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1.
《赤峰学院学报(自然科学版)》2017,(6)
目的:探讨自发性脑出血患者术后再次出血的可能原因及预防再出血的措施;方法:3例自发性脑出血患者行开颅血肿清除术,其中2例行小骨窗神经内镜血肿清除,1例常规大骨瓣开颅血肿清除并去骨瓣外减压;3例患者术前均行血管调查,CTA或者DSA均未见明显血管异常,其中一例术后6月临近部位再出血患者,术前再次行血管调查,DSA未见异常,再次行小骨窗内镜血肿清除手术.结果:1例接受再手术患者恢复良好,其他2例未再手术,放弃治疗后死亡.结论:脑血管调查结果阴性的脑出血患者,手术后仍有再出血的可能,再次出血后者预后差,无论患者有无高血压,术后均需控制血压水平. 相似文献
2.
我们自2003.2-2005．12月采用小骨窗微创手术治疗高血压脑出血42例,取得了良好的效果,现报道如下。 相似文献
3.
采用微创置管清除术治疗高血压脑出血49例，有效率86％，且死亡率仅14％，明显好于内科保守治疗和外科开颅手术．本方法简单易学，不需要在手术室，仅在床边就可做．它的优点还有：损伤轻微，并发症少，不加重神经功能损伤，疗效明显，花费少，易为患者和家属接受． 相似文献
4.
《赤峰学院学报(自然科学版)》2008,(Z1)
目的:探讨CT定位下运用无框架硬通道置入技术微创穿刺治疗高血压脑出血的临床疗效。方法:将符合纳入标准和排除标准的20例高血压脑出血患者依CT片简易三维立体定位后用无框架硬通道置入技术一次性穿刺血肿靶点进行抽吸及应用生化,酶技术将血肿液化对血肿进行引流达到治疗的目的。同期符合入选标准但家属要求保守治疗20例高血压脑出血患者给予内科常规保守治疗。结果:微创穿刺治疗组较内科保守治疗组在血肿体积、GCS评分以及日常生活活动能力评价有着明显差异(P(0.01),其疗效明显优于内科保守治疗。结论:微创穿刺术是治疗高血压性脑出血的有效方法,明显降低了患者的致残率,改善了患者的预后,且损伤小,便于操作。 相似文献
5.
对于高血压性脑出血的患者,适时进行钻颅血肿抽吸术,是一种疗效好,创伤小的治疗手段。采用此方法救治脑出血,快捷、方便,手术要件要求低,能迅速减轻血肿压迫,降低死亡率和恢复期致残率,因此是治疗高血压性脑出血的行之有效的好方法。我科自1989年以来,应用钻颅血肿抽吸术治疗高血压性脑出血,均因护理措施得当,而取得较好疗效。 相似文献
6.
60例膝外翻矫形术的临床分析 总被引：1，自引：0，他引：1
目的 :探讨膝外翻的病因、发病机制及最佳治疗方法。方法 :本组 6 0例 ,K型腿 35例 ,X型腿 2 5例 ,共计 85个膝 ;致病原因 :佝偻病后遗症 2 9例、外伤性骨折 16例、骨骺炎 7例、原因不明 8例。 85个膝均手术截骨 ,楔型截骨 38例 (5 3个膝 )、嵌插截骨 11例、杵臼型截骨 11例。大腿下段前内侧切口 4 0例 (5 4个膝 )、前外侧 2 0例 (31个膝 )。结果 :术后疗效评定优 (36例 ) 5 8个膝、良 (14例 ) 16个膝、可 (6例 ) 7个膝、差 (4例 ) 4个膝 ,其中二次矫形 1例 ,股中间肌及髌上囊粘连松解 1例 ,截骨部位不愈合二次植骨 1例。结论 :儿童为特发性或发育性及佝偻病性膝外翻呈X型腿 ;成人为骨骺外伤、感染及骨折后遗症膝外翻呈K型腿 ;发病年龄13～ 16岁最多即青春发育期 ,女性多于男性 ;只要膝外翻角度大于 2 0°、膝关节活动范围大于90°,无手术禁忌症均可手术 ,手术最佳年龄在 2 0～ 2 5岁 ,2 7岁以慎重手术 ;截骨平面在股骨髁内收肌结节上 1～ 1.5cm为宜 ,以前内侧切口为佳。手术方法为楔形、V形、杵臼形及嵌插截骨术依患者具体情况及术者熟炼程度而定。 相似文献
7.
