ABSTRACT
Objective To investigate the value of cerebrospinal fluid drainage after aneurysm clipping in patients with intracranial aneurysm complicated with subarachnoid hemorrhage .Methods 84 intracranial aneurysms patients with subarachnoid hemorrhage were selected ,and they were randomly divided into study group (n =42) and control group (n =42).The control group used simple suture after aneurysm clipping ,the study group was given lumbar cistern drainage by implementation of the dural suture tube after aneurysm clipping .Before and after hydro-cephalus and cerebral vasospasm ,treatment changes of serum insulin-like growth factor 1 (IGF-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) levels were compared between the two groups .Results The incidence rate of hydrocephalus of the study gruop was 4.8%,which was significantly lower than the 14.3% of the control group (χ2 =9.743,P <0.05).The incidence rate of cerebral vasospasm of the study group was 7.1%,which was significantly lower than 19.0% of the control group (χ2 =11.802,P <0.05).The incidence rates of intracranial infection,cerebrospinal fluid leakage and other complications between the two groups had no statistically significant differences (χ2 =2.074,2.125,all P >0.05).The serum levels of IGF-1 and sVCAM-1 between the two groups had no statistically significant differences before operation (t =0.417,0.603,all P >0.05).At the 8th day after oper-ation,the serum levels of sVCAM-1 and IGF-1 of the study group were significantly lower than those of the control group (t =7.335,6.856,all P <0.05).Conclusion After aneurysm clipping,the lumbar cistern drainage tube drainage is beneficial to reduce hydrocephalus and cerebral vasospasm incidence ,inhibit the expression of serum IGF-1,sVCAM-1,with less adverse reactions,it is worthy of application.
ABSTRACT
Objective To explore the cerebral protective effect of edaravone combined with mild hypothermia in patients with severe craniocerebral injury. Methods 64 patients with severe craniocerebral injury were divided into control groups ( n =21 ) , mild hypothermia groups ( n =22 ) and combination groups ( n =21 ) according to the random number table method. All patients were treated with symptomatic supportive therapy and surgical decompression,and the patients in the mild hypothermia group accepted physical cooling and drugs to maintain a low body temperature, and the patients in the combination group accepted edaravone 30mg on the basis of the mild hypothermia group,1 time every 12 hours,and the course of treatment was lasted for two weeks. The Glasgow coma score(GCS),the degree of brain edema and the Glasgow prognostic score( GOS) were observed in the three groups. Results The GCS scores of the mild hypothermia group and combination group at 7d after admission were (9. 54 ± 1. 26) points and (10. 15 ± 1. 56)points,respectively,which were higher than (7. 58 ± 1. 12) points of the control group,the differences were statistically significant(t=7. 867,12. 232,all P<0. 05),and the GCS score of the combination group was higher than that of the mild hypothermia group(t =7. 986,P <0. 05). The GCS scores of the mild hypothermia group and combination group were (12. 21 ± 1. 47)points and (12. 35 ± 1. 12)points at 14d after admission,which were higher than (10.28 ±2.28)points of the control group,the differences were statistically significant(t=8. 823,9. 066,all P<0. 05). The proportions of mild edema patients in the mild hypothermia group and combination group were 69. 09%,71. 43%,respectively,which were higher than 19. 05% of the control group,the differences were statistically significant(χ2 =9. 019,7. 563,all P<0. 05). The GOS scores of the mild hypothermia group and combination group at discharge were (4. 15 ± 0. 51) points and (4. 51 ± 0. 37) points,respectively,which were higher than (3. 69 ± 0. 61)points of the control group,the differences were statistically significant(t=5. 328,6. 228,all P<0. 05),and the GOS score of the combination group was higher than that of the mild hypothermia group(t=4. 251,P<0. 05). Conclusion The curative effect of edaravone combined with mild hypothermia in the treatment of patients with severe craniocerebral injury is significantly better than conventional therapy and mild hypothermia treatment, and it is conducive to promote the recovery of the nerve function.
ABSTRACT
Objective To explore the cerebral protective effect of edaravone combined with mild hypothermia in patients with severe craniocerebral injury. Methods 64 patients with severe craniocerebral injury were divided into control groups ( n =21 ) , mild hypothermia groups ( n =22 ) and combination groups ( n =21 ) according to the random number table method. All patients were treated with symptomatic supportive therapy and surgical decompression,and the patients in the mild hypothermia group accepted physical cooling and drugs to maintain a low body temperature, and the patients in the combination group accepted edaravone 30mg on the basis of the mild hypothermia group,1 time every 12 hours,and the course of treatment was lasted for two weeks. The Glasgow coma score(GCS),the degree of brain edema and the Glasgow prognostic score( GOS) were observed in the three groups. Results The GCS scores of the mild hypothermia group and combination group at 7d after admission were (9. 54 ± 1. 26) points and (10. 15 ± 1. 56)points,respectively,which were higher than (7. 58 ± 1. 12) points of the control group,the differences were statistically significant(t=7. 867,12. 232,all P<0. 05),and the GCS score of the combination group was higher than that of the mild hypothermia group(t =7. 986,P <0. 05). The GCS scores of the mild hypothermia group and combination group were (12. 21 ± 1. 47)points and (12. 35 ± 1. 12)points at 14d after admission,which were higher than (10.28 ±2.28)points of the control group,the differences were statistically significant(t=8. 823,9. 066,all P<0. 05). The proportions of mild edema patients in the mild hypothermia group and combination group were 69. 09%,71. 43%,respectively,which were higher than 19. 05% of the control group,the differences were statistically significant(χ2 =9. 019,7. 563,all P<0. 05). The GOS scores of the mild hypothermia group and combination group at discharge were (4. 15 ± 0. 51) points and (4. 51 ± 0. 37) points,respectively,which were higher than (3. 69 ± 0. 61)points of the control group,the differences were statistically significant(t=5. 328,6. 228,all P<0. 05),and the GOS score of the combination group was higher than that of the mild hypothermia group(t=4. 251,P<0. 05). Conclusion The curative effect of edaravone combined with mild hypothermia in the treatment of patients with severe craniocerebral injury is significantly better than conventional therapy and mild hypothermia treatment, and it is conducive to promote the recovery of the nerve function.