引用第11楼rainmanjh于2007-08-10 23:40发表的:名单里都是博士么？都是有编制的么？
李学恩是七年制，这个网站还有他的报道。
http://www.msw.sdu.edu.cn/cms/html/xwzx/0405a/20061216/250.htmlhttp://www.zhuomu.cn/bbs/read.php?tid=26753其论文也能检索到
http://202.194.11.26:8001/xwlw/detail.jsp?channelid=65004&record=11125ID 23701020003170131 [ 公开 ]
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论文名称 外伤性颈动脉海绵窦瘘的临床诊断及血管内治疗/Clinical diagnosis and endovascular treatment for traumatic carotid cavernous fistula
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作者 李学恩 <>
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学位 硕士
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答辩日期
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培养单位 山东大学．医学院．外科学（神经外科）．
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研究方向 脑血管疾病
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中文关键词 外伤性颈动脉海绵窦瘘; 血管内治疗; 数字减影血管造影; 临床诊断; 预后
英文关键词 TCCF; endovascular treatment; DSA; clinical diagnosis; prognosis
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指导老师 李新钢 .山东大学齐鲁医院 . .
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论文总页码
共52页
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馆藏号
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服务年限
0 年后
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中文摘要 目的：探讨外伤性颈动脉海绵窦瘘（TCCF）的临床诊断、血管内治疗及预后影响的因素；并探讨TCD、CT、MRI、DSA等影像学检查手段在其诊断、治疗及随访的作用。方法：回顾性分析山东大学齐鲁医院1996年7月至2007年1月期间收治的外伤性颈动脉海绵窦瘘31例。利用logistic回归分析研究影响TCCF 血管内治疗预后的因素。结果：本组TCCF患者31例，男性患者多于女性（23∶8），平均年龄38.2岁，男性平均年龄低于女性（男31.2岁，女57.5岁）。临床症状主要表现为搏动性突眼、颅内杂音和结膜充血水肿，症状出现时间主要在外伤后7天内（25/31），个别患者在伤后近两个月出现症状。31例患者中，13例患者出现首发症状后没有得到及时诊断和治疗。31例患者均行DSA确诊，其中29例患者采用球囊栓塞瘘口，1例行弹簧圈填塞海绵窦，1例行覆膜支架封闭瘘口。一次栓塞成功率为87.1%（27/31），复发患者再次行栓塞治疗，均治愈。Logistic回归分析发现年龄、出现首发症状到治疗的时间、栓塞球囊数目、并发症等因素对眼球活动障碍的恢复有显著性影响，OR值分别为1.048、2.362、2.333、2.337（p< 0.05）；年龄、出现首发症状到治疗的时间、栓塞球囊数目、并发症等因素对视力的恢复有显著性影响，OR值分别为2.230、2.680、2.476、 2.523（p< 0.05）。结论：对颅脑外伤的患者常规询问及听诊是否存在颅内杂音，有助于及时诊断TCCF，典型的临床体征结合一项或多项影像学特征即可做出正确的临床诊断。全脑血管造影是诊断TCCF的决定性的和必不可少的检查，是诊断该疾病的“金标准”。血管内栓塞治疗是一种行之有效的治疗手段，是目前治疗TCCF的最理想的方法，具有其他方法不可替代的长处。 Logistic回归分析发现年龄、出现首发症状到治疗的时间、栓塞球囊数目、并发症等因素影响患者预后。因此及时的诊断和治疗，缩短出现首发症状到治疗的时间，能够改善TCCF患者的预后。
外文摘要 Objective: To discuss the clinical diagnosis, endovascular treatment and factors affecting the prognosis of traumatic carotid cavernous fistula (TCCF). To discuss the application of imaging examinations and their contributions to the diagnosis, treatment and follow-up. Methods: Retrospectively, we analyzed the clinical data of 31 TCCF patients treated in Qilu Hospital from July 1996 to January 2007. We particularized the possible factors affecting the prognosis of TCCF and analyzed their relationship with the prognosis by logistic regression. Results: This group included 31 TCCF patients with the characteristics: the incidence rate of this disease for male is higher than that for female; the average age is 38.2 year-old, the male average age is lower than that of female. The common clinical symptoms are pulsatile intracranial bruit, pulsating exophthalmos and congested and edema conjunctiva, which usually appeared in 7 days after the trauma. These symptoms even appeared two months after the trauma in exceptional patients. Among the 31 patients, 13 patients didn’t get timely diagnosis and treatment when they had presented typical symptoms. Twenty nine patients were treated with detachable balloon, 1 with coils and 1 with covered stent. The rate for the first successful embolization was 87.1% and all the recurrent patients were successfully treated by endovascular approach again. We found the recovery of eyeball movement was affected by factors such as age, interval from the appearance of initial symptom to the diagnosis, the number of balloon and complication with OR value 1.048、2.362、2.333、2.337 respectively (p< 0.05); the recovery of visual sight was affected by factors such as age, interval fro the appearance of initial symptom to the diagnosis, the number of balloon and complication with respective OR value 2.230、2.680、2.476、2.523 respectively (p< 0.05). Conclusions: The intracranial bruit should be asked and auscultated in order to diagnose the disease timely. Clinical diagnosis can be established with the typical symptoms and one or more imaging examinations. DSA is decisive and absolutely necessary, which is called the gold standard for TCCF. Endovascular treatment is considered the most ideal approach with the advantage that other treatments can not substitute. We found the prognosis was affected by factors such as the age, interval from the appearance of initial symptom to the diagnosis, the number of balloon and complication. So timely diagnosis and treatment for this disease can reduce the interval from the appearance of initial symptom to diagnosis, and this can improve the prognosis.
