Résumé
Objective To study the different effects on unilateral middle cerebral artery infarction with standard large trauma craniotomy and frontotemporal craniectomy and decompression treatment.Methods The clinical data of 56 patients with unilateral middle cerebral artery infarction were retrospectively analyzed.They were divided into the two groups according to the different operation methods,and compared the incidence of postoperative complications and GCS score after 1 week,GOS score after 1 month,and ADL score after 6 months and so on.Results The differences were significant between the two groups in incidence of postoperative complications [ incidence of rebleeding after the operation(A group 5 cases,B group 4 cases),showing of brain pools(A group 23 cases,B group 14 cases),lung infection(A group 7 cases,B group 13 cases),gastrointestinal bleeding(A group 8 cases,B group 17 cases),χ2 =0.579,4.703,8.606,7.081] and postoperative GCS score after a week[12 -15points(A group 5 cases,B group 2 cases),9-11points(A group 15 cases,B group 10 cases),5-8points(A group 6 cases,B group 8 cases),3-4points(A group 2 cases,B group 4 cases),death(A group 1 case,B group 3 cases),W value was 599.500,P=0.028] (all P0.05).Conclusion Standard large trauma craniotomy has features as decompression full,low early complication rate,and can improve the short-term efficacy of unilateral middle cerebral artery infarction in patients,and promote recovery.
Résumé
Objective To evaluate retrospectively the efficacy of cistema magna plastic repair in the treatment of Chiari malformation complicated with syringomyelia Methods Fifty-one patients suffered from Chiari malformation complicated with syringomyelia were treated in our department from May 2004 to October 2009. Seventeen patients received cistema magna plastic repairment (the decompression of posterior cranial fossa, duraplastic repair,resection of hernia below cerebellar tonsil and separation of adherence of arachnoid membrane). Results Clinical symptoms disappeared or improved in 15 cases (effective rate of 90%). MRI showed tonsillar herniation disappeared,syringomyelia narrow. MRI showed cistema magna plastic repair, syringomyelia disappeared or significantly thinned and spinal cord subarachnoid space widened. Effective treatment obtained in 12 cases (effective rate 70%). Conclusions The efficiency of Cistern magna plastic repair treating Chiari malformation with syringomyelia is satisfied.
Résumé
Objective To explore the drug resistance diversity of pseufomonsd aeruginosa.Methods We did sensitivity experiments by 23 antibiotic of 1731 pseudomonad aeruginosa identified from clinic during 1997 to 2008,Results In 1 731 pseudomonad aeruginosa,the samples were main from phlegm,accounted for 58.5%.the second from secretion accounted for 24.7%.The drug resistance of pseudomonad aeruginosa for ampicillin、cefazolin and cefuroxime sodium were all higher than 90%,the second were trimethoprim/sulfamethoxazole 83.2%.The antibacterial medicines of drug resistance higher than 70%were netilmicn(75.2%)、ofloxacin(70.4%)、tetracycline(74.1%)、choramphenicol(72.0%).The antibacterial medicines of drug resistance Iower than 30%were Cefoperazone/Sulbactam、cefepime、imipenem、ceftazidme.In 12 years,the drug resistance diversity had enhanced prevalent trend.The enhanced speed of proportion drug was slow in 2004～2007,but it was fast again in 08 year.Conclusion The pseudomonad aeruginosa have become one of the most clinical routine nosogenetic germs.It showed single and anti muhiresistance of antibioties seriously.In order to improve antibacterial treating effect,we should inspect the drug resistance continuously in our area.We could select rationally antibacterial medicine according to the result of medicine sensitivity experiments.