{"nowTime30":1785233853804,"lyBarModerator":null,"metaSearch":{"description":"男,53岁。脑梗失语 ，行走不利索右偏，有时咬异物，大小便不知。目前影像检查脑血肿请教脑血肿老人不手术保守治疗方法和用药","keywords":"请教脑血肿治疗和用药_洞医","title":"请教脑血肿治疗和用药_洞医","channels":null},"identificate":{"id":null,"isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"realName":null,"certifiedStatus":0,"phone":null,"email":null,"hospitalId":null,"departmentId":null,"illName":null,"illId":null,"cardType":0,"cardImg":null,"idCardImg":null,"identityType":0,"stop":0,"departmentName":null,"hospitalName":null},"canEdit":null,"adList":[],"lyBar":{"id":"1690","isDel":0,"createAt":1483439340281,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"北京协和医院神经外科","type":101,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":"110000","cityId":"110101","illId":null,"hospitalId":"15009","keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"description\":\"洞医为您提供:北京协和医院神经外科专家、北京协和神经外科专家、北京协和神经外科电话、病友的治疗经验等相关信息，让您在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"北京协和医院神经外科专家_北京协和神经外科专家_北京协和神经外科电话_洞医\",\"title\":\"北京协和医院神经外科专家_北京协和神经外科专家_北京协和神经外科电话_洞医\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"1899","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"颅裂的预防","content":"

     本病是胎儿期神经管闭合不全后的一种常见畸形，其病因可能是与中枢神经系统在发育中对各种创伤、感染、放射性照射或化学性损害等因素的易感性有关，但具体某一因素致哪一种畸形，目前尚未清楚。孕妇在妊娠早期应避免上述因素的接触；一旦婴儿在生后发现头部膨出物时，不要用民间膏药外敷消肿，以免肿物溃破引起脑膜炎，宜到医院接受医生指导治疗。手术后患儿应避免过多哭闹、咳嗽，防止修补的脑膜破裂，颅内容再膨出。  


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　　脑疝患者怎么护理

　　1.临床证实，对所有脑出血患者应用皮质类固醇治疗，并未显示任何好处，但仍需应用这类药物来预防继发的脑疝和最大可能地保持意识清醒。

　　2.临床推荐，初次剂量10mg～12mg地塞米松静注，随后每6小时给4mg。渗透性利尿剂甘露醇每4小时静脉快速滴入100g，预防因颅内压增高引起的急性脑疝。

　　宜与忌

　　1.观察患者神志意识，生命体征。

　　2.保持呼吸道通畅，必要时吸氧或进行人工换气。

　　3.如为钩回疝，应立即输注甘露醇、激素;如为小脑扁桃体疝，应立即人工辅助呼吸。紧急时作侧脑室空刺放液，并尽快查明病因，酌情手术切除病变部位或施行减压术。

　

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于2006年发现有手指抖动症状。渐进出现活动僵硬症状。目前不能自理，运动困难。搀扶可以走路。睡觉不能自主翻身。想问问神经外科是否能做脑内深部电极植入？整个治疗过程需要多长时间？电池需要多久更换？电池能否充电？整个费用怎样？或者是否还有更好的治疗方案？谢谢

","barId":"1690","topicTypeId":null,"topicThemeId":"1020","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":2},{"id":"1143","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"吃德巴金起了皮疹怎么办?","content":"

2015年六月第一次发作，没有意识到是这个病，未就医。2016年四月第二次发作，去甘肃中西医结合医院确疹为癫痫开始每天吃一片德巴金，每三十几天发作一次，都是大发作。八月四号去唐都作全面检查，八月八号开始加量，控制的挺好，就是身上痒，有皮疹。 
德巴金加量后效果理想，就是出现皮疹，望指导！

