目的:探討顱腦損傷后腦耗鹽綜合征患者的診斷與治療策略。方法:對我科2006~2007年收治的37例CSWS患者臨床資料進(jìn)行回顧性分析和總結(jié)。結(jié)果:經(jīng)治療,37例CSWS患者31例血鈉恢復(fù)正常,4例死亡,無1例發(fā)生橋腦髓鞘溶解癥。結(jié)論:腦耗鹽綜合征是顱腦損傷后患者低鈉血癥的最主要原因。早期明確診斷,積極穩(wěn)妥補(bǔ)液補(bǔ)鈉是有效治療CSWS患者的關(guān)鍵。
目的:探討經(jīng)側(cè)裂島葉入路微侵襲手術(shù)對高血壓性殼核出血患者的治療價值。方法:回顧性分析65例HPH患者的臨床資料,其中51例患者接受經(jīng)側(cè)裂島葉入路開顱手術(shù)治療,14例采用保守治療。結(jié)果:手術(shù)組平均住院日、主要并發(fā)癥發(fā)生率、總體死亡率均低于保守治療組。隨訪6月時,手術(shù)組恢復(fù)良好率高于對照組。結(jié)論:經(jīng)側(cè)裂島葉入路手術(shù)治療可改善高血壓性殼核出血患者臨床預(yù)后。
【摘要】 目的 探討開顱手術(shù)夾閉顱內(nèi)前循環(huán)動脈瘤破裂的方法和療效。 方法 回顧分析2005年1月-2008年1月28例前循環(huán)動脈瘤破裂的早期外科手術(shù)治療情況。分析其臨床表現(xiàn)、手術(shù)入路和預(yù)后，用格拉斯哥術(shù)后評分量表對術(shù)后患者神經(jīng)功能評分。 結(jié)果 28例患者共30個動脈瘤，手術(shù)成功夾閉28個，包裹2個。術(shù)后3個月內(nèi)，患者恢復(fù)良好15例（53.57%），中度病殘7例（25.00%），重度病殘5例（17.86%），死亡1例（3.57%）。 結(jié)論 早期開顱手術(shù)夾閉動脈瘤能減少再出血率和術(shù)前死亡率，術(shù)后預(yù)后較好，是治療前循環(huán)動脈瘤破裂較為理想的方法。【Abstract】 Objective To investigate the clinical strategy and effect of early phase surgery for ruptured cerebral anterior circulating aneurysm. Methods A retrospective analysis was done for 28 patients with ruptured anterior circulating aneurysms who underwent early phase (within 3 days) surgical clipping from January 2005 to January 2008. Their manifestations, surgical approach, and outcomes were analyzed. Glasgow outcome scale (GOS) was used to evaluate patients’ neurological function after operation. Results Among 30 intracranial aneurysms in 28 patients, 28 aneurysms were clipped successfully, and the other 2 were wrapped. One patient (3.57%) died after surgery. The follow-up data showed an excellent outcome was achieved in 15 cases, mild disability in 7 cases, and severe disability in 5 cases. Conclusion Early phase surgical clipping for ruptured cerebral anterior circulating aneurysm can reduce the chance of reruputure of aneurysms and the mortality in preoperative phase with good outcomes. The early phase surgical clipping the aneurysms is considered the feasible opinion.