目的:探讨自身免疫性脑炎(AE)患者应用甲泼尼龙联合人血免疫球蛋白的临床价值.方法:选取2015年1月-2019年1月笔者所在医院接收的自身免疫性脑炎患者66例为对象,以整群随机化方式分设成两组.给予对照组行甲泼尼龙治疗,研究组行甲泼尼龙联合人血免疫球蛋白治疗.观察两组的认知能力、细胞免疫水平和炎症因子水平.结果:对照组治疗后认知功能评分低于研究组,对照组治疗后的炎症因子水平均高于研究组,研究组治疗后细胞免疫水平优于对照组,差异均有统计学意义(P<0.05).结论:对自身免疫性脑炎患者予以甲泼尼龙联合人血免疫球蛋白治疗,能取得较好效果,提高认知能力,机体免疫功能提升,炎症因子水平降低.

目的 探究急性脑梗死静脉溶栓治疗桥接血管内介入治疗后应用丁苯酞氯化钠治疗的临床疗效.方法 选取急性脑梗死静脉溶栓治疗桥接血管内介入治疗后患者86例,依据治疗方法的不同将其随机分为对照组、观察组,对照组采取标准药物治疗,观察组在标准药物治疗基础上加用丁苯酞氯化钠治疗.比较两组患者治疗前后的美国国立卫生研究院卒中量表(NIHSS)、改良Barthel指数(MBI)、改良Rankin量表(mRS).结果 两组患者治疗前NIHSS评分、MBI指数、mRS评分比较无显著差异常(P>0.05);治疗后观察组患者的NIHSS评分、MBI指数、mRS评分均显著优于对照组(P<0.05).结论 急性脑梗死患者静脉溶栓治疗桥接血管内介入治疗后联合丁苯酞氯化钠治疗疗效确切,能有效改善急性脑梗死患者的神经缺损功能、日常生活活动能力以及神经功能恢复状态.

目的观察尤瑞克林联合巴曲酶治疗急性脑梗死的临床疗效及安全性。方法选择急性脑梗死患者72例,随机分为观察组36例、对照组36例,观察组给予尤瑞克林和巴曲酶治疗,对照组仅给予巴曲酶治疗。分别观察两组治疗前后神经功能缺损评分(NIHSS评分)和临床疗效。结果观察组总有效率明显高于对照疗组(P<0.05);治疗后第14天观察组NIHSS评分低于对照组(P<0.05)。结论尤瑞克林联合巴曲酶治疗可以显著提高急性脑梗死的临床疗效。

Objective:To invetigate the value of a novel puncture and drainage of intracranial hematoma for the treatment of hypertensive intracerebral hemorrhage.Methods:In the group there were 27 patients with hypertensive intracerebral hemorrhage,with mean age of 61 years. Their hematomas located in thalamus(1 patient),basal ganglia(22 patients),and lobe(4 patients).The mean(SD)hematoma volume was 40(3.2)mL,the mean Glasgow Coma Scale (GCS)score was 10.15,and the mean National Institutes of Health Stroke Scale(NIHSS)score was 30.65 at admission.CT scan provided hematoma location.and the percutaneous puncture. grind and drainage were performed under the local anesthesia by using a novel puncture and drainage of intracranial hematoma.Results:No adverse events occurred during the punctures and after the procedures.One patiems died 20 days after procedure.Other patients were followed up for more than 6 months.Eight patients had a good outcome as assessed by Glasgow Outcome Scale(GOS)scores,15 had mild disability,2 had serious disability,and 1 was in a permanent vegetative state.Conclusions:This novel puncture and drainage of intracranial hematoma can be used in the treatment of hypertensive intracerebral hemorrhage,and it is simple and safe.

Objectsive To explore surgical treatment of refractory epilepsy involving in the central sulcus region. Method Epileptogenic focus must be assessed and fMRI was used to locate the functional area before surgery.During operation,epileptogenic focus was delineated by EEG/ECoG and functional area was located by direct cortex electrical stimulation.Epileptic focus was resected if not involved the functional area,and multiple subpial transactions was performed when involved functional area.Results No functional deficts were found after surgery,1case was seizure free,1 experienced occasional partial seizure,and 1 reduced 75% than before after 8 months.Conclusions Preoperative functional area mapping amd imtraoperative monitoring are important in functional protection amd improving seizure control rate.

目的 探讨经皮穿刺在救治特急性颅内血肿中的作用.方法 对13例特急性颅内血肿的患者在开颅术前先进行紧急经皮穿刺.硬脑膜下血肿7例,硬脑膜外血肿3例,硬脑膜外合并硬脑膜下血肿2例,自发性脑内血肿1例;术前双侧瞳孔散大7例,单侧瞳孔散大6例;呼吸改变者9例;入院GCS 3分4例,4分6例,5分1例,7分2例.结果 穿刺后10例患者瞳孔有不同程度回缩,8例患者自主呼吸转平稳.手术治疗11例,余2例未能手术.术后随访6个月至2年,按GOS评分,良好4例,重残1例,植物生存2例,死亡6例.结论 在特急性颅内血肿的救治中,先期的紧急经皮穿刺,能为后期的治疗提供有效帮助.

Objective To explore the surgical treatment for children with catastrophic epilepsy.Methods The clinical data of 10 children who underwent surgical treatment for their catastrophic epilepsy were retrospectively analyzed,in order to compare the preoperative and postoperative seizures and intelligence of these children.Results Except for one case withdrawn,the other cases were all followed up for more than 12 months;all cases had no postoperative aggravation of nerve function impairment complicated with intelligence disturbances.Evaluation on therapeutic effects showed that therapeutic satisfaction was realized in 4 cases,significant improvement in 2 cases,good improvement in another 2 cases and mild improvement in 1 case.Postoperative deteriorations in behavioral abnormalities and language disorders were evident,but there was no significant difference between preoperative and postoperative IQ.Conclusion Active surgical treatment for children with catastrophic epilepsy can not only control seizures effectively,but also partially alleviate intelligence disturbances.