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Right heart catheterization was performed 120 times in 112 cardiac cases admitted into Chung-Shan Hospital of Shanghai First Medical College in a period of 13 months from September 1957 to September 1958. Catheterization was done in this series of cases chiefly for the purpose of studying the hemodynamic changes in the lesser circulation and as an aid to diagnosis in congenital heart diseases and rheumatic mitral valvular disease, when cardiac surgery was considered for treatment. In 8 of them catheterization...

Right heart catheterization was performed 120 times in 112 cardiac cases admitted into Chung-Shan Hospital of Shanghai First Medical College in a period of 13 months from September 1957 to September 1958. Catheterization was done in this series of cases chiefly for the purpose of studying the hemodynamic changes in the lesser circulation and as an aid to diagnosis in congenital heart diseases and rheumatic mitral valvular disease, when cardiac surgery was considered for treatment. In 8 of them catheterization was repeated 6 weeks after surgical repair of an interauricular septal defect or valvotomy of a stenotic pulmonic valve. In this paper the entire procedure of catheterization has been described in detail, particuhrly with regard to some technics of manipulation of the catheter in order to let it get through the tricuspid and pulmonic orifice, and to wedge it into the "pulmonary capillary". Indications, contraindications, complications and results of catheterization in our cases have been dicussed. Among the complications, cardiac arrhythmia was the most common but it was seldom serious. Electrocardiographic observation during the procedure showed that premature beats especially of ventricular origin occured nearly in every case. Two patients developed pulmonary edema shortly after catheterization. One of them survived, while the other unfortunately died in spite of energetic treatment. Both were cases of mitral stenosis with marked pulmonary hypertension. In the entire series of 112 cases, catheterization helped us to establish the diagnosis in 107 of them, among which 68 patients were operated upon after catheterization, and in 66 of them the preoperative diagnoses proved to be correct. According to the material presented, right heart catheterization appears to be a comparatively safe and useful procedure in the diagnosis of cardiac diseases.

一、本文分析报告112例住院心脏病病人,120次右心导管檢查的結果。二、本病例檢查的指征主要是对先天性心脏病及二尖瓣病的診断和外科治疗的选擇。三、对檢查方法加以描述,对影响檢查成敗的因素加以討論。四、分析檢查的結果,认为右心导管檢查对上述心脏病的診断有重大的价值,而危險性不大,但檢查时仍应提高警惕,掌握禁忌証并注意安全防止严重并发症的发生。

Traumatic hemorrhage of brain stem is a serious and irreversible brain damage.It consti- tutes one of the important causes of death in patients with acute cranio-cerebral injury.Un- fortunately,this condition is rarely diagnosed antemortemly,although much has been learnt recently regarding its clinical manifestations. In the present series of 33 fatal cases of acute cranio-cerebral injury,10 cases of brain stem hemorrhage were found on autopsy.Definite focal hemorrhages in the brain stem were seen grossly in...

Traumatic hemorrhage of brain stem is a serious and irreversible brain damage.It consti- tutes one of the important causes of death in patients with acute cranio-cerebral injury.Un- fortunately,this condition is rarely diagnosed antemortemly,although much has been learnt recently regarding its clinical manifestations. In the present series of 33 fatal cases of acute cranio-cerebral injury,10 cases of brain stem hemorrhage were found on autopsy.Definite focal hemorrhages in the brain stem were seen grossly in 6 cases and microscopically in another 4 cases.The most common site of hemorrhage, was found to be on the dorsal part of the pens, periaqueductal area and median raphe.In 3 cases Hemorrhage was also found in the segmental part of the mid-brain.Bleeding might have been either petechial or massive with clot formation. Death occurred to about half of these patients within 24 hours after injury,while the rest survived for varying periods,the longest being 53 days.

对10例外伤性脑干出血死亡病例进行了临床及病理资料的分析。发现致伤机制都属于加速性损伤。脑干出血部位均见于桥脑背部,大脑导水管周围或正中缝附近,其中3例同时伴有中脑被盖部出血。本中半数于伤后24小时内死亡,但少数病例是尚可维持较长生存时间,最长者达58天。对脑干损伤综合征作了简单的描述。本患者同时合并急性颅内血肿者5例,其中4例虽经血肿清除术,但未取得预期疗效,另一例钻孔探查阴性,尸检见巨大脑内血肿,并已破入脑室内。对产生脑干出血的机制作了简单的讨论。认为可根据病人(1)受伤当时的意识状态,(2)出现脑干损伤综合征的时间,及(3)致死时间,作为区别是原发性或继发性脑干损伤的标准,并提出外伤性脑干出血系脑干不可逆性损伤的一种表现,目前对脑干出血还不能找到其特征性的临床表现,因此仍是诊断中有待解决的问题。关于防治工作方面,强调提出对防止继发性脑干损伤的发生或防止其发展为不可逆性阶段的重要意义,因此应当仔细观察病情的发展动向,经常保持戒备状态,及时识别颅内血肿,迅速予以手术处理,并提出在清除血肿后尚有明显脑疝存在时的处理步骤及采用其他各种综合治疗的重要性。

The author analysed a series of 57 cases with cysticercosis of posterior fossa in this study. The cardinal clinical features are as tollows, intermittent destructive attacks of intracranial hypertension; less neurological deficit by involvement of cerebellum and brain stem and meningo-encephalitis like change of the cerebrospinal fluid. Cysticercosis of the posterior fossa may be classified as follows: ventricle type (fourth ventricle or aqueduct) pia mater type (cisterna Magna or cerebello pontine angle), cerebellar...

The author analysed a series of 57 cases with cysticercosis of posterior fossa in this study. The cardinal clinical features are as tollows, intermittent destructive attacks of intracranial hypertension; less neurological deficit by involvement of cerebellum and brain stem and meningo-encephalitis like change of the cerebrospinal fluid. Cysticercosis of the posterior fossa may be classified as follows: ventricle type (fourth ventricle or aqueduct) pia mater type (cisterna Magna or cerebello pontine angle), cerebellar cortex type, and mixed type; end among them there are strikingly different clinical manifestations, treatments, and prognosis. The complement fixation reaction with the cerebrospinal fluid and the Conray Ventriculography are still effective examination methods in diagnosis of cystecercosis of posterior fossa. The surgical method was discussed for cysticercosis of posterior fossa. In this series, all of 57 cases were treated by operation. Its results were fairly good, the mortality of 3.5% was obtained.

本文对57例颅后窝脑囊虫病进行分析,其主要临床特点如下:颅内压增高呈间歇性梗阻性发作,小脑及脑干受损神经体征较少;脑脊液呈脑膜脑炎性变化。颅后窝脑囊虫病可分脑室型(第四脑室或导水管),软脑膜型(枕大池或桥脑小脑角),小脑皮质型和混合型,其临床表现、治疗和予后各有不同。脑脊液囊虫补体结合试验和脑室碘水造影仍是诊断颅后窝脑囊虫病有效检查方法。对颅后窝脑囊虫病的手术方法进行讨论,本57例均行手术,手术效果较好,手术死亡率3.5%。

 
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