理盐水100mL中静滴,每日2次,连用2周,2周后观察疗效。结果 2周后评价依达拉奉疗效,治疗组治愈7例,显著进步9例,好转8例,总有效率为85.71%,对照组治愈3例,显著进步7例,好转6例,总有效率57.14%,两组比较有统计学意义（P〈0.05）。结论依达拉奉治疗急性脑梗死优于常规治疗,是消除自由基、治疗急性脑梗死的理想药物。     

氯吡格雷联合依达拉奉治疗急性脑梗死的临床疗效分析

目的探讨氯吡格雷联合依达拉奉治疗急性脑梗死的临床效果。方法选择笔者所在医院2008年10月～2010年10月收治的急性脑梗死患者90例,随机分为两组各45例,均给予常规治疗,联合组患者在常规治疗的基础上给予氯吡格雷联合依达拉奉治疗,对照组在常规治疗基础上给予依达拉奉治疗,观察两组治疗效果。结果联合组总有效率明显高于对照组,两组比较差异有统计学意义（P〈0.05）;两组治疗后神经功能缺损评分较之前明显改善,前后比较差异有统计学意义。结论氯吡格雷联合依达拉奉治疗能改善急性脑梗死的近期神经功能缺失和日常生活能力,治疗急性脑梗死效果较好。     

80例急性脑梗死临床相关性研究

目的：观察80例急性脑梗死的临床相关性。方法将2012年6月～2013年6月期间80例急性脑梗死患者随机分为治疗组和观察组，每组40例，治疗组给予疏血通联合依达拉奉静脉滴注；对照组给予低分子右糖旋酐＋血栓通冻干粉静脉滴注。疗程各为14d，两组同时予肠溶阿司匹林，胞磷胆碱，依病情调脂、降糖、控制血压等治疗。结果治疗组有效率和生活能力量表评分都高于观察组（P＜0.05）。结论疏血通联合依达拉奉治疗急性脑梗死具有有良好的临床效果，和提高患者预后生活质量。     

依达拉奉治疗急性脑梗死的临床观察

目的观察依达拉奉治疗急性脑梗死的疗效和安全性。方法65例急性脑梗死患者随机分为两组，对照组常规治疗基础上加丹红注射液静脉滴注，治疗组在对照组治疗基础上加用依达拉奉30mg＋生理盐水100mL静脉滴注，2次／d。结果治疗组加用依达拉奉治疗后，无严重不良反应发生．神经功能缺损评分及治疗总有效率明显优于对照组，差异具有统计学意义（P〈0．05）。结论依达拉奉治疗急性脑梗死安全、有效，值得推广应用。     

亚低温联合依达拉奉与醒脑静治疗急性脑出血患者临床疗效观察

目的:观察依达拉奉与醒脑静注射液联合亚低温治疗急性脑出血的近期疗效.方法:48例急性脑出血随机分成2组,对照组24例采用依达拉奉30mg静滴,2次/d,疗程14d.亚低温组24例采用依达拉奉与醒脑静治疗的同时给予亚低温治疗72h,治疗14d后评定疗效.结果:观察组和对照组的有效率分别是83.4%和75%,对照组与观察组比较差异有统计学意义(P<0.05);治疗3d、7d、14d分别进行NIHSS评分,发现3d和7d无明显差异(P>0.05),14d亚低温组明显低于常规治疗组(P<0.05).结论:依达拉奉联合脑亚低温治疗急性脑出血是一种更有效的治疗方法,值得推广.     

尼莫地平联合依达拉奉治疗高血压小脑出血60例临床观察

目的:探计尼莫地平注射液联合依达拉奉治疗高血压小脑出血的疗效和安全性.方法:随机选取发病48h以内的高血压小脑出血患者60例,分尼莫地平注射液联合依达拉奉联合治疗组30例及尼莫地平注射液单药治疗组30例.治疗组:尼莫地平注射液1-2 mg/h静脉泵入,2次/d,合并依达拉奉注射液30mg+(NS) 250ml静脉滴注,2次/d共用14天;对照组:以尼莫地平注射液1-2 mg/h静脉泵入,2次/d,用14d,治疗前后定期对患者进行临床神经功能缺损程度评分及临床疗效评定.结果:30d后治疗组与对照组相比有极显著性差异(P＜0.05).结论:尼莫地平注射液联合依达拉奉治疗效果明显优于尼莫地平单药治疗组,安全性高.     

奥扎格雷钠联合依达拉奉注射液治疗急性脑梗死的临床疗效研究

目的:分析探讨奥扎格雷钠联合依达拉奉注射液治疗急性脑梗死的临床疗效及安全性。方法:120例脑梗死患者随机分为观察组和对照组各60例,观察组采用奥扎格雷钠联合依达拉奉治疗,对照组单用奥扎格雷钠治疗,观察治疗前及治疗2周、4周后神经功能缺损评分。结果:观察组总有效率显著高于对照组(P<0.05);治疗前两组患者神经功能缺损评分无显著差异(P>0.05);治疗2和4周后两组较治疗前均有所改善,且观察组明显优于对照组,差异有统计学意义(P<0.05);两组患者均无明显不良反应发生。结论:奥扎格雷钠联合依达拉奉治疗急性脑梗死疗效显著且不良反应少,是较理想的安全有效的药物,值得临床推广应用。     

胫骨平台骨折手术治疗的治疗体会

胫骨平台骨折又称胫骨近端关节内骨折,是膝关节创伤中最常见的骨折之一.在临床中较常见,约占全身各种骨折的4%.胫骨平台骨折大多是由于高能量损伤导致的,骨折类型复杂,并伴有严重软组织、侧刮韧带、膝关节韧带、交叉韧带半月板等损伤,治疗难度大.我科2007年10月至2010年3月,共手术治疗胫骨平台骨折21例,取得较为满意的效果.     

