脑卒中患者脑电图与癫痫发作的相关性研究

目的探讨脑卒中患者脑电图EEG和癫痫发作的相关性研究。方法对73例脑卒中后继发癫痫的患者进行EEG监测,癫痫发作时监测皮层EEG,记录异常放电情况。结果经过EEG监测,73例患者EEG的频率均减慢到7-8 Hz,均出现异常放电情况,且多为α波变慢,波率不规则及背景活动不对称,弥散性或局限性及一侧性出现低中等波幅;慢波增多及单侧的痫样放电,多为中度以上异常。最后总结为局限性异常16例,重度异常13例,中度异常36例,轻度异常8例。结论 EEG监测与癫痫的发作具有较高的相关性,所以EEG作为研究脑功能的医学手段,对预测癫痫的发作有着重要价值。     

脑卒中继发癫痫的护理体会

目的研究分析脑卒中继发癫痫患者的临床护理方式。方法 2012年1月~2013年12月我院接收了脑卒中继发癫痫患者40例,将患者分为对照组和观察组,各20例,对照组采取常规护理干预,观察组使用优质护理干预,对比两组患者的运动能力FM评分、治疗前后Barthel评分以及护理满意度。结果观察组和对照组两组患者接受护理之后,观察组的FM评分优于对照组,P0.05,差异具有统计学意义,观察组的护理满意度95%高于对照组82%,P0.05,差异具有统计学意义。结论脑卒中继发癫痫患者接受优质护理干预的临床效果较好,患者的运动能力以及生活能力恢复快,患者接受度高。     

化浊通督针法治疗中风后假性球麻痹的临床疗效及其对患者吞咽功能、构音功能的影响研究

目的观察化浊通督针法治疗中风后假性球麻痹(PBP)的临床疗效,并探讨其对患者吞咽功能及构音功能的影响。方法将80例中风后PBP患者随机分为2组。对照组40例,予内科常规治疗;治疗组40例,在对照组的基础上加用化浊通督针法治疗。观察比较2组临床疗效,并比较2组治疗前后吞咽功能及构音功能的变化,吞咽功能采用洼田氏饮水试验评定,构音功能采用改良Frenchay构音障碍评估量表评定。结果治疗组治疗后总有效率90.0%,对照组总有效率77.5%,2组总有效率比较差异有统计学意义(P0.05),治疗组疗效优于对照组;2组治疗后吞咽功能洼田氏饮水试验分级情况较本组治疗前均有改善,比较差异均有统计学意义(P0.05),且治疗组治疗后吞咽功能洼田氏饮水试验分级情况较对照组治疗后改善更明显(P0.05);2组治疗后构音功能改良Frenchay量表评分较治疗前均有提高,比较差异均有统计学意义(P0.05),且治疗组治疗后构音功能改良Frenchay量表评分较对照组治疗后提高更明显(P0.05)。结论化浊通督针法治疗中风后PBP临床疗效确切,可明显改善患者的临床症状,改善患者的吞咽功能及构音功能,促进神经功能恢复,提高患者生活质量。     

益气活血片对人工寒潮诱发脑卒中大鼠凝血和纤溶系统的影响

【目的】探讨益气活血片对人工寒潮促发脑卒中大鼠凝血和纤溶系统的影响。【方法】选用SD大鼠,随机分为4组,按照双肾双夹法复制易卒中型肾血管性高血压大鼠模型,中药组给予益气活血片（剂量为1.89 g·kg－1·d－1）,阳性对照组给予阿司匹林（剂量为80 mg·kg－1·d－1）,模型组及空白对照组给予等容积蒸馏水,从高血压模型复制术后14 d开始,每天1次,直到112 d后置于人工寒潮箱中3 d诱发卒中,取血检测血浆凝血酶激活的纤溶抑制物（TAFI）、蛋白C （PC）、凝血酶—抗凝血酶复合物（TAT）及纤溶酶（PAP）水平。【结果】与模型组比较,益气活血片组可显著降低血浆TAFI、 PC、 TAT、 PAP水平,差异均有统计学意义（P＜0.05）。【结论】益气活血片对脑卒中的防治作用与其能改善凝血和纤溶系统的平衡状态有关。     

银杏达莫和神经节苷酯GM1联合治疗脑卒中后血管性痴呆疗效观察

目的:观察银杏达莫联合神经节苷酯(GM1)治疗脑卒中后血管性痴呆(VD)的疗效. 方法:选取我院收治的80例脑卒中后血管性痴呆患者,依据用药方案分为银杏达莫联合GM1组40例(记为观察组),银杏达莫组40例(记为对照组).测定给药前后的简易精神状态量表(MMSE)及Barthel指数评分(MBI),对比两组疗效.结果:观察组的MMSE评分、Barthel指数评分及总有效率均显著高于对照组(P<0.05).结论:银杏达莫联合GM1治疗脑卒中后VD能有效提高认知能力及日常生活能力且安全有效,值得推广.     

Repeated Remissions of Cushing's Disease Due to Recurrent Infarctions of an ACTH-Producing Pituitary Macroadenoma

Infarction of prolactin-secreting or growth hormone-secreting pituitary adenomas is not unusual. However, Infarction of ACTH-secreting adenomas has rarely been reported. Cyclical course of Cushing's syndrome alternating with adrenal insufficiency due to recurrent infarction of an ACTH-secreting pituitary adenoma has not been reported. We report here a 20-year-old lady who presented with florid signs of Cushing's syndrome but was found to have adrenal insufficiency on biochemical evaluation. Magnetic resonance imaging (MRI) of the pituitary gland showed that she had infarction of an ACTH-secreting macroadenoma. Over the next 6 years, her disease ran a cyclical course characterized by periods of hypercortisolism alternating with adrenal insufficiency due to repeated episodes of infarctions of the ACTH-secreting pituitary macroadenoma with corresponding changes in the pituitary adenoma on serial MRIs. The case alerts clinicians to this possibility when a patient presents with clinical picture of Cushing's syndrome but has adrenal insufficiency on biochemical testing. It also suggests that silent or subclinical infarction of pituitary adenomas is not uncommon and is probably under diagnosed.     

Pituitary Apoplexy Following Mitral Valvuloplasty

Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome caused by the sudden enlargement of a pituitary adenoma secondary to hemorrhage or infarction. Pituitary apoplexy after cardiac surgery is a very rare perioperative complication. Factors associated with open heart surgery that may lead to pituitary apoplexy include hemodynamic instability during cardiopulmonary bypass and systemic heparinization. We report a case of pituitary apoplexy after mitral valvuloplasty with cardiopulmonary bypass. After early pituitary tumor resection and hormonal replacement therapy, the patient made a full recovery.