Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.Th...Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.The patients were divided into observation group(n=15)and control group(n=40)according to received perioperative cranial ultrasound or not.The general data and surgical data were compared between groups,and ultrasonic data of observation group were analyzed.Results The proportions of good prognosis 1 and 6 months after operation in observation group were both higher than those in control group,while the incidence of cerebral infarction in observation group was lower than that in control group(all P<0.05).No significant difference of general data nor other surgical data was found between groups(all P>0.05).Acute encephalocele occurred in 1 case in observation group during operation,and cranial ultrasound accurately showed the contralateral secondary epidural hematoma.Increased intracranial pressure in different degrees were found in all 15 cases(15/15,100%)in observation group after operation with transcranial color coded Doppler(TCCD)or transcranial Doppler(TCD),while cerebral vascular spasm was observed in 5 cases(5/15,33.33%),among them 4 cases(4/5,80.00%)were diagnosed cerebral infarction based on CT examination.Conclusion Cranial ultrasound could be used to evaluate changes of sTBI in perioperative period and guide adjusting treatment strategy in time,being valuable for reducing risk of postoperative cerebral infarction and improving prognosis.展开更多
目的探讨沙格列汀对2型糖尿病伴缺血性脑卒中患者血糖水平及认知功能的影响。方法选择2018年11月至2020年11月焦作市人民医院收治的150例2型糖尿病伴缺血性脑卒中患者为研究对象。将患者随机分为观察组和对照组,每组75例。2组患者均给...目的探讨沙格列汀对2型糖尿病伴缺血性脑卒中患者血糖水平及认知功能的影响。方法选择2018年11月至2020年11月焦作市人民医院收治的150例2型糖尿病伴缺血性脑卒中患者为研究对象。将患者随机分为观察组和对照组,每组75例。2组患者均给予常规治疗,对照组患者在常规治疗基础上给予二甲双胍治疗,观察组患者在常规治疗基础上给予沙格列汀治疗,均连续治疗3个月。比较2组患者治疗前后的血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、血糖漂移幅度[日内平均血糖漂移幅度(MAGE)、日间血糖漂移幅度(MODD)、平均餐后血糖漂移幅度(MPPGE)、血糖水平标准差(SDBG)]、肾功能指标[血肌酐(SCr)、血尿素氮(BUN)、血清胱抑素C(Cys C)]、认知功能[蒙特利尔认知评估量表(MoCA)评分]及不良反应发生情况。结果治疗前2组患者FBG、2 h PBG、HbA1c比较差异均无统计学意义(P>0.05);2组患者治疗后FBG、2 h PBG、HbA1c水平均低于治疗前(P<0.05);治疗后,2组患者的FBG、2 h PBG、HbA1c水平比较差异均无统计学意义(P>0.05)。治疗前2组患者的MAGE、MODD、MPPGE、SDBG比较差异均无统计学意义(P>0.05);治疗后,2组患者的MAGE、MODD、MPPGE、SDBG均低于治疗前(P<0.05),且观察组患者的MAGE、MODD、MPPGE、SDBG低于对照组(P<0.05)。治疗前2组患者的SCr、BUN、Cys C水平比较差异均无统计学意义(P>0.05);2组患者治疗后的SCr、BUN、Cys C水平均低于治疗前(P<0.05);治疗后,2组患者的SCr、BUN、Cys C水平比较差异均无统计学意义(P>0.05)。治疗前2组患者的MoCA评分比较差异无统计学意义(P>0.05);2组患者治疗后的MoCA评分均高于治疗前(P<0.05);治疗后,2组患者的MoCA评分比较差异无统计学意义(P>0.05)。观察组和对照组患者不良反应发生率分别为12.00%(9/75)、14.67%(11/75),2组患者的不良反应发生率比较差异无统计学意义(χ^(2)=0.231,P>0.05)。结论沙格列汀能有效降低2型糖尿病伴缺血性脑卒中患者的血糖水平、改善患者的肾功能和认知功能,获得与二甲双胍相同的治疗效果,其对血糖漂移幅度的改善作用更强,且安全性佳。展开更多
