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Objective To investigate the comparison of clinical improvement effect of lamotrigine and sodi-um valproate on treatment of tardive epilepsy after traumatic brain injury.Methods According to SAS randomly gen-erated random number,the 120 patients with tardive epilepsy after traumatic brain injury in our hospital were randomly divided into lamotrigine group and sodium valproate group,with 60 cases in each group.Lamotrigine group was given lamotrigine for treatment,while the sodium valproate group was given sodium valproate.The clinical improvement effect,the quality of life and the adverse reactions were compared between the two groups.Results After treatment, the total rate of clinical improvement effect in lamotrigine group was 95.00%,which was higher than that in the sodium valproate group(78.33%),and it was statistically significant(χ2 =4.123,P <0.05).The quality of life in the lam-otrigine group was (62.9 ±22.2),which was significantly higher than sodium valproate group(50.6 ±21.7),the difference was statistically significant(t =2.728,P <0.05).The rate of adverse reactions in lamotrigine group was 23.33%,significantly lower than sodium valproate group(73.33%),it was statistically significant(χ2 =4.297,P <0.05).Conclusion Comparison with sodium valproate,patients with tardive epilepsy after traumatic brain injury who were given lamotrigine can effectively improve clinical effect,safety and reduce the rates of adverse reactions.Eventually, treatment with lamotrigine can improve the life quality of patients,which is worth further clinical application.
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Objective To compare on therapeutic efficacy and prognosis evaluation of extended pterional approach operation with the traditional operation treatment for frontotemporal contrecoup craniocerebral injury , and provide the clinical basis for the treatment.Methods By retrospective study,112 patients with frontotemporal contrecoup craniocerebral injury were selected randomly .There was extended pterional approach operation group ( observation group,58 cases) and traditional operation treatment group (the control group,54 cases).We observed and evaluated indexes including of postoperative GOS grade assessment ,intracranial pressure measurement of 1,3,6 day preoperative and postoperative and the outcomes after operation of two groups .Results The plant survival rate of the observation group was 10.34%(6/58),lower than that of the control group 27.78%(15/54),the difference was significant (χ2 =4.58,P<0.05);The residual rate in the observation group was 29.31%(17/558),more than that of control group 16.67%(9/54),the difference was significant (χ2 =4.20,P<0.05);The severe brain edema of the observation group was 10.34%(6/58),lower than that of the control group 20.37%(11/54),the difference was significant (χ2 =4.78,P<0.05);Subdural effusion of the observation group was 12.07%(7/558),lower than that of the con-trol group 24.07%(13/54),the difference was significant(χ2 =3.96,P<0.05).The intracranial pressure of observa-tion group after 1 days and 3 days after operation were(302.18 ±17.33)mmH2O and (260.32 ±17.42)mmH2O,low-er than that of the control group was (371.24 ±18.40)mmH2O and (322.17 ±16.28)mmH2O,the difference was significant(t=7.53,5.39,all P<0.05).Conclusion Extended pterional approach could clean wound and hemato-ma fully,bleed thoroughly ,and be conducive to the protection of brain function .It is important for the clinical value to improve the quality of life of patients .
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Objective To investigate the clinical value of ventricular intracranial pressure monitoring in treatment of severe craniocerebral trauma with high intracranial pressure.Methods A retrospective analysis was conducted on forty cases of severe craniocerebral trauma with GCS score of 3-5 undergone bilateral decompressive craniectomy from October 2010 to January 2012.The patients were divided into three groups:Group A (12 cases received craniotomy after the placement of ventricular intracranial pressure probe) ; Group B (15 cases had craniotomy ahead of the probe placement) ; control group (13 cases had probe placement alone).Intracranial pressure control,dose and duration of administration of dehydrator and prognosis were compared among groups.Results Groups A and B showed a better result in aspects of controlling intracranial pressure within 15 mm Hg,dose and duration of mannitol treatment,and prognosis,as compared with control group (P ＜ 0.05).Furthermore,Group A had seven cases of severe disability or in vegetable state,but only three cases in Group B (P ＜ 0.05).Conclusion Ventricular intracranial pressure monitoring can effectively reduce intracranial pressure,raise treatment success rate and decline the use of mannitol in management of severe craniocerebral trauma.