亚低温治疗急性脑梗死不同起始时间的近期及远期预后观察

目的：研究全身亚低温不同起始时间对急性脑梗死近期与远期预后的影响,以进一步探讨亚低温治疗最佳时间窗。方法对急性大面积脑梗死患者117例,随机分为亚低温治疗组6～12 h 时（A1）22例及12～24 h（A2）32例;对照组6～12 h （B1）30例及12～24 h（B2）33例。对照组予常规抗血小板、降脂稳定斑块、改善循环、脑保护及对症治疗,亚低温治疗组在常规治疗的基础上采用全身亚低温治疗,配合冬眠合剂。使肛温控制在33～35℃。降温持续时间5～7 d 。评定治疗前、治疗后第7、14天、1、3、6个月各时间点 NIHSS 评分、MRS 评分。并记录死亡、再发脑梗死等终点事件。结果①起始时间6～12 h与12～24 h 亚低温治疗组的近期疗效与远期疗效均优于各自对照组。②6～12 h 亚低温组近期与远期疗效均优于12～24 h亚低温组。③肺部感染是亚低温治疗较常见并发症,但可降低急性脑梗死患者应激性溃疡、脑心综合征的并发症。结论24 h 内长程亚低温治疗急性脑梗死可改善神经功能,降低致残率,且越早效果越好。     

银丹心脑通软胶囊治疗腔隙性脑梗死的临床疗效评价

目的 观察银丹心脑通软胶囊治疗腔隙性脑梗死的临床疗效.方法 将烟台市烟台山医院神经内科自2009年7月至2010年9月收治入院的58例腔隙性脑梗死患者按随机数字表法分为治疗组(30例)和对照组(28例).对照组进行常规治疗,治疗组在常规治疗的基础上加用银丹心脑通软胶囊(每日3次,每次4粒,持续4周).检测治疗前后两组患者血液流变学指标、纤维蛋白原水平,并对患者神经功能缺损程度进行评分,最后对两组患者的总体疗效进行评价.结果 与治疗前相比,治疗后两组患者血液流变学指标、纤维蛋白原水平以及神经功能缺损评分明显降低,且治疗组效果优于对照组,差异有统计学意义(P<0.05).秩和检验结果表明治疗组与对照组疗效差异有统计学意义(P<0.05),从平均秩次判断,治疗组疗效优于对照组.结论 银丹心脑通软胶囊能下调血液中纤维蛋白原水平,明显改善腔隙性脑梗死患者的神经功能缺损症状及其血液流变学指标,对腔隙性脑梗死的治疗安全有效.

Abstract：

Objective To observe the clinical therapeutic effect of Yindanxinnaotong capsule on patients with lacunar infarction. Methods Fifty-eight patients with lacunar infarction, admitted to our hospital from July 2009 to September 2010, were randomly divided into control group (n=28) and Yindanxinnaotong capsule treatment group (n=30). The patients in the control group were treated with conventional therapy and those in the treatment group were treated by combination of Yindanxinnaotong capsule (3 times daily, 4 capsules timely for a consecutive 4 weeks) with conventional method. The hemorrheological indexes, fibrinogen level and scores of neurological impairment were inspected before and after the treatment, respectively. The overall effect was evaluated. Results The hemorrheological indexes, fibrinogen level and scores of neurological impairment in the treatment group were decreased significantly as compared with those in the control group (P<0.05). The overall effect of the treatment group was better than that of control group. Rank sum test indicated that the treatment efficacy between treatment group and control group was significantly different (P<0.05);mean rank order indicated that the improvement of the treatment group was better than that of control group. Conclusion Yindanxinnaotong capsule can decrease the fibrinogen level, improve the hemorrheological indexes and neurological impairment of patients with lacunar infarction;it has definite curative effect on lacunar infarction.     

抗癫痫药卡马西平疗效与血药浓度的相关性研究

目的 探讨卡马西平血药浓度与疗效的相关性.方法 收集服用卡马西平(CBZ)的癫痫患者80例,观察疗效.根据疗效分为有效组和耐药组,同时测定其血药浓度;将有效组和耐药组的CBZ血药浓度及疗效进行比较.结果 在80例患者中,有效组49例,耐药组31例.耐药组的CBZ血药浓度略高,对两组每公斤体重血药浓度进行t检验(t=0.313,P=0.756),无统计学差别.结论 耐药组卡马西平剂量高于有效组,差异显著,而血药浓度无统计学差异,提示疗效不佳时不能盲目增加剂量.     

健康管理对老年高血压依从性和生活质量影响

目的健康管理治疗对老年高血压患者依从性和生活质量的影响分析。方法将2018年3月-2019年3月本院收治的80例老年高血压患者,分为观察组和对照组,每组40例,观察组患者实施健康管理治疗,对照组患者实施传统的降压治疗,分析两组患者的依从性及生活质量。结果实施健康管理治疗的观察组患者比实施传统降压治疗的对照组患者依从性高,生活质量也明显优于对照组,两组对比,其差异具有统计学意义(P<0.05)。结论实施健康管理治疗,提高了老年高血压患者的依从性及生活质量,帮助患者有效的控制血压,具有显著疗效。     

化脓性脑膜炎并发癫痫40例临床分析

目的 探讨化脓性脑膜炎与继发癫痫的关系.方法 回顾性分析近10年来我院收治的205例化脓性脑膜炎患者的临床资料,其中40例继发癫痫发作,统计化脑并发癫痫的发病率、发作时间、发作类型及转归.结果 化脓性脑膜炎癫痫发作的发病率为19.5%,其中儿童的发病率为25.4%;成人的发病率为10.1%,两组比较差异有显著性(P<0.01).部分性发作占50%(20/40),其中部分发作继发全身强直阵挛发作占12.5%(5/40);全身强直阵挛发作占42.5%(17/40),同时伴有两种发作类型的占7.5%(3/40).结论 化脓性脑膜炎可并发继发性癫痫发作,尤其是儿童,应注意防治.

Abstract：

Objective To study epilepsy associated with purulent meningitis.Methods Two hundred and five patients with purulent meningitis were analyzed retrospectively.among them 40 cases developed epilepsy.The 40 cases were analyzed on their incidence,seizure type and prognosis.Result The incidence of epilepsy associated with purulent meningitis Was 19.5%(40/205).The incidences of children and adults were respectively 25.4%(32/126)and 10.1%(8/79).The incidence of children Was higher than that of adults(P<0.01).Seizures of 50%(20/40)cases were the focalonset type,among them,12.5%(5/40)were with secondary generalization.Generalized seizures made up to 42.5%(17/40).7.5%(3/40)of cages had two types of seizures.Conclusions Purulent meningitis is a cominon cause of symptomatic epilepsy,especially for the children.We should take precautionary measures on it.