Rasmussen脑炎的诊断与手术治疗

目的探讨Rasmussen脑炎的诊断和手术治疗。方法回顾性分析广东三九脑科医院2014年4月至2017年6月,经手术治疗及病理检查证实的5例Rasmussen脑炎患者的临床资料;并复习相关文献。结果本组患者的临床表现为单侧大脑半球皮层炎症、药物难治性癫痫及进展性神经功能和认知功能损害。最具特征性的表现为进展性局部脑皮层萎缩和部分性癫痫发作持续状态(EPC)。癫痫发作的类型多样,但EPC发作一般不继发全面性强直阵挛发作。脑电图表现无特异性,为患侧广泛性慢波、棘-慢波,甚至波及对侧。MRI典型表现为T_2FLAIR局灶性皮层及皮层下、尾状核头部高信号,并且病灶可以随着病程延长不同程度的扩大。PET检查表现为较局灶性病灶明显扩大的低代谢范围。本组患者均经侧裂入路行解剖式大脑半球切除术,包括岛叶皮层切除。术后随访8个月至3年,患者的癫痫发作均得到完全控制,神经功能损害均较术前有不同程度恢复。结论根据好发年龄及典型临床表现,结合影像学检查,Rasmussen脑炎的诊断不难。积极采取合理的治疗方法,特别是外科大脑半球切除术,患者能获得良好的疗效。     

外伤性脾破裂合并颅脑损伤的观察与护理

回顾性总结22例外伤性脾破裂合并颅脑损伤患者的护理方法。采取及时、有效、合理的抗休克和手术治疗,严密观察病情变化,并实施整体护理,可使患者尽早康复,并且提高了护理质量。     

老年非胰岛素依赖型糖尿病67例分析

我院2年来收治糖尿病人（DM）108例，≥60岁67例，占62．96％。兹对其临床特点作一分析。1临床资料1．1一般资料全部病例均符合1980年WHO诊断标准为非胰岛素依赖型糖尿病（NIDDM）。67例中男22例，女45例。年龄60～81岁，平均63．4岁。病程10～20年。肥胖型28例，非肥胖型39例。有DM家族史8例。按DM病情分型属：轻型12例，中型37例，重型18例。1·2临床表现①首诊表现：以多饮、多食、多尿、消瘦典型症状就诊23例，因各种感染就诊19例，其中急性肺炎4例，活动性肺结核3例，泌尿系感染8例，腹膜炎2例，皮肤脓毒感染2例。因器官功能不全…     

肾膀胱双原发癌伴子宫肌瘤红色变性1例报告

患者,女,年龄43岁。因下腹部肿物半年伴尿频、阴道不规则出血,拟诊为子宫肌瘤,于1997年4月12日收住院。体检:下腹部微膨隆,子宫如孕16周大小,质硬尚活动。右肾区叩击痛。B超及CT均显示子宫及右肾有实质占位性病变。IVU示右肾上中极肾盏受压变形,杯口消失;膀胱受压变形,膀胱内可见条索状密度增高影,提示为右肾及膀胱肿瘤。膀胱镜检查见膀胱顶部受压,左后壁粘膜生长一水草样肿物,基底细小,长1.5cm。在粘膜下注射无水乙醇后钳夹基底全部取出。同月18日在全麻下行右肾癌根治子宫全切术。术后恢复良好,定期膀胱灌注化疗,随访12个月未见肿瘤复…     

失血性休克后肠淋巴液引流恢复小鼠肾组织ACE/ACE2平衡的作用

目的:观察失血性休克后肠淋巴液(PHSML)引流对失血性休克小鼠肾组织血管紧张素转换酶(ACE)/ACE2平衡的作用。方法:复制小鼠失血性休克模型,随机分为休克组与休克+引流组,行液体复苏;休克+引流组液体复苏后,引流肠淋巴液。在液体复苏后6 h,检测肾组织ACE、ACE2、血管紧张素II(Ang II)1型受体(AT1R)、Mas相关G蛋白偶联受体(MasR)的mRNA表达以及Ang II、Ang(1-7)含量。结果:失血性休克提高了肾组织ACE mRNA、AT1R mRNA和Ang II水平,降低了ACE2 mRNA、MasR mRNA和Ang(1-7)水平,PHSML引流抑制了失血性休克对ACE2和AT1R mRNA表达的影响;同时PHSML引流也降低了失血性休克增加ACE/ACE2、Ang II/Ang(1-7)和AT1R/MasR比值的作用。结论:PHSML引流恢复了失血性休克后肾组织的ACE/ACE2平衡,有利于减轻失血性休克所致的肾损伤。     

突发公共卫生事件预警系统的建立及作用

建立科学合理的卫生信息网和疫情信息快速反应机制是预防和控制突发公共卫生事件的重要措施。突发公共卫生事件预警系统从疫情首发地及时获取疫情信息，自动启动疫情上报功能，在第一时间传递到疾病控制中心和卫生局，从而建立了一个涵括全市人口、以个人健康档案与家庭档案为中心，具有传染病诊断报告、密切接触／高危／易感人群筛选、传染病预警等功能的疫情信息快速反应机制。     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

周围神经减压术治疗糖尿病性周围神经病的临床疗效观察

目的:探讨周围神经减压术治疗糖尿病性周围神经病的临床疗效.方法:应用腓总神经、腓深神经及胫后神经三处周围神经减压术治疗17例糖尿病性周围神经病患者,并回顾性分析其临床疗效.结果:患者术后疼痛缓解率为100%,麻木的缓解率为94.1%,神经传导速度明显改善.结论:周围神经减压术是治疗糖尿病性周围神经病的有效方法.