杨明炜 《荆门职业技术学院学报》2003,18(3):83-85
目的：通过动态血压监测(ABPM)，对武都力治疗老年轻中度高血压的疗效进行评价．方法：48例老年高血压患者每天服用武都力一片，在治疗前后分别进行动态血压监测，观察24h的收缩压(SBP)、舒张压(DBP)及降压谷／峰比值(T／P)，并观察治疗前后对代谢的影响。结果：治疗前后24h及白昼、夜间SBP，DBP均有显著下降(P＜0．01)，T／P比值为71％．两组代谢均无明显变化．结论：武都力一次给药治疗老年性高血压，降压平稳且不影响代谢。 相似文献
8.
高血压性脑出血是中老年人主要致死致残疾病之一,随着老龄化人数的增多,发病率呈上升趋势。脑出血的外科治疗,以往主要是通过全麻下行开颅清除血肿术,这种手术对于基底节区主要神经结构创伤大大,且手术时间长,失血多,其病死率和病残率较高,同样内科保守治疗也得不到满意疗效。近年来,立体定向血肿清除术的临床应用,使本病的治愈率明显提高。致残率和死亡率明显降低。我院自1997a开展 相似文献
9.
目的:观察血塞通加尼莫地平治疗血栓性脑梗塞的疗效。方法:52例血栓性脑梗塞患者随机分为血塞通组和丹参组血塞通组28例,在病因治疗和常规治疗基础上,加用血塞通注射液500mg静滴,每日一次(加5％G．S或0．9N．S)及口服尼莫地平20mg每日三次。丹参组24例,病因治疗及常规治疗其础上加丹参20ml静滴每日一次(加5％G．S或0．9％N．S)。观察入选病例4周后临床症状变化及头颅CT改变。结果:血塞通组总有效率79％,丹参纽总有效率49．7％。结论:血塞通加尼莫地平可明显改善血栓性脑梗塞的症状。 相似文献
10.
肖乃梅 《河北北方学院学报(医学版)》1997,(6)
我科近2年来对20例脑出血病人CT定位血肿,采用锥颅穿刺血肿腔内注入尿激酶引流治疗脑出血,取得较好疗效,大部病人得以病愈。1 临床资料1.1 一般资料 本组20例病人,男16例,女4例,年龄最小25岁,最大72岁,其中高血压性15例,外伤性5例,病人分别有昏迷,头痛、呕吐、痫痛、肌力障碍等临床症状,脑CT扫描所见,基底节脑出血11例,皮质下脑出血2例,脑室内出血2例,外伤性创伤为硬膜外血肿2例,硬膜下血肿1例,额叶脑内血肿2例,经治疗后,痊愈14人,好转4人,死亡2人。 相似文献
11.
标准大骨瓣开颅减压治疗重型颅脑损伤80例临床分析 总被引：1，自引：0，他引：1
目的:探讨标准大骨瓣减压手术治疗重型颅脑损伤的疗效。方法:回顾性分析80例行标准大骨瓣开颅减压治疗的重型颅脑损伤患者的临床资料。结果:术后6~18个月,采用格拉斯哥预后标准(GCS)评估:良好36例(45%),中残10例(12.5%),重残6例(7.5%),植物生存2例(2.5%),死亡26例(31.25%)。结论:标准大骨瓣术式清除血肿彻底,减压充分,可改善重型颅脑损伤患者的预后。 相似文献
12.
Yun-zhen Hu Jian-wen Wang Ben-yan Luo 《Journal of Zhejiang University. Science. B》2013,14(6):496-504
Ethnicity and socioeconomic factors can influence disease susceptibility, clinical presentation, and outcome. We investigated the clinical characteristics (age, sex, seasonal variation, lesion site, symptoms, complications, prognosis, and sequelae) and risk factors for intracerebral hemorrhage (ICH) in 266 cases treated at our hospital in Hangzhou City, China, from January 2011 to December 2011. Risk of ICH increased dramatically with age; only 4.3% of cases were <30 years old, while 44.4% were >60 years of age. Men outnumbered women by 2:1 (67.3% vs. 32.7%). Single hemorrhage was most often located in the cerebral lobes (37.2% of cases), basal ganglia (34.2%), thalamus (8.3%), cerebellum (6.8%), ventricle (1.5%), and brainstem (1.1%), while 10.9% of cases exhibited hemorrhages at multiple sites. Hypertension was also a major risk factor for ICH, as 47% of all patients were hypertensive and the percentage increased with age. In hypertensive patients, the most common hemorrhage site was the basal ganglia and ICH was often associated with thrombopenia. In patients with leukemia (all forms), most hemorrhages were lobar. Warfarin- and encephalic operation-associated ICHs were all lobar. Headache was the major symptom of occipital, temporal, and frontal lobe hemorrhage. Dizziness, nausea, and vomiting were the major symptoms of cerebellum hemorrhage. Limb dysfunction was the major symptom of thalamic and basal ganglia hemorrhage. Disturbed level of consciousness was the major symptom in multisite, ventricular, parietal lobe, and brainstem hemorrhage. Hyperspasmia occurred most often in lobar hemorrhage and blurred vision in occipital lobe hemorrhage. Hospital mortality was 24.4% (n=65) with a mean delay from presentation to death of (10.5±18.5) d. The majority of fatalities were cerebral hernia cases (58.5%) and these patients also had the shortest time to death [(2.9±3.5) d]. Mortality was 100% in brainstem ICH and hemorrhagic conversion of cerebral infarct. Thrombopenia-associated ICH also had a high mortality rate (81.0%), while patients with cerebrovascular malformations and cerebral aneurysms demonstrated a much better prognosis (46.2% recovery). 相似文献
13.
