脑血管意外患者的家庭护理指导

目的 提高脑血管意外患者恢复期的家庭护理质量,促进患者早日康复,减少并发症、降低死亡率.方法 我们对本科治疗后出院的28例脑血管病患者实施家庭护理指导,并于同期内未行护理指导的27例对照.结果 遵循指导的28例家庭患者不仅症状减轻,并发症发生率也极低.未坚持遵循的27例患者临床症状不见好转或加重,并发症发生率也较高(P＜0.01).结论 家庭护理指导对脑血管意外患者家庭康复具有重大意义,能减轻患者的临床症状,减少并发症.     

枕叶扁平海绵状血管瘤手术切除

1临床资料 患者男,14岁,以发作性抽搐3年入院.3年前无明显原因出现右侧肢体抽搐,继之发展为全身抽搐伴意识丧失,小便失禁,持续1～2分钟后清醒.     

脑血管病偏瘫病人的肢体功能训练

存活的脑血管病人75％以上丧失劳动能力．给病人、家庭、社会带来精神、经济上的沉重负担．加强偏瘫病人的肢体训练是减少脑血管病致残的关键。因此，我院自2004年开始对脑血管病人实施康复训练，在偏瘫病人肢体功能恢复方面取得了良好的效果。现将护理经验总结如下。     

Feasibility of establishing cerebral ischemia models by using aerocyst-blocking bilateral ascending pharyngeal artery of piglets Imaging assessment

BACKGROUND: The cerebral ischemia and ischemia/reperfusion animal models are used to simulate the human cerebrovascular diseases is one of the popular topics of neurological science recently. To study the pathophysiology, pathogenesis, prophylaxis and treatment of ischemic cerebrovascular diseases and to establish the ideal animal model that is the most similar to the human cerebral ischemia, are the topics that the people generally cared about. OBJECTIVE: To evaluate the effects of aerocyst-blocking bilateral ascending pharyngeal artery on the establishment of cerebral ischemia models by using digital subtraction angiography (DSA), magnetic resonance diffusion-weighted imaging (DWI) and magnetic resonance perfusion-weighted imaging (PWI). DESIGN: Repetitive measure animal experiment. SETTING: Zhongshan Hospital Affiliated to Dalian University. MATERIALS: The experiment was carried out in the Animal Laboratory (Provincial Laboratory), Zhongshan Hospital of Dalian Univeristy from January to May 2006. A total of 14 domestic piglets, of 6 months old, weighing 12–15 kg, of either gender, were selected from Animal Experimental Center, Dalian University. Multistar T.O.P digital subtraction angiography machine was provided by Siemens Company, German. METHODS: Aerocyst-blocking bilateral ascending pharyngeal artery was used to establish cerebral ischemia models. And then, Multistar T.O.P. DSA was used for imaging of cerebral vessels before blocking, during blocking and at 0.5 and 2 hours after ischemia perfusion. GE Signa 1.5 T supraconduction magnetic resonance imaging was used for DWI examination; in addition, PWI was used based on focal sites and areas. Otherwise, magnetic resonance imaging (MRI) was used to detect signal changes of T1WI and T2WI in ischemic areas. MAIN OUTCOME MEASURES: Analytic results of DSA, DWI, PWI and MRI. RESULTS: All 14 experimental piglets were involved in the final analysis. ① DSA: The blood flow of bilateral ascending pharyngeal arteries and its branch were blocked at blocking phase, which restored 0.5 and 2 hours after reperfusion. ② DWI and PWI: There were no observable abnormalities in PWI and DWI at pre-blocking. Abnormal increased signals were found on both DWI and PWI at during and post-blocking. There were reduction in ADC and rCBF and delay in rTTP at all time points except pre-blocking. ③ MRI: There were no abnormal signals observable at any time of pre- and post-blocking in T1WI and T2WI. CONCLUSION: It is feasible to establish this kind of animal experimental models, and it can simulate the ischemic state; meanwhile, the existence and extent can be showed directly by DSA, DWI, and PWI.     

