心房黏液瘤致脑栓塞动脉溶栓治疗后延迟再通一例

患者，女，64岁，于2010年8月14日因右侧肢体活动不灵5h人院，睡前上厕所时发病，查体：BP120／80mmHg（1mmHg=0．133kPa），神志清楚，失语，双眼左侧凝视，右侧鼻唇沟浅，伸舌不能，右侧肢体瘫，肌力II级，左侧肢体肌力正常，右侧巴氏征阳性。

介入溶栓治疗产褥期颅内静脉窦血栓形成1例的护理

现将介入溶栓治疗产褥期颅内静脉窦血栓形成1例的护理总结如下。 1病历摘要女，29岁。因剖宫产术后7d出现持续性头痛伴双眼胀痛、四肢无力3d于2011-01—25以颅内静脉窦血栓收入院。入院时患者神志清楚，精神烦躁，左上下肢肌力Ⅳ级。头颅MRI检查示上矢状窦、左侧横窦、乙状窦其颈内静脉未显影。入院后给予抗凝、脱水降颅压补液等治疗。2011-01—26患者癫痫发作，左上下肢肌力0级，给予对症治疗后2～3min症状缓解。

COMPARISON OF CELLULOSE ACETATE POLYMER AND ELECTROLYTIC DETACHABLE COILS FOR TREATMENT OF CANINE ANEURYSMAL MODELS

Electrolytic detachable coils (EDC) have been the main embolic materi als for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, t he embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared. Methods. The canine aneurysmal models constructed by anastomosis of venous pouch es were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow ups were performed at 24 hour, 2 week , and 2 month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research. Results. The effect of embolization was significantly better with WEDC than that with CAP . Post embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathol ogical research showed that CAP mass could packed the aneurysms more densely tha n coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltra tion was prominently found in early stage after CAP embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orific es of aneurysmal necks could be found in both groups 2 months after embolization . But parts of coils might be exposed outside endothelial layer. Conclusions. EDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of stron g chemical corrosion and difficulty in control before it is widely used.

脑脂肪栓塞综合征并发昏迷2例诊治分析

1病历摘要 例1：男，38岁。主因车祸致左小腿疼痛、出血、畸形12h入院。患者由他人送入院，未能提供相关病史。查体：中度昏迷，T36．5℃．P80次／min，BP120／80mmHg．血氧饱和度80％（低流量面罩吸氧后维持在92％），四肢抽搐．腱反射亢进Ot右上肢明显），病理征阳性，左胫腓骨开放骨折，左大腿后侧软组织大面积潜行剥脱，

心源性脑栓塞24例溶栓疗效分析

目的对接受溶栓治疗的心源性脑栓塞患者进行分析,探讨溶栓治疗的有效性。方法分析24例溶栓治疗CCE患者的病因、静脉溶栓时机、年龄等指标。结果 24例CCE患者病因多样。4例治愈,显效5例,好转7例,无效8例,其中2例细菌性心内膜炎及1例心肌黏液瘤患者治疗无效。治愈患者与无效患者年龄比较,差异有统计学意义(P<0.05),且发病时间明显短于其他疗效患者(P<0.01)。结论早期心源性脑栓塞溶栓疗效肯定,但受病因及发病时间的影响。