ABSTRACT
The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.
ABSTRACT
Objective:To explore the effect of problem-originated clinical medical curriculum(PCMC) teaching method combined with PDCA(plan, do, check and action) circulation in the training of craniocerebral ultrasound for neurologically intensive refresher physicians.Methods:Thirty-two refresher physicians who entered the neurosurgery ICU of Henan Provincial People's Hospital from January 2018 to December 2019 were divided into test group ( n=18) and control group ( n=14) according to the time of admission. The test group accepted the teaching mode of PCMC teaching method combined with PDCA circulation, the control group accepted the traditional teaching methods of demonstration, student practice and teacher evaluation. One week before graduation, the differences between two groups in the theoretical assessment, operational skills and questionnaire were compared to evaluate the effectiveness of teaching mode. SPSS 23.0 was used for t-test and chi-square test. Results:Compared with the control group, the individual scores and total scores of the theoretical and operational assessments of craniocerebral ultrasound in the test group were significantly improved, and the questionnaire survey showed that the test group was superior to the control group in all the 7 items of teaching effect and satisfaction with the teaching method, with statistical significance ( P < 0.05). There was no significant difference between the two groups in increasing their interest in learning ( P > 0.05). Conclusion:PCMC teaching method combined with PDCA circulation can improve the training effect and satisfaction of clinical teaching of craniocerebral ultrasound.
ABSTRACT
Objective To discuss the clinical value of interventional treatment for Klippel-Trenaunay syndrome complicated by spinal arteriovenous fistula and subarachnoid hemorrhage, and to report 1 patients with this disease who were successfully treated with interventional treatment. Methods One female children patient with clinically confirmed Klippel-Trenaunay syndrome complicated by spinal arteriovenous fistula and subarachnoid hemorrhage were enrolled in this study, who was underwent the embolization of arteriovenous fistula in the spinal. Results The interventional procedure was successfully accomplished in this case. The patient's clinical symptoms was disappeared gradually. No complications occurred. Conclusion For the treatment of Klippel-Trenaunay syndrome complicated by spinal arteriovenous fistula and subarachnoid hemorrhage, interventional management is minimally-invasive, safe and Reliable.