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颅内压增高症状 

早期病人一般无颅内压增高一旦出现说明病情危重，而且多为晚期。系发生梗阻性脑积水所致个别出现较早的病人可能为合并颅内肿瘤或蛛网膜囊肿的原因。病人表现为剧烈头痛、恶心呕吐视盘水肿甚至发生枕骨大孔疝，出现意识障碍呼吸循环障碍或突然呼吸停止而死亡颅底陷入病人出现颅内高压并不多见


","barId":"1690","topicTypeId":null,"topicThemeId":"1016","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"3681","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"颅底陷入症病因","content":"

病因以先天性发育畸形为常见，可与扁平颅底(颅前窝底与斜坡构成的颅底，角>145度)、环枢椎畸形、小脑扁桃体下疝等合并存在。  


","barId":"1690","topicTypeId":null,"topicThemeId":"1015","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"4962","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"女孩被飞镖穿颅骨 呼吁网上和学校周边管制此类仿真玩具","content":"

　　浙青网-青年时报消息，正在教室安静写作业，谁知一个“火影忍者”飞镖忽然飞来插入头顶。昨天下午，杭州某学校11岁女生雯雯被紧急送到浙江大学医学院附属儿童医院神经外科。
飞来横祸插入头顶飞来横祸插入头顶

　　昨天下午5点多，浙大儿院神经外科副主任医师沈志鹏接到急诊求助。赶来一看，一个女孩左侧头顶被插入一个飞镖。雯雯家长反映，雯雯下午课间时在教室里写作业，同班的同学在玩飞镖时不慎将她砸中。

　　“可以看得出，这个飞镖仿真度特别高，是金属制品，飞镖的一角像针刺一样牢牢插入头顶左侧。飞镖插入多深？是否伤及脑实质？这些都需要进一步探查。”沈志鹏告诉记者，当时，神经外科立马为雯雯做了CT，检查发现，飞镖一角穿透头皮2cm，但具体伤到什么程度，只能通过手术才能发现。

　　术前，雯雯的家长十分紧张。“当时有两个方案，一个是直接清创拔出，另一个则需要打开头皮颅骨进一步探查，但对雯雯的创伤无疑是非常大的。在经过反复研究讨论后，家长决定清创拔出。” 沈志鹏说，“昨天晚上10点，手术开始了，手术过程中，我们发现已经穿透整个颅骨，所幸的是被颅骨下一层黏膜挡住，没有损伤到脑实质。”

　　整个手术进行了一个小时。术后，雯雯的状态比较好。今天上午查房时，雯雯表示除了伤口处还有点疼，其他也都好。沈志鹏谈到，接下来还要观察伤口是否会继续感染，需要核磁共振再检查，如果没有其他问题，过3-5天就可以出院了。

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\"女孩被飞镖穿颅骨

\n

　　

\n

网上仿真玩具太多风险大

　　近几年，沈志鹏遇到形形色色的患儿，可被飞镖砸中插入颅骨的还没有遇到过。这样的玩具也让不少家长感到担忧。

\n

对此相关网友如下表示：

\n

秋风素意：强烈建议家长一定要看管好自己的小孩，不要孩子要什么就给，万一那天小孩说要把刀，难道家长真的去买吗？出了这样的事，家长先反省反省
你是绿色酿的酒：子不教 父之过 这家长也是有病 小孩子玩这样杀伤性玩具也不知道管管或者叮嘱不要在人多的地方玩
狙肉脯哈你切：所幸没有生命危险这让女孩子们对顽劣男同学的印象更加坏了
微梁平：学校的管理跟上了吗？这些东西根本应当严禁带入学校。
小小鸟小小人666：这样还怎么让我们放心的把孩子交给学校！还有这些没脑子的家长！什么都给！哪天说给毒药小孩自己吃，也给么！！！
宸睿小王子：幸好孩子没有生命危险！可是这也必然对她生活完成严重影响。严查管制刀具和利器。

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\n

 

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男,53岁。脑梗失语 ，行走不利索右偏，有时咬异物，大小便不知。目前影像检查脑血肿

请教脑血肿老人不手术保守治疗方法和用药

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