目的 探讨磷酸化tau蛋白(P-tau)及其与总tau蛋白(P-tau/T-tau)比对预测创伤性脑损伤(traumatic brain injury,TBI)病人6个月内死亡和预后情况的诊断效能.方法 2017年6月～2019年6月收治的TBI病人90例.采用格拉斯哥预后评分(GOS)记录病人随访6个月后死亡和预后情况,由此将病人分为死亡组、存活组、预后良好组、预后不良组,采用Logistic回归分析死亡相关因素,分析伤后6小时内P-tau、P-tau/T-tau与GOS评分相关性,绘制ROC曲线评估前二者对死亡和预后的预测效能.结果 最终纳入86例,死亡组发病至入院时间、P-tau、P-tau/T-tau均高于存活组,格拉斯哥昏迷评分(GCS)低于存活组,差异有统计学意义(P<0.05);P-tau和P-tau/T-tau为死亡危险因素(P<0.05);预后良好组GOS评分高于预后不良组,P-tau和P-tau/T-tau低于预后不良组,差异有统计学意义(P<0.05);P-tau和P-tau/T-tau均与GOS评分呈负相关(r=-0.773、-0.745,均P=0.000);P-tau和P-tau/T-tau预测病人死亡的AUC分别为0.767与0.873、0.968与0.961,两者预测死亡(91.30％和91.34％)和预后(94.11％和91.24％)的敏感性无明显差异(P>0.05).结论 P-tau水平和P-tau/T-tau值可有效预测TBI病人6个月内死亡和预后情况.
目的：探讨对脑室出血患者采用侧脑室引流联合腰大池引流手术方式的疗效。方法对入选的20例脑室出血病例采用侧脑室引流联合腰大池引流术，并同时应用尿激酶，观察其治疗效果。结果本组术后死亡1例，为再出血致血肿增大致脑疝而死亡。术后存活19例，随访6个月GOS评分：优良11例，轻残4例，重残4例，植物状态1例，均无脑积水发生。结论脑室出血采用侧脑室引流联合腰大池引流术，可明显降低死亡率，同时清除脑室系统及蛛网膜下腔的积血，可明显减少脑积水发生。
Objective To study the effect of Encephalo-Duro-Arterio-Myo-Synangiosis(EDAMS) method for the treatment of moyamoya disease.Methods 11 cases of moyamoya patients diagnosed with digital subtraction cerebral angiography(DSA) were chosen and treated with EDAMS method.All the patients were followed up after operation and their DSA reviewed.The clinical efficacy was observed.Results Follow-up(3~24 months) revealed all the 11 patients recovered well.Smog-like vessels decreased in three cases by DSA review two years after operation.External carotid artery blood was apparently supplied to the cortex.DSA retests were not conducted on other cases.Conclusion EDAMS is an indirect vascular fusion surgery for the treatment of moyamoya disease,which is relatively simple and has certain curative effect on some patients.
