致心律失常性右室心肌病患者Epsilon波的检出率

Objective To investigate the prevalence of Epsilon wave in patients with arrhythmogenic right ventrieular cardiomyopathy (ARVC). Methods The Epsilon wave was detected in 32 patients [24 men, mean age (42.3±13.3) years] with ARVC using three different electrocardiography (ECG) recording methods: standard twelve leads ECG (S-ECG), right precordial leads ECG (R-ECG) and Fontaine bipolar precordiai leads ECG (F-ECG). The Epsilon wave was defined as wiggle, small spike wave and smooth potential between the end of the QRS complex and the beginning of the ST segment. Results Epsilon wave was detected in 37.5%, 37.5% and 50.0% patients with ARVC by S-ECG, R-ECG and F-ECG respectively. The detection rates derived from the three recording methods were similar(P ＞ 0.05). The Epsilon wave was only detectable by S-ECG in one case, by R-ECG in three cases, and by F-ECG in five cases. The detection rate of Epsilon wave was 50.0% by combined use of S-ECG and R-ECG (SR-ECG), 56.3% by combined use of S-ECG and F-ECG (SF-ECG), and 65.6% by combined use of the three recording methods (SRF-ECG). The detection rate was significantly higher by SF-ECG (56.3%) and SRF-ECG (65.6%) than by S-ECG alone (37.5%, all P ＜0.05). Most Epsilon waves detected by the S-ECG, R-ECG and F-ECG were small spiked waves. Conclusion Combined use of S-ECG, F-ECG and R-ECG could increase the detection rate of Epsilon wave in patients with ARVC.     

理气益胃汤治疗胃脘痛疗效观察

近年来，笔者运用自拟理气益胃汤治疗慢性胃炎之胃脘痛100例，取得满意的疗效，现报道如下。 1 临床资料 本组100例患者中，男46例，女54例。年龄25～56岁，均经胃镜检查确诊为慢性胃炎，都以胃脘痛为主症。男性多由饮食不节，嗜酒过度为诱因。女性多由饮食不当，寒温不适，情志不畅为诱因。病程最长15年，最短5个月。……     

自发性蛛网膜下腔出血致脑积水的治疗体会

脑积水是自发性蛛网膜下腔出血(SAH)后最常见的并发症之一,处理不当可严重影响患者的预后.而引起自发性SAH的常见原因为先天性颅内动脉瘤、血管畸形、高血压、脑动脉硬化、颅内肿瘤、血液病等.由于动脉瘤好发于颅底动脉交叉处,最易直接受到血流冲击,加上血管先天性发育不良,极易破裂出血.我科自2003年1月至2011年7月手术和介入栓塞治疗210例以动脉瘤破裂出血为主要表现的颅内动脉瘤,其中15例并发脑积水,现就其治疗情况报告如下.     

悬吊牵引配合手法及夹板固定治疗肱骨干骨折30例体会

<正>肱骨干骨折是骨科的常见病及多发病,由于易合并挠神经损伤,骨折延迟愈合或不愈合,所以对于肱骨干骨折的治疗一直都是骨科的难题。我们对肱骨干骨折采取上肢悬吊牵引配合手法复位,夹板外固定治疗肱骨干骨折30例,效果良好,现介绍如下:     

127例脑室出血的外科治疗

1 对象与方法 1999年7月～2007年10月，我科治疗脑室出血127例，其中男79例，女48例：年龄20～83岁，平均55岁；病程3～72h。高血压病史87例，家族史38例。入院时收缩压≥150mmHg105例。GCS评分9～13分48例，7～8分42例，〈6分37例。手术方法：单纯血肿穿刺引流、单纯一侧或双侧侧脑室穿刺引流、血肿穿刺＋侧脑室穿刺引流，术后用尿激酶溶血引流。术后2～5d行腰穿脑脊液置换。     

致心律失常性右室心肌病患者Epsilon波的检出率

Objective To investigate the prevalence of Epsilon wave in patients with arrhythmogenic right ventrieular cardiomyopathy (ARVC). Methods The Epsilon wave was detected in 32 patients [24 men, mean age (42.3±13.3) years] with ARVC using three different electrocardiography (ECG) recording methods: standard twelve leads ECG (S-ECG), right precordial leads ECG (R-ECG) and Fontaine bipolar precordiai leads ECG (F-ECG). The Epsilon wave was defined as wiggle, small spike wave and smooth potential between the end of the QRS complex and the beginning of the ST segment. Results Epsilon wave was detected in 37.5%, 37.5% and 50.0% patients with ARVC by S-ECG, R-ECG and F-ECG respectively. The detection rates derived from the three recording methods were similar(P ＞ 0.05). The Epsilon wave was only detectable by S-ECG in one case, by R-ECG in three cases, and by F-ECG in five cases. The detection rate of Epsilon wave was 50.0% by combined use of S-ECG and R-ECG (SR-ECG), 56.3% by combined use of S-ECG and F-ECG (SF-ECG), and 65.6% by combined use of the three recording methods (SRF-ECG). The detection rate was significantly higher by SF-ECG (56.3%) and SRF-ECG (65.6%) than by S-ECG alone (37.5%, all P ＜0.05). Most Epsilon waves detected by the S-ECG, R-ECG and F-ECG were small spiked waves. Conclusion Combined use of S-ECG, F-ECG and R-ECG could increase the detection rate of Epsilon wave in patients with ARVC.     

自发性脑出血并脑室出血56例的外科治疗

目的探讨自发性脑出血破入脑室的治疗方法和疗效。方法采用单纯血肿穿刺引流、一侧或双侧侧脑室穿刺引流、血肿穿刺＋侧脑室穿刺引流，辅以腰穿脑脊液置换治疗56例自发性脑出血并脑室出血。结果恢复良好13例（23．2％），中度残疾21例（37．5％），重度残疾14例（25．0％）；植物生存2例（3．6％）；死亡6例（10．7％）。结论微创钻（锥）颅血肿穿刺、脑室穿刺溶血引流＋腰穿脑脊液置换治疗脑室出血的方法简单易行，疗效确切。     

甲氰咪胍引起低血压1例

患者男,24岁,因反复上腹痛20余天入院。入院后经胃镜检查诊为十二指肠球部溃疡(活动期),急性出血糜烂性胃炎。入院时血压120/80mmHg。给甲氰咪胍0.2g每日3次服,睡前服0.4g。1周后腹痛明显