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Objective To investigate the effect of cisternostomy on the prognosis of patients with traumatic brain injury (TBI).Methods A retrospective case control study was conducted to analyze the clinical data of 46 patients with TBI admitted to Shanxi Dayi Hospital from May 2017 to September 2018.There were 37 males and nine females,aged 24-80 years [(49.8 ± 15.7)years].The injury severity score (ISS) was 6-42 points [(25.0 ± 8.2)points],and the Glasgow Coma score (GCS) was 3-14 points [(3.4 ± 1.7) points].Twenty-three patients underwent routine surgery only (control group),and 23 patients underwent cisternostomy (cisternostomy group) on the basis of routine surgery.Intracranial pressure monitoring was performed in both groups before surgery.The postoperative intracranial pressure,intracranial pressure 1 week after operation,postoperative mechanical ventilation time,neurosurgical ICU (NICU) time,postoperative dehydration dose,decompressive craniectomy rate,postoperative infection rate,mortality rate,length of hospital stay,GCS at discharge,and Glasgow outcome score (GOS) of 3 months of follow-up were compared between the two groups.Results Compared with the control group,the cistemostomy group had lower postoperative intracranial pressure [(7.1 ± 5.7) mmHg vs.(14.2 ± 12.0) mmHg)],intracranial pressure 1 week after operation [(11.8 ± 0.5) mmHg vs.(14.0 ± 0.7) mmHg],postoperative dosage of dehydrating agent [0 (0-500.0) ml vs.1 275 (787.5-3 812.5) ml] and decompression rate (57％ ∶ 91％) (P ＜ 0.05).There were no significant differences between the cistemostomy group and control group in postoperative mechanical ventilation time [120 (42.0-225.0)hours vs.89(65.5-203.5)hours],NICU time [236(182.0-340.5)hoursvs.281 (114-400)hours],postoperative infection rate (4％ vs.0),mortality rate (13％ vs.39％) and hospital stay [32 (20.0-44.5) hours vs.25 (12.0-30.5)hours] (P ＞ 0.05).The cisternostomy group had higher GCS score at discharge than the control group [(10.7 ± 4.2) points vs.(7.9 ± 4.2) points] (P ＜ 0.05).After 3 months of follow-up,18 patients in the cisternostomy group showed good prognosis,better than that in the control group (11 patients) (P ＜ 0.05).Conclusion For TBI patients,cisternostomy can clear the blood cerebrospinal fluid,reduce harmful metabolic products in the brain,reduce intracranial pressure and hence improve the prognosis of patients.
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Objective To evaluate the effect of gastric compound on patients with middle-late gastric cancer of spleen deficiency and stasis toxin. Methods Ninety patients with middle-late gastric cancer of spleen deficiency and stasis toxin were randomly divided into combined group, chemotherapy group, and gastric compound group, 30 cases in each group. Patients in the combined group were treated with gastric compound and chemotherapy;patients in the chemotherapy group were treated with placebo;patients in the gastric compound group were treated with gastric compound. The changes of QLQ-C30 scale integral, fatigue scale intergral, TCM symptom intergral, Karnofsky integral, and toxic and side effects of digestive tract and myelosuppression were observed to evaluate the effect of gastric compound on quality of life in patients. Results The changes of QLQ-C30 scale integral, fatigue scale intergral, TCM symptom intergral, Karnofsky intergal in combined group were better than those in chemotherapy group and gastric compound group, with statistical significance (P<0.05). The changes of fatigue scale intergral and TCM symptom intergral in gastric compound group were better than those in chemotherapy group, with statistical significance (P<0.05). The myelosuppression and toxic and side effects of digestive tract of combined group was lighter than those of chemotherapy group, with statistical significance (P<0.01). Conclusion Gastric compound combined with chemotherapy can improve quality of life in patients with middle-late gastric cancer of spleen deficiency and stasis toxin, and reduce myelosuppression and toxic and side effects of digestive tract.