急性脑损害早期血糖变化临床分析

目的探讨急性脑损害后早期血糖变化与病情严重程度及预后的关系。方法对2008-01~2010-12收治的113例急性脑损害病人早期(24 h内)血糖值按GCS、GOS及年龄分别进行分组统计,并与GCS、GOS的关系进行统计学分析。当血糖值≥10.1 mmol/L时采用胰岛素治疗进行干预。结果血糖值高低与病情严重程度(GSC)、预后(GOS)及年龄呈正相关,早期血糖与GCS及GOS具有相关性。结论急性脑损害后早期血糖值可作为判断脑损害严重程度的一项指标,并间接影响预后。血糖值≥10.1 mmol/L可作为药物干预的阈值。     

术前标志物CT联合术中超声定位颅内小病灶

定位是神经外科的基本问题之一,它包括术前定位和术中定位,前者涉及如何设计皮瓣;后者包括如何在最小的创伤下寻找到病灶.对于颅内小病灶,定位问题显得尤为重要.虽然术中超声在神经外科已广泛应用,较好地解决了术中定位问题,但其不能穿透颅骨,对术前定位无效.为解决此问题,对2008年3月至2011年10月河南省人民医院神经外科收治的18例颅内小病灶患者,本研究通过术前标志物CT联合术中超声准确定位病灶并行手术切除,现报道如下.     

经顶上小叶切除侧脑室三角区脑膜瘤

脑室内脑膜瘤发病率较低,侧脑室三角区是其好发部位,约占80％[1],左侧略多于右侧.对于左侧侧脑室三角区脑膜瘤,在切除时,除考虑运动、感觉和视野缺损等问题外,如何避免语言障碍也应注意.     

气管切开后持续湿化气道在重型颅脑损伤患者肺部感染防治中的疗效观察

肺部感染是重型颅脑损伤患者最常见、最严重的并发症之一,也是患者死亡的主要原因之一[1],它严重影响患者预后,早期气管切开是最有效预防肺部感染的方法[2],而体位引流是治疗肺部感染的重要措施。气管切开后早期用微量泵向气管内持续足量泵入雾化液,不仅可以稀释呼吸道内的黏稠痰液,防止痰痂堵管,而且可以刺激呼吸道使痰液容易     

尿激酶引流联合终池引流治疗脑室出血64例分析

我科自2003—06-2005—06，采用尿激酶引流联合终池引流治疗脑室出血64例，效果满意，现报告如下。     

垂体瘤经蝶手术中脑脊液漏的防治

目的探讨经蝶人路垂体瘤切除术中脑脊液漏的防治的方法。方法回顾河南省人民医院神经外科2006—03-2009—12经鼻蝶入路垂体瘤切除手术460例,分析术中手术操作、脑脊液漏及修补以及术后效果,结合文献对术中脑脊液漏的预防措施进行评估。结果术中脑脊液漏184例（40％）,术后脑脊液漏31例（6．7％）。结论预防脑脊液鼻漏应贯彻于自打开鞍底至手术结束的始终,术前认真读片、术中小心操作、出现脑脊液漏后及时修补可以减少术后脑脊液漏的发生。     

Prognostic analysis and complications of traumatic carotid cavernous fistulas after treatment with detachable balloon and／or coil embolization

Objective : To explore the causes of the formation of traumatic carotid-cavernous fistulas and the therapeutic effect of detachable balloon and/or coil embolization and the prevention of its complications. Methods: From October, 1992 to March, 2002, 17 patients with traumatic carotid-cavernons fistulas were treated with detachable balloon and/or coil embolization in our hospital. The clinical data and imaging features of CT, MR and selective angiogram of these patients were analyzed. Results : One week after treatment with embolization, the clinical symptoms of the 17 patients were remitted, and optic cacophony, nystagmns, exophthalmos and dropsy of conjunctiva disappeared. Two patients manifested surgical complications, one patient died. Sixteen patients survived. They were all followed up for more than 2 years, which showed one patient had handicap in movement, and in one patient the signs and symptoms of traumatic carotid-cavernous fistulas reoccurred 2 months after treatment. Conclusions: The detachable balloon and/or coil embolization is safe and reliable. It is a good method to treat traumatic carotid-cavernous fistulas.     

100例颅脑损伤脑电地形图与CT表现对比分析

报告了１００例轻，中度颅脑损伤病人的ＣＴ及脑电地形图表现的对比分析。其中脑震荡４７例，局限性脑挫伤２６例，颅脑损伤后综合征２３例，硬膜下积液４例。