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1.
张英茹 《河北北方学院学报(医学版)》1998,(3)
新生儿惊厥是一危重症状,惊厥本身也可导致或加重脑组织的损害。其预后主要取决于病因及大脑受损的程度。须尽早使用止惊剂迅速控制,以利于整体治疗。本文仅对新生儿惊厥及止惊剂的临床应用进行探讨。 1 一般资料 1992-1997年共5年间,本院收住伴有惊厥症状新生儿76例,其中:男45例,女31例;按分娩方式分;顺产44例,难产32例。76例中,惊厥的首发日龄:生后第一天39例(占51.3％),7天以内63例(占82.9％),8-28天13例(占17.1％)。本文患儿惊厥多发于新生儿 相似文献
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足月新生儿缺氧缺血性脑病CT诊断 总被引：1，自引：0，他引：1
目的 :分析足月新生儿缺氧后脑损伤的机理 ,总结其CT征象 ,以提高诊断正确率 ,为临床采取及时而准确的治疗措施提供依据。方法 :回顾性分析近 10年经我院临床确诊的HIE患儿的临床资料和CT片 4 3例 ,分析其CT特征表现。结果 :4 3例均为足月产 ,生后出现不同程度缺氧体征 ,阿氏评分 3～ 6分 / 1min ,于发病 2h～ 2 2d行CT检查。影像学表现 :4 3例患儿双侧脑实质均出现不同程度的密度减低区 ,占 10 0 % ;9例蛛网膜下腔出血 ,占 2 1% ,其中 ,发生于右颞部 1例 ,后纵裂池 8例 ;管膜下出血 1例 ,占 2 .3% ,并破入侧脑室。结论 :新生儿缺氧缺血性脑病主要依靠临床诊断 ,影像检查可以发现脑损害的程度范围及是否伴发蛛网膜下腔出血。为诊断、选择治疗方案及判断预后提供重要依据。脑组织发生缺氧时 ,随着时间及乏氧程度的进展 ,其CT表现具有一定特征性 ,因此 ,对临床怀疑及已诊断为HIE的患儿进行CT检查是必要的。 相似文献
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目的:明确安宫牛黄丸对HIE(缺氧缺血性脑病)的治疗作用是否与S-100B的含量有关。方法:选取2015年1月至2016年1月赣州市人民医院收治的新生儿缺氧缺血性脑病患儿60例,随机分为常规组和治疗组(安宫牛黄丸组),各30例。常规组给予吸收氧气,纠正酸中毒、控制血压、控制血糖,补充液体和维持电解质及酸碱平衡等常规治疗;治疗组在常规组的基础上加用安宫牛黄丸治疗。比较两组患者血清S-100B水平并评价临床疗效。结果:安宫牛黄丸组血清S-100B蛋白水平为1.168±0.632,显著低于常规组的3.998±1.953,两组比较差异有统计学意义(P<0.05),说明安宫牛黄丸对HIE的治疗效果明显。结论:安宫牛黄丸对HIE的治疗作用与S-100B蛋白的含量有关,其在新生儿HIE患儿中的效果显著,值得临床推广应用。 相似文献
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目的:分析新生儿缺氧缺血性脑病(HIE)的CT表现.方法:162例HIE患儿均作头颅CT扫描,并在病灶部位测量CT值.结果:162例HIE患儿CT改变主要为脑白质低密度,可合并颅内出血.结论:据新生儿宫内窒息缺氧病史及临床表现,结合头颅CT表现,对本病可做出诊断. 相似文献
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伏爱国 《河北北方学院学报(医学版)》2000,(1)
目的 探讨新生儿缺氧缺血性脑病(HIE)的病因及临床特点。方法 对80例HIE患儿发病原因,临床表现,CT检查结果作总结、分析。结果 HIE病因以窒息和宫内窘迫最常见,临床表现多见意识障碍,原始反射异常,CT检查对HIE确诊更有意义。结论 基层医院应重视病因及临床表现,CT结果对HIE诊断帮助很大,并提出临床中应注意的几个问题。 相似文献
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目的:分析新生儿缺氧缺血性脑病(HIE)的CT表现.方法:162例HIE患儿均作头颅CT扫描,并在病灶部位测量CT值.结果:162例HIE患儿CT改变主要为脑白质低密度,可合并颅内出血.结论:据新生儿宫内窒息缺氧病史及临床表现,结合头颅CT表现,对本病可做出诊断. 相似文献
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目的:分析神经科患者以眩晕为主诉的常见病因,以及以眩晕为主诉的常见疾病的临床特征.方法:320例患者均为同一时期门诊及住院患者(门诊161例,住院159例),根据临床特点结合辅助检查,包括CT、TCD检查,Dix-Hallpike 试验,分析确定眩晕病因.结果:320例眩晕患者病因:良性阵发性位置性眩晕(BPPV)158例(49.37%),后循环缺血(PCI)107例(33.44%),神经症19例(5.94%),维生素B12缺乏10例(3.13%),其它26例(8.12%).结论:BPPV是眩晕患者常见病因;在眩晕病因的诊断中,TCD检查基底动脉血流速度缺乏特异性;年龄、眩晕持续的时间等特征可以做为眩晕病因诊断的重要指标. 相似文献
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李雪红 《赤峰学院学报(自然科学版)》2008,(12)
目的观察复方丹参注射液治疗新生儿缺氧缺血性脑病(HIE)的疗效及预后。方法在综合治疗的基础上应用复方丹参注射液治疗中,重度HIE30例,并与单纯综合治疗组30例进行对照。在患儿出院后12、18个月左右首次随访,4～6岁行智力测试。结果显效率和总有效率:治疗组为60%和90%,对照组为26.7%和66.7%,差异有显著性(P<0.01;P<0.05);20项新生儿神经行为评分,治疗组较对照组明显升高,差异有显著性;治疗组近期后遗症发生率显著低于对照组(P<0.05);智力测试正常率及平均智商显著高于对照组(P<0.05)。在丹参注射液的治疗过程中,未发现不良反应。结论复方丹参注射液治疗HIE安全有效,可以改善预后。 相似文献
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目的:探讨新生儿皮下坏疽临床治疗.方法:回顾性分析20年收治120例新生儿皮下坏疽病例,男性78例,女性42例.位于臀、背部80例,占67%;其它部位40例,占33%.结果:坏疽型最多72例,占60%;蜂窝织炎型25例,占20.8%;脓肿型17例,占14.2%;坏疽型6例,占5%.血液、脓汁培养阳性共111例,85例为金黄色葡萄球菌,15例为大肠杆菌,5例为白色葡萄球菌,4例为绿脓杆菌,2例各为链球菌、变形球菌,其中7例死亡.结论:新生儿皮下坏疽如早期诊断,早期正确治疗,不但能提高治愈率,而且可以减少后遗症. 相似文献
