目的 探讨基于CT三维可视化在脑动脉瘤介入术中的应用效果.方法 选择2018年8月—2020年8月九江学院附属医院收治的30例脑动脉瘤患者作为研究对象,按照随机数字表法将其分为观察组和对照组,每组各15例.观察组采用CT三维可视化技术辅助脑动脉瘤介入术治疗,对照组采用常规介入栓塞术治疗.比较两组临床疗效、介入时间、住院时间、Hunt-Hess分级、并发症及预后.结果 观察组患者介入治疗时间、住院时间短于对照组,治疗后格拉斯哥预后评分高于对照组,差异有统计学意义(P<0.05);两组的治疗总有效率、手术前后Hunt-Hess分级及并发症总发生率比较,差异无统计学意义(P>0.05).结论 CT三维可视化技术辅以脑动脉瘤介入术治疗能够节省手术时间且术后并发症少,有利于促使患者快速恢复,改善患者预后,降低患者致残风险,临床应用安全可靠.

Cerebrovascular injury is the most prevalent human cerebrovascular disease and frequently results in ischemic stroke. Simvastatin may be a potential therapeutic agent for the treatment of patients with cerebrovascular injury. The present study aimed to investigate the efficacy of and the potential mechanisms regulated by simvastatin in a rat model of ischemia-reperfusion (I/R)-induced cerebrovascular injury. Cerebrovascular injury model rats were established and were subsequently treated with simvastatin or a vehicle control following I/R injury. Cell damage, neurological functions and neuronal apoptosis were examined, as well as the nuclear factor (NF)-kappa B-mediated myeloid differentiation primary response protein 88 (MyD88)/toll-interleukin-1 receptor domain-containing adapter molecule 1 (TRIF) signaling pathway following simvastatin treatment. The results of the present study demonstrated that simvastatin treatment led to a reduction in cell damage, improvement of neurological functions and decreased neuronal apoptosis compared with vehicle-treated I/R model rats, 14 days post-treatment. In addition, simvastatin treatment reduced cerebral water content and blood-brain barrier disruption in cerebrovascular injury induced by I/R. The results also revealed that simvastatin treatment inhibited neuronal apoptosis via the NF-kappa B-mediated MyD88/TRIF signaling pathway. In conclusion, simvastatin treatment may reduce I/R-induced neuronal apoptosis via inhibition of the NF-kappa B-mediated MyD88/TRIF signaling pathway.

目的：探讨不同剂量叶酸对“H型高血压”患者卒中风险的影响。方法300例H型高血压患者随机分为A、B、C组,每组100例。 A组给予安慰剂作为对照；B组给予叶酸5mg/d；C组给予叶酸0.4mg/d。对比三组患者在服药前和服药第3,6,9,12个月末同型半胱氨酸水平和脑卒中发生率。结果服药前三组患者的Hcy水平差异无统计学意义(>0.05)；服药3,6,9,12个月后,A组的Hcy水平无显著变化,B组和C组的Hcy水平均出现显著降低(﹤0.05),B组和C组的Hcy水平显著低于A组(﹤0.05),但B组和C组之间差异无统计学意义(>0.05)。 B组和C组的脑卒中发生率分别为1.7%和3.3%,显著低于A组的13.3%(﹤0.05),B组和C组之间的脑卒中发生率差异不显著。结论每日服用0.4mg叶酸即可使H型高血压患者达到降低同型半胱氨酸水平和预防脑卒中的作用。

