ABSTRACT
Objective The level of lactic acid in blood can reflect the degree of ischemia and hypoxia of brain tissue and cerebral perfusion pressure. The aim of this paper is to explore the value of blood lactate and lactate clearance in evaluating the survival rate and neurological outcome of patients with craniocerebral trauma. Methods The clinical data of 497 craniocerebral trauma patients admitted to our hospital from September 2017 to July 2018 were collected and retrospectively analyzed. Patients were divided into groups with different 6 h lactate clearance rates and admission lactate levels, and the differences in mortality and outcome of neurological function in each group were compared. Results The serum admission lactate levels、serum lactate levels at 6 hours, 28-day mortality and 28-day poor nerve function prognosis rate of patients with different 6h lactate clearance rates were statistically significant differences(P < 0. 05). The efficacy of 6h lactic acid to predict the mortality rate of patients was better than that of admission lactic acid and 6h lactate clearance rate (Z=3.71、Z=3.95,P<0.05). However, in predicting the neurological function of patients, the lactate clearance rate is not better than blood lactate level at any time(Z=1.30，Z=0.81，P>0.05). Conclusion 6h lactic acid has the best ability to judge the mortality of patients while lactic acid clearance rate is not better than the blood lactate level at any time in predicting the neurological function of patients.
ABSTRACT
BACKGROUND: Patients with cranial defects undergoing cranioplasty can develop complications related or unrelated to repair materials. OBJECTIVE: To explore the differences and similarities between the two-dimensional and three-dimensional digital shaping titanium meshes for cranioplasty. METHODS: The clinical data of 221 patients with skull repair were retrospectively analyzed. Two-dimensional digital shaping titanium mesh was used in 61 cases, and three-dimensional digital shaping titanium mesh used in 160 cases. Postoperative complications related (including exposure of titanium mesh and nail and loosening of titanium nail) or unrelated (including refractory subcutaneous effusion, epilepsy, scalp necrosis, scalp infection, intracranial infection and intracranial hematoma) to repair materials were summarized. RESULTS AND CONCLUSION: There were 14 cases of complications (4 related and 10 unrelated) in the two-dimensional digital shaping titanium mesh group, including 2 cases of intractable subcutaneous effusion, 7 cases of epilepsy, 2 cases of titanium mesh and nail exposure, 2 cases of titanium mesh and titanium nail loosening and 1 case of scalp infection. There were 17 cases of complications (0 related and 17 unrelated) in the three-dimensional digital shaping titanium mesh group, including 5 cases of refractory subcutaneous effusion, 9 cases of epilepsy, 1 case of scalp necrosis, 1 case of intracranial infection and 1 case of intracranial hematoma. Significant differences in the complications related to repair materials were found between the two groups (χ2=5.577, P=0.018). Overall findings suggest that the craniotomy with three-dimensional digital shaping titanium mesh can cause fewer material-related complications than that with two-dimensional digital shaping titanium mesh.