ABSTRACT
Objective:To investigate the curative effect of decompression with reserved superficial temporal artery for treatment of severe traumatic brain injury (sTBI).Methods:A retrospective case-control study was conducted to analyze the clinical data of 265 patients with sTBI who underwent decompressive craniectomy in Shaanxi Provincial People's Hospital from July 2016 to December 2019. Among them, 152 were males and 113 were females, with the age of 33-72 years [(50.1±12.8)years]. On admission, the Glasgow Coma Score (GCS) was 3-8 points [(5.7±1.4)points]. A total of 135 patients were treated with reserved superficial temporal artery decompression after admission (observation group) and 130 patients were treated with conventional decompression without deliberately preserving the superficial temporal artery (control group). The amount of intraoperative scalp bleeding, scalp healing time, cerebrospinal fluid incision leakage, healing degree and postoperative craniocerebral CT angiography (CTA) were compared between the two groups.Results:All patients were followed up for 7-15 days [(12.4±2.5)days]. The amount of intraoperative scalp bleeding was (15.4±4.5)ml in observation group and (65.2±4.7)ml in control group ( P<0.01). The healing time was (7.1±1.1)days in observation group and (9.5±2.3)days in control group ( P<0.01). There were 5 patients (3.7%) with cerebrospinal fluid incision leakage in observation group compared to 21 patients (16.2%) in control group ( P<0.01). There were 114 patients with Grade A healing in observation group compared to 91 patients in control group ( P<0.05). Based on the postoperative craniocerebral CTA, the superficial temporal artery was intact and the blood supply was normal in observation group, while the main trunk of the superficial temporal artery was disconnected from the zygomatic arch segment and the blood supply was incomplete in control group. Conclusions:For patients with sTBI, decompressive craniectomy with reserved superficial temporal artery can promote the healing of the scalp. Moreover, keeping the superficial temporal artery can significantly reduce the amount of bleeding during operation, reduce postoperative scalp healing time and incidence of cerebrospinal fluid incision leakage and assist cerebral blood perfusion.
ABSTRACT
Objective To evaluate the relationship between hypertriglyceridemia and acute pancreatitis.Methods Data was analyzed from 41 patients with acute pancreatits from Apr.1998 to Oct.2000 in our hospital.Of the 13 patients(GroupⅠ) with plasma TG level being higher than 11.3 mmol/L, 8 accompanied with gallstone(61.5%)and 5 without gallstone(38.5%)of the 28 patients (GroupⅡ) with plasma TG level being lower than 11.3 mmol/L,19 accompanied with gallstone(47.3%)and 9 without gallstone(52.7%)RANSON score,morbidity of complications and the level of ALT and AST were compared between two groaps.The correlation between TG and RANSON score was analysed.Results There were significant difference between the two groups on RANSON score,morbidity of complications and level of ALT and AST(P0.05).Conclusion There is an close relationship between hypertriglyceridemia and acute pancreatitis,the high level of plasma TG plags a key a role in acute pancreatitis,patients with acute pancreatitis with hypertriglyceridemia are more likely to have higher morbidity of complications and liver function aggravating.