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OBJECTIVE:To investigate clinical efficacy and safety of linezolid in the treatment of intracranial infection after neurosurgery operation. METHODS:Medical information of 39 intracranial infection patients receiving linezolid in Xijing Hospital of Air Force Medical University during Jul. 1st,2015-Aug. 29th,2016 were analyzed retrospectively. The clinical efficacy andsafety of linezolid in the treatment of intracranial infection after neurosurgery operation were evaluated according to indexes of intracranial infection patient,such as symptoms,signs,lab indexes test and bacterial culture results. RESULTS:Total response rate of 39 intracranial infection patients after neurosurgery operation was 79.49％ after linezolid treatment. After treatment,the patients' body temperature,white blood cell,neutrophil absolute value,white blood cell in cerebrospinal fluid and cerebrospinal fluid protein level were all significantly lower than before treatment,with statistical significance(P<0.05). Of 39 patients,cerebrospinal fluid of 27 patients were cultured before treatment,and 8 cases(29.6％)of which were positive,among which there were 6 cases (75.0％) of Gram-positive bacteria such as Staphylococcus and Enterococcus. No obvious ADR related to linezolid was found in patients. CONCLUSIONS:Linezolid can effectively control the intracranial infection caused by Gram-positive bacteria such as Staphylococcus and Enterococcus with good safety.
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Objective To compare the advantages and disadvantages of non-irrigation and irrigation in the surgical approach of chronic subdural hematoma (CSDH),thus to provide reference for clinical treatment of CSDH.Methods Clinical data of 102 patients with CSDH were retrospectively analyzed.According to the different operation methods,the patients were divided into the non-irrigation group(52 cases) and the irrigation group(50 cases).The blood loss during the procedure,operative time,length of stay and postoperative complication rate between the two groups were compared,and the causes of postoperative complications were analyzed.Results The blood loss during the procedure,operative time and length of stay in the non-irrigation group were (6.73 ± 1.17) mL,(15.06 ± 2.64) min and (10.74 ± 2.20) d,respectively,which in the irrigation group were (19.52 ± 3.18) mL,(38.54 ± 6.95) min and (10.44 ± 2.07)d,respectively,there were statistically significant differences between the two groups in the blood loss during the procedure and the operative time (t =-27.11,-22.72,all P ＜ 0.05),there was no statistically significant difference between the two groups in the length of stay (t =0.70,P ＞ 0.05).The incidence rates of postoperative complication in the non-irrigation group and irrigation group were 8.00％ and 7.69％,respectively,there was no significant difference between the two groups (x2 =0.003,P ＞ 0.05).Conclusion Each of the two methods has its own advantages and disadvantages in the treatment of CSDH.Compared with burr hole irrigation,burr hole non irrigation has the advantages of less blood loss and shorter operative time.However,burr hole non-irrigation is more likely to suffer serious complication.We should select suitable surgical approach by the specific circumstances of the patients.The causes of postoperative complications of CSDH are varied.In particular,there is an important relationship between the non-standard operation and postoperative complications.
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Objective To explore the reasons for rebleeding and its coping strategies.Methods To study the 19 hypertensive intracerebral hemorrhage patients'medical records who suffered postoperative rebleeding in our department from June 2011 to May 2015.Results Rebleeding time:within 6 hours:11 cases,6 ~24 hours:5 cases, 2 ~3 weeks:3 cases.Among 19 cases,hematoma puncture drainage in 2 cases,small bone window craniotomy surgery in 9 cases,craniotomy with big bone flap decompression in 8 cases,6 cases with severely disabled and 7 cases died. Conclusion Intraoperative bleeding operation is not standardized,early postoperative blood pressure control failure in patients,preoperative instability function are the main causes of postoperative bleeding.Choosing a better operating time,the specification intraoperative hemostasis and controlling blood pressure to stable after surgery can reduce the membership of hypertensive intracerebral hemorrhage incidence of postoperative bleeding.
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OBJECTIVE:To observe the influence and safety of dexmedetomidine (DEX) on intraoperative wake-up quality of patients underwent neurosurgical surgery. METHODS:126 patients with general anesthesia in neurosurgery were enrolled and randomized equally into observation group and control group,with 63 cases in each group. Control group was given target con-trolled infusion of propofol with plasma target concentration of 3-5 μg/ml and remifentanil with target effect site concentration of 2-6 ng/ml for anesthesia induction and maintenance,and then plasma target concentration of remifentanil decreased to 0.5 ng/ml 30 min before wake-up. Observation group received target controlled infusion of propofol with plasma target concentration of 3-5 μg/ml and remifentanil with target effect site concentration of 2-6 ng/ml for anesthesia induction and maintenance,and then given DEX 0.3 μg/kg intravenously 30 min before wake-up and maintained at 0.1 μg/(kg·h). MAP,HR,SBP,SaO2,serum levels of IgA,IgM,IgG,IL-6,IL-8 and TNF-α were observed in 2 groups 2 h before operation(T1)and after extubation(T2)as well as the occurrence of ADR during wake-up. RESULTS:There was no statistical significance in HR,MAP,SBP,SaO2,IgA,IgM, IgG,IL-6,IL-8 and TNF-α levels at T1 and SaO2 levels at T2 between 2 groups(P>0.05). HR,MAP,SBP,IL-6 and TNF-α lev-els of observation group decreased significantly at T2 and lower than those of control group;IgA,IgM and IgG increased signifi-cantly and higher than those of control group,with statistical significance (P0.05). CONCLUSIONS:DEX influence intraoperative wake-up quality of patients underwent neurosurgical surgery slightly,and can reduce inflammatory reaction with less ADR.