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This paper analysed the rhinoscope's clinical value in microsurgical treatment of intracranial aneurysms. Application of the rhinoscope in 87 patients, only 2 patients had ruptured during operation. However, 11 cases had ruptured in 94 cases without using rhinoscope, P < 0.05, they had a significant difference. By DSA follow-up review, 82 cases of used rhinoscope only 2 cases had remained the aneurysm neck, but 9 cases had the aneurysm neck in 77 cases which had not used the rhinoscope in the microsurgical treatment, P < 0.05, they also had significant difference. The application of rhinoscope in microsurgical treatment of intracranial aneurysms intraoperative, can reduce the risk of the intraoperative aneurysm rupture. It can achieve better clinical effect.
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Adult , Aged , Female , Humans , Male , Middle Aged , Endoscopy , Intracranial Aneurysm , General Surgery , Microsurgery , Nose , General Surgery , Treatment OutcomeABSTRACT
Objective To analyze the relationship between the varicosity of esophagus and portal hypertensive gastropathy(PHC) in patients with upper gastrointestinal hemorrhage of hepatocirrhosis. Methods The damage degree of esophageal varicosity was divided into four grades and the PHG were divided into three groups according to the McCormack standards by emergency gastric endoscopy. Results Among 200 patients with upper gastrointestinal hemorrhage,100 cases(50. 0%) were caused by esophageal varicosity explosion and 44 cases(22. 2% ) were induced by PHG,38 cases (19. 0%) were due to gastric ulcer, 18 cases (9. 0%) were duo to other causes. Comparison between etiology and liver function of A-class(except for other reasons group) were significantly different(X2 =4. 23 ,X2 =4. 15 ,X2 =4. 18,X2 =4. 07,P＜0. 05 ;X2 =6. 83 ,X2 =7. 01 ,P＜0. 01 ) ;The portal vein diameter＞1.5cm bleeding incidence(32. 5% ) were significantly higher than the diameter＜1. 1cm bleeding incidence( 12. 5% ) (X2 =4. 73 ,P ＜0. 05 ) ;The degree of PHG in severe esophageal varices (55. 6% ) were significantly higher than the mild esophageal varices( 11.1% )( X2 = 7.73, P＜0. 01 ). The correlation between PHG degree and esophagus varicosity were positive related(r=0.455,X2 = 4.01,P＜0.05). Conclusion The esophageal varicosity explosion and PHG are two major factors to cause hepatocirrhosis complicated with upper gastrointestinal hemorrhagein. The more severe the damage degree of esophageal varicosity is,the higher incidence and the more severe the PHG will be.
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Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.
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0.05).The ADCs of low-grade(gradeⅠ～Ⅱ) astrocytomas were significantly higher(P