目的观察注射用丹参多酚酸治疗中度急性缺血性脑卒中的有效性和安全性。方法采用多中心、随机、双盲、平行对照临床研究方法。以美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分为6~22分的急性缺血...目的观察注射用丹参多酚酸治疗中度急性缺血性脑卒中的有效性和安全性。方法采用多中心、随机、双盲、平行对照临床研究方法。以美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分为6~22分的急性缺血性卒中患者为对象,将其随机分为研究组和对照组。两组患者均给予常规基础治疗,研究组在基础治疗上加用注射用丹参多酚酸静脉滴注,每日1次,每次130 mg,对照组在基础治疗上给予等量生理盐水,两组均连续治疗14 d。在用药后第14 d、第30 d和第90 d评估NIHSS评分、Barthel指数评分,以治疗后30 d、90 d时改良Rankin量表评分(modified Rankin scale,mRS)评估预后(0~2分为预后良好),根据患者不良事件进行安全性评估。结果共纳入1529例脑卒中患者,其中研究组1021例,对照组508例。研究组和对照组在治疗后第14 d、第30 d和第90 d的NIHSS评分、Barthel指数组间差异均有统计学意义(均P<0.05),治疗后30 d、90 d研究组预后良好率高于对照组,组间差异有统计学意义(P<0.05)。研究组与对照组不良事件发生率差异无统计学意义(P>0.05)。结论注射用丹参多酚酸用于治疗中度急性脑卒中有效且安全,在连续治疗2周后其疗效优于基础治疗。展开更多
文摘Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.The patients were divided into observation group(n=15)and control group(n=40)according to received perioperative cranial ultrasound or not.The general data and surgical data were compared between groups,and ultrasonic data of observation group were analyzed.Results The proportions of good prognosis 1 and 6 months after operation in observation group were both higher than those in control group,while the incidence of cerebral infarction in observation group was lower than that in control group(all P<0.05).No significant difference of general data nor other surgical data was found between groups(all P>0.05).Acute encephalocele occurred in 1 case in observation group during operation,and cranial ultrasound accurately showed the contralateral secondary epidural hematoma.Increased intracranial pressure in different degrees were found in all 15 cases(15/15,100%)in observation group after operation with transcranial color coded Doppler(TCCD)or transcranial Doppler(TCD),while cerebral vascular spasm was observed in 5 cases(5/15,33.33%),among them 4 cases(4/5,80.00%)were diagnosed cerebral infarction based on CT examination.Conclusion Cranial ultrasound could be used to evaluate changes of sTBI in perioperative period and guide adjusting treatment strategy in time,being valuable for reducing risk of postoperative cerebral infarction and improving prognosis.
文摘目的探讨沙格列汀对2型糖尿病伴缺血性脑卒中患者血糖水平及认知功能的影响。方法选择2018年11月至2020年11月焦作市人民医院收治的150例2型糖尿病伴缺血性脑卒中患者为研究对象。将患者随机分为观察组和对照组,每组75例。2组患者均给予常规治疗,对照组患者在常规治疗基础上给予二甲双胍治疗,观察组患者在常规治疗基础上给予沙格列汀治疗,均连续治疗3个月。比较2组患者治疗前后的血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、血糖漂移幅度[日内平均血糖漂移幅度(MAGE)、日间血糖漂移幅度(MODD)、平均餐后血糖漂移幅度(MPPGE)、血糖水平标准差(SDBG)]、肾功能指标[血肌酐(SCr)、血尿素氮(BUN)、血清胱抑素C(Cys C)]、认知功能[蒙特利尔认知评估量表(MoCA)评分]及不良反应发生情况。结果治疗前2组患者FBG、2 h PBG、HbA1c比较差异均无统计学意义(P>0.05);2组患者治疗后FBG、2 h PBG、HbA1c水平均低于治疗前(P<0.05);治疗后,2组患者的FBG、2 h PBG、HbA1c水平比较差异均无统计学意义(P>0.05)。治疗前2组患者的MAGE、MODD、MPPGE、SDBG比较差异均无统计学意义(P>0.05);治疗后,2组患者的MAGE、MODD、MPPGE、SDBG均低于治疗前(P<0.05),且观察组患者的MAGE、MODD、MPPGE、SDBG低于对照组(P<0.05)。治疗前2组患者的SCr、BUN、Cys C水平比较差异均无统计学意义(P>0.05);2组患者治疗后的SCr、BUN、Cys C水平均低于治疗前(P<0.05);治疗后,2组患者的SCr、BUN、Cys C水平比较差异均无统计学意义(P>0.05)。治疗前2组患者的MoCA评分比较差异无统计学意义(P>0.05);2组患者治疗后的MoCA评分均高于治疗前(P<0.05);治疗后,2组患者的MoCA评分比较差异无统计学意义(P>0.05)。观察组和对照组患者不良反应发生率分别为12.00%(9/75)、14.67%(11/75),2组患者的不良反应发生率比较差异无统计学意义(χ^(2)=0.231,P>0.05)。结论沙格列汀能有效降低2型糖尿病伴缺血性脑卒中患者的血糖水平、改善患者的肾功能和认知功能,获得与二甲双胍相同的治疗效果,其对血糖漂移幅度的改善作用更强,且安全性佳。
