颅内动脉瘤栓塞术中突发性颈内动脉闭塞性痉挛的紧急处理

目的总结颅内动脉瘤栓塞术中突发性颈内动脉闭塞性痉挛的紧急处理。方法 681例颅内动脉瘤栓塞术中,14例发生颈内动脉闭塞性痉挛。早期的8例采用经导引导管灌注罂粟碱和尿激酶等常规治疗方法处理;后期的6例采用动脉内灌注利多卡因和尿激酶等。结果常规方法治疗的8例中,仅5例痉挛部分解除,均未完成栓塞。采用利多卡因治疗的6例中,痉挛完全解除5例,4例完成栓塞,恢复正常。结论颈内动脉闭塞性痉挛常规治疗效果极差,采用利多因动脉内灌注可取得较好效果。     

颅内夹层动脉瘤血管内栓塞治疗

Objective To analyze the clinical features of intracranial dissecting aneurysm and summarize the experience of its endovascular embolization. Methods 16 cases of intracranial dissecting aneurysm were treated by endovascular embolization. Among these 16 patients, 3 patients were treated with single stent or double stent placement technique, 9 patients were treated with stent- assisted coil embolization technique, 3 patients were ball artery occluded using the balloon - assisted or coil - assisted technique, and 1 patient was treated by simple coil embolization. Results Out of the 16 patients, 9 cases were completely occluded ( including parent artery occlusion cases ), 3 cases were subtotally occluded, 4 cases were incompletely occluded ( including cases of stent implantation ). Followed up for 6 months to 3 years, in addition to 1 case of early death, GOS evaluation results were respectively: grade Ⅰ 8 cases, grade Ⅱ 4 cases, grade Ⅲ 2 cases, grade Ⅳ 1 case. Cerebral angiography was carried out in 8 follow - up patients. No recurrence was watched in 7 cases, aneurysm neck recanalization was watched in 1 case, follow up was continued. Conclusion According to different localization of intracranial aneurysm and different pathological features, different methods of endovascular embolization are selected. It is the safe and effective treatment of dissecting aneurysm.     

超选择性血管内栓塞治疗颅内动静脉畸形

我科于 1997年 6月～ 2 0 0 0年 6月间对 2 1例颅内动静脉畸形 (ＡＶＭ )采用氰基丙烯酸正丁酯 (ＮＢＣＡ)血管内栓塞治疗 ,取得了良好效果 ,现报告如下。临床资料一、一般资料 :男 12例 ,女 9例 ,年龄 12～ 6 5岁 ,平均 32 3岁。其中癫痫 9例 ,颅内出血 7例 (2例有 2～ 3次出血史 ) ,阵发性头痛、头昏 5例。二、辅助检查 :18例ＣＴ扫描示脑内有边界不清的点、线状混杂密度影 ,出血者可见脑、脑池内有高密度影。 12例ＭＲＩ检查示脑内有无信号蜂窝状血管流空影。全部病例均行ＤＳＡ检查 ,提示颅内ＡＶＭ ,其中顶枕叶 6例 ,额顶叶 4例 ,颞顶…     

外周血造血干细胞与白细胞在脑外伤后的动态变化及意义

脑外伤患者38例,采用流式细胞仪、全自动血细胞分析仪动态检测第1、3、5、7、14天外周血CD34^＋的绝对值和白细胞的变化。结果显示,脑外伤后,轻症组、重症组均出现CD34^＋细胞逐步上升,重症组上升幅度较大;而白细胞值在伤后迅速升高并逐步下降,与CD34^＋细胞变化呈负相关。认为脑外伤后CD34^＋细胞与白细胞计数可作为重要观察指标,脑外伤后机体存在CD34^＋细胞的动员,参与脑外伤的修复。     

神经内镜联合电生理监测在治疗原发性三叉神经痛的应用

目的 探讨神经内镜联合电生理监测在微血管减压术(micro-vascular decompression, MVD)中治疗原发性三叉神经痛(trigeminal neuralgia, TN)的疗效及术后并发症情况。方法 回顾性分析2016年1月至2022年12月镇江市第一人民医院和东南大学附属中大医院收治的142例原发性三叉神经痛患者的病例资料,其中66例在神经内镜联合电生理监测下行微血管减压手术(研究组),76例采用显微镜下行微血管减压手术(对照组),对两组的手术疗效和术后并发症发生情况进行分析。结果 研究组的有效率为96.96%,对照组的有效率为96.05%,两组有效率相比较无统计学差异(P>0.05)。两组中等级分布无统计学差异(P>0.05),说明研究组的疗效和对照组同样确切。研究组的并发症发生率为10.60%,对照组的并发症发生率为14.47%,两组无统计学差异(P>0.05)。其中研究组中的面听神经损伤的发生率明显小于对照组,具有统计学差异(P<0.05)。结论 神经内镜联合电生理监测下行微血管减压术治疗原发性三叉神经痛具有和传统显微镜相比同样确切的...     

颅内夹层动脉瘤血管内栓塞治疗

目的 分析颅内夹层动脉瘤的临床特点,总结血管内栓塞治疗的经验.方法 对16例颅内夹层动脉瘤患者采用血管内栓塞治疗,其中3例采用单支架或双支架置入术,9例应用支架辅助下弹簧圈栓塞技术,3例使用球囊或弹簧圈辅助下球囊载瘤动脉闭塞术,1例使用单纯弹簧圈动脉瘤栓塞术.结果 16例中,动脉瘤完全闭塞9例(包括载瘤动脉闭塞病例),次全闭塞3例,不全闭塞4例(包括支架植入病例).随访6个月-3年,除早期1例死亡外,GOS结果评定:Ⅰ级8例,Ⅱ级4例,Ⅲ级2例,Ⅳ级1例.8例随访时脑血管造影,7例未见复发,1例瘤颈再通,正在随访.结论 根据颅内夹层动脉瘤的不同部位、不同病理特点,选择不同的血管内栓塞治疗方法,是治疗夹层动脉瘤安全、有效的方法之一.

