Cerebral venous sinus thrombosis: a clinical study of 23 cases

Objective To describe the etiologies, clinical features and diagnosis of cerebral venous sinus thrombosis.
Methods We reviewed the records of 23 patients admitted with a documented diagnosis of c erebral venous sinus thrombosis from 1991 through 1999 in the Beijing Tiantan Hospital.
Results Infection was the major condition associated with cerebral venous sinus thrombos is. Pseudotumor cerebri syndrome was the most common manifestation, while hemip legia, seizure and unconsciousness may occur alone or in association. The diagn ostic sensitivity of computed tomography (CT), magnetic resonance imaging (MRI) and digital subtract angiography (DSA) were 59%, 86% and 100%, respectively. Th e sensitivity of MRI with magnetic resonance angiography (MRA) reached 96%.
Conclusion As the clinical findings were found to be nonspecific, CT combined with DSA, or MRI with MRA turns out to be valuable for the early diagnosis of cerebral venous sinus thrombosis.     

脑脉通胶囊的药效学研究

目的观察中药脑脉通胶囊对实验动物心血管方面的药理效应作用,为其临床适应证提供实验依据。方法按照中药三类新药要求,采用大鼠脑梗死损伤模型、体内血栓形成模型、血液流变学及麻醉犬脑血流动力学等实验项目,灌胃给予脑脉通胶囊,测定其相关实验指标。结果脑脉通胶囊能改善大鼠缺血引起的脑组织损伤,促进其梗死病灶的修复,降低血小板的黏附率和延长体内血栓形成时间,改善其血液流变学指标,并能增加犬脑内血流量和减少其血管阻力等。结论脑脉通胶囊对治疗缺血性中风及相关病症有较好的作用。     

注射用熊胆粉对大鼠脑血栓的影响

目的观察注射用熊胆粉对脑血栓、脑缺血动物模型的影响。方法观察注射用熊胆粉iv给药后对大鼠大脑中动脉血栓模型、不完全性脑缺血、血小板、血栓形成、血瘀大鼠血液流变性的影响。结果注射用熊胆粉可明显抑制大鼠体内外血栓的形成,降低血液黏度,改善血液流变性,抑制血小板聚集,降低血小板黏附性,改善血栓性缺血脑组织病变程度,降低毛细血管通透性,且可降低损伤脑组织中丙二醛(MDA)水平,保护超氧化物歧化酶(SOD)活性。结论注射用熊胆粉对脑缺血有保护和治疗作用。     

三保心对大鼠心肌缺血-再灌注损伤保护作用及其对体内外血栓形成影响的实验研究

目的：探讨三保心中药复方(三保心)对大鼠心肌缺血-再灌注损伤的保护作用及对体外血栓形成的影响。方法：结扎大鼠左冠状动脉前降支40min后再灌注180min。观察三保心对心肌缺血再灌注损伤大鼠超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量和一氧化氮(NO)含量的影响。采用chandler法造成体外血栓和电刺激颈总动脉形成体内血栓，观察三保心对体内外血栓形成的影响。结果：三保心可显著提高心肌缺血-再灌注损伤大鼠血清中SOD活性，降低MDA含量，同时明显升高NO含量。三保心高剂量组明显延长大鼠体内血栓形成时间。各剂量组均能显著抑制大鼠体外血栓的形成。结论：三保心对缺血再灌注心肌损伤有一定的保护作用，其作用机制可能与扩张血管、提高氧自由基清除酶活性、抑制脂质过氧化反应有关。且具有抑制体内外血栓形成的作用。     

红景天注射液对麻醉犬心脏血流动力学及心肌耗氧量的影响

目的:研究红景天注射液治疗冠心病的药理作用及作用机制。方法:将实验犬20只,随机分为空白对照组、阳性药对照组和红景天注射液小、大剂量组。经戊巴比妥钠30mg·kg^-1静脉麻醉后开胸,分别测定冠脉血流量、心输出量、左室内压、左室内压上升最大速率(dp/dt_max)、冠状静脉窦血氧含量、动脉血氧含量、心肌耗氧量、心搏出量、耗氧指数、心脏指数、冠脉阻力、总外周阻力及氧利用率等。结果:动物静脉注射红景天注射液后,冠脉阻力、动脉血压、总外周阻力、耗氧指数、心肌耗氧量、心率明显降低,心输出量、心搏出量及冠状静脉窦血氧含量明显上升,与药前及空白对照组比较均有显著性差异(P<0.05-0.01);左室内压和心肌收缩力则无明显改变。结论:结果表明,用红景天注射液可扩张冠脉血管、降低心脏后负荷,在不明显增加心肌收缩力和左心室压力的情况下,心输出量和每博出量明显增加,心脏有效作功得到加强;还能使冠状静脉窦血氧含量显著增加,心肌耗氧指数降低,心肌耗氧量下降,从而改善心肌的供血供氧,调整心脏血管的顺应性,对心血管系统起到调整和改善作用。这可能是红景天注射液治疗冠心病的药理机理。     

Reciprocating tachycardia during central venous cannulation in a patient with Wolff-Parkinson-White syndrome

Wolff-Parkinson-White syndrome is important for the anesthesiologist because the sudden development of tachyarrhythmias may result in deleterious hemodynamic changes. We describe an episode of reciprocating tachycardia triggered by the insertion of the guide wire during central venous cannulation in a patient with this syndrome.     

