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Objective:To investigate the effect of microsurgery by modified pterional approach in the treatment of temporal lobe epilepsy under intraoperative cortical encephalon electricity graph (EEG) monitoring.Methods:The clinical data of 32 patients with temporal lobe epilepsy who were admitted to the Department of Neurosurgery of Shangqiu First People's Hospital from January 2012 to June 2021 were retrospectively analyzed, all patients underwent microsurgical resection of epileptogenic foci by modified pterional approach under cortical EEG monitoring.Results:The postoperative follow-up was from half a year to 6 years. According to the Tan's classification, 25 cases (78.1%(25/32)) of seizures disappeared completely, 3 cases (9.4%(3/32)) of seizures decreased by more than 75%, and 4 cases (12.5%(4/32)) of seizures decreased by more than 50%. Isotropic hemianopia occurred in 1 case (3.1%) after operation, and there was no operative death.Conclusion:Microsurgical resection of epileptogenic foci through modified pterional approach under intraoperative cortical EEG monitoring was a safe and effective method for the treatment of temporal lobe epilepsy.
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Objective To systematically evaluate the efficacy and safety of craniotomy and decompressive craniectomy in the treatment of acute subdural hematoma.Methods A systematic search was performed in PubMed,EMbase,the Cochrane Library,Web of science,China National Knowledge Infrastructure (CNKI),WanFang Data,and CBM databases up to June 2018 for the studies that provided comparisons between craniotomy hematoma evacuation and decompressive craniectomy for acute subdural hematoma.For the two categorical variables,the Odds Ratio (OR) and its 95％ Confidence Interval (95％ CI) are used.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias of the included studies.The meta analysis was performed using Stata/SE 12.0 software.Results A total of 8 studies were included in the meta analysis,of which 828 patients underwent craniotomy,and 663 patients underwent decompressive craniectomy.Meta analysis results showed that patients receiving decompressive craniectomy had a significantly lower Glasgow Coma Scale (GCS) when they first had symptoms.The residual rate of acute subdural hematoma in the decompressive craniectomy group was significantly lower than that in the craniotomy group (P =0.015),but there was no significant difference in the rate of reoperation.The incidence of poor outcome at following was lower in the craniotomy group compared with decompressive craniectomy group (50.1％ vs 60.1％;P =0.003).Similarly,the mortality of the craniotomy group was lower than that of the decompressive craniectomy group (P =0.002).Conclusions Decompressive craniectomy may be the first choice for acute subdural hematoma,but the study is influenced by many factors and is not sufficient to provide definitive evidence.
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The realizing of standard service under the present status of medical moral depends on the construction of medical moral engineering in every level and in diversified forms, Strengthening of management, and arising of the interest and efficience of construction medical moral. Therefore, standard service is the object of medical moral construction engineering under market economy,Meanwhile, the deepening of standrd service also depends on medical moral construction engineering.
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The relationships of therapeutic regime, glycemic control and quality of life with depression were observed in 193 type 2 diabetic patients. The results showed that 46.6% of the diabetic patients manifested depression in various degrees; the depression status was correlated with age or duration of diabetes; the patients under insulin treatment showed more marked depression than the other patients (P