Abstract：

Objective To analyze the clinical features of intracranial dissecting aneurysm and summarize the experience of its endovascular embolization. Methods 16 cases of intracranial dissecting aneurysm were treated by endovascular embolization. Among these 16 patients, 3 patients were treated with single stent or double stent placement technique, 9 patients were treated with stent- assisted coil embolization technique, 3 patients were ball artery occluded using the balloon - assisted or coil - assisted technique, and 1 patient was treated by simple coil embolization. Results Out of the 16 patients, 9 cases were completely occluded ( including parent artery occlusion cases ), 3 cases were subtotally occluded, 4 cases were incompletely occluded ( including cases of stent implantation ). Followed up for 6 months to 3 years, in addition to 1 case of early death, GOS evaluation results were respectively: grade Ⅰ 8 cases, grade Ⅱ 4 cases, grade Ⅲ 2 cases, grade Ⅳ 1 case. Cerebral angiography was carried out in 8 follow - up patients. No recurrence was watched in 7 cases, aneurysm neck recanalization was watched in 1 case, follow up was continued. Conclusion According to different localization of intracranial aneurysm and different pathological features, different methods of endovascular embolization are selected. It is the safe and effective treatment of dissecting aneurysm.     

125I-神经生长因子对人脑胶质瘤细胞株U251的作用

目的 探讨125I-神经生长因子(125I-NGF)对U251细胞的杀伤能力及作用机制.方法 通过噻唑蓝(MTT)试验检测分别以18.5、37.0、74.0、148.0、296.0、592.0、1184.0、1480.0、1850.0、2590.0、3330.0、3700.0 kBq/ml 125I-NGF处理的U251的吸光度值,选择吸光度值趋于最低时最小125I-NGF浓度为其最低有效浓度.采用平板克隆形成试验,比较分别给予完全培养液、592 kBq/mlNa125I、1 mg/L NGF和592 kBq/ml 125I-NGF溶液处理的各组细胞克隆形成率,评价上述因素处理后U251细胞的增殖能力.采用放射自显影技术观察细胞内银颗粒分布,从而反映125I-NGF进入细胞的能力.并通过彗星试验及微核形成试验观察125I-NGF作用后U251细胞DNA的损伤,有明显彗尾及微核形成者DNA损伤严重.通过流式细胞仪检测125I-NGF作用后U251 G0/G1及S期细胞比例变化.结果 125I-NGF的最低有效浓度为592 kBq/ml,在此浓度下,125I-NGF可以有效进入细胞核内并损伤靶细胞DNA,经125I-NGF处理的胶质瘤细胞克隆形成率(0.02±0.01)较对照组(0.33±0.02)明显降低(P<0.01).125I-NGF作用后S期细胞比例(10.69±0.02)较对照组(35.47±0.02)下降,G0/G1期细胞比例(75.10±0.22)较对照组(53.17±0.03)升高(P<0.01).结论 125I-NGF在U251细胞中可以被转运入细胞核内,并可以有效杀伤靶细胞,其杀伤作用主要针对S期胶质瘤细胞.     

超选择性栓塞治疗颅内后循环动脉瘤

目的 分析后循环动脉瘤的特点,总结血管内介入治疗的经验、教训.方法 采用血管内栓塞治疗32例后循环动脉瘤,对临床资料、疗效、并发症等进行分析总结.结果 32例中,动脉瘤闭塞＞95%占90.7%.＜95%占9.3%.术中常见并发症是动脉瘤破裂、血管痉挛和血栓形成,本组占15.6%.术后早期死亡2例,23例获得随访,GOS评定,Ⅰ级16例,Ⅱ级4例,Ⅲ级2例,Ⅳ1例.结论 血管内栓塞治疗是后循环动脉瘤的理想治疗方法,它具有安全性高,并发症少,病死率低等优点.     

后循环多发性动脉瘤1例报告

患者女,47岁。因突发性头痛5h,于2009年6月18日入院。入院查体：意识清楚。双侧瞳孔等大,直径约3．0mm,对光反射灵敏。颈项强直,Keming征阳性,Lasegue征阳性,双侧巴彬斯基征阴性。Hunt分级为Ⅱ级。头颅CT扫描提示蛛网膜下腔出血,主要位于脚间池及环池。     

重型颅脑损伤后脑脊液中β-内啡肽动态变化及纳洛酮治疗作用

一、资料及方法1.76例重型 (ＧＣＳ 3～ 8分 )颅脑损伤患者 ,按配对试验法分为 2组。对照组 (常规治疗 ) :37例 ,其中男 2 1例 ,女 16例 ,平均年龄 48 2岁。治疗组 (常规治疗 纳洛酮 ) :38例 ,其中男 2 3例 ,女 15例 ,平均年龄 5 3 6岁。入院后第 1、 3、 7、 15、30天用放射免疫法测定ＣＳＦ中 β ＥＰ值。并对大部分病人 (71 5 % )进行颅内压 (ＩＣＰ)监护 ,持续 4～ 9天。再由公式ＣＰＰ =ｍＳＡＰ ＩＣＰ计算出每日脑灌注压 (ＣＰＰ)。治疗组于入院当日开始使用纳洛酮 ,采用纳洛酮 4ｍｇ/日加入 10 %葡萄糖溶液 5 0 0ｍｌ中 ,持续缓慢…