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Objective:To investigate the efficacy of different surgical treatments for hypertensive cerebral hemorrhage in older adult patients and their effects on traumatic stress and cerebral edema.Methods:A total of 100 older adult patients with hypertensive cerebral hemorrhage who received treatment in Zhejiang Xin'an International Hospital from January 2018 to June 2020 were included in this study. They underwent either craniotomy (craniotomy group, n = 50) or hard channel minimally invasive puncture drainage (minimally invasive puncture group, n = 50) according to the willingness of patients and their close relatives. Perioperative indexes, Barthel index after treatment, nerve injury indexes before and after treatment, prognosis related indexes, trauma stress indexes and brain edema were compared between the two groups. Results:Operative time, intraoperative blood loss and postoperative hospital stay in the craniotomy group were (147.21 ± 31.35) minutes, (289.74 ± 22.75) mL and (42.74 ± 6.82 ) days, respectively, which were significantly longer or greater than (41.88 ± 7.19) minutes, (4.62 ± 0.88) mL and (16.27 ± 4.02) days in the minimally invasive puncture group ( t = 38.73, 62.17, 23.17, all P < 0.001). Barthel index at 1 and 3 months after treatment in the minimally invasive puncture group was (63.11± 9.64) and (93.51 ± 11.38), respectively, which was significantly greater than (44.78 ± 8.85) and (81.29 ± 10.37) in the craniotomy group ( t = 3.17, 6.21, both P < 0.05). Before treatment, there were no significant differences in nerve injury index, prognosis index, trauma stress index and brain edema between the two groups (all P > 0.05). At different time points after treatment, each indicator in the minimally invasive puncture group was significantly superior to that in the craniotomy group (all P < 0.05). Conclusion:Hard channel minimally invasive puncture drainage exhibits advantages over traditional craniotomy in the treatment of hypertensive cerebral hemorrhage in older adult patients. Hard channel minimally invasive puncture drainage can more greatly reduce injury to brain tissue, better control nerve injury and brain edema, and more remarkably improve patient's quality of life than traditional craniotomy.
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Objective:To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on awakening of cerebrum frontal lobe area and neural function in the patients with brain injury.Methods:The clinical data of 70 patients with brain injury in Zhejiang Xin′an International Hospital from March 2020 to July 2021 were retrospectively analyzed. Among them, 34 cases were treated with conventional awakening rehabilitation (control group), and 36 cases were treated with rTMS combined with conventional awakening rehabilitation (observation group). The efficacy was evaluated after treatment, the cure and effective were taken as total effective. The Glasgow coma scale (GCS) was used to evaluate the conscious state; the modified coma recovery scale (CRS-R) was used to evaluate the neural function; the brainstem auditory evoked potential (BAEP) classification criteria was used to evaluate the conscious state, the electroencephalogram powers of five channels FP1, F3, C3, F7 and T3 were measured; and the adverse reactions were recorded.Results:The total effective rate in observation group was significantly higher than that in control group: 94.44% (34/36) vs. 76.47% (26/34), and there was statistical difference ( χ2 = 4.61, P<0.05). The eye opening response, motor response, language response and total score of GCS after treatment in observation group were significantly higher than those in control group: (4.28 ± 0.57) scores vs. (3.03 ± 0.59) scores, (4.57 ± 0.85) scores vs. (3.24 ± 0.67) scores, (3.99 ± 0.92) scores vs. (3.01±0.48) scores and (12.85 ± 2.01) scores vs. (10.47 ± 1.95) scores, and there were statistical differences ( P<0.01). The CRS-R score after treatment in observation group was significantly higher than that in control group: (15.28 ± 3.17) scores vs. (12.33 ± 3.09) scores, and there was statistical difference ( P<0.01). The BAEP classification after treatment in observation group was significantly better than that in control group, and there was statistical difference ( P<0.05). The powers of F3, C3, F7 and T3 after treatment in observation group were significantly lower than those in control group: (41.25 ± 6.35) μV 2/Hz vs. (53.19 ± 10.37) μV 2/Hz, (39.17 ± 5.61) μV 2/Hz vs. (48.94 ± 6.63) μV 2/Hz, (63.94 ± 7.57) μV 2/Hz vs. (69.85 ± 7.35) μV 2/Hz and (51.76 ± 6.84) μV 2/Hz vs. (62.47 ± 7.62) μV 2/Hz, and there were statistical differences ( P<0.01); there was no statistical difference in power of Fp1 after treatment between two groups ( P>0.05). No serious complications such as epilepsy occurred in two groups. There was no statistically significant difference in the incidence of adverse reactions between two groups ( P>0.05). Conclusions:The rTMS can improve the excitability of brain cells and the degree of brain injury in patients with brain injury, improve the CRS-R score, promote waking up and the recovery of cognitive functions, with safety and efficiency.
