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Objective:To investigate the application value of CT-guided localization with medical glue or puncture needle before thoracoscopic pulmonary ground-glass nodule resection.Methods:The clinical data of 92 patients who underwent localization before thoracoscopic resection of pulmonary ground-glass nodules in Beijing Chao-Yang Hospital from June 2019 to November 2022 were retrospectively analyzed. According to the preoperative localization method, the patients were divided into puncture needle group (52 cases) and medical glue group (40 cases). The localization success rate, localization time and incidence rate of complications were compared between the two groups.Results:The success rate of localization in both groups was 100%. In puncture needle group, the guide wire of 1 case (1.9%) prolapsed, but it did not affect the surgical resection. The localization time of puncture needle group and medical glue group was (18±6) min and(14±5) min, and there was a statistical difference between the two groups ( t = 3.06, P = 0.003). The incidence of bleeding and pneumothorax in medical glue group was lower than that in puncture needle group [12.5% (5/40) vs. 38.5% (20/52), χ2 = 7.70, P = 0.009; 35.0% (14/40) vs. 71.2% (37/52), χ2 = 11.96, P = 0.001]. The incidence rate of irritating cough in was higher than that in puncture needle group [50.0% (20/40) vs. 11.5% (6/52), χ2 = 16.50, P < 0.05]. Conclusions:CT-guided localization with medical glue or puncture needle can achieve satisfactory results in the localization of pulmonary ground-glass nodule before thoracoscopic resection and help to improve the accuracy of surgical resection. The incidence rates of bleeding and pneumothorax of medical glue localization are lower than those of puncture needle localization.
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Objective:To compare postural reduction combined with percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCFs).Methods:From January 2019 to January 2020,68 patients with OVCFs who met the inclusion and exclusion criteria in the Second Hospital of Tangshan Hebei Province were included in the observation study. A prospective randomized controlled study was used. The matched groups were divided into PVP combined group (adjust the overextension of the operating table by 20°-30°, if the posture reduction fails, pry the puncture needle on both sides in reverse according to the compression degree of the end plate before operation, and inject bone cement) and PKP group (do not adjust the operating table before operation, insert a balloon and expand on both sides after operation, and inject bone cement), with 34 cases in each group. The Cobb angle of the injured vertebrae was measured by taking the anterior and lateral X-ray film of the patient's lumbar spine before operation. The degree of pain and low back function were evaluated by visual analogue scale (VAS) and Oswetry disability index (ODI). The operation time and fluoroscopy times were recorded during the operation. On the second day after operation, the anterior and lateral X-ray of lumbar spine were taken to measure the Cobb angle of injured vertebrae. All patients were underwent computed tomography (CT) check the bone cement for leakage, record the VAS score, and record the ODI 3 months after operation to evaluate the patient's function. Follow up at the end of 12 months after operation to count the treatment cost and re-fracture of the patient. The data analysis and measurement data were compared by independent sample t-test between the two groups, paired sample t-test was used for intra-group comparison before and after operation. χ 2 test was used for counting data comparison between two groups. Results:All patients were followed up for 12 months. The operation time ((42.7±5.9) min), fluoroscopy times ((20.0±3.6) times) and treatment cost ((19 153±601) yuan) in the PVP combined group were better than those in the PKP Group ((67.4±7.3) min, (30.1±5.9) times, (27 496±669) yuan), and the difference was statistically significant ( t values were 15.39, 8.46, 54.12; all P<0.001). Cobb angle: Postoperative Cobb angle of injured vertebrae in the two groups (PVP combined group (10.7±4.5)°) and (PKP group (13.4±3.8)°) decreased compared with preoperative (PVP combined group (17.0±5.1)°) and (PKP group (16.7±5.1)°) ( t values were 10.61, 5.61; all P=0.001), and PVP combined group recovered better than PKP group, with statistically significant difference ( t=2.70, P=0.009). VAS score: Postoperative (PVP combined group (3.9±1.5) points) and (PKP group (4.1±1.6) points) was lower than preoperative the scores of (PVP combined group (6.9±1.1) points) and (PKP group (7.1±0.9) points), and the difference was statistically significant ( t values were 8.63, 8.88; all P=0.001). There was no significant difference in VAS scores between the two groups ( t=0.48, P=0.630). ODI scores: The scores of (PVP combined group (0.315±0.068)) and (PKP group (0.319±0.077)) after operation were lower than preoperative (PVP combined group (0.574±0.066), (PKP group (0.553±0.075)), and the difference was statistically significant ( t values were 18.54, 14.16, all P=0.001). There was no significant difference in ODI between the two groups ( t=0.25, P=0.803). There was no statistical significance in the two groups of postoperative bone cement leakage (χ 2=0.22, P=0.642). In PVP combined group, 1 case was re-fractured due to trauma, and there was no re-fracture in PKP group. Conclusion:Postural reduction combined with percutaneous needle prying reduction of PVP and PKP can alleviate the pain, improve the postoperative function and restore kyphosis in patients with OVCFs. Postural reduction combined with needle prying reduction of PVP has more advantages in operation time, radiation injury to doctors and patients, treatment cost, and the effect of correcting deformity is more significant.