Surgical treatment of peritoneal carcinomatosis: current treatment modalities

Background

Selected patients with peritoneal surface malignancies (PSM) have been treated effectively by the combination of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Purpose

The purpose of this study is to summarize the treatment outcomes and general considerations regarding definitions and staging systems of current CRS and HIPEC modalities in malignant peritoneal mesothelioma and in secondary peritoneal malignancies such as peritoneal metastasis from appendiceal, colorectal, gastric, and epithelial ovarian cancers.

Conclusion

Disease progression within the peritoneal cavity has in the past been regarded as a terminal event. Accumulating evidence underlines the therapeutic potential and the acceptable morbidity and mortality rates of CRS and HIPEC in selected patients.     

Pain treatment today--current standing of pain treatment in Germany

Beyond doubt the provision of pain therapy for patients with acute and chronic pain in Germany has improved over the last 30 years. This positive development comprises i. e. the growing impact of acute pain services on the treatment of patients with postoperative pain and the implementation of new developments in research into the clinical setting of obstetric pain therapy. Nevertheless, the provision of pain therapy for patients with chronic pain syndromes, for children, and in the fields of cancer pain and palliative medicine is neither qualitatively nor quantitatively sufficient.     

颈椎过伸性脊髓损伤保守和手术治疗疗效分析

目的回顾性分析比较颈椎过伸性损伤患者行早期（小于24h）和晚期（大于24h）手术以及非手术治疗的疗效。方法自1995年1月～2005年6月间收治并获得随访的132例过伸性脊髓损伤患者中，31例行保守治疗，27例24h内行手术治疗，74例24h后行手术治疗，观察各组治疗前、后及随访时的AISA评分以及相关并发症。结果早期和晚期手术组术后随访临床疗效好于保守治疗组，差异有统计学意义（P〈0．01），早期和晚期手术组间差异无统计学意义（P〉0．05）；保守治疗、早期和晚期手术组肺炎的并发症的发生率分别是2／31（6．5％）、1／27（3．6％）和9／74（12．2％）。结论颈椎过伸性损伤患者手术治疗疗效好于保守治疗，晚期和早期手术对神经功能改善无明显差异，但晚期手术并发症相对增多。     

Results of treatment

Overall results of management in patients admitted to the 8 Italian centers participating in the International Cooperative Study on Timing of Aneurysm Surgery were rather unsatisfactory, with good recovery in only 42% of patients, and death in 45% of patients. As compared to the other centers included in the Study, Italian centers exhibited a significantly lower recovery rate and a significantly higher mortality rate. There were significant differences also between the individual Italian centers; independently of admission neurological status and timing of surgery, the outcome was better in centers 2 and 6 (a mortality rate under 20%) and worse in centers 1 and 8 (a mortality rate around 60%). Using prognostic factor models, higher than expected mortality rates were observed in 4 centers, and lower than expected good recovery rates in 3 centers. In Italian centers vasospasm accounted for the highest morbidity and mortality rate; the difference in mortality rate from vasospasm between Italian and other centers was very significant. Other important causes of death and disability were constituted by direct effect of the initial bleed and by recurrent hemorrhage. Patients operated on in Italian centers exhibited a good recovery in 57% of cases; the mortality was 27%. Differences from the other centers were less marked than for the overall management results. Mortality rates from vasospasm and from surgical complications were significantly higher in Italian than in the other study centers. Between the individual Italian centers, vasospasm accounted for the highest mortality rate in centers 7 and 8 (17% and 28% respectively). Postoperative pneumonia was significantly more frequent in Italian than in the other centers. In regard to timing of surgery, the differences in results between Italian and other centers were less marked when surgery was performed after 10 days from hemorrhage. In Italian centers as a whole, a delayed operation was linked with a better outcome than an early or subacute operation. The lowest recovery rate was observed in drowsy patients operated on between 4 and 10 days from the hemorrhage. Focal ischemic deficits and pneumonia were prevalent after an operation within 3 days of hemorrhage, while postoperative brain swelling was most frequent in patients operated on between 4 and 10 days from hemorrhage. The differences in results between Italian and other centers and among the individual Italian centers are widely discussed; possible explanations include inadequate modalities of treatment (especially inadequate management of vasospasm) and structural deficiencies of intensive care management in seriously ill patients.     

Surgical treatment of reruptures of the tendoachilles following nonsurgical treatment.

Nine patients who sustained a rerupture of their Achilles tendon after nonsurgical treatment were evaluated both subjectively and objectively with the Cybex isokinetic dynamometer. Subjectively, only 5 of the 8 patients were satisfied as compared to a 93% satisfaction rate in our previous series of patients with primary surgical repair. Cybex measurements were statistically inconsistent, unlike the primary repairs. This small series of patients in which the tendoachilles was reconstructed following failed nonsurgical treatment suggests that early surgical repair is the treatment of choice unless otherwise medically contraindicated.