视觉眼电生理在视网膜挫伤中的应用

86例86眼视网膜挫伤患者经过视觉眼电图检查。异常率81例(94％)。异常改变主要表现为光峰电位降低或者光峰电位和暗谷电位一致降低。患者Arden比有变化,部分降低,部分正常,部分增高。光峰电位降低幅度超过100Nu者63例(78％)。光峰电位降低幅度与视力变化受检时间和视网膜挫伤程度均无显著性差异。在诊断方面,EOG的价值与ERG和FFA作了对比。异常EOG和病理所见的视细胞损害相吻合。本文还对外伤性白内障、玻璃体积血和视神经挫伤的EOG检查进行了探索。     

The time course of the vascular response to human brain injury – an immunohistochemical study

In a total of 104 individuals who had sustained traumatic brain injury (TBI), the time-dependent vascular response was investigated at the injured cortical area during the first 30 weeks after the trauma. The immunohistochemical staining of the cerebral blood vessels was performed with antibodies against laminin, type IV collagen, tenascin, thrombomodulin and factor VIII associated antigen. Compared to the immunoreactivity in unaltered control tissue, a significantly increased vascular expression could be detected in cortical contusions after a postinfliction interval of at least 3 h for factor VIII, after 1.6 days for tenascin or after 6.8 days for thrombomodulin, whereas the immunostaining for laminin and type IV collagen was regularly positive even in the vascular endothelium of uninjured brain tissue. Received: 22 April 1999 / Received in revised form: 7 October 1999     

Low-dose prostacyclin in treatment of severe brain trauma evaluated with microdialysis and jugular bulb oxygen measurements

BACKGROUND: The endogenous substance prostacyclin is a substance with the potential to improve microcirculation and oxygenation around contusions in the brain following a head trauma by its vasodilatory, antiaggregatory and antiadhesive effects. Microdialysis measurements of local concentrations of selected interstitial substances in the brain, and measurements of venous jugular bulb oxygenation reflecting overall brain oxygenation, might be useful to evaluate possible therapeutic effects of a specific therapy, such as treatment with prostacyclin. METHODS: This case report study on six patients, of whom five were given prostacyclin, includes cerebral microdialysis measurements of interstitial lactate (n=5), pyruvate (n=3), glycerol (n=5) and glucose (n=4), and is combined with measurements of venous jugular bulb oxygenation in three of the patients. One microdialysis catheter was placed adjacent to a contusion, and in four of the patients another catheter was also placed in the contralateral less injured side for comparison. Low-dose prostacyclin infusion (0.5-1.0 ng kg(-1) min(-1)) was started when lactate concentrations in the more injured side was raised at a constant level for more than 10 h. The study also includes one patient used as control to whom no prostacyclin was given. RESULTS: Lactate was markedly lower in the less injured than in the more injured area of the brain. During the prostacyclin infusion elevated lactate and lactate/pyruvate ratio were reduced. Elevated glycerol decreased, a low glucose increased and jugular bulb blood oxygenation increased following start of prostacyclin. The control patient showed an increase in lactate and lactate/pyruvate ratio. CONCLUSION: The microdialysis data combined with the jugular bulb oxygenation data indicated that low-dose prostacyclin exerts effects compatible with improved oxygenation and reduced cell damage in the severely traumatised brain.     

挫伤性晶状体后脱位的手术治疗

目的 探讨挫伤性晶状体后脱位治疗的2种手术方式及特点，评价其临床疗效。方法 回顾分析眼挫伤所致晶状体后脱位并经手术治疗的27例(27眼)的病例资料，按照摘出品状体的不同术式分为2组，对伤眼术前的临床表现、两种手术方法的特点和并发症进行观察。结果 两种术式治疗的病例全部成功摘出了后脱位的晶状体，无严重手术并发症发生。术后平均随访8．3月，23眼(85．19％)视力有不同程度的提高。结论 挫伤性晶状体后脱位的手术应根据脱位的情况、核的硬度以及眼前后段的状态，综合分析选择合理的手术方式。     