老年血管性痴呆的治疗与预防

近年来，老年痴呆发病率呈明显上升趋势，我国北方地区60岁以上老人痴呆患病率已达3．96％，其中由于脑梗塞等脑血管疾病导致的血管性痴呆占多数，是最常见的老年痴呆。血管性痴呆的实质是脑动脉硬化，是由于血管管腔狭窄、血管弹性减低，造成脑组织供血不足，脑细胞因缺血缺氧发生坏死造成的。     

健康教育在神经内科护理质量及防范老年患者意外伤害中的应用

随着社会的进步,经济的发展,医学知识的普及,公民对健康需求的期望值越来越高,自我保护意识和维权意识也日益增强.神经内科的患者病情危重、意识障碍、易发生病情危变及多种并发症,是存在医疗风险、发生医疗纠纷的高危科室[1].意外伤害是一种突发事件,这是由于各种原因造成的客观损伤.2005～2008年笔者所在科发生10例住院老年患者意外伤害,现将原因分析如下.     

复方丹参注射液治疗脑中风的Meta-分析

目的：在严格的质量评价的基础上，对复方丹参注射液的临床疗效与安全性进行系统评价。方法：全面收集复方丹参注射液治疗脑中风的临床试验，在严格质量评价的基础上，利用RevMan4.1进行Meta-分析；对不同纳入标准的结果进行了敏感度分析，对中风病分脑出血和脑梗死两个亚组进行分析；用漏斗图分析发表性偏倚。结果：复方丹参注射液治疗(总有效例数)的效应值(复方丹参组与其他治疗组疗效的比)OR=0.60，95％可信区间[0.50，0.72]；未发现不良反应；漏斗图提示存在发表性偏倚。结论：现有的证据不足以显示复方丹参注射液对脑中风有较明确的治疗疗效，应进行严格的、多中心的随机双盲对照试验，以提供更具说服力的证据。     

脑血管意外患者预防褥疮的护理

脑血管意外患者因存在不同程度的意识障碍、肢体活动失调甚至瘫痪,大小便失禁而造成污染等原因,使得褥疮成为脑血管意外患者重要并发症之一。因此,对脑血管意外患者预防褥疮的发生是一项重要的护理任务。1　脑血管意外病人预防褥疮的护理1.1　头部护理:为防止加重出血,脑血管意     

清开灵注射液治疗脑血管性痴呆32例

目的观察清开灵注射液治疗脑血管性痴呆的疗效.方法将中医学辨证属于实证的64例脑血管性痴呆患者随机分为治疗组(清开灵注射液组)和对照组(脑复康组),治疗5周后,将两组治疗前后在智力障碍程度、肢体功能、血液流变学指标、中医证型疗效方面的变化进行比较.结果经治疗后治疗组和对照组相比较,智力障碍程度变化(有效率、MMSE、ADL积分)、肌力、步行能力改变有显著性差异,p＜0.05.而治疗前后组内及组间血流变指标虽有一定下降,但无统计学意义(p＞0.05).结论清开灵注射液对脑血管性痴呆患者,在改善智力障碍、肌力、步行能力方面有较好的疗效.     

脑血管意外患者急性期动态脉压和脉压指数的对比研究

无创性动态血压监测是近年来发展起来的一项新技术 ,由于监测血压的次数较多 ,故能较可靠地反映血压的水平和血压波动等情况 ,能补充诊室血压的不足 ,动态血压参数的变化与靶器官损害的相关程度也较为密切[1] 。本研究利用无创性动态血压监测 (ABPM )方法 ,观察脑血管意外患者急性期脉压 (PP)和脉压指数 (PPI)的变化 ,为脑血管意外急性期的血压管理提供新的治疗线索。1　资料和方法1.1　研究对象　所有脑血管意外患者的诊断均按照全国第四届脑血管病学术会议的诊断要点[2 ] ,并全部经颅脑CT或MRI证实 ,共 76例 ,其中①脑梗死组 4 0例 …