Lance-Adams symptom also called secondary to hypoxic encephalopathy intentionality or action myoclonus syndrome.Domestic reports on treating Lance-Adams syndrome was relatively small.Our hospital treated one patients with Lance-Adams symptom by using antiepileptic drugs liked diazepam and valproic acid.The clinical feature and electroencephalogram situation was observed to explore the clinical feature of Lance-Adams symptom and treatment method.Then enhance the understanding about Lance-Adams symptom,in order to early diagnosis and timely treatment. After a series of treatment,clinical symptoms of patient under control,electroencephalogram results from the initially mainly with 3-5 Hz high-frequency theta and delta waves and with medium and high amplitude,spike wave and spine slow wave gradually transformed into mainly with 8-10 Hz rhythmic alpha pointed, spike wave and spine slow wave disappeared.The disease process and signs of this patient were consistent with the relevant literature.Throuhg treated with diazepam and valproic acid,this patient’s condition effectively alleviated,life quality improved obvious.Diazepam and valproic acid may be a good choice for Lance-Adams symptom.

目的 探讨分析左乙拉西坦在成人癫痫发作的临床治疗效果. 方法 选取2010年2月至2013年12月我院收入治疗的64例成人癫痫患者,随机分成单纯组和添加组,单纯组30例患者采用左乙拉西坦单药治疗,添加组34例患者则在原来用药基础上加用左乙拉西坦治疗,持续用药半年,比较两组患者的治疗有效率及不良反应发生率差异. 结果 单纯组患者总治疗有效28例(93.3%),服用半年内发生头晕等不良反应5例(16.7%)与添加组患者总治疗有效31例(91.2%)和服用半年内发生头晕等不良反应7例(20.6%)无统计学差异,P>0.05. 结论 左乙拉西坦无论是单独用药还是作为添加药物在治疗成人癫痫发作中都具有较为理想的临床疗效,且不良反应发生率较低,患者均可耐受,值得临床应用.

目的：分析前列地尔治疗脑梗塞的临床效果。方法选取我院收治的83例脑梗塞患者，按照随机双盲法分为两组，治疗组(43例)采取前列地尔治疗，对照组(40例)采取血塞通治疗，分析两组患者治疗总有效率、神经功能缺损改善及生活能力。结果治疗组与对照组治疗临床疗效总有效率分别为93.0%、77.5%，两组间对比(<0.05)。治疗组神经功能缺损及生活能力改善情况均优于对照组(<0.05)。结论前列地尔治疗脑梗塞的临床疗效值得肯定，可明显改善患者神经功能，降低患者神经功能缺损评分，使患者生活质量明显提高，安全有效，值得作为治疗脑梗塞的理想药物。

Objective To investigate the rt-PA combined endovascular therapeutic effect on severe venous sinus thrombosis.Methods From 2008January to 2012December,22patients with severe venous sinus thrombosis patientour hospital were enrolled as cases,all caese received the treatment of rt-PA combined intravascular therapy,and the clinical effects of surgical treatment were retrospectively analyzed.Results Of all the 22cases,16patients had disturbance of consciousness before treatment,of which,4cases of cerebral hernia,12cases of tracheal intubation.Patients with a GCS score results in 3to 12points respectively,6patients died,16patients recovered well and after 10to 24months follow-up,4patients were partially passable,and 12cases were fully paassable.Conclusion rt-PA combined with intravascular therapy may have good efficacy on severe venous sinus thrombosis and be worthy of clinical application.

Objective To analyze the therapeutic effect of the treatments with dexamethasone and mannitol for acute severe cerebrovascular disease. Methods 120 cases of patients with acute severe cerebrovascular disease in our hospital from January 2011 to January 2013 were selected and divided randomly into the control and researching group.The control group(n=60) was given the treatment of mannitol,and the researching group( n=60) was given the treatment of dexamethasone combined with mannitol.The intracranial pressure,complications,and score of GCS were analyzed in the two groups. Results After the treatments,the proportion of ICP returned to normal at the first to fourth day in the researchin group was significantly higher than that of the control group( P0.05).The incidence rate of complications in the acute stage had no significant difference between the two groups( P0.05).After 3 monthes of the treatment,the score of GCS in the researching group were significantly superior to the control group( P0.05). Conclusion The treatment of dexamethasone combined with mannitol for acute severe cerebrovascular disease can make the patients recovered quickly and have the good quality of prognosis.

