168例带状疱疹及疱疹后遗神经痛临床分析

目的 了解带状疱疹的临床发病特点及相关因素.方法 回顾性分析168 例带状疱疹住院患者的临床资料.结果 发病以老年人较多(61.9%),发病部位以肋间神经区较多见(48.2%),伴发病占32.1%,误诊患者12.5%,后遗神经痛占21.4%.结论 带状疱疹老年患者、有伴发病、治疗延误者易出现后遗神经痛.     

带状疱疹神经痛20例误诊分析

目的 20例带状疱疹引起身体不同部位疼痛而被误诊为各种疾病的病例进行分析.方法 对20例因疼痛来诊的病人进行详细询问病史、全面物理检查以及会诊随诊观察等进行全面分析.结果 带状疱疹神经痛在院内外被误诊为偏头痛、颈椎病、冠心病心绞痛、胆石症、泌尿系结石、坐骨神经痛等多种疾病,最后确诊为带状疱疹神经痛.结论 对20例带状疱疹神经痛误诊原因进行分析,尤其对无疹性带状疱疹神经痛要提高认识,并提出防止误诊措施,强调作好鉴别诊断可减少误诊.     

早期控制带状疱疹性神经痛的临床探讨

目的探讨带状疱疹性神经痛的有效治疗方法。方法随机将90例带状疤疹性疼痛患者分为3组，每组30例。基本处方为口服阿昔洛韦0．2g，4次／d。第一组基本处方加布洛芬0．2g，3次／d，美西律50mg，3次／d，腺苷钴胺1．0g，3次／d。第二组基本处方加卡马西平0．2g，3次／d。第三组基本处方加强的松10mg，3次／d。3组疗程均为14d。结果第一组总有效率93，3％，第二组总有效率73．3％，第三组总有效率90％。第一组与第三组总有效率无显著性差异（P〉0．05），第一、三组与第二组总有效率具有非常显著性差异（P〈0．01）。后遗神经痛发病率第一组6．7％，第二组36．7％，第三组33．3％，第二组与第三组无显著性差异（P〉0．05），第一组与第二、三组具有非常显著性差异（P〈0．01）。结论阿昔洛韦、布洛芬、美西律与腺苷钴胺联合治疗带状疱疹性疼痛疗效显著，后遗神经痛发病率较低。     

带状疱疹后遗神经痛病因分析及干预

对我院皮肤科2008-01～2009-01收治的带状疱疹后遗神经痛的老年患者的治疗情况进行总结,现报告如下。     

早期带状疱疹神经痛延误诊断12例分析

我科自2005年以来收治早期带状疱疹神经痛延误诊断患者12例,现总结报告如下。1临床资料1.1一般资料本组12例患者中男8例,女4例,年龄22～81岁,既往患有高血压7例,糖尿病5例,冠心病4例,误诊时间3～10d。1.2临床表现本组患者在发病前分别有劳累、受凉感冒等诱因,又出现低热、乏力等不适,但均以局部疼痛为主诉就     

红光联合药物治疗带状疱疹神经痛临床观察

目的探讨红光联合药物治疗带状疱疹神经痛的疗效。方法对照组给予口服伐昔洛韦片0.3 g,2次/d,连续1周;泼尼松片10 mg,3次/d,连服5 d;维生素B1片,20 mg/次,3次/d;腺苷钴胺片0.5 mg,3次/d;阿昔洛韦膏外用,2次/d,连续2周;治疗组在对照组的治疗基础上加用红光照射,2周后评价疗效。结果治疗组愈显率86.7%,对照组59.4%,2组比较差异有统计学意义(P<0.05)。结论红光联合药物治疗带状疱疹神痛疗效显著,为治疗带状疱疹神经痛开辟了一条新途径,有重要临床参考价值。     

加巴喷丁治疗带状疱疹后神经痛临床观察

目的 观察加巴喷丁对带状疱疹后神经痛的临床疗效.方法 30例带状疱疹后神经痛患者分为2组, 治疗组15例应用加巴喷丁(GBP)治疗,对照组15例应用卡马西平(CBZ)治疗,于治疗1、2、4周进行视觉模拟评分(visual analogue scale, VAS).结果 加巴喷丁组在治疗后VAS明显低于卡马西平组( P<0.0 5 ).结论 加巴喷丁对带状疱疹后神经痛疗效优于卡马西平.     

