高血压脑出血术后早期亚低温治疗的临床研究

近年来．有关亚低温的脑保护作用的实验研究和临床应用取得了广泛的支持，但高血压脑出血术后早期低温治疗的临床报道不多。本院神经外科应用亚低温早期治疗高血压脑出血术后患者，取得良好效果。现报道如下。     

垂体前叶激素对急性颅脑创伤病情及预后的监测与评估

急性颅脑创伤期间。由于直接和间接的损伤以及应激反应，垂体前叶（腺垂体）的功能可发生不同程度的改变，影响颅脑创伤患者健康及功能的恢复。笔者对90例急性颅脑创伤患者垂体前叶激素水平作了动态检测，现报告如下。     

亚低温对急性重型颅脑损伤患者血清S-100 B蛋白的影响

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.     

老年人椎管内肿瘤的治疗

椎管内肿瘤是神经外科的一种重要疾病，可发生于任何年龄，但以青壮年者为最多，现将我科１９８６年６月至１９９８年５月间经手术及病理证实的４７例≥６０岁老年人椎管内肿瘤进行分析，对老年人椎管内肿瘤治疗特点进行研究，现报道如下。１临床资料１．１性别与年龄本组...     

亚低温对急性重型颅脑损伤患者血清S-100 B蛋白的影响

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.     

47例后颅窝骑跨型急性硬膜外血肿手术治疗分析

目的总结后颅窝骑跨型急性硬膜外血肿诊治经验。方法回顾性分析47例后颅窝骑跨型急性硬膜外血肿患者的临床资料。结果术后3月按GOS评分,恢复良好33例,中残8例,重残4例,死亡2例。结论后颅窝骑跨型急性硬膜外血肿应积极手术,根据出血范围选择合适的手术方式。     

脑深部异物处理3例

在日常生活和工作中颅脑深部异物的发生虽不及战时多见,但一旦发生死亡率和致残宰相当高,必须予以及时、正确的处理。我院于1990年4月～1993年4月成功处理颅脑深部异物3例,报道如下。     

亚低温对急性重型颅脑损伤患者血清S-100 B蛋白的影响

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.     

亚低温对急性重型颅脑损伤患者血清S-100 B蛋白的影响

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.     

盐酸纳洛酮对大鼠颅脑损伤后神经细胞凋亡及脑水肿的影响

目的 探讨纳洛酮对大鼠颅脑损伤后神经细胞凋亡状态及脑水肿的影响.方法 采用Feeney氏自由落体法制备脑损伤动物模型,将100只SD大鼠随机分为3组:假伤对照组(n=20)、损伤对照组(n=40)及治疗组(n=40).治疗组再分4个业组,每组10只,分别于伤后30 min,6 h,24 h及48h给予纳洛酬,而各对照组在各时间点均给予等量的牛理盐水,伤后第7天断头处死大鼠,采用缺口末端标记法(TUNEL)原位标记DNA片段检测神经细胞凋亡情况,采用干湿法测定脑组织含水量.用SPSS 10.0统汁软件进行方差分析,组间比较采用因因素方差分析,以P＜0.05为并异具有统计学意义.结果 损伤对照组神经细胞凋亡数和脑组织含水量较假伤对照组显著增加(P＜0.05);与损伤埘照组比较,各治疗组神经细胞捌亡数和脑组织含水量均显著减少(P＜0.05);治疗组中各给药亚组间比较,早期给药组(伤后30 min及6 h)神经细胞凋亡数明显少于晚期给药组(伤后24 h及48 h,P＜0.05),但脑组织含水量无明显差异(P＞0.05).结论 纳洛酮可通过减轻神经细胞的凋亡及脑水肿以实现对神经细胞损伤的保护作用,且早期使用效果更佳.