ABSTRACT
Objective@#To investigate the clinical value of multimodal navigation-based virtual reality (MNVR) in the needle biopsy of intracranial eloquent lesions.@*Methods@#From January 2016 to January 2017, 20 patients with intracranial deep-seated lesions involving eloquent brain areas underwent MNVR-aided needle biopsy at Department of Neurosurgery, People′s Liberation Army General Hospital. Preoperatively, MNVR was used to propose and revise the biopsy planning. Intraoperatively, navigation helped trajectory avoid the eloquent structures. Intraoperative MRI (iMRI) was performed to prove the biopsy accuracy and detect the intraoperative complications. Perioperative neurological status, iMRI findings, intraoprative complications, surgical outcome and pathological diagnosis were recorded. Wilcoxon rank-sum test was conducted to compare the preoperative and postoperative neurological scores.@*Results@#MNVR helped revised 45%(9/20) initial biopsy trajectories, which would probably injury the nearby eloquent structures. Navigation helped biopsy trajectories spare the eloquent structures during the operation. No statistical difference was found between postoperative and preoperative neurological status, despite all the lesions were adjacent to eloquent areas. Additionally, 20 patients totally received 21 iMRI scanning. iMRI helped revise incorrect biopsy site in one case and detected intraoperative hemorrhage in another case, both of cases were treated immediately and effectively. No MNVR related adverse events and complications occurred.@*Conclusions@#MNVR-aided needle biopsy of intracranial eloquent lesions is a safe, novel and efficient biopsy modality. This technique is helpful to reduce the incidence of surgery related neurological deficits.
ABSTRACT
Objective To explore the effect of the diet recovery time on postural hypotension after gynecological laparoscopic operation. Methods A total of 300 patients undergoing gynecological laparoscopy were randomly divided into observation group and control group according to the order of admission,150 cases in each group. Patients in observation group took liquid food since recovery from anesthetic, their appetite and dietary levels restored to preoperative level within 24 h after surgery from liquid diet to regular diet. Patients in control group were given routine nursing care of diet after belly operation. Results The diet recovery time and the anal exhaust time of patients in observation group were (21.2±3.5) h and (15.5±4.7) h, the control group were (46.8±5.4) h and (23.4±5.4) h, there was significant difference between two groups (t=7.543,5.126, P<0.05).The incidence rate of orthostatic hypotension in observation group was 9.3% (14/150), the control group was 33.3% (50/150), there wassignificant difference between two groups (χ2=8.907, P<0.05). Conclusions Patients undergoing gynecological laparoscopy took food as soon as possible, their appetite and dietary levels restored to preoperative level within 24 h after operation. It didn′ t increase abdominal distension, but helped the intestinal function recovery and helped to reduce the incidence of postoperative orthostatic hypotension.
ABSTRACT
Objective To summarize the experiences of microsurgery for treatment of middle cerebral artery aneurysms (MCAA). Methods The clinical data of 35 patients with MCAA treated by microsurgery in General Hospital of PLA from 2004 to 2008 were retrospectively reviewed. Of them there were 20 males and 15 females, aged 18 to 72 years with a mean of 40 years. Of the 35 patients, subarachnoid hemorrhage occurred formerly in 22, intracerebral hemorrhage occurred in 11 and subdural hematoma in one patient. The MCAA located in the middle cerebral artery trunk in 10 patients, at the bifurcation in 20 patients (including one patient with 2 MCAAs), and in the distal segment in 5 patients. MCAA located on the left side in 13 and on right side in 22 patients. There were 7 patients with giant aneurysms, 11 with large aneurysms and 17 with small aneurysms. Microneurosurgery was performed in all cases, and different approaches were taken according to the locations of aneurysms. Superior temporal gyrus approach was conducted in 3 patients with giant intracerebral hematoma. Bypass of superficial temporal artery to middle cerebral artery was performed before occlusion of the afferent artery in one patient with giant aneurysm. Bypass with saphenous vein to middle cerebral artery was performed in another patient with giant aneurysm. Results The giant and large MCAAs consisted of 51.4% of all cases. Excellent outcomes were achieved in 20 patients, no marked change in 12 patients, and post-operative complications were observed in 3 patients. No perioperative death occurred. Conclusions Giant and large aneurysms are more common in middle cerebral artery aneurysms. Proper surgical approaches based on different situations during operation should be considered to achieve satisfactory outcome.