【摘要】 目的 探討伴有動(dòng)眼神經(jīng)麻痹的后交通動(dòng)脈瘤的顯微手術(shù)治療效果?！》椒ā』仡櫺苑治?008年1月—2010年12月采用顯微外科手術(shù)治療的伴隨動(dòng)眼神經(jīng)麻痹的后交通動(dòng)脈瘤患者52例的臨床資料，觀察動(dòng)眼神經(jīng)麻痹的恢復(fù)情況，總結(jié)臨床經(jīng)驗(yàn)。術(shù)后隨訪時(shí)間3～36個(gè)月，平均16個(gè)月?！〗Y(jié)果 發(fā)病至手術(shù)時(shí)間lt;14 d患者34例，22例（64.7%）完全恢復(fù)，12例（35.3%）部分恢復(fù)。gt;14 d者18例，6例（32.3%）完全恢復(fù)，12例（67.7%）不完全恢復(fù)。不完全性麻痹15例，12例（80.0%）完全恢復(fù)，3例（20.0%）得到改善；而術(shù)前完全動(dòng)眼神經(jīng)麻痹的37例中，僅11例（29. 7% ）徹底恢復(fù)、26例（70. 3% ）部分恢復(fù)。 結(jié)論 早期明確診斷及盡早手術(shù)治療，對(duì)于伴隨有動(dòng)眼神經(jīng)麻痹的后交通動(dòng)脈瘤患者的神經(jīng)功能恢復(fù)極為重要?！続bstract】 Objective To explore the curative effect of microsurgical treatment for posterior communicating artery aneurysms associated with oculomotor palsy. Methods The clinical data of 52 patients with posterior communicating artery aneurysms associated with oculomotor palsy treated microsurgically from January 2008 to December 2010 were retrospectively analyzed. Recovery of oculomotor palsy was observed, and clinical experiences were summarized. Results The follow-up time ranged from 3 to 36 months with a mean period of 16 months. Among the 34 patients operated on within 14 days after the onset of oculomotor palsy, 22 (64.7%) showed complete recovery, and 12 (35.3%) partial recovery. In the 18 patients operated on more than 14 days after the onset of the disease, 6 (32.3%) showed complete recovery, and 12 (67.7%) partial recovery. Incomplete palsy occurred in 15 patients among whom 12 (80%) had complete recovery and 3 (20%) alleviation. Among the other 38 patients with complete oculomotor palsy, only 11 (29.7%) got complete recovery, and the remaining 26 (70.3%) partial recovery. Conclusion Early and positive diagnosis and treatment of patients with posterior communicating artery aneurysms associated with oculomotor palsy is of great importance to the nerve function recovery.
目的:探討內(nèi)鏡在梗阻性腦積水治療中的臨床應(yīng)用價(jià)值。方法:將我院80例梗阻性腦積水患者隨機(jī)分為治療組及對(duì)照組,對(duì)照組患者采用分流術(shù),治療組患者采用神經(jīng)內(nèi)鏡下三腦室底造瘺術(shù)。結(jié)果:治療組均造瘺成功,無(wú)中轉(zhuǎn)分流術(shù)。手術(shù)時(shí)間治療組明顯短于對(duì)照組,術(shù)后并發(fā)癥例數(shù)也明顯少于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(Plt;0.05),術(shù)后癥狀緩解率差異無(wú)統(tǒng)計(jì)學(xué)意義(Pgt;005)。兩組患者均獲隨訪,時(shí)間6～12個(gè)月,癥狀均有鎖緩解,復(fù)查CT或MRI見(jiàn)腦室均有不同程度縮小.結(jié)論:ETV治療梗阻性腦積水符合當(dāng)今神經(jīng)外科微創(chuàng)原則,療效確切,手術(shù)時(shí)間短、腦暴露少、對(duì)組織損傷小,手術(shù)費(fèi)用降低,并發(fā)癥少,值得推廣。
目的:研究微創(chuàng)側(cè)腦室穿刺聯(lián)合置管外引流術(shù)治療腦室出血的療效。方法:將我院48例腦室出血患者隨機(jī)分為治療組及對(duì)照組,對(duì)照組采用常規(guī)內(nèi)科藥物治療,治療組在對(duì)照組基礎(chǔ)上采用微創(chuàng)側(cè)腦室穿刺聯(lián)合置管外引流術(shù)。結(jié)果:治療組的總有效率為83.33%,顯著高于對(duì)照組的50.0%,死亡率顯著低于對(duì)照組,以上差異有統(tǒng)計(jì)學(xué)意義(Plt;0.05)。結(jié)論:微創(chuàng)側(cè)腦室穿刺聯(lián)合置管外引流術(shù)治療腦室出血效果好,損傷小、操作簡(jiǎn)便易行,縮短了病程,顯著降低了患者致殘率及死亡率,及早手術(shù),可提高治愈率和生存質(zhì)量,值得推廣。
通過(guò)應(yīng)用管理理論中的態(tài)勢(shì)分析法（SWOT），對(duì)縣級(jí)醫(yī)院現(xiàn)有的優(yōu)劣勢(shì)及機(jī)遇威脅進(jìn)行剖析，并依據(jù)其自身的優(yōu)劣勢(shì)，選擇和策略性規(guī)劃發(fā)展戰(zhàn)略，構(gòu)筑提升醫(yī)院核心競(jìng)爭(zhēng)力的SWOT矩陣，明確提升醫(yī)院核心競(jìng)爭(zhēng)力的路徑，為西部縣級(jí)醫(yī)院科學(xué)決策和可持續(xù)發(fā)展提供參考依據(jù)。