Experimental study of prethrombotic state in early severe myocardial contusion

Myocardialcontusioniscommonbothinwartimeandpeacetime-Clinicalandautopticstud-ieshaveallsupportedthetheorythatthrombosisandthromboembolismisoneoftheseriouscompli-cationsofmyocardialcontusion[l'2].Sofar,therehasbeennoreportonwhethertherearespecifichemorrheologicchangesorbloodcoagulopathyinpatientswithmyocardialcontusion.Therearestillcontroversiesoverthenecessityofanticoagulation,thetime,anditsindicationandsignificanceformy-ocardialcol,tusion[l'3]-Basedontheestablishmentofgradedmyocardialcontusio…     

重度心肌挫伤的发病机制

目的：探讨兔重度心肌挫伤发病机制。方法：新西兰兔３２只,随机平分成两组：重度心肌挫伤组（实验组）和伪撞击组（对照组）,实验后２４ｈ检测血液流变学、血清ＩＬ－８含量、心肌含量和心肌中性粒细胞（ＰＭＮ）浸润,结果：一比较,且全血粘度、红细胞聚集指数、红细胞压积、血浆纤维蛋白原、ａｓｓｏｎ掘服值、红细胞沉降率均非常显著升高;ＩＬ－８含量、受创的心肌含水量和心肌ＰＭＮ浸润数均显著增加。结论血液流变学异常、     

实验性眼球挫伤眼血液动力学改变及其治疗

目的 探讨钝挫伤性眼血液动力学变化并评价药物对改善脉络膜络血供的疗效。方法 以自由落体击伤,损伤能量为３．３Ｊ,造成灰兔单眼轻度钝挫伤模型。伤后分别用生理盐水,复方樟柳碱,妥拉苏林治疗,１次／１日连续１周。用眼血流图检测双眼伤前,伤后即刻,１,３７天ＲＯＧ波幅值,结果 伤后即刻各组伤眼ＲＯＧ波幅值均降低,与伤前比较Ｐ〈０．０１。     

老年脑挫裂伤并脑内血肿的临床分析

目的探讨脑挫裂伤合并脑内血肿的老年患者临床特点及治疗效果。方法回顾性分析2005年5月～2010年12月我科收治的年龄60岁以上的脑挫裂伤并脑内血肿患者,总结其临床特点及其治疗效果。结果 67例老年患者平均住院时间49天,GOS分级评估:良好38例,中残11例,重残5例,植物生存6例,死亡7例。结论老年脑挫裂伤并脑内血肿致残率、病死率高,预后不佳,临床上应早期观察、早期治疗,注意并发症的防治,以提高生存质量及生存率。     

通经散瘀针法治疗武术训练引发的急性扭挫伤疗效观察

目的：武术训练中的急性运动扭挫伤是体育训练和武术训练中极为常见的问题,如果处理不当很容易造成后遗症,影响运动质量和运动成绩。方法：采用随机同期对照试验方法,将90例患者分为针刺组49例和对照组41例,对两组基线资料统计分析（P〉0.05）,两组间差异无统计学意义,具有可比性,分别采用通经散瘀针刺法和常规处理法,进行临床观察。结果：通经散瘀针刺组的有效率91.84%;对照组的有效率78.05%。通过两组有效率差异性比较,两组间存在较显著性差异（P〈0.01）。结论：针刺组疗效较对照组显著,通经散瘀针法明显优于常规处理法。针刺治疗该病,有利于后期康复,能减少并发症、合并症,使武术训练人员及时康复参加训练。     

准静态下颞部撞击致颅脑伤的有限元模拟分析及其临床意义

目的 建立准静态下颞部撞击致颅脑伤的虚拟模型,研究准静态下颞部撞击所致的应力分布以及应力波的传播,探讨颞部撞击致颅脑伤的生物力学机制.方法 在Hypermesh软件中建立准静态颞部撞击伤的有限元模型,用Ls-Dyna软件对该有限元模型进行数值模拟计算,最后用Ls-Prepost软件进行后处理.结果 撞击点处颞骨Von Mises应力以及颅内压力随撞击速度的提高而增大;应力波在颅骨表面的传播以撞击点为圆心的径向上传播,在颅骨-脑组织耦合处急剧衰减;颅底有应力集中区域.该数值模拟的结果与生物试验结果较吻合.结论 本研究对颞部撞击致颅脑损伤的诊断和防护有重要意义.