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Objective To study the efficacy of two different modes of surgical intervention for the treatment of hypertensive intracerebral hemorrhage (HICH):YL-1 type hematoma removed by needle aspiration plus bio-enzyme liquefaction versus conventional craniectomy plus hematoma evacuation.Methods Medical records of 23 patients with HICH treated from December 2012 to February 2017 were retrospectively analyzed.The differences in demographics,length of operation time,costs and length of hospital stay,Glasgow Outcome Scale scores and 3-month follow-up results were compared between the YL-1 type hematoma removed by needle aspiration plus bio-enzyme liquefaction in 12 patients and conventional craniectomy plus hematoma evacuation in 11 patients.Results There were no significant differences in the gender (male 58.33％ vs.63.64％,femal 41.67％ vs.36.36％),age (65.5±11.8 years vs.56.8±10.1 years),preoperative GCS (6.83±3.93 vs.5.82±3.40),intracranial hematoma volume (50.52±23.07 mL vs.68.77±11.18 mL) and length of hospital stay (15.58±14.72 days vs.22.45±18.37 days) (P＞0.05);There were statistically significant differences in length of operation time (0.73±0.21 h vs.3.92±0.67 h) and hospitalization costs (45 230.50±36 566.88 yuan of RMB vs.79 857.90±34 916.48 yuan of RMB) between two groups (P＜0.05);Follow-up 3 months,there were no significant differences in rate of good recovery 33.3％ vs.18.1％,severe disability rate (25.0％ vs.27.3％) and mortality rate (41.7％ vs.54.6％) between two groups (P＞0.05).Conclusions The minimally invasive YL-1 type hematoma aspiration procedure with bio-enzyme liquefaction as a minimally invasive surgery may be superior to conventional craniectomy for treating HICH because it can offer shorter operation time,more accurate hematoma localization,lower risk of injury,and lower hospitalization costs.In particular,the procedure is suitable for elderly,frail,and poor general condition patients.It can also be applied as emergency treatment for HICH.
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Objective To evaluate the effect of micropercutaneous nephrolithotomy(microperc) for treatment of renal calculi with self-made F 4.8 optic puncture needle combined with ureteral access sheath.Methods There were 23 patients undergoing microperc with the self-made device from June 2016 to April 2017,Male,12 cases,female,11 cases.The mean ±SD (range) patient age was (49 ±14) years(28-67 years),stone volume was (1.7 ± 0.6) cm (1.0-3.0 cm) and stone density was (934.5 ± 282.7) HU (357-1 500 HU).The self-made all-seeing system consists of a puncture needle (F4.85) and two 3-way connector allowing the insertion of a flexible microoptic system,laser fiber and attaching to irrigation system.Single tract with one puncture with ultrasound guide was fit to treat the calices containing calculi or calices at one stage operation.The course of puncture could be " all-see" on the display which was connected with flexible microoptic system.After stone fragmentation,the procedure was terminated in tubeless fashion.Ureteral double J stent was inserted in order to prevent postoperative complications.The factors analysed were demographic variables including age,sex,stone volume,stone density [Hounsfield units (HU)] and stone location,and intra-and peri-operative variables such as operating time,drop in haemoglobin level,stone clearance and complications.Results Conversion to PCNL was required in one patient because intraoperative bleeding obscured vision.The mean ± SD (range) operation duration was (46.2 ± 19.9) min (20-120 min),pain score was 2.8 ± 1.2(1-6),hemoglobin decrease was 6.6 g/L,and in hospital time was (2.9 ± 0.8) d (2-5 d),respectively.No patient required blood transfusion.Stone-free rate at 1 and 3 months postoperation was 90.9％ (20/22) and 100 ％ (22/22),respectively.Two who suffered hematuria (Clavien Ⅰ)underwent conservative treatment and recorered well.One suffered urinary tract infections (Clavien Ⅱ) and was treated with antibiotics.There were no major complications.Conclusions Mircoperc with the self-made device and ureteral access sheath in management of renal calculi is feasible and effective.
