微创钻孔引流治疗硬膜外血肿

目的探讨硬膜外血肿的手术治疗。方法回顾性分析15例硬膜外血肿患者进行微创钻孔引流术的临床资料、手术方法和治疗效果。结果15例中有1例在引流中出血,注入凝血酶后血止住。1例出现硬膜下积液,没作任何处理,3周后吸收。15例患者均治愈,最短3d出院,最长12d出院。1例轻瘫患者出院后一月完全恢复。结论与传统手术相比,微创钻孔引流治疗硬膜外血肿是一种行之有效的治疗方法,安全、创伤小,对一些血肿稳定,不需要减压的硬膜外血肿患者行微创钻孔引流术更合适。     

Kyste hydatique intra- et extracrânien de la fosse cérébrale postérieure (à propos d’un cas)

Hydatidosis is an endemic disease in Morocco. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2 % of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease: only four cases have been reported in the literature. We report the case of a 37-year-old admitted for high intracranial pressure. Brain MRI showed an extradural and extracranial posterior fossa cyst without enhancement after contrast medium injection. Multiple hydatid cysts were removed and the histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole postoperatively with good follow-up 6 months later.     

颞下经岩前硬膜外入路相关中颅窝显微解剖

目的 利用颞下经岩前硬膜外入路研究中颅窝解剖结构之间的关系.方法 国人成人尸头湿标本10例20侧.模拟颞下经岩前硬膜外入路操作.磨除岩尖骨质,暴露并保留内听道(IAC)、耳蜗(Coch)、颈内动脉(ICA).观察并总结各解剖结构之间的关系.结果 (1)弓状隆起(AE)依气化程度不同,可分为3类:平坦型、梯田型和砾石型.前2型AE与上半规管(SSC)的关系容易确定;(2)颞下经岩前硬膜外入路所涉及的中颅窝解剖结构均位于以"三叉神经节"和"膝状神经节"为中心的两个扇形结构中."前扇"由三叉神经及三叉神经节组成,"后扇"由岩浅大神经(GSPN)、AE、IAC构成.ICA及Coch位于"后扇"内.两个扇形由GSPN相联系;(3)IAC位于"后扇"内,GSPN与AE的夹角为122.7°±7.6°(108.1°～137.5°),GSPN与IAC前壁的夹角为46.6°±4.9°(35.0°～55.2°).Coch位于GSPN与IAC前壁的夹角内.结论 两个扇形可以将颞下经岩前入路相关的中颅底解剖结构加以概括,简单直观,便于理解与记忆;磨除岩尖时,IAC的保护选择IAC前壁较安全.     

Clinoidectomía anterior extradural en el manejo de meningiomas paraselares: análisis de 13 años de experiencia y revisión de la literatura

Background and aim

The extradural anterior clinoidectomy (EAC) is a key microsurgical technique that facilitates the resection of tumors located in the parasellar region. There is currently no consensus regarding the execution of the procedure via extradural or intradural nor scientific evidence that supports its routine use. The purpose of this article is to expose our experience in performing EAC as part of the management of the parasellar meningiomas.

硬膜外封闭阶梯治疗腰椎间盘突出症

目的：探讨硬膜外封闭在腰椎间盘突出症治疗中的作用。方法：104例腰椎间盘突出症患者经硬膜外封闭等保守治疗后,对其治疗前后的生活质量进行评价,以评估治疗的效果。结果：经平均38个月的随访,经保守治疗无效而改用手术治疗的有13例（12.5%）,其余患者均获得良好的疗效。结论：硬膜外封闭作为保守治疗的一个环节,具有起效快,疗程短等的优点,在腰椎间盘突出症的阶梯治疗中起到重要的作用。     

六十岁以上老年人连续硬膜外阻滞麻醉下的低血压及其处理(附633例临床分析)

本文分析了633例60岁以上老人连续硬膜外阻滞麻醉下的低血压及其处理。旨在说明连硬在老年人麻醉中的安全度,有助于提高县医院及其以下基层医院对老年人手术麻醉过程中循环系统的管理水平。     

Extradural haematoma of the posterior fossa. Twelve years experiences with CT-scan

Summary 18 cases of an extradural haematoma of the posterior fossa (EDHPF) are presented and the clinical and radiological findings are demonstrated. The onset of symptoms was acute in 10 patients and subacute in the other 8 patients. The overall mortality was 22%, but only acute course patients died (40%). All subacute cases survived. The most important factors influencing mortality were the level of consciousness immediately before the operation and the presence of hydrocephalus prior to surgery. Other coexisting intracranial lesions had no influence on mortality but on the quality of survival. Compared with the literature there is a certain decrease in mortality in the subacute course patients since the introduction of computed tomography.     

小儿外伤性单纯硬膜外血肿的诊断与治疗

目的 :探讨小儿外伤性单纯硬膜外血肿的诊断及治疗。方法 :回顾性分析我院1985年1月～2003年1月收治321例小儿外伤性单纯硬膜外血肿的临床资料。结果 :手术治疗176例 (其中9例为非手术治疗的中转手术 ) ,非手术治疗145例。316例临床痊愈 ,死亡5例 ,死亡率为1 56 %。结论 :小儿外伤性单纯硬膜外血肿确诊主要依靠临床基本特征及影像学资料 ,处理时应掌握其手术和非手术治疗的指征     

Adolapin - A newly isolated analgetic and anti-inflammatory polypeptide from bee venom

Adolapin was isolated by a two-step procedure: gel filtration and chromatography on CM cellulose. The molecular mass of the polypeptide as determined by SDS electrophoresis and amino acid composition proved to be 11500 and 11092 respectively. Adolapin exhibited a potent analgetic effect demonstrated by the “writhing” test (ED50-0,016mg/kg) and by the Randall-Sellito's test (ED50-0,013 mg/kg). The anti-inflammatory activity of adolapin was most marked with regard to carrageenin, prostaglandin and adjuvant rat hind paw edemas and adjuvant polyarthritis. The adolapin effects are preseumably due to its capacity to inhibit the prostaglandin synthetase system, following a biphasic dose-response relationship. It is likely that central mechanisms are also involved in the analgetic action of adolapin.     

针药复合麻醉对腹部术后患者使用镇痛泵的影响

目的　为观察电针复合全麻对腹部手术术后患者使用静脉镇痛泵的影响。方法　随机选择择期胆道手术术后使用静脉镇痛泵患者 4 0例 ,分为对照组 (单纯全麻组 )和电针组 (电针复合全麻组 ) ,记录术中麻醉药用量 ,术后 6h、2 4h、4 8h镇痛泵用量以及肛门排气、排便时间。结果　电针组与对照组相比 ,术中芬太尼、异丙酚用量 ,术后 6h镇痛泵用量均较少 ,有显著性差异 (P <0 .0 5 ) ,而术中卡肌宁用量 ,术后 2 4h、4 8h镇痛泵用量以及术后肠蠕动恢复时间无明显差异。结论　电针复合全麻能增加镇痛效果 ,但对术后肠蠕动恢复无显著影响。