腹部闭合性肾损伤66例诊治体会 总被引：1，自引：0，他引：1
目的：探讨闭合性肾损伤的诊断和治疗方法。方法：对66例闭合性肾损伤的临床资料进行回顾性分析。结果：66例肾损伤中,Ⅰ级11例,Ⅱ级25例,Ⅲ级17例,Ⅳ级12例,Ⅴ级1例,伴有合并伤27例。保守治疗49例,手术治疗17例,其中包括选择性肾动脉栓塞治疗5例。治愈64例,死亡2例。结论：1）CT、B超检查准确率高,是诊断肾损伤的主要方法;2）迅速而正确的病情评估是治疗的关键;3）大多数腹部闭合性肾损伤可以采取保守治疗;4）选择性肾动脉栓塞创伤小,止血迅速有效,可作为Ⅲ级肾损伤的首选治疗方法,亦可作为肾修补术后继发性出血的治疗措施。 相似文献
14.
目的:探讨归芪五味消毒饮联合抗生素预防关节置换术后感染的临床疗效。方法:2015年10月至2020年10月收治200例关节置换患者,其中全髋关节置换50例,人工股骨头置换80例,全膝关节置换40例,膝关节单髁置换30例,每种病例随机分成2组,一组为观察组,另一组为对照组。所有患者常规应用抗生素,同时观察组于术后第1d开始口服归芪五味消毒饮,每天1剂,连用5d。分别于手术前、术后1、5d抽静脉测定C反应蛋白(CRP)、血测白细胞数量(WBC)、红细胞沉降率(ESR)。同时随访观察患者的切口愈合情况。结果:观察组和对照组手术前和手术后第1d后的CRP、WBC计数、ESR比较,差异均无统计学意义。术后1d的CRP、WBC计数、ESR均高于术前和术后5d(对照表1、2、3)。术后第5天两组之间的CRP、WBC计数、ESR比较,差异均有统计学意义。术后观察组均未发生感染,切口均愈合良好,对照组4例切口浅表感染,伤口延迟愈合。观察组切口愈合时间(13±3)d,对照组切口愈合时间(16±4)d。结论:归芪五味消毒饮联合抗生素可明显改善血液炎性指标,预防关节置换术后感染。 相似文献
15.
目的:探讨鼻内镜手术失败的原因及修正性鼻内镜手术的方法,避免并发症,提高治疗效果.方法:回顾性分析我科39例复发性鼻窦炎、鼻息肉患者的病例资料.结果:通过术后一年以上的随访,治愈29例(74.35%),有效8例(20.51%),无效2例(5.1%).术中并发症大出血3例,眶周损伤2例,术后鼻腔粘连4例.结论:病变去除不彻底,鼻腔粘连、息肉复发及鼻窦口阻塞是鼻内镜手术失败的常见原因;修正术中辨认残存解剖标志,熟练的技术操作,适当的术式、术后处理以及长期随访是提高疗效防止并发症的关键. 相似文献
16.
