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Objective To explore the clinical effect and influence of hemocoagulase on bleeding control and coagulation function in neu -rosurgery .Methods A total of 300 patients with surgical treatment in our hospital from June 2013 to June 2014 were randomly divided into control group (n=150) and observation group (n=150).The patients in control group were treated with physiological saline 10 mL topical spraying,while the patients in observation group were treated with physiological saline 10 mL plus hemocoagulase 4U topical spraying.The clinical effect and coagulation index were compared between the two groups .Results The bleeding volume of the observation group was sig-nificantly lower than that of the control group (P0.05).Conclusion Hemocoagulase treatment during the operation can reduce the volume of bleeding and transfusion of blood ,and do not affect the coagulation function in the patients .
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Objective To investigate the effect of intracranial aneurysm isolation combined with extra-intracranial bypass in treatment of middle cerebral artery aneurysm.Methods From January 2013 to March 2015,there were 32 patients with complex middle cerebral artery aneurysm in our hospital,who were treated by intracranial aneurysm isolation combined with extra-intracranial bypass.The clinical symptoms and image examination after surgery were retrospectively analyzed,and the hemodynamic index of middle cerebral artery before and after treat-ment was statistically analyzed.Results The postoperative clinical symptoms of 25 patients were relieved,the mRS score was 0 point.Seven patients received surgery,1 week later,the muscle force of involved side was grade 2 to 3,the mRS score was 2 to 3 point,the blood flowing smoothly in target vessel,with no original aneurysm,no new ischemic stroke or infarct.After intervention,systolic and diastolic blood flow ve-locity were faster than those before the intervention(P <0.05),blood flow resistance were lower than those before intervention(P <0.05). Conclusion The intracranial aneurysm isolation combined with extra-intracranial bypass can effectively improve the clinical symptoms of pa-tients with complex intracranial aneurysms,with high graft patency rate and reliable effect.
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Objective To explore the efficacy and clinical value of video-assisted thoracoscopic surgery (VATS) in elderly patients undergoing lung resection surgery.Methods A total of 100 elderly patients with lung cancer in our hospital from January 2009 to March 2012 were randomly divided into VATS group and traditional operation group (n=50,each group).Patients in VATS group were given VATS with 3 minimally invasive cuts.Patients in traditional operation group were treated with traditional thoracotomy.There were 23 cases undergoing upper left lobectomy,24 cases undergoing left lower lobectomy,24 cases with right upper lobectomy,14 cases with right lobectomy,6 cases with right lower lobectomy,3 cases with right pneumonectomy and 6 cases with left pneumonectomy.Results The operative time was shorter in VATS group than in traditional operation group [(109± 15) min vs.(125±22) min,t=4.25,P＜0.05].The intraoperative bleeding volume and total drainage volume were less in VATS group than in traditional operation group [(105.0±21.8) ml vs.(121.0±28.2) ml,(225.0±50.4) ml vs.(121.0±28.2) ml,respectively,t=3.17,4.99,both P＜0.05].The hospital stay and surgery extubation days were less in VATS group than in traditional operation group [(3.1 ± 0.8) d vs.(3.8 ± 1.1) d,(5.8 ± 1.8) d vs.(8.7 ± 2.4) d,respectively,t =3.64,6.84,both P＜ 0.05].The incidence of pulmonary infection was lower in VATS group than in traditional operation group (10％ vs.28％,x2 =5.26,P＜0.05).Conclusions VATS is safe and effective for lobe resection in elderly lung cancer with a high cure rate and fewer complications,which can be widely applied in elderly patients with lung cancer.
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Objective The purpose of this study was to investigate the preparation of a pulmonary self-expanding valved stent and the percutaneous implantation of a valved stent in the pulmonary valve position without cardiopulmonary bypass.Methods A bovine jugular valve conduit was trimmed to remove the extraneous materials to reduce profile,and then was sutured onto nitinol stents to form a pulmonary self-expanding valved stent.In vitro,it was tested by a pulsatile mock loop system.Through a 24F delivery system,the valved stents were deployed in the pulmonary valve position of 8 pigs,and then in vivo assessment with echocardiography and a postmortem examination were carried out.Results The pulmonary self-expanding valved stent has an inner diameter of (21.9 ± 1.6) mm,an outer diameter of (24.6 ± 1.5 ) mm,a length of (27.9 ± 4.3 )mm,and an effective orifice area of ( 1.8 ±0.2) cm2.7 of the 8 valved stents were exactly deployed in the native pulmonary valve position,1 valved stent failed.The transvalvular pressure gradient was (7.9 ± 3.3 ) mm Hg by catheter measurement,(9.3 ±4.1 ) mm Hg by Doppler echocardiography.The angiography showed no migration,no regurgitation and no paravalvular leak.The echocartiography showed all the new valves opened and closed well with 2 cases of mild regurgitation.Postmortem examination confirmed the valved stent straddled the pulmonary annuli without migration,the native valve was locked between the stent and arterial wall.Conclusion The acute study demonstrates that the self-expanding valved stent can be successfully implanted in the pulmonary position by a catheter delivery system and function well.Percutaneous pulmonary valve implantation without cardiopulmonary bypass is feasible and has a wide clinical perspective.