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Objective To develop a new type of lumbar puncture needle to facilitate to measure intracranial pressure,decrease the risks for intracranial infection and brain hernia.Methods The needle was composed of a body,no.1 and no.2 sleeves,a stylet,a needle base,a catheter,joints and etc.The needle had body and stylet made of stainless steel,the catheter manufactured with medical silicone tube,the joints produced by medical rubber and the remained components by medical plastics.Results The developed needle executed pressure measuring,cerebrospinal fluid collection and medication injection with no extracting the stylet.The outflow velocity of cerebrospinal fluid was limited,and the incidences of the complications were decreased including infection,brain hernia and etc.Conclusion The lumbar puncture needle has simple structure,easy operation and high safety,and thus is worthy promoting practically.
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Objective To evaluate the clinical value of a new optic puncture needle designed by our department for renal calculi treatment. Methods There were 8 patients undergoing micro-PCNL with the new device from June 2016 to February 2017. Values of basic demographic data ,operation time ,pain score ,drop in hemoglobin and complications were recorded. Results The mean stone size,operation time,pain score,drop in hemoglobin,and in-hospital time was(21.9 ± 7.3)mm,(43.6 ± 13.6)min,2.8 ± 1.3,7.0 g/L[(133.2 ± 10.3 g/L vs.(123.2 ± 13.9)g/L,P>0.05]and(3.1 ± 1.0)d,respectively. No patient required blood transfusion. Stone-free rate at 1 and 3 months post-operation were 87.5%(7/8)and 100%(8/8),respectively. One suffered urinary tract infections( ClavienⅠ)and was treated with antibiotics. There were no major complications. Conclusion The new device for treatment of renal calculi is feasible and effective.
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Objective To evaluate the clinical value of a new optic puncture needle designed by our department for renal calculi treatment. Methods There were 8 patients undergoing micro-PCNL with the new device from June 2016 to February 2017. Values of basic demographic data ,operation time ,pain score ,drop in hemoglobin and complications were recorded. Results The mean stone size,operation time,pain score,drop in hemoglobin,and in-hospital time was(21.9 ± 7.3)mm,(43.6 ± 13.6)min,2.8 ± 1.3,7.0 g/L[(133.2 ± 10.3 g/L vs.(123.2 ± 13.9)g/L,P>0.05]and(3.1 ± 1.0)d,respectively. No patient required blood transfusion. Stone-free rate at 1 and 3 months post-operation were 87.5%(7/8)and 100%(8/8),respectively. One suffered urinary tract infections( ClavienⅠ)and was treated with antibiotics. There were no major complications. Conclusion The new device for treatment of renal calculi is feasible and effective.
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Objective To compare the effect of puncture needles with different diameter on percutaneous biopsy for transplant kidney under ultrasound guidance. Methods A total of 82 cases underwent percutaneous renal biopsy for transplant kidney under ultrasound guidance,and were divided into two groups based on the diameters of puncture needles, Group 18 G (n =31)and Group 16 G (n =51).The effect of biopsy and complications were compared between the two groups. Results Compared with Group18 G,Group16 G used less puncture needles and obtained more glomeruli (both P <0.01).The qualified rate of renal specimens in Group 16 G was significantly higher than that of Group 18 G(P <0.05). There was no significant difference in postoperative complications between the two groups (P >0.05 ).Further stratified comparison was conducted,and the results showed that complications of the two groups were not statistically significant in case of puncture with 2 needles or 3 needles (both P >0.05). Conclusions There is similar safety of 16 G puncture needle and 18 G puncture needle to perform renal biopsies under ultrasound guidance.Under the allowable condition of patients,16 G puncture needle is superior to 18 G puncture needle and realizes high quality of renal specimens.
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Objective To study the relationship between the exposure time of puncture needle of infusion bottle stopper and microbial contamination during clinical intravenous transfusion. Methods A total of 600 cases from November 1, 2014 to January 31, 2015 who have received the clinical intravenous transfusion for investigation were selected.When replacing the infusion bottle (bag), inserting the puncture needle slowly across the bottle stopper and making the needle tip be canted to the transfusion bottle mouth (bag) of the rubber plug, gently squeezing the Murphy's tube until solution was not dripping, recording down the exposure time in the air of the needle tip from medicine droplet to the end. To dip the lower part with sterile swabs and culture the swabs in nutrient broth medium. Meanwhile, to replace the next bottle of medicine and get the remaining 2 ml of liquids into the culture broth medium, after 48 h, both of which medium were switched to blood plate culture cultivation for observing the general situation of the bacteria growth. Results Among the 600 cases of clinical transfusion, 24 cases were positive for sterile swabs microorganisms culture, positive rate was 4.0%, among which microorganisms, 15 cases were gram-positive coccus, 3 cases were gram-negative bacillus, 3 cases were gram-positive bacillus and 3 cases were fungi. Correspondingly, 3 cases were positive for liquid broth culture, positive rate was 0.5%as the gram-positive coccus. The exposure time and broth microbial culture result was statistically significant, while the exposure time and medicinal broth microorganisms culture result possesses had no statistical significance. Conclusions Inserting the puncture needle across the bottle stopper could successfully reduce the liquid drug residues in the infusion bottle (bag), however, which might also cause time-dependent microbial contamination during the exposure process in the air.
