后颅窝实质性血管母细胞瘤的诊断和治疗

目的探讨后颅窝实质性血管母细胞瘤（ＰＦＳＨｓ）的诊断和治疗。方法回顾性分析经外科手术和病理证实的２２例资料。结果仅１３／２２获术前确诊。肿瘤全切２０例,手术死亡２例。２０例随访２个月至８年（平均２年）,Ｋａｎｏｆｓｋｙ评分：８０分１５例,６０～７０分１例,死亡４例。结论ＭＲＩ和ＤＳＡ是术前诊断ＰＦＳＨｓ的主要方法,ＰＦＳＨｓ仍是神经外科较难处理的肿瘤,术中应用特殊的显微外科技术和提高操作技巧可提高手术疗效。     

外伤性白内障术前B超检查的临床意义

目的 探讨外伤性白内障术前采用Ｂ超检查后囊破损情况的临床意义。方法 外伤性白内障３０只眼,术前采用Ｂ超检查评估后囊情况,显微镜下白内障摘除术中直接观察后囊情况并记录。结果 １４只眼术前Ｂ超检查后囊完整,手术证实１２只眼后囊完整,２只眼后囊小破坏。１６只眼术前Ｂ超检查后囊破损,手术证实１４只眼后囊存在大小不等的破损,２只眼后囊完整。结论 外伤性白内障术前Ｂ超检查为非侵入性、无痛性检查方法,操作简便,     

B超在近视眼巩膜后葡萄肿诊断中的应用价值

目的 :探讨B超在近视眼巩膜后葡萄肿中的应用价值。方法 :用B型超声仪检查 >3.0 0D的 38例76眼进展性近视眼的巩膜后葡萄肿的发生情况。结果 :76眼中 5 8眼发生后葡萄肿。其中各级后葡萄肿的平均屈光度及眼轴差异均有非常显著性意义 (P <0 .0 1和P <0 .0 0 1)。 1～ 4级后葡萄肿与 0级葡萄肿的弧形斑发生率比较差异有非常显著性意义 (P <0 .0 1)。结论 :B超是诊断巩膜后葡萄肿最安全、快速、可靠的方法 ,对近视眼的预后判断有着重要作用。近视眼的屈光度和眼轴随巩膜后葡萄肿的加重而增加 ,眼底弧形斑的形成与后葡萄肿的形成有密切关系     

Transpedicular reduction and stabilization for postlaminectomy lumbar instability

Summary This study retrospectively reviewed the outcomes of 17 patients with postlaminectomy lumbar instability treated by transpedicular reduction and stabilization. The criteria of instability were defined strictly by both the clinical symptom of instability catch and the radiological findings that fulfilled Nachemson's criteria. Low back pain and/or sciatica that interfered largely with the patients' work or quality of life were the indications for this treatrment. All the operations were performed by one surgeon with the same spinal instrumentation system — AO internal fixator. The follow-up period was between 16 and 36 months (mean 24 months).Face to face questionnaire revealed that this treatment modality is encouraging. Fourteen patients (82%) had complete or nearly complete relief from all the pre-operative symptoms. Two (12%) had partial relief of the symptoms that required a subsequent discectomy or wider laminectomy. Only one case (6%) with osteoporosis remained unchanged after the operation. On the follow-up radiographs, sixteen patients (94%) showed good alignment and solid arthrodesis of the treated motion segment. These radiological findings correlated quite well with the absence of the clinical symptom of instability catch.A common, but acceptable, complication found in this series was a variable degree of low back stiffness secondary to the instrumentation. Fracture of the screw was found in one patient and pull out of the screw was found in another patient. However, they did not elicit detectable symptoms.Osteoporosis, concomitant disc herniation and persistent spinal stenosis at/or adjacent to the operated level were the three main factors that may contribute to unsatisfactory results secondary to this treatment. These problems remain to be resolved in thp future.     

Clivus ependymoma

Summary An 8-month-old girl had an ependymoma in the clivus, 2x6 cm in size, connected with the fourth ventricle by a cord of tissue 0.5 cm thick. There were no indications to make us suspect the origin of the tumour in the fourth ventricle, or that it was a case of ependymoma.     

Metallurgical evaluation of the compatibility of surgical clips with their appliers

Summary Five aneurysm clips and their respective appliers (Heifetz, Vari-Angle, McFadden, Scoville, and Yaargil) were tested for the production of small metal shards that could provoke a foreign body reaction or increase the risk of a stresscorrosion failure. Pivot and Vari-Angle-McFadden clips produced numerous large shards, the Scoville clip produced a few fine shards, and the Yaargil and Heifetz clips produced none. Metal shard production due to cold metal transfer is attributed to the abrasive mechanical interaction between clips and appliers made from metals with different degrees of hardness.     

A new model for non-invasive,reproducible fixation of a stereotaxic frame using an orthodontic resin plate

Summary The authors describe a new method for reproducible, non-invasive fixation of a stereotaxic localizing frame. A localizing system similar to that of Brown-Roberts-Wells for MR can be fixed at the base of the facial skeleton to the upper dental arch by an orthodontic resin plate. Results of trials with CT scan, advantages and disadvantages are discussed.The new fixture could be employed in open surgery and in fractionated radiotherapy.     

颈内动脉—后交通动脉瘤的外科治疗：附13例报告

我院自1982年～1988年共收治13例颈内动脉-后交通动脉瘤。本文就该处动脉瘤的临床诊断、手术入路以及动脉瘤破裂的预防和处理进行了讨论。     

生长抑素治疗食管静脉曲张破裂出血30例疗效分析

目的：观察生长抑素治疗食管静脉曲张破裂出血的疗效。方法：治疗组30例用生长抑素静滴维持，对照组30例用垂体后叶素及硝酸甘油静滴维持。结果：治疗组48h内止血27例，止血率为90％，对照组48h止血16例，止血率为53．3％。两组相比止血率有非常显著性差异（P＜0．01）。结论：生长抑素治疗食管静脉曲张破裂出血，具有止血速度快，止血率高及无明显副作用等优点，疗效优于垂体后叶素。     

后颅窝骨性扩大术治疗Chiari畸形合并脊髓空洞症

目的　介绍后颅窝骨性扩大术治疗Chiari畸形合并脊髓空洞症。方法　该手术分为两种亚术式 ,一种是枕颈固定扩大术 :取自体髂骨 5cm× 10cm ,打磨成“凹”字形。上端为齐头端 ,固定在后颅窝减压窗缘。缺口端为下端 ,固定在枢椎棘突上 ,将扩大的硬脑 (脊 )膜修补筋膜片固定在植骨片内面 ,使筋膜片贴附在植骨片内面 ,形成帐篷状 ;另一种是单纯骨性扩大术 :取自体髂骨 6cm× 8cm的梯形骨片 ,并利用较厚的髂骨缘打磨成弧形。植骨片固定在后颅窝减压窗上 ,弧形端构成枕骨大孔后缘。将扩大的硬脑 (脊 )膜修补筋膜片也固定在植骨片内面 ,使筋膜片贴附在植骨片内面 ,也形成帐篷状。结果　本组病例随访 2～ 7年 ,术后症状体征缓解总有效率为91.6% ,肌力比以前提高 2～ 3级。结论　该术式比其他治疗Chiari畸形合并脊髓空洞症的术式 ,治疗效果显著 ,疗效切实可靠