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Objective:To investigate the effect of drilling and drainage based on spiral CT-guided on hematoma clearance and serum inflammatory factors levels in patients with basal ganglia region hypertensive cerebral hemorrhage.Methods:A total of 112 patients with basal ganglia region hypertensive cerebral hemorrhage admitted to Lanling County People′s Hospital from May 2017 to February 2020 were selected as the research objects, and 56 patients performed traditional craniotomy(craniotomy group), and 56 patients used spinal CT to locate the hematoma area and puncture point before the surgery, and performed drilling and drainage according the scanning results (drilling group). The operation conditions, hematoma volume changes and hematoma clearance rate in two groups were compared. The levels of neuron-specific enolase (NSE), specific protein S100B, interleukin(IL)-17, IL-1β and C-reactive protein (CRP) in two groups before and after the treatment for 1 month were compared. The scores of National Institute of Health Stroke Scale (NIHSS) and Barthel Index Scale(BI) in two groups before and after the treatment for 3 months were compared.Results:The operative time, intraoperative blood loss, postoperative drainage volume in the drilling group were lower than those in the craniotomy group: (1.21 ± 0.28) h vs. (2.43 ± 0.37) h, (131.98 ± 39.51) ml vs. (231.64 ± 47.65) ml, (41.05 ± 5.68) ml vs. (62.93 ± 7.83) ml; the hematoma clearance rate in the drilling group was higher than that in the craniotomy group: (89.57 ± 6.15)% vs. (77.95 ± 5.92)%, there were statistical differences ( P<0.05). After treatment for 1 month, the levels of S100B, NES, IL-17, IL-1β, CRP in the drilling group were lower than those in the craniotomy group: (0.49 ± 0.18) μg/L vs. (0.67 ± 0.24) μg/L, (15.32 ± 1.67) μg/L vs. (17.61 ± 1.59) μg/L, (147.38 ± 14.86) ng/L vs. (172.59 ± 12.94) ng/L, (84.17 ± 10.48) ng/L vs. (107.43 ± 9.35) ng/L, (33.78 ± 4.77) mg/L vs. (47.01 ± 4.15) mg/L, there were statistical differences ( P<0.05). After treatment for 3 months, the scores of NIHSS in the drilling group was lower than that in the craniotomy group and the scores of BI in thedrilling group was higher than that in the craniotomy group: (3.57 ± 2.13) scores vs. (7.83 ± 2.96) scores, (84.56 ± 8.16) scores vs. (67.43 ± 6.95) scores, there were statistical differences ( P<0.05). The complication rate in the two groups had no statistically differences ( P>0.05). Conclusions:Compared with traditional craniotomy, the drilling and drainage based on spiral CT-guided on hematoma clearance has the advantages of shorter operation time, less injury, better regulation of inflammation and better improvement of neurological function.
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Objective To investigate the application effect of drainage of intracranial hematoma in bedside skull soft channel.Methods In the hospital in October 2014 to 2015 years 5 months in the diagnosis and treatment of intracranial he-matoma in patients with selected 20 cases as the research object and the principles were randomly divided into 2 groups, and the observation group ( n=10) the application of bedside cranial awl soft channel drainage in the treatment of , control group (n=10) application of conventional drilling drainage treatment .Two groups patients therapeutic effect and complications in-cidence were compared .Results To observe the surgical treatment group the total effective rate was 90.0%, and complica-tion rate was 10.0%;Observation group , operation treatment , the total effective rate is 60.0%, and complication rate was 40.0%.Two groups of patients with surgical treatment of total efficiency and complication rates between the groups compared with statistical difference (P<0.05).Conclusion The application of bedside cone cranial soft passage drainage in intracra-nial hematoma is effective , can significantly improve the postoperative cognitive function and muscle strength , improve the a-bility to take care of themselves , and less complications .
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Objective To compare different incidence between lateral position and horizontal position in the Burr holes irrigation drainage(BHID).The BHID is wildly known as the most frequently used neurosurgical treatment of chronic subdural hematoma(CSDH).Methods A total of 80 cases were selected which were undergone BHID during January 2010 and December 2015,and the incidence of intracranial pneumatocele was compared after operation.All of cases came from the Second People′s Hospital of Tai Zhou City.Results There were 5 cases(out of 50,10%)having moderate intracranial pneumocephalus but no numerous intracranial pneumocephalus in lateral position,while 26 cases(out of 30 cases,87%)in horizontal position emerging moderate amount or more intracranial pneumatocele.And there were 8 cases'numerous pneumatocele in the horizontal postion group.There was no tension pneumothorax emerging in both groups.Both groups had statistical difference (χ2 =46.43,P <0.01.Conclusion BHID in lateral postion is a simple and effective method for CSDH,and it is conducive to reduce postoperative intracranial pneumatosis.That is worthy of application and promotion.
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Objective To study the application of nerve block scalp combined with sevoflurane in children drilling drainage oper-ation .Methods 40 children cases undergoing drilling drainage were selected and randomly divided into the scalp nerve block com-bined sevoflurane group(A ,n=20) and the sevoflurane intravenous inhalational combined anesthesia (B ,n= 20) .The changes of HR and MAP before before induction and at 5 min after induction ,skin incision ,15 min after operation beginning ,operation end , postoperative 30 ,120 min were observed and recorded .The awaking time ,occurrence rate of postoperative nausea and vomiting ,in-cidence rate of postoperative dysphoria and fentanyl dosage were compared between the two groups .Results HR ,MAP at skin in-cision ,15 min after operation beginning ,operation end ,postoperative 30 ,120 min in the group B were significantly increased than before operation(P<0 .05);the awaking time in the group A was significantly shortened compared with the group B (P<0 .05) , the fentanyl dosage was significantly reduced (P<0 .05);in the group B ,crying and screaming appeared in 16 cases ,dysphoria oc-curred in 14 cases ,the incidence rate was significantly higher than that in the group A (P<0 .05) .Conclusion Compared with sim-ple sevoflurane intravenous inhalational combined anesthesia ,sevoflurane combined with scalp nerve block used in children drilling drainage operation has rapid induction and rapid awaking ,stable vital signs ,fewer adverse reactions ,small fentanyl dosage and bet-ter anesthetic and postoperative analgesic effects ,which is safe ,feasible ,simple and effective .