Low-dose dopexamine in patients undergoing hemihepatectomy: an evaluation of effects on reduction of hepatic dysfunction and ischaemic liver injury

BACKGROUND: Hepatic dysfunction is a common problem in patients after hemihepatectomy. Treatment with low-dose dopamine has been shown to be beneficial in hemihepatectomy patients. We hypothesized that dopexamine, a synthetic vasoactive catecholamine, due to its specific pharmocodynamic profile may be more effective in reducing hidden ischaemic episodes in the hepato-splanchnic region during and after temporary total cross-clamping of hepatic inflow in these patients. METHODS: The effects of low-dose dopexamine on hepatic venous haemoglobin oxygen saturation (ShvO2), hepatic venous lactate level, monoethylglycinxylid (MEGX) formation, hepatic synthetic function and indicators for hepatic cell damage were studied during hemihepatectomy and for 16 h postoperatively in hemihepatectomy patients and compared to those of low-dose dopamine. In a prospective, double-blind clinical study 20 patients received randomly either dopexamine (DPX) 0.5 microg kg(-1) min(-1) (n=10) or dopamine (DO) 2.5 microg kg(-1) min(-1) (n= 10). Infusions were started after induction of anaesthesia and continued 16 h postoperatively. Hepatic vein, radial and pulmonary artery were catheterized. Measurements were carried out after induction of anaesthesia, after total cross-clamping of hepatic inflow, and at 2 h and 16 h postoperatively. RESULTS: There were no differences in systemic haemodynamics, oxygenation, ShvO2, serum aminotransferases or MEGX levels between the groups. At 16 h postoperatively prothrombin and antithrombin III levels were significantly lower while hepatic venous lactate was significantly higher in the DPX group compared to the DO group. CONCLUSION: In patients undergoing hemihepatectomy, we could not reveal superior hepatoprotective effects of low-dose dopexamine compared to low-dose dopamine.     

不同参数激光诱导脉络膜视网膜静脉吻合

目的　探讨不同激光参数、不同击射部位对脉络膜 视网膜静脉吻合形成的影响。方法　在视网膜分支静脉阻塞模型上 ,以不同参数在不同部位诱导吻合支的形成 ,以荧光素眼底血管造影、连续组织切片观察吻合支的建立及其周围组织反应情况。结果　功率 90 0、12 0 0、15 0 0、180 0mW诱导吻合支的成功率为 0、2 0 .83%、4 5 .83%、6 2 .5 0 % (P=0 .0 0 1) ;直径 5 0、10 0 μm诱导吻合支的成功率分别为 4 3.75 %、2 0 .83% (P =0 .0 16 ) ;击射部位距视盘边缘 2DD与 3DD对吻合支形成的影响无统计学意义 (P =0 .732 ) ,2DD与4DD间 (P =0 .0 2 8) ,3DD与 4DD间 (P =0 .0 2 3)差异均有显著性 ;12 0 0、15 0 0mW诱导的吻合支周围组织损伤较轻 ,180 0mW诱导的吻合支周围组织损伤较重。结论　功率、光斑直径是影响脉络膜 视网膜静脉吻合形成的 2个主要因素 ,其中功率起决定性作用 ;5 32nm激光诱导吻合支形成的最适功率和直径为 12 0 0～ 15 0 0mW、5 0 μm ;击射部位以距视盘 3DD处最佳     

下肢深静脉血栓形成患者血浆抗凝蛋白水平检测的临床意义

目的：探讨下肢深静脉血栓形成（LDVT）患者的发病机制，研究抗凝血酶（AT）、蛋白S（PS）、蛋白C（PC）、活化蛋白C抵抗性（APCR）在LDVT患者中的变化。方法：用ACL Puturn 型全自动血凝仪检测LDVT患者100例（初发、复发患者各73、27例）和健康者100例的AT、PS、PC活性及APCR。结果：LDVT组与正常对照组相比，LDVT复发组与初发组相比，AT、PS、PC活性明显降低，APCR阳性率明显升高,差异有统计学意义（P＜0.01～0.001）；100例LDVT患者中，25例有抗凝蛋白缺陷，以PS缺陷的总发生率最高,占13%(13例),其次是PC缺陷,占8%(8例)，AT缺陷占5%(5例)，APCR缺陷的总发生率最小，占4%（4例）。结论：先天性或获得性抗凝蛋白缺陷是LDVT发病和复发的重要机制之一。     

急性肠系膜静脉血栓形成的介入治疗

目的探讨介入治疗急性肠系膜静脉血栓形成(AMVT)的方法及疗效。方法对15例经影像学确诊的AMVT患者进行了介入治疗,其中经肠系膜上动脉途径溶栓治疗8例,经皮经肝穿刺门静脉途径机械性取栓5例,经颈静脉经肝穿刺门静脉途径机械性取栓2例。结果15例患者均获成功,介入治疗后腹痛消失,血管造影可见肠系膜上静脉内血流通畅。本组均获随访,随访时间为10～22个月,均未复发。结论对于早期AMVT病例,介入治疗是一种较好的方法。