Diagnosis and treatment of pheochromocytoma in urinary bladder 总被引：1，自引：0，他引：1
Objective： To study the diagnosis and treatment ofpheochromocytoma in urinary bladder. Methods： Six cases of bladder pheochromocytoma were studied. Four cases showed hypertension, 3 of which were paroxysmal hypertension during urination. Catecholamine （CA） was increased in a case, and vanillymandelic acid （VMA） was increased in 2 cases. Bladder submucosal mass was detected by B-ultrasound in 5 cases （5/5）, computerized tomography （CT） in 3 cases （3/3）, cystoscopy in 5 cases （5/6）. Four cases took a-receptor blocker for 2 weeks, 1 case took β-receptor blocker to decrease heart rate. All patients were treated with surgical operation including 4 partial cystectomies, 2 excavations. Results： Three cases had manifestations including headache, excessive perspiration and hypertension during cystoscopy. Four cases were confirmed before operation. Two cases showed hypertension during operation. All patients were pathologically diagnosed as pheochromocytoma post- operatively. In five cases followed up, blood pressure returned to normal. No patient had relapse and malignancy. Conclusions： Typical hypertension during urination comprised the main symptoms. We should highly suspect bladder pheochromocytoma if a submucosal mass was discovered with B-ultrasound, CT, ^131I-M1BG （methyliodobenzylguanidine） and cystoscopy. The determination of CA in urine is valuable for qualitative diagnosis. The preoperative management of controlling blood pressure and expansion of the blood volume are very important. Surgical operation is a good method for effective treatment. Postoperative long-time followed up is necessary. 相似文献
17.
陈荣 《襄樊职业技术学院学报》2011,10(4):27+31-27,31
目的研究末节断指再植术后甲床放血治疗的意义。方法对我院15例末节断指再植术病例,术中行吻合指动脉,术后行甲床放血治疗。结果 14例存活,1例坏死。结论末节断指再植术后甲床放血治疗效果满意。 相似文献
18.
目的：探讨护理措施及康复指导对高血压性脑出血患者治疗效果的作用。方法：随机抽取我院自2011年1月至2013年12月62例住院治疗的高血压性脑出血患者,作回顾性分析,总结护理经验及康复指导措施,为救治今后接诊的高血压性脑出血患者提供参考依据。结果：通过采取常规的护理措施及预防并发症的护理措施后,62例高血压性脑出血患者中基本痊愈36例、部分恢复22例、死亡4例。结论：对高血压性脑出血患者在临床治疗期间进行有效的护理措施及康复指导,可提高治愈率,有效降低死亡率及致残率,提高患者的生活质量。 相似文献
19.
目的 探讨宽颈动脉瘤介入治疗时应用支架辅助弹簧圈进行栓塞的术后护理.方法 27例颅内宽颈动脉瘤破裂出血的患者均采用支架辅助弹簧圈栓塞治疗的方法,并实施相关护理措施,通过回顾性分析总结护理经验.结果 27例介入手术术后患者,2例手术12h后发生脑血管痉挛,其中1例致大面积梗塞而死亡,1例瘤体再次破裂,其余患者均未发生护理并发症,术后恢复良好.结论血管内支架植入避免弹簧圈弹出的治疗技术使以前无法介入治疗的颅内宽颈动脉瘤有可能得到根治,有效的术后护理配合起着非常重要的作用,能减少并发症的发生,提高治愈率,降低致残率. 相似文献
20.
Objective: To investigate the time and postoperative binocular vision of strabismus surgery for children with intermittent exotropia (X (T)). Methods: A retrospective investigation was conducted in 80 child patients with intermittent exotropia. Pre- and postoperative angles of deviation fixating at near (33cm) and distant targets (6m) were measured with the prolonged alternate cover testing. The binocular function was assessed with synoptophore. Twenty-one patients took the postoperative synoptophore exercise. Results: (1) A week after surgery, 96.2% of the 80 patients had binocular normotopia, while a year after surgery, 91.3% of the 80 patients had binocular normotopia; (2) Preoperatively, 58 patients had near stereoacuity, while postoperatively, 72 patients achieved near stereoacuity (P<0.05); (3) Preoperatively, 64 patients had Grade I for the synoptophore evaluation and postoperatively, 76 patients achieved Grade I. Meanwhile, 55 patients had Grade Ⅱpreoperatively and 72 achieved Grade Ⅱ postoperatively. For Grade Ⅲ, there were 49 patients preoperatively and 64 patients postoperatively (P<0.05); (4) Patients of 5～8 years old had a significantly better recovery rate of binocular vision than those of 9～18 years old (P<0.05); (5)Patients taking postoperative synoptophore exercise had a better binocular vision than those taking no exercise (P<0.05). Conclusions: (1) Strabismus surgery can help to preserve or restore the binocular vision for intermittent exotropia; (2) Receiving the surgery at young ages may develop better postoperative binocular vision; (3) The postoperative synoptophore exercise can help to restore the binocular vision. 相似文献