简介:摘要目的分析麻痹性痴呆(GPI)误诊原因,研究GPI的诊断与治疗。方法对曾被误诊的15例GPI,使用简易智力状态检查量表(MMSE)评定其智力状况,并予以驱梅素及抗精神病药物治疗。结果驱梅素治疗可显著提高疗效。结论GPI极易被误诊,忽略了患者的认知障碍和未做细致的神经系统检查是误诊的重要原因。早期诊断和治疗是预后的关键。
简介:腹间隔综合征(abdominalcompartmentsyn-drome,ACS)是腹腔内高压持续一定时间后导致的多个器官功能不全甚至衰竭。在临床上可表现为严重腹胀、通气障碍、难治性高碳酸血症、肾功能不全等。目前该病的报道较少见。为提高儿科医生对本病的认识,现将我院2005年6月至2008年11月收治的15例ACS患儿的临床资料回顾性分析并报告如下。1对象与方法1.1研究对象15例ACS患儿中男9例,女6例;年龄40d至12岁。其中原发病为急性出血性坏死性小肠结肠炎9例,急性胃扩张3例,继发性腹膜炎3例。发病至诊断治疗时间:48h内8例,48~72h内5例,超过72h2例。1.2ACS诊断
简介:摘要目的探讨机械通气在重症哮喘患儿抢救治疗中的疗效。方法对2005年1月至2010年1月在我院住院治疗的15例重症哮喘患儿因发生严重呼吸衰竭而危及生命,采用无创通气或者气管插管机械通气,观察上机前和上机后pH值、Pa02、PaC02等动脉血气指标变化。结果经机械通气治疗后15例患儿的动脉血pH值、Pa02、PaC02等动脉血气指标变化均值恢复正常,与治疗前比较差异有统计学意义(P<0.05)。结论机械通气可迅速缓解患儿的呼吸衰竭状况,为药物治疗赢得时间。无创通气时要密切观察患儿情况,把握适应征、调节适当的通气模式和参数、尽早撤机拔管是抢救治疗成功的关键。
简介:AbstractTwin anemia polycythemia sequence (TAPS) is a chronic form of unbalanced feto-fetal transfusion through minuscule placental anastomoses in monochorionic twin pregnancies, leading to anemia in the donor twin and polycythemia in the recipient twin. TAPS can occur spontaneously in up to 5% of monochorionic twins or can arise in 2%-16% of cases after incomplete laser surgery for twin-twin transfusion syndrome. TAPS can develop across the entire second and third trimester. Antenatal diagnosis for TAPS is reached via Doppler measurement of the fetal middle cerebral artery peak systolic velocity, showing an increased velocity in the donor, combined with a decreased velocity in the recipient. Treatment options for TAPS include expectant management, preterm delivery, intrauterine blood transfusion with or without a partial exchange transfusion, fetoscopic laser surgery and selective feticide. The best treatment option is unclear and is currently being investigated in an international multicenter randomized trial (the TAPS trial). Spontaneous fetal demise occurs in 5%-11% of TAPS twins, more often in donors (8%-18%) than in recipients (2%-5%). Severe long-term neurodevelopmental impairment is seen in 9% of TAPS twins, with donors having an increased risk for cognitive impairment and hearing problems (15%).