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Objective To discuss the risk factors of progressive hemorrhagic injury(PHI)in patients with craniocerebral injury.Methods Clinical data of 149 patients with closed craniocerebral injury were retrospectively analyzed,and the patients were divided into PHI group (42 cases)and non -PHI group (107 cases)according to PHI appeared or not.The patients were immediately given CT scan after admitted,the first CT review was given in the non -PHI group within routine 4 -8h after first CT scan,and due to deterioration of clinical symptoms,the PHI group was given CT review in advance.The intracranial hematoma volume changes between first CT and first CT review in the two groups were observed,then clinical symptoms,signs,biochemical indicators and CT performance in the two groups were compared,and analyzed risk factors of PHI.Results The intracranial hematoma volume showed in CT scan,first CT review and increment volume of the PHI group were significantly higher than the non -PHI group [(14.59 ±4.60)mL vs.(7.28 ±2.94)mL,(25.92 ±8.84)mL vs.(8.35 ±3.41)mL,(10.20 ±3.45)mL vs. (2.10 ±0.65)mL],the differences were significant (t =6.796,11.894,9.367,all P 10mL were major risk factors of PHI (P 50 years old,mydriasis,conscious disturbance,intracranial hematoma volume >10mL in first CT scan.
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Objective To discuss the surgery for the patients with bruise of bilateral frontal lobes complicated with central encephalocele.Methods 48 patients diagnosed as bruise of bilateral frontal lobes complicated with central encephalocele were analyzed retrospectively.According to the results of CT and clinical symptoms,timing of surgery was selected.All patients were given unilateral decompressive craniectomy or bilateral decompressive craniectomy.Results All patients were followed up for 1 year.42 cases survived,while 6 cases died.All cases were estimated with GCS:18 cases ( 37.5％ ) were cured excellently,16 cases ( 33.3％ ) were mild morbidity,5 cases ( 10.4％ ) were severe morbidity,3 cases ( 6.3％ ) were in persistent vegetative state and 6 cases ( 12.5％ ) were dead.Conclusion The progression of patients with bruise of bilateral frontal lobes comphcated with central encephalocele were rapid.Diagnosis and treatment at the early stage could improve patients' prognosis.
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ObjectiveTo study the influence of mannitol used in eraly stage of intracranial hematoma.Methods178 cases diagnosed intracranial hematoma were divided into two groups according to the treatment.After admission,all patients were detected by CT.On the basis of the routine treatment,the treatment group(88 cases) were given mannitol within 6h after bleeding,while the control group were given nothing.To observe the change in hematoma size,GCS score and the quality of life 30d after treatment.ResultsThe experiment group's average bleeding loss was(27.6±5.7)ml,while the control group's average bleeding loss was(23.1 ±4.8)ml,the proportion of patient of treatment groups whose hematoma increased was significantly greater than the control group(P ＜0.05).At the aspect of GCS score,the experiment group was (5.0 ± 1.5 ),while the control group was ( 9.5 ± 1.5 ),the average score of treatment group was significantly lower than the control group(P ＜ 0.05).30d after treatment,14 cases of experiment group dead,the mortality rate was 15.91％,while the control group's motality rate was 7.78％.The mortality rate of treatment group was significantly higher than the control group(P ＜ 0.05).ConclusionMannitol used in early stage of intracranial hematoma promotes the growth of intracranial hematoma and increases the mortality.The patients with intracranial hematoma should avoid the use of manntol in early stage.
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Medical disputes caused by suspected AIDS infection via blood transfusion are characterized by high sensitivity, involvement of many persons, great difficulty in carrying out investigation and obtaining evidence, and demand for a large compensation. The key to handling this kind of medical dispute lies in clarifying whether there is a causal relationship between the blood transfusion and the AIDS infection, whether there have been illegal activities in the process of blood collection and transfusion, and whether there is a causal relationship between such activities and the AIDS infection. In addition, the partys right of privacy should be protected. Measures of prevention include: handling without gloves activities of illegal blood supply and collection and the arrangement for other people selling their blood; strictly assessing and consolidating the blood centers; blood centers and hospitals jointly preventing the spread of AIDS via blood transfusion; taking proper care of the raw data of blood supply and collection; and speeding up the establishment of an insurance system for blood transfusion and the implementation of the States plans for AIDS prevention and treatment.