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Objective:To study the effect of early hyperbaric oxygen combined with rehabilitation training on neurological rehabilitation and prognosis of patients with hypertensive intracerebral hemorrhage after borehole drainage.Methods:Eighty-five patients with hypertensive intracerebral hemorrhage admitted to Zhejiang Xin'an International Hospital from January 2018 to March 2020 were enrolled, and all of them were treated with minimally invasive drilling and drainage and they were divided into two groups by the order of admission. The control group (41 cases) received rehabilitation training after 48 h of stable vital signs. The research group(44 cases) was treated on the base of the control group combined with early hyperbaric oxygen therapy. The levels of neuron-specific enolase (NSE), S100β and scores of National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Barthel index, cerebral blood flow, and Glasgow Outcome Scale (GOS) were observed in the two groups before and after treatment.Results:After treatment, the levels of NSE and S100β in the two groups were decreased and those in the research group were lower than those in the control group: (14.38 ± 1.47) μg/L vs. (18.04 ± 2.95) μg/L, (0.24 ± 0.03) μg/L vs. (0.32 ± 0.04) μg/L, the differences were statistically significant ( P<0.05). The scores of NIHSS in the two groups were decreased, while the scores of FMA and Barthel index were increased, while the scores of NIHSS in the research group was lower than that in the control group: (9.18 ± 1.02) scores vs. (11.85 ± 1.47) scores; the scores of FMA and Barthel index in the research group were higher than those in the control group: (68.38 ± 8.93) scores vs.(61.42 ± 8.01) scores, (63.25 ± 7.65) scores vs. (56.11 ± 6.04) scores, the differences were statistically significant ( P<0.05). The average cerebrovascular blood flow and flow rate of patients in both groups were higher than those before treatment, and the peripheral cerebrovascular resistance of patients in both groups was lower than that before treatment, while the average cerebrovascular blood flow and flow rate in the research group were higher than those in the control group: (17.85 ± 2.48) ml/s vs. (15.12 ± 2.01) ml/s, (20.61 ± 2.88) cm/s vs. (17.04 ± 2.47) cm/s; the peripheral cerebrovascular resistance in the research group were lower than that in the control group: (1 328.95 ± 114.29) kPa·s/m vs. (1 558.13 ± 157.21)kPa·s/m, the differences were statistically significant ( P<0.05). The good prognosis rate of research group was higher than that of control group: 84.09%(37/44) vs. 60.98%(25/41), the difference was statistically significant ( χ2 = 4.634, P<0.05). Conclusions:Early hyperbaric oxygen combined with rehabilitation training can promote the recovery of neurological function of patients with hypertensive intracerebral hemorrhage after borehole drainage, and can improve cerebral blood flow and prognosis.
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Objective To explore the effects of minimally invasive intracranial hematoma removal in the treatment of cerebral hemorrhage,and its influence on neurological functional recovery,serum levels of high-sensitivity C-reactive protein (hs-CRP),interleukin-6 (IL-6),interleukin-8 (IL-8),tumor necrosis factor-alpha (TNF-α).Methods From January 2016 to December 2017,100 patients with cerebral hemorrhage admitted to Zhejiang Xin'an International Hospital were selected and randomly divided into two groups according to the digital table,with 50 cases in each group.The control group was given routine symptomatic treatment,the observation group received minimally invasive intracranial hematoma removal combined with conventional treatment.The curative effect,restoration of nerve function,the levels of hs-CRP,IL-6,IL-8 and TNF-were observed in the two groups.Results After treatment,the blood loss and edema volume around the hematoma in the two groups were declined significantly (t =5.74,9.32,7.41,9.32,all P ＜ 0.05),and the improvements of the observation group was better than those of the control group (t =8.29,5.28,all P ＜ 0.05).The excellent and good rate of the observation group was 90％ (45/50),which was significantly higher than 72％ (36/50) of the control group (x2 =3.62,P ＜ 0.05).After treatment,the NDS scores of the two group were significantly lower than those before treatment (t =4.64,5.75,all P ＜ 0.05),the GCS scores of the two groups were significantly improved (t =5.41,7.86,all P ＜ 0.05).The NDS score of the observation group was significantly lower than that of the control group (t =5.31,P ＜ 0.05),the GCS score of the observation group was significantly higher than that of the control group (t =3.84,P ＜ 0.05).After treatment,the levels of inflammatory factors in the two groups were significantly reduced compared with those before treatment (t =3.27,3.75,3.38,3.61,5.74,4.39,6.52,8.26,all P ＜ 0.05),the levels of inflammatory factors in the observation group were significantly lower than those in the control group (t =4.37,3.92,8.52,4.28,all P ＜0.05).Conclusion Minimally invasive removal of intracranial hematoma combined with conventional treatment in the treatment of patients with cerebral hemorrhage can obtain satisfactory clinical effect,can promote neural functional recovery,improve inflammatory factor levels (hs-CRP,IL-6,IL-8,TNF alpha),it is worthy of application.
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Objective@#To explore the effects of minimally invasive intracranial hematoma removal in the treatment of cerebral hemorrhage, and its