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目的:观察咪达唑仑持续静脉推注治疗小儿难治性惊厥的临床疗效及不良反应。方法:选择以频繁惊厥为主要表现且按传统方法抗惊厥治疗无效的住院儿童42例。研究分两组,对照组21例在出现频繁惊厥采用苯巴比妥联用安定治疗无效后以安定加入葡萄糖溶液静脉持续滴注,研究组则给予咪达唑仑静脉持续推注。对比两组疗效,同时观察两组的不良反应。结果:研究组21例患儿有20例惊厥完全得到控制,1例无效,有效率为95.2%,且气道分泌物少,无明显呼吸抑制及其他不良反应。对照组仅12例惊厥被完全控制,9例无效,有效率为57.1%,且部分患儿在治疗过程中出现呼吸抑制,气道分泌物增加等不良反应。两组有效率具显著性差异(P<0.01)。结论:咪达唑仑对小儿难治性惊厥疗效明显,不良反应少,可作为治疗小儿难治性惊厥的首选方法。 相似文献
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为探讨BTX—A的疗效和不良反应,对我国已开展的BTX—A注射疗法的神经科适应症、方法、疗效、副作用和注意事项进行分析;治疗眼睑痉挛197例,24 h起效,2~7 d迅速缓解,治疗面肌痉挛573例,有效率分别为98.3%和98.02%;治疗M e ige综合症3例;配合口服安定和氯硝安定明显加强了疗效,对于痉挛状态,结合针灸推拿、疗效优于单纯用BTX—A或针灸推拿;治疗痉挛性构音障碍,3~7 d发音恢复正常;局部运用BTX—A无全身不良反应,局部反应轻微;局部注射BTX—A治疗多种运动障碍简便、安全、有效。 相似文献
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目的：用斑马鱼建立一种电惊厥动物模型。方法：50μA电流刺激斑马鱼,观察其惊搐反应;2000μA电流刺激斑马鱼,观察其惊厥反应。地西泮、咪达唑仑、苯巴比妥、苯妥英、丙戊酸、琥珀酸预处理斑马鱼后,分别给予50斗A和2000μA电流刺激斑马鱼1s,观察药物抗惊搐及惊厥作用。结果：50μA电流刺激1s可使斑马鱼发生惊搐反应,2000μA刺激斑马鱼可发生类似小鼠最大电休克的惊厥反应。上述抗惊厥药物均可抑制电刺激所致的惊搐反应与惊厥反应（P〈0．05,P〈0．01）。结论：斑马鱼可作为一种新型电惊厥模型,对于神经药理学研究和抗癫痫药筛选有积极意义。 相似文献
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OBJECTIVE: The purpose of this study was to investigate retrospectively neonatal health and maternal background among a sample of children taken into custody and placed in foster care and to investigate the relation between medical and social risk in the neonatal period. METHOD: The data-linkage study combined two registries: the Finnish Medical Birth Registry (MBR), from January 1, 1987 to December 31, 1989, and the Finnish Child Welfare Registry (CWR) from January 1, 1987 to December 31, 1997 using personal identification numbers (n=1,668). As controls all Finnish children born in 1987 were chosen (n=59,727). Infant neonatal health was estimated using the following indicators: birth-weight and birth-length, birth-weight by gestational age, 1-minute Apgar scores, and discharge age from the nursery. Maternal background characteristics included maternal age, parity, marital status, number of antenatal visits at maternity clinics and smoking during pregnancy. RESULTS: We found that the 1,668 children in the study had a lower birth-weight and birth-length, shorter gestational age, lower 1-minute Apgar scores and later discharge from the nursery than the population-based controls. The proportion of teen-age mothers was about four times higher and the proportion of unmarried women was twice as high. A majority of the women (56%) reported smoking during pregnancy, compared with only 15% of the population-based comparisons. Children subsequently taken into custody had poorer health at the time of birth than other children and these differences could only partly be explained by the differences in smoking habits during pregnancy. The women in the study made use of the free health controls at maternity clinics as much as the population-based comparisons. CONCLUSIONS: Our findings indicate that social and medical risks are related in the neonatal period. Since almost all mothers visit maternity clinics, there are possibilities for early intervention. 相似文献