带状疱疹神经受累与后遗神经痛发生关系的临床分析

目的探讨带状疱疹受累神经与后遗神经痛发生的关系。方法选择2013-06—2014-07在我院皮肤科急诊且完成随访的189例带状疱疹患者为研究对象,通过调查收集患者的相关疾病信息,依据受累神经进行分组,比较后遗神经痛发生的差异。结果 189例带状疱疹患者中,三叉神经受累52例(27.51%),颈臂丛神经受累11例(5.82%),肋间神经受累78例(41.27%),腰骶丛神经受累48例(25.40%)。共有32例患者发生带状疱疹后遗神经痛(postherpetic neuralgia,PHN),PHN的总体发生率为16.93%。比较显示,4种神经受累患者PHN发生率差异具有统计学意义(χ2=15.941,P=0.001),三叉神经受累的带状疱疹患者PHN发生率最高为34.62%。颈臂丛神经、肋间神经、腰骶丛神经受累患者PHN的发生率分别为9.09%、7.69%和14.58%。结论带状疱疹后遗神经痛发生与患者神经受累密切相关,三叉神经受累患者发生率相对较高。     

41例带状疱疹临床分析

临　床　资　料一般资料 :本组 4 1例中男 2 5例 ,女 16例 ,年龄在 35～81岁之间 ,其中 5 0岁以下者 9例 ,5 0岁以上者 32例 ,并均年龄 5 1.3岁。 4 1例带状疱疹者 ,其发病前即有脑梗塞 ,脑出血者 10例 ,均出现于胸背部 ;糖尿病者 6例 ,结核病史 1例 ,糖耐量异常 2例 ,恶性肿瘤 2例。饮酒的发病者 2例 ,上感后发病者共计 18例。发病情况 :先疼痛 1～ 5天后出疱疹者 32例 ,一例胸背部痛一周后出疱疹 ,另 1例右侧上臂痛 2周后出疱疹。其中上感后 1～ 2天出现头面部及耳廓疼痛 8例 ,于 3～ 4天出疱疹 ,另10例疱疹几乎与疼痛同时出现。疱疹成簇…     

亚低温治疗重型外伤性颅脑损伤的临床对照观察

目的 比较亚低温治疗和常温治疗重型外伤性颅脑损伤的治疗效果,方法 50例重型颅脑损伤患者随机分为常温组26例和亚低温组24例.入院后病人均持续监测颅内压7 d.对照组维持正常体温,亚低温组入院后在3～7 h内将肛温降至33℃左右,并维持3～7 d.比较2组GCS评分、颅内压、临床预后指标.结果 在伤后第7天,亚低温组和...     

Brain‐behavior relationships in young traumatic brain injury patients: DTI metrics are highly correlated with postural control

Traumatic brain injury (TBI) is a major cause of impairment and functional disability in children and adolescents, including deterioration in fine as well as gross motor skills. The aim of this study was to assess deficits in sensory organization and postural ability in a young group of TBI patients versus controls by using quantitative force‐platform recordings, and to test whether balance deficits are related to variation in structural properties of the motor and sensory white matter pathways. Twelve patients with TBI and 14 controls (aged 8–20 years) performed the Sensory Organisation Test (SOT) protocol of the EquiTest® (Neurocom). All participants were scanned using Diffusion Tensor Imaging (DTI) along with standard anatomical scans. Quantitative comparisons of DTI parameters (fractional anisotropy, axial and radial diffusivity) between TBI patients and controls were performed. Correlations between DTI parameters and SOT balance scores were determined. Findings revealed that the TBI group scored generally lower than the control group on the SOT, indicative of deficits in postural control. In the TBI group, reductions in fractional anisotropy were noted in the cerebellum, posterior thalamic radiation, and corticospinal tract. Degree of white matter deterioration was highly correlated with balance deficits. This study supports the view that DTI is a valuable tool for assessing the integrity of white matter structures and for selectively predicting functional motor deficits in TBI patients. Hum Brain Mapp, 2010. © 2009 Wiley‐Liss, Inc.     

A single dose of gabapentin reduces acute pain and allodynia in patients with herpes zoster

This randomized, double-blind, placebo-controlled crossover study measured the effect of a single dose of oral gabapentin (900 mg) on pain and allodynia associated with herpes zoster. Pain severity decreased by 66% with gabapentin compared to 33% with placebo. Reductions in allodynia area and severity, and overall pain relief, were also greater with gabapentin.     