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Objective As there are difficult problems in surgical puncture needle cleaning and cleaning effect monitoring,we are aiming at finding some reliable solutions through relevant comparative tests. Methods Lumbar puncture needle,bone puncture needle and anesthe-sia spinal needle after clinical use,80 of each kind,were randomly collected and equally divided into the experimental group and the control group. The control group was given traditional lumen surgical instruments cleaning procedure,and the experimental group was given newly cre-ated small lumen instruments manual cleaning procedures. Magnifying glass,self-made instruments monitoring and ATP bioluminescence mo-nitoring were respectively used to verify the cleaning effect. Results All needles were monitored with magnifying glass,self-made instruments monitoring and ATP bioluminescence monitoring after cleaning,and the qualified rate were 98. 33%,97. 00% and 93. 33% respectively in the experimental group while 95. 00%,83. 33% and 78. 33% respectively in the control group. Results of self-made instruments monitoring and ATP bioluminescence monitoring showed that there was no difference between the two kinds of detection methods. Conclusion Newly created small lumen instruments manual cleaning procedures and self-made instruments monitoring were of reliable effect and strong operabili-ty in terms of puncture needle cleaning and cleaning effect monitoring,and they were worthy of further research and application.
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ObjectiveTo study the clinical value and efficacy of intracranial hemorrhage smashpuncture needle with YL-1 type disposable under CT monitoring in treatment of hypertensive intracerebral hemorrhage.MethodsThe data of 80 cases with hypertensive intracerebral hemorrhage patients who accepted the transcranial puncture under CT monitoring application of YL-1 type disposable intracranial hemorrhage smash puncture needle and drainage of hemorrhage,punctuated with urokinase washout and drainaged residual blood clot.Evaluation criteria:hemorrhage volume reduction,average operation time,preoperative and postoperative Glasgow coma scale(GCS) score,the clinical effect of long-term follow-up.ResultsOperation time was 15-45 (25.0 ± 2.8) minutes;hemorrhage volume was reduced by an average of 30％-80％ (56.8 ± 3.2)％,the average increase of GCS was(2.3 ±0.3) scores,10 cases death in 80 patients,70 survivors' activities of daily living (ADL) assessments:grade ADL 1 in 17 cases ( 24.3 ％ ),grade ADL2 in 36 cases( 51.4％ ),grade ADL3 in 13 cases ( 18.6％ ),grade ADL4 in 3 cases(4.3％ ),grade ADL5 in 1 case ( 1.4％ ).ConclusionsYL-1 type disposable intracranial hemorrhage smash puncture needle under CT monitoring in the treatment of hypertensive intracerebral hemorrhage is a simple,fast and accurate positioning,without craniotomy and blood transfusion,safe and effective operation,but should pay attention to operation indications.
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Objective To research and develop a kind of puncture needle depth -controlled device. Methods Based on mechanical design principle, and with stainless steel and plexiglass as materials, the puncture needle depth -controlled device is composed of syringe, needle guard, pin pusher, scale gauge, depth-controlled nut, and locking screw and pedestal hood. Results The puncture needle depth-controlled device is suitable for different kinds of puncture needles and syringe needles, and has many advantages including operation labor -saving, controlling depth, diminishing contamination and infection, avoiding needle guard slippage and needle bending. The operation can be implemented in one minute. Conclusion The kind of puncture needle depth-controlled device is developed successfully and as new first-aid equipment is provided for war wounds or accidents scene rescue.
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Objective To introduce a puncture-drainage system for intracranial hematoma, which can be used in both peacetime and wartime. Methods The inserting-style connections were taken to design the catheter needle and driller. In the design of the combined T-piece, silica membrane was used to be the main sealing end. The fixed division between the main sealing end and the catheter needle took thread connections. The angle between the side-tube of the T-piece and the catheter needle was 120 degree; the side-tube of the T-piece and the Y-tube also took thread connections. The another two sides of Y-tube linked to different drainage bag and syringe, and all of the hoses got the individual and portable switches. Results This system was more efficient, rapid, safe and convenient. What's more, the injury was minimal when doctor performed an intracranial hematoma puncture surgery by using the puncture-drainage system. Conclusion It is very easy to operate and suitable to puncture drainage for intracranial hematoma surgery in both peacetime and wartime.