ABSTRACT
Objective To explore the clinical effect of targeted soft channel intracranial hematoma drainage combined with urokinase and autologous serum on hypertensive cerebral hemorrhage.Methods Form October 2016 to October 2017,120 patients with hypertensive cerebral hemorrhage were selected as the research objects in Handan First Hospital.In accordance with the principle of random number rule,they were divided into two groups,60 cases in each group,the study group was given directional soft channel with autologous serum treatment,the control group was given directional soft channel joint urokinase for treatment of intracranial hematoma drainage,and then nerve function,clinical curative effect,inflammatory factors and endothelial function of two groups were compared.Results Before treatment,the National Institutes of HealthStroke Scale (NIHSS) score of the study group and the control group were (4.70±0.99) and (4.71 ± 1.02),after treatment were (9.57± 1.54) and (6.63 ± 1.35),respectively.The difference between the two groups before treatment was not statistically significant (t =0.054,P =0.957).After treatment,the NIHSS scores of patients in both groups were significantly higher than those before treatment (Study group t =20.605,P=0.000,Control group t =8.790,P =0.000),The NIHSS score of the study group was significantly higher than that of the control group and the difference was statistically significant (t=11.120,P=0.000).Before treatment,Interleukin-6 (I1-6) in the study group and the control group were(45.61 ±4.13) ng/L and (44.98±2.19) ng/L,after treatment were (13.72±2.19) ng/L and (26.17±2.51) ng/L,respectively,and the two groups before treatment showed no significant difference (t =0.065,P =0.948).After treatment,IL-6 in both the study group and the control group decreased significantly (Studygroup t =52.841,P =0.000,Control group t =43.740,P =0.000),and IL-6 in the study group was significantly lower than that in the control group (t =28.951,P=0.000).Before treatment,the Tumor necrosis factor-α (TNF-αt) of the study group and the control group were (63.01 ± 4.22) μg/L and (62.96 ± ±4.21) μg/L,after treatment were (40.92 ± 3.12) μg/L and (55.67.4.02) μg/L,respectively.The difference between the two groups before treatment was not statistically significant (t =0.065,P =0.948).TNF-α in both the study group and the control group significantly decreased after treatment (Study group t=32.604,P=0.000,Control group t=9.933,P=0.000).TNF-α in the study group was significantly lower than the control group (t =22.453,P=0.000).Before treatment,the nitric oxide of the study group and the control group were (33.46±4.27) μmol/L and(32.97±4.25) μmol/L,after treatment were(54.15±3.11) μmoL/L and (43.17± 3.22) μmol/L.No statistically significant difference was observed between the two groups before treatment (t =0.630,P =0.530).After treatment,nitric oxide was significantly increased in both the study group and the control group (Study group t =30.339,P =0.000,Control group t =14.818,P =0.000).Nitric oxide in the study group was significantly higher than that in the control group (t =18.999,P=0.000).Before treatment,the Endothelin-1 of the study group and the control group before and after treatment were (84.43±4.22) μg/L and (84.51±4.26) μg/L,after treatment were(57.47±5.07) μg/L and (70.14±5.12) μg/L.There was no statistically significant difference between the two groups before the treatment (t =0.335,P =0.738).After the treatment,endothelin-1 in both the study group and the control group was significantly reduced (Study group t =22.889,P =0.000,Control groupt =10.662,P =0.000),and endothelin-1 in the study group was significantly lower than that in the control group (t =9.226,P =0.000).The total effective rate of the study group after treatment was 88.33％ (53/60),significantlyhigher than that of the control group (73.33％) (44/60).The difference between the two groups was statistically significant (x2 =4.357,P =0.037).Conclusion Targeted soft channel intracranial hematoma drainage combined with autologous serum was effective in the treatment of hypertensive cerebral hemorrhage,which is worthy of clinical application.