重型颅脑损伤术中急性脑膨出38例分析

目的分析重型颅脑损伤术中急性脑膨出的临床特点。方法将重型颅脑损伤术中出现急性脑膨出的38例病人进行回顾性分析,总结其形成原因及易发条件,比较各种防治措施的效果。结果迟发性血肿、手术处理不当、急性脑肿胀等是颅脑损伤术中急性脑膨出形成的主要原因,正确的手术处理、缓慢的降低颅内压、控制性低血压、过度换气等是防治术中急性脑膨出的有效措施。结论应根据形成原因的不同而采取相应的措施防治颅脑损伤术中急性脑膨出。     

Effect of methylphenidate on ICU and hospital length of stay in patients with severe and moderate traumatic brain injury

OBJECTIVE: Traumatic brain injury is one of the major causes of death and disability among young people. Methylphenidate, a neural stimulant and protective drug, which has been mainly used for childhood attention deficit/hyperactivity disorder, has shown some benefits in late psychosocial problems in patients with traumatic brain injury. Its effect on arousal and consciousness has been also revealed in the sub-acute phase of traumatic brain injury. We studied its effect on the acute phase of moderate and severe traumatic brain injury (TBI) in relation to the length of ICU and hospital admission. PATIENTS AND METHODS: Severely and moderately TBI patients (according to inclusion and exclusion criteria) were randomized to treatment and control groups. The treatment group received methylphenidate 0.3mg/kg per dose PO BID by the second day of admission until the time of discharge, and the control group received a placebo. Admission information and daily Glasgow Coma Scale (GCS) were recorded. Medical, surgical, and discharge plans for patients were determined by the attending physician, blinded to the study. RESULTS: Forty patients with severe TBI (GCS = 5-8) and 40 moderately TBI patients (GCS = 9-12) were randomly divided into treatment and control groups on the day of admission. In the severely TBI patients, both hospital and ICU length of stay, on average, were shorter in the treatment group compared with the control group. In the moderately TBI patients while ICU stay was shorter in the treatment group, there was no significant reduction of the period of hospitalization. CONCLUSION: There were no significant differences between the treatment and control groups in terms of age, sex, post resuscitation GCS, or brain CT scan findings, in either severely or moderately TBI patients. Methylphenidate was associated with reductions in ICU and hospital length of stay by 23% in severely TBI patients (P = 0.06 for ICU and P = 0.029 for hospital stay time). However, in the moderately TBI patients who received methylphenidate, there was 26% fall (P = 0.05) only in ICU length of stay.     

急性颅脑损伤患者血清及脑脊液中炎性因子的变化及临床意义

目的探讨炎症细胞因子IL-1β,IL-6与颅脑损伤程度的关系及临床意义。方法对近年来我院收治的780例急性颅脑损伤患者按损伤程度分组（轻、中、重及特重型组）,检测血清及脑脊液中IL-1β及IL-6水平,并对比了不同程度急性颅脑损伤患者上述因子水平的差异并分析其临床意义。结果轻型、中型、重型及特重型颅脑损伤患者血清及脑脊液IL-1β及IL-6水平均显著增加,而重型和特重型颅脑损伤患者两种因子水平要显著高于其他患者,死亡患者IL-1β及IL-6水平高于其他所有患者。结论血清及脑脊液中IL-1β及IL-6水平与颅脑损伤的程度密切相关,能够作为临床监测指标。     

104例双侧重型颅脑损伤患者的临床治疗

目的 探讨双侧重型颅脑损伤(STBI)的治疗方法.方法 104例双侧STBI患者分为A、B、C3组.其中A、B组为手术组,A组(36例)行单侧开颅减压术,B组(24例)行双侧平衡开颅减压术;C组(44例)行保守治疗.并于3个月后根据GOS预后评分标准评定预后情况.结果 手术组恢复良好率优于保守组(P＜0.05),死亡率低于保守组(P＜0.05);B组术中脑膨出和迟发性血肿的发生率明显低于A组(P＜0.05),其恢复良好率优于A组(P＜0.05),但两组死亡率差异无统计学意义(P＞0.05);B组恢复良好率优于C组(P＜0.05),死亡率低于C组(P＜0.05).结论 双侧平衡开颅减压术在救治双侧STBI疗效优于单侧标准外伤大骨瓣减压术和保守治疗.