Objective To explore the effect and safety of ketamine on pain relieve of neurosurgery operation after anesthesia. Methods 63 patients w ith brain tumor underw ent craniotomy in neurosurgery of our hospital w ere randomly divided into observtion group( n = 37) and control group( n = 26),conventional anesthesia w as adopted in control group,ketamine w as adopted in observation group w hen sew ed. Anesthesia recovery after surgery such as revive time,extubation time,adverse reactions of paients w ere recorded; Ramsay composure degree grade w as adopted for grading composure,pain degree of patients after revival w as evaluated by pain visual analog score( VAS). Results Revive time of observation group w as( 54. 7 ± 23. 1) min,w hile it w as( 55. 8 ± 27. 3) min in control group,there w as no significant difference betw een the tw o groups( P 0. 05); the incidence of adverse reactions in observation group and control group w ere 48. 15% and 42. 31%,there w as no significant difference betw een the tw o groups( P 0. 05).Ramsay composure degree at 15 min after revival of observation group( 3. 0 ± 0. 7) w as significantly higher than that of control group( 2. 3 ± 0. 8)( P 0. 05),VAS score of observation group at 15 min,1 h after revival w ere significantly low er than those of control group,there w ere significant differences betw een the tw o groups( P 0. 05). Conclusion Small dose of ketamine can alleviate the pain sensitivity of neurosurgery operation after anesthesia,w ithout effect on revive time and extubation time,it is safe and w orthy of clinical promotion.

<正>肝细胞生长因子(hepatocyte growth factor,HGF)是一种多功能细胞因子,它可以作为分裂素、生成素、活力素和细胞毒素作用于各种细胞。内源性肝营养因子的存在早在1949年就被人们发现,但直到将

<正>凡是病人或家属对患者诊疗护理过程不满意,认为医务人员在诊疗护理过程中有失误,对病人造成不良后果、伤残或死亡,以及诊疗过程中,加重了病人痛苦或经济负担等情况,

Objective To study the effect of hypothermia on ATPase activity and neuron apoptosis at hippocampus in rats with brain trauma,and to find theoretical evidence for its clinical application.Methods 42 Spregue-Dawley rats were randomly divided into 3 groups.They were pseudo-operation contral group,traumatic brain injury group and hypothermia treat group.Fluidpercussion led to brain trauma.31℃±1℃ hypothermia was given to the rats with brain trauma and persist 24 h in hypothermia treat group.2 days after injury or pseudo-operation,the behavior scales of neural function were estimated,and all rats were killed for detecting ATPase activity and neuron apoptosis(TUNEL) at CA1 area of hippocampus.Results Hypothermia treat can obviously add the behavior scales(P0.05),increase Ca~(2+)-ATPase activity(P0.01),and reduce the number of neurons of apoptosis(P0.01)at hippocampus of traumatic brain.Conclusions Hypothermia take a protective role in brain trauma by adding Ca~(2+)-ATPase activity,inhibiting Ca~(2+)-overloading and reducing neuron apoptosis.

一枚圆圆的铜钱,中间透着棱角分明的小方孔.这个古人设计出的"万能"的小东西,能给我们怎样的启示呢?它能启示我们做人的道理就是要外圆内方."方",就是做人的正气,具有优秀的品质;"圆",就是处世灵活,善用技巧.一个人如果过分方正,就像生铁一样,容易折断;一个人如果圆滑透顶,也易引起别人反感.做人必须方外有圆,圆内有方,外圆而内方.当医生也莫过于此.

输血在临床抢救和治疗中发挥了重要作用,但随着我国经济发展和医疗水平的提高,临床用血量还将逐年增加,可能引起血源性传染疾病的发生.同时,伴随着人们法律意识的增强,由输血而引发的医疗纠纷和医疗事故也日益增多.因此,临床输血流程再造、安全输血是防范医疗纠纷的重要措施.

讨论高渗甘露醇在失血性休克急诊复苏中的应用和作用机制.

我院2000年10月至2003年6月对入院时无明显手术指征的160例外伤性颅内血肿患者首选非手术治疗,结果6例死亡,现报道如下.

1临床资科 例1,男,40岁.1974年因头部坠落伤致右颞顶部开放性粉碎性凹陷性骨折,当时清除碎骨片,半年后用有机玻璃行颅骨修补术.术后病人无特殊不适.1998年4月,病人因感左下肢乏力,作头部CT诊断右颞顶部脑膜瘤.遂入院手术,术中取除4 cm×5 cm椭园形有机玻璃板一块,形态完整,肿瘤位于有机玻璃板下方,球形,直径约3 cm,界线清楚,肉眼全切.病检报告:合体型脑膜瘤.

原发性脑干损伤是颅脑外伤中死亡率和致残率较高的一种复杂病变,我院从1994.1～1999.12月共收治原发性脑干损伤病人37例,通过各种手段综合治疗取得良好效果,现报告如下.

钻孔引流术是治疗慢性硬膜下血肿常用的手术方法,其操作简单、安全、疗效可靠.但是仍有少数患者采用该方法并不能获得治愈或治愈后又复发,造成病程延长,并增加了患者的经济负担.

本文收集16例因外伤所致的迟发性颅内血肿的CT及临床资料,现报道分析如下:

狭颅症是一种婴幼儿颅缝早闭造成的头颅畸形的少见疾病.而全颅缝早闭(尖头畸形Cxycep haly)则更为罕见.笔者报告4例全颅缝早闭的狭颅症患儿,采用改良冠状切口形(图1)一期全颅缝再造手术治疗,效果满意.

作者2001年5月至2002年5月在同济医科大学协和医院进修期间,共收治鞍区颅咽管瘤儿童患者17例,均手术切除并病理证实.其中16例出现术后并发症,经治疗取得满意疗效,报告如下.

狭颅症是一种较少见的婴幼儿颅缝早闭造成的头颅畸形,而尖头畸形(全颅缝早闭)则更为少见.我们近几年收治2例尖头畸形的狭颅症患儿,采用改良冠状切口一期全颅再造治疗,效果满意,报告如下.