ABSTRACT
Objective@#To investigate the efficacy and safety of cuboid stereotactic aspiration of necrotic brain tissue for treating malignant middle cerebral artery infarction in the elderly patients.@*Methods@#Sixteen elderly patients with malignant middle cerebral artery infarction were selected from June 2017 to January 2019 in our hospital. Patients were followed up for 6 months to evaluate the efficacy of stereotactic aspiration of necrotic brain tissue using the modified Rankin Scale (mRS).@*Results@#The 30-day mortality was 18.75%. Among the 16 elderly patients, 6 (37.5%) had an mRS score of 3 (defined as moderate disability), 6 (37.5%) had an mRS score of 4 (defined as moderate to severe disability), 1 (6.25%) had an mRS score of 5 (defined as severe disability), and 3 (18.75%) had an mRS score of 6. The probability of 6-month favorable outcome, defined as an mRS score of ≤3, was 37.5%, and the 6-month mortality was 18.75%.@*Conclusions@#It is a simple, minimally invasive, effective and safe method to treat malignant middle cerebral artery infarction in the elderly patients with cuboid stereotactic aspiration of necrotic brain tissue, which needs to be confirmed by further randomized controlled studies.
ABSTRACT
Objective To investigate the efficacy and safety of cuboid stereotactic aspiration of necrotic brain tissue for treating malignant middle cerebral artery infarction in the elderly patients.Methods Sixteen elderly patients with malignant middle cerebral artery infarction were selected from June 2017 to January 2019 in our hospital.Patients were followed up for 6 months to evaluate the efficacy of stereotactic aspiration of necrotic brain tissue using the modified Rankin Scale (mRS).Results The 30-day mortality was 18.75％.Among the 16 elderly patients,6 (37.5％) had an mRS score of 3 (defined as moderate disability),6 (37.5％) had an mRS score of 4 (defined as moderate to severe disability),1 (6.25％) had an mRS score of 5 (defined as severe disability),and 3 (18.75％) had an mRS score of 6.The probability of 6-month favorable outcome,defined as an mRS score of ≤ 3,was 37.5％,and the 6-month mortality was 18.75％.Conclusions It is a simple,minimally invasive,effective and safe method to treat malignant middle cerebral artery infarction in the elderly patients with cuboid stereotactic aspiration of necrotic brain tissue,which needs to be confirmed by further randomized controlled studies.
ABSTRACT
Objective?To compare the clinical efficacy and prognosis of neural endoscopic intracranial hematoma evacuation (NEIHE) and soft channel puncture drainage (SCPD) in treatment of hypertensive intracerebral hemorrhage (HICH).?Methods?106 HICH cases from January 2015 to December 2016 were divided into endoscopic group (51 cases, NEIHE scheme) and drainage group (55 cases, SCPD scheme) according to random number, operation and complications indicators were recorded, variations on peripheral inflammatory factors and NIHSS neurological deficit score were compared, meanwhile, clinical efficacies were determined.?Results?Though the endoscopic group with operative time (108.5 ± 33.8 vs 85.8 ± 25.4) min and intraoperative blood loss (54.2 ± 17.7 vs 42.6 ± 14.5) ml were significantly higher than drainage group (P < 0.05), the endoscopic group associated with a higher hematoma clearance 48 h post operation (85.8 ± 7.8 vs 74.7 ± 9.2) % (P < 0.05) and lower overall complication rate (13.7% vs 29.1%) (P < 0.05). After 14 d, the endoscopic group with the decreased value of peripheral blood TNF-α (129.5 ± 33.7 vs 107.8 ± 29.5) pg/ml, IL-6 (74.3 ± 22.8 vs 56.7 ± 18.2) pg/ml, hs-CRP (32.6 ± 7.5 vs 27.2 ± 6.6) mg/L were all significantly higher than the drainage group (P < 0.05). After 14 d, endoscopic group with decreased value of NIHSS score was significantly higher than the drainage group (13.0 ± 3.8 vs 10.3 ± 3.5) (P < 0.05). 6 months after operation, the increased Barthel index in the survivors of endoscopic group was significantly higher than the drainage group (44.8 ± 9.7 vs 39.5 ± 11.2) (P < 0.05).?Conclusion?Though the NEIHE is more complicated than SCPD in treatment of HICH, the hematoma clearance is more complete, the complications are less, and the short-term efficacy and prognosis with obvious advantages.
ABSTRACT
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 .