ABSTRACT
Objective To explore the value of neuroendoscopy combined with Endport for the surgery of hypertensive intracerebral hemorrhage.Methods We retrospectively analyzed 92 cases of hypertensive intracerebral hemorrhage in our department from January 2016 to February 2018.According to the different surgical methods,they were divided into small bone window group and neuroendoscopic group,47 cases in small bone window group and 45 cases in neuroendoscope group.The amount of intraoperative bleeding,operative time,postoperative hematoma clearance,postoperative rebleeding,hospitalization time,postoperative complications and Glasgow prognosis expansion score (GOS-E) were recorded for statistical analysis.Results Compared with neuroendoscopy group,small bone window group had more bleeding loss [(182.6 ± 34.5) ml vs (103.3 ± 25.7) ml] and longer operation time [(168.7 ± 26.3) min vs (115.7 ± 18.7)min],with significant statistically difference (P ＜ 0.05).The hematoma clearance rate (90.3 ± 5.3) ％ in the small bone window group,was lower than that in the neuroendoscopic group (92.8 ± 6.8) ％,but with no statistical significance (P ＞ 0.05);Postoperative rebleeding occured in 3 cases (6.4％) in small bone window group and 2 cases (4.4％) in the neuroendoscopic group,with no statistically significant difference between the two groups (P ＞ 0.05).Compared with neuroendoscopy group,small bone window group had longer hospitalization time [(18.5 ± 4.3) days vs (13.5 ± 3.8) days],higher tracheotomy rate [15 (31.9％) vs 8 (17.8％)],with significant statistically difference (P ＜ 0.05).The number of patients with GOS-E score ＞ 4 in small bone window group 2 months after operation was less than that in neuroendoscopy group [42.6％ (20/47) vs 62.2％ (28/45)],with significant statistically difference (P ＜ 0.05).Conclusions Endoscopic treatment of intracerebral hemorrhage has the advantages of minimally invasive,short operation time,less intraoperative hemorrhage,low incidence of complications and fast recovery of postoperative function.
ABSTRACT
Objective To investigate the evaluation value of magnetic resonance spectroscopy (MRS) combined with S-100B protein in the severity and prognosis in patients with acute subdural hematoma ( ASDH).Methods Eighty cases of ASDH patients and 20 cases of healthy check-up were selected.MRS was used to test NAA/Cr, Cho/Cr, NAA/Cho, and Glx /Cr in thalamus and corpus callosum.The blood S-100B protein was detected in 72 h after injury.The relationships of those MRS detection indices with glasgow coma scale ( GCS) and glasgow prognostic score ( GOS) for 2 months after injury were analyzed .Results MRS detection in-dex and the S100B protein in ASDH were compared between each group relative to normal control group , all difference had statistical significance ( P <0.05).As aggravating the severity of traumatic brain injury , Cho/Cr, Glx/Cr ratio, and S-100B protein concentra-tion were elevated , and NAA/Cho and NAA/Cr were reduced .All differences were statistically significant among poor recovery , good recovery, and normal control groups ( P <0.05).For patients with traumatic brain injury, there were worse prognosis, the higher ra-tios of Cho/Cr and Glx/Cr, higher concentration of S-100B protein, and lower ratios of NAA/Cho and of NAA/Cr.GCS score and GOS scores were negatively correlated with Cho/Cr and Glx/Cr ratios of corpus callosum , and were positively correlated with NAA/Cho, NAA/Cr ratios of corpus callosum .S-100B protein was positively correlated with Cho/Cr and Glx/Cr, and was negatively correlated with NAA/Cho and NAA/Cr.MRS combined S-100B can improve the prognosis of patients with up to the accuracy of 81%.Conclu-sions MRS detection in the early stage after injury of ASDH patients has important value in assessment of the severity of the injury and its prognosis , the accuracy of assessment of prognosis is improved with a combination of MRS detection and blood S -100 B protein meas-urement.