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OBJECTIVE: There were two aims: First, to compare children's rates of being battered in home, by peers, and by teachers among students between China and Korea, and second, to identify particular risk factors for such violence. METHODS: Children in grades four through six in Shanghai (238 cases) and Yanji (245 cases) in China and Seoul (248 cases) and Kimpo (241 cases) in Korea were surveyed by questionnaire method. They were asked to complete the Straus' Conflict Tactics Scale and their frequencies in the three situations respectively, and other demographic items. RESULTS: Family violence during the last 1 year was experienced in 70.6% (minor 42.2%; serious 22.6%) of the children in China and 68.9% (minor 9.4%; serious 51.3%) of those in Korea. Experience rates of violence by peers were 42.7% (minor 25.7%; serious 13.7%) in China and 26.0% (minor 11.5%; serious 14.3%) in Korea. Finally, rates of corporal punishment by teachers were 51.1% (minor 28.0%; serious 4.1%) in China and 62.0% (minor 8.8%; serious 43.8%) in Korea. The most important and common risk factor for violence in one situation was the presence of violence in another situation. CONCLUSIONS: The findings indicate that the differences in children's overall experience rates were not particularly striking. However, Korean children experienced more severe forms of violence from family members and from teachers. Findings of risk factors clearly imply that there are children vulnerable to violence from multiple sources. 相似文献
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M A Zelenko L C Huffman B W Brown K Daniels J Lock Q Kennedy H Steiner 《Child abuse & neglect》2001,25(11):1481-1495
OBJECTIVE: The study explores the prenatal Child Abuse Potential (pCAP) scores derived from the Child Abuse Potential Inventory administered to expectant adolescent mothers. The aim of the study was to assess the association of the pCAP scores with maternal negative prenatal behaviors, and evaluate the contribution of the pCAP scores to neonatal morbidity. METHOD: The pCAP scores, demographic data, and self-report on prenatal behaviors were obtained during the second half of the pregnancy in a sample of 45 poor single adolescent mothers. A pediatrician blind to the prenatal data reviewed the neonatal records to assess neonatal morbidity. Maternal prenatal records were reviewed for obstetric risk assessment by an obstetrician who was blind to the rest of the data. The relations among the pCAP scores, prenatal behaviors, and neonatal morbidity were analyzed. RESULTS: In the prenatal period, the pCAP scores were positively correlated with self-reported prenatal smoking and substance use. The multiple linear regression analysis showed that the pCAP scores significantly contributed to neonatal morbidity independently of obstetric risk factors. CONCLUSIONS: The Child Abuse Potential scores obtained during pregnancy in poor single adolescent mothers reflect domains of maternal functioning that are associated with negative prenatal behaviors and appear to be important for predicting neonatal morbidity. Further studies are warranted to validate the prenatal use of the Child Abuse Potential Inventory. 相似文献
