ABSTRACT
After more than 40 years of development, the techniques of liver transplanta-tion have gradually matured, which make liver transplantation become the effective means for the treatment of patients with end stage liver disease. Preoperative evaluation of donors and recipients, intraoperative management, monitoring and treatment of complications such as postoperative immune rejection and infection are all important contents of perioperative management of liver transplantation. With the development and mature of surgical techniques and the expansion of the scope of indications, perioperative management and complications prevention and treatment of liver transplantation need to be explored and optimized. The authors analyze the latest literature reports at home and abroad, investigate the perioperative management and complications prevention and treatment of recipients in liver transplantation combined with clinical practice.
ABSTRACT
Objective To assess the safety and efficacy of stent-assisted coil embolization for acutely ruptured wide-necked intracranial aneurysms. Methods We retrospectively reviewed 192 wide-necked intracranial aneurysms in 178 patients. The efficacy and peri-procedure complications of stent-assisted embolization were compared between rup?ture aneurysms and unrupture aneurysms. Results Stent was successfully implanted in 78 rupture aneurysms and 114 un?rupture aneurysms. There was statistically significant difference between rupture aneurysms and unrupture aneurysms groups in rate of poor prognosis on discharge ( 23.1%vs. 5%,χ2=12.726, P0.05)nor in the rate of mortality and permanent disability (8.9%vs. 6.1%,χ2=0.475, P>0.05). Angiograms at 14.7 months of follow-up did not reveal any significant difference between rupture aneu?rysms and unrupture aneurysms groups in aneurysm complete occlusion (74.1%vs. 70.6%,χ2=0.197,P>0.05), recana?lization (10.3%vs. 9.4%,χ2=0.034,P>0.05)and in-stent stenosis (3.4%vs. 4.7%,χ2=0.136,P>0.05). Conclusion Stent-assisted coil embolization for acutely rupture wide-necked intracranial aneurysms can prevent recurrence effective?ly and can achieve high complete occlusion rate in long term follow-up. However, its procedure related complications and mortality is higher in rupture aneurysms than in unrupture aneurysms, which indicates that a caution is needed to conduct stent-assisted coil embolization in rupture aneurysms.
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Objective To discuss the postoperative complications of hypertensive intracerebral hemorrhage treated with freehand drilling skull minimally invasive puncture drainage therapy .Methods The clinical data of 158 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed .The incidence rate ,causes and preventative measures of the postoperative complications of hypertensive intracerebral hemorrhage treated with free -hand drilling skull minimally invasive puncture drainage therapy were analyzed .Results 10 cases of scalp bleeding , 4 cases of epidural hemorrhage , 9 cases of puncture pathway bleeding , 24 cases of secondary bleeding , 1 case of intracranial infection,3 cases of low intracranial pressure ,5 cases of pneumoencephalos and 2 cases died.Conclusion Freehand drilling skull minimally invasive puncture drainage leads to less complications and so far it is a safe and effective therapy for hypertensive intracerebral hemorrhage .
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Objective To approach the effect of bed exercise for patients with intracranial aneurysm undergoing neural interventional treatment. Methods Ninety-six patients with intracranial aneurysm were divided into the test group(50 cases) and control group(46 cases).The control group received routine nursing, while the test group carried out bed exercise base on routine nursing. The incidence of complica-tions and changes of life quality were compared between the 2 groups. Results Lower incidence of com-plications took place in the test group than the control group(P ＜ 0.05).But changes in pulse rate and blood were not significant (P ＞ 0.05).The score of life quality in the physical domain and psychological domainwere not statistically different between the two groups (P ＜ 0.01 ),but no evident difference was seen in the domain of social relationship and environmental domain (P ＞ 0.05). Conclusions Bed exercise could al-leviated the anxiety and trepidation of patients with intracranial aneurysm,decrease the incidence of compli-cations such as body pain caused by absolute bed rest,thus improve patients' life quality.
ABSTRACT
The enteral nutritin(EN) is the prefer- able rout of clinical nutrition support.But its septic complication,in especial,the pul- monary aspiration is serious and fatal some- times.In this report,3elderly male patients receiving EN were described;the pathogene- sis,the pathological changes,the clinical features,diagnosis,prevention and treat- ment of aspiration from EN were discussed; and itis stressed that for prevention of aspi- ration the effective method is the use of feeding tube via jejunostomy to maintain EN.