目的探讨结核性脑膜炎的临床症状、诊断以及治疗方法。方法对该院收治的80例结核性脑膜炎患者的临床资料进行回顾性分析。结果 80例结核性脑膜炎患者大都呈现出慢性或者亚急性起病,经过正规抗结核治疗,临床治愈为48例,好转为18例,12例没有好转,自动出院或者转院进行治疗,2例死亡。结论患者的脑脊液特点以及头颅CT或者MRI检查作为诊断结核性脑膜炎一个重要的指标,早期诊断以及科学合理治疗可以有效增强结核性脑膜炎的治愈率。

目的:为治疗偏头痛提供临床依据,分析中西医结合治疗偏头痛的临床疗效。方法:随机抽取2011年2月~2012年1月我院偏头痛患者100例,平均分成两组。对照组给予尼莫地平、谷维素及安定治疗,观察组在西药治疗基础上加服中药。结果:对照组总有效率为84%;观察组总有效率比对照组高,为94%。结论:两组的治疗方法都对偏头痛有一定疗效,但中西医结合治疗方法疗效更佳,并且更具有安全可靠性,值得在临床治疗中进一步推广。

目的分析三叉神经痛的临床治疗效果,提供治疗依据,改进治疗方法。方法对2011年4月至2012年4月在我院治疗的80例三叉神经痛患者,随机为了两组治疗,治疗组40例患者以西医治疗,对照组40例患者以中医治疗,比较治疗效果。结果治疗组完全治愈的有28例,治愈率为70%,整组总的有效率为92.5%;对照组完全治愈的有13例,治愈率为32.5%,整组总的有效率为75%。治疗组的治疗效果明显高于对照组的治疗效果。结论三叉神经痛通过西医治疗,不仅临床效果非常明显,还有较强的针对性,不良反应又相对较少。西医治疗在三叉神经痛患者中受到广泛的欢迎,减轻了患者的痛苦,缩短了疗程,在临床上非常值得推广。

目的 总结中西医结合治疗急性脑出血的疗效.方法 对照组45例患者给予西医治疗,治疗组55例患者给予中西医结合治疗,对两组患者的疗效进行对比分析.结果 对照组45例患者的总有效率为66.67%,治疗组55例患者的总有效率为89.09%,两组差异明显,存在统计学意义(P<0.05).结论 中西医结合治疗急性脑出血,可以有效改善患者脑组织缺氧及缺血症状,减轻患者的脑水肿,且其疗效较为理想,值得在医学实践中推广使用.

Objective To observe the curative effects of endovascular stent angioplasty on transient ischemic attack(TIA) with intracerebral artery stenosis.Methods By the examination of digital subtraction angiography(DSA),97 patients were dignosed as TIA with intracerebral artery stenosis.Then,all of them received the treatment of endovascular stent angioplasty.The exanmination of DSA and transcranial doppler(TCD) were applied to detect the degree of artery stenosis and mean velocity(Vm) of stenosed artery pro-operative,immediate post-operative(or next day after operation) and 6 months post-operative.The rates of TIA and stroke were observed for 6 months followed-up.Results One handred and tweleve stenosis places were found out in the 97 patients.During the operation of endovascular stent angioplasty,109 stents were implanted,and the success rate was 94.5%.Compared with pro-operation,the degrees of artery stenosis and Vm of stenosed artery were significantly decreased at immediate post-operation(or next day after operation) and 6 months post-operation(all P0.01).Thalamic hemorrhage was happened in 1 cases at immediate post-operation.During the 6 months followed-up,83 cases(92.5%)were no occurrenced TIA or stroke.While,TIA was happened in 9 cases(9.68%) and cerebral infarction was happened in 3 cases(3.23%);and 2 cases(2.15%) were dead.Conclusion Treated with endovascular stent angioplasty on TIA with intracerebral artery stenosis is effective and safe.