Development and application of disposable constant volume and negative pressure drainage device / 中华危重病急救医学

The common negative pressure drainage bottle used in the vacuum sealing drainage (VSD) cannot quantitative and automatically cut off. Excessive drainage damages the negative pressure source, causes drainage interruption, so once drainage was continuously performed, medical staff need to closely observe drainage bottle calibration. It was also important to known whether there was a large amount of fresh blood sucked out during continuous drainage because it could lose too much blood. To solve these two problems, we designed a kind of negative pressure drainage device, which volume was constant, with the function of automatic cutting off continuous drainage. It can not only prevent drainage fluid flowing back to the negative pressure source and cause drainage interruption, but also prevent massive blood loss from continued drainage after the hemorrhage. We could benefit from this device, which possess many advantages, such as simple structure, security and reliability. It is worthy promoting in the clinical work.

Clinical study of two routes of vancomycin assisted continuous drainage in the treatment of secondary intracranial infection after traumatic brain injury / 中国生化药物杂志

Objective To investigate the clinical effect of continuous infusion of vancomycin in the treatment of intracranial infection secondary to traumatic brain injury by intrathecal injection and intravenous infusion. Methods 96 patients with traumatic brain injury from December 2015 to March 2017 were randomly divided into study group and control group, the patients were randomly divided into study group and control group (n=48).The study group of patients with continuous drainage combined with vancomycin intrathecal injection treatment, the control group of patients with continuous drainage combined with vancomycin intravenous infusion. The clinical effects of two groups of patients with secondary intracranial infection after traumatic brain injury were recorded. Results After treatment, the total effective rate of clinical treatment in the study group was as high as 89.58%, compared with 70.83% in the control group, the differences were statistically significant(P<0.05). Conclusion Vancomycin intrathecal injection combined with continuous drainage is effective in the treatment of secondary intracranial infection after brain injury, and it is beneficial to protect the quality of life and life safety of the patients.

Clinical study of two routes of vancomycin assisted continuous drainage in the treatment of secondary intracranial infection after traumatic brain injury / 中国生化药物杂志

Objective To investigate the clinical effect of continuous infusion of vancomycin in the treatment of intracranial infection secondary to traumatic brain injury by intrathecal injection and intravenous infusion. Methods 96 patients with traumatic brain injury from December 2015 to March 2017 were randomly divided into study group and control group, the patients were randomly divided into study group and control group (n=48).The study group of patients with continuous drainage combined with vancomycin intrathecal injection treatment, the control group of patients with continuous drainage combined with vancomycin intravenous infusion. The clinical effects of two groups of patients with secondary intracranial infection after traumatic brain injury were recorded. Results After treatment, the total effective rate of clinical treatment in the study group was as high as 89.58%, compared with 70.83% in the control group, the differences were statistically significant(P<0.05). Conclusion Vancomycin intrathecal injection combined with continuous drainage is effective in the treatment of secondary intracranial infection after brain injury, and it is beneficial to protect the quality of life and life safety of the patients.

Intraoperative lumbar cathetering for prevention of postoperative cerebrospinal fluid leakage in lumbosacral vertebral canal / 局解手术学杂志

Objective To study the technique of lumbar cathetering in lumbosacral vertebral canal operation and its effect on prevention of postoperative cerebrospinal fluid leakage.Methods Retrospectively analyzed the clinical data of patients who underwent lumbosacral ver-tebral canal surgery and suffered from difficult dural repair during the operation in Department of Neurosurgery from August 2015 to October 2015.These patients were divided into the observation group (11 cases)and the control group (12 cases)according to whether lumbar cathe-ter were placed during the operation or not.Volume of drainage was strictly controlled after surgery.Remove the epidural drainage after primi-tive healing of the dura mater.The lumbar catheter was removed after 7 to 10 days.The indwelling time of each patient was collected and sta-tistical analyzed.Results The observation group got obvious shorter epidural drainage indwelling time than the control group(P <0.05). Short-term postoperative complications did occur in some cases in observation group,however,there was no obvious increase of infection rate in patients with lumbar continuous drainage indwelling.Conclusion Lumbar cathetering during the operation could be an effective method to solve difficult problem of placeing a lumbar drainage after lumbar puncture and to prevent cerebrospinal fluid leakage after operations of lum-bosacral vertebral canal.But it can not replace the delicate operation and tight dural suture.Drainage should be used only as a remedial measure of dural repair failure.

Effect of continuous drainage of subglottic secretion on ventilator associated pneumonia / 现代临床护理

Objective To study the effect of continuous drainage of subglottic secretion on ventilator associated pneumonia (VAP).Method One hundred and thirty two patients undergoing continuous drainage of subglottic secretion were divided into the control group(n=70)and the experiment group(n=62):the former group underwent sputum suction in case of bucking,wheezy phlegm or decreased oxygen saturation and the latter continuous drainage of subglottic secretion.The incidence of VAP was compared between the two groups.Result The incidences of VAP in the experiment and control groups were 17.7%and 32.9%,respectively, with significant difference between the groups(χ2=3.928,P﹤0.05).Conclusion The continuous drainage of subglottic secretion can effectively reduce the incidence of VAP.

Angiographic observation of the effect to prevent and reverse cerebral vasospasm by lumbar subarachnoid space continuous drainage following subarachnoid hemorrhage / 介入放射学杂志

Objective In this study,the authers investigate the effect of lumbar arachnoid space continuous drainage to prevent and reverse cerebral vasospasm (CVS) angiographically following experimental subarachnoid hemorrhage (SAH).Methods SAH model was achieved by cisternal magna twice injections of autolugous blood.Thirty adult mongrel dogs presented with SAH were randomly divided into five groups: early-drainage group,later-drainage group,early-puncture group,later-puncture group and control group. The lumbar puncture two groups started to puncture and exclude blood cerebral spinal fluid(CSF) 2 hours later following the second injection and on day 5 respectively,while the drainage two groups started to drain at the same time.The degrees of CVS were analyzed through cerebral angiography(%reduction of basilar artery diamiter,%RBAD). Results ①Compared with early puncture group and control group,early drainage group had less cases of CVS and the degrees of CVS were more slight which relieved within shorter period than other two groups.②Compared with later puncture group and control group,later drainage group had less cases of CVS and the period of CVS was shorter.③Compared with later drainage group,there were less cases of CVS and the degrees of CVS were more slight in early drainage group.Conclusions Lumbar subarachnoid space continuous drainage may prevent and reverse the CVS following SAH.Early lumbar subarachnoid space continuous drainage should be presented with better consequence.

Effect and mechanism of lumbar subarachnoid space continuous drainage on cerebral vasospasm prevention and treatment following experimental subarachnoid hemorrhage / 介入放射学杂志

Objective To investigate the effect of lumbar subarachnoid space continuous drainage on cerebral vasospasm(CVS) prevention and treatment following experimental subarachnoid hemorrhage(SAH), and further explore the mechanism of CVS prevention and treatment.Methods An experimental SAH was achieved by twice injections of fresh autologous arterial blood into cisterna magna of each dog. The dogs were randomly divided into drainage group and control group and it was just after the second injection of fresh blood that the drainage group began to drain blood cerebral spinal fluid(CSF).The contents of red blood cell(RBC), endothelin-1(ET-1) and nitric oxygen(NO) in CSF were measured respectively. The degree of CVS was analyzed through angiography (%reduction of basilar artery diamiter,%RBAD). The angiographic results of CVS were analyzed and the changes of RBC, ET-1 and NO in CSF at different stages were compared between two groups. Results The drainage group had fewer cases of CVS and the severity of CVS was more slight compared with control group.Drainage group had a significantly higher cleaning rate of RBC.In drainage group,the content of ET-1 was lower and the content of NO was higher significantly than control group.Conclusions Through cleaning the vasogenic substances in subarachnoid space,lumbar subarachnoid space continuous drainage can change the levels of ET-1 and NO in CSF and may prevent and reverse CVS following.