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目的通过对襄阳市某三甲医院218例黄疸新生儿进行血清学检测及结果分析,了解本地区新生儿溶血病（HDN）的发病情况,为本地区临床诊疗HDN提供依据。方法对218例黄疸新生儿进行常规血型鉴定、血清不规则抗体筛查和新生儿溶血病三项检查。结果218例患儿中,确诊HDN患儿占21．56％（47／218）,其中ABO—HDN为21．11％（46／215）、Rh—HDN为0146％（1／215）。确诊为ABO—HDN的患儿血型分布情况为A型占10．23％（22／215）,B型占9．77％（21／215）,AB型占0．93％（2／215）,0型无。3例RhD阴性患儿中,发生1例HDN。结论本地区A型和B型新生儿患ABO—HDN均常见,母婴Rh血型不合者中黄疸新生儿HDN患病率较高,应引起重视。对于临床表现疑似HDN患儿应将HDN三项检查列为重要有力证据。 相似文献
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目的 :分析及探讨住院儿童死亡原因 ,以提高儿科临床工作质量 ,降低儿童死亡率。方法 :对 188例住院患儿死亡病例进行回顾分析。结果 :住院患儿的病死率为 2 .0 %。新生儿死亡数占总死亡数的 2 3.4 % ,1岁占 38.8% ,故 1岁以内死亡数占总死亡数的 6 2 .2 %。导致住院儿童死亡的前十位疾病是肺炎、病毒性脑炎、白血病、新生儿窒息、婴幼儿腹泻、败血症、结核病、先天性心脏病、新生儿硬肿症和中毒意外。新生儿、婴幼儿、学龄前及学龄儿的首位死因分别是新生儿窒息、肺炎和白血病。结论 :加强围生期保健 ,预防窒息 ,重视肺炎、白血病的防治对降低儿科住院病死率有重要意义。 相似文献
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Gao Min Zhou Wen Shi Jian-ming Hong De-fei Mu Yi-ping Wang Jian-guo Wang Yao-dong 《浙江大学学报(A卷英文版)》2000,1(4):456-458
Objective: To evaluate the benefit of intraoperative ERCP and endoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy
(LC) in the treatment of cholelithiasis with choledocholithiasis. Methods: Fifty-two patients with cholelithiasis and choledocholithiasis
(as determined by intraoperative cholangiography) were randomly divided into 2 groups during LC. In group A (27 patients),
common bile duct stones were extracted by intraoperative EST during LC. In group B(25 patients), common bile duct (CBD) stones
were extracted by conversion to open CBD exploration and cholecyctectomy. Results: The success rate was 26/27 (96.3%) in group
A and 25/25 (100%) in group B (0.25<P<0.5); The mean postoperative hospitalization was 3.32±0.56 days in group A and 17.5±4.61 days in group B (P<0.001). In group A, two cases were complicated transient hyperamylasemia after the combined procedure. In group B, one case
of bile leakage and one case of duodenal ulcer occurred after conversion to open cholecystectomy with CBD exploration. There
were no retained stones in group A but 2 cases in group B. Conclusion: Intraoperative ERCP and endoscopic sphincterotomy combined
with LC for treatment of cholelithiasis and chiledochlithiasis is safe, effective and results in shorter hospitalization and
fewer complications than traditional open cholecystectomy with CBD exploration. 相似文献
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目的探讨用三种不同方法取痰培养对明确下呼吸道感染病原菌的价值.方法对58例下呼吸道感染的患者进行了三种不同方法取样培养.结果普通自然咳痰培养(下文简称PZK)标本合格54例,占93.1%;培养阳性16例,占29.63%;用复方洗必泰含漱液漱口后取样(下文简称FXHY)标本合格56例,占96.55%;培养阳性28例,占50%;用经纤支镜防污染毛刷取样(下文简称FBPSB)标本合格58例,占100%;培养阳性32例占55.2%,FXHY与PZK比较P＜0.05有差异,FXHY与FBPSB比较P＞0.05无差异,且FXHY与FBPSB阳性符合率为81.3%.结果FXHY取痰法是一种简便易行,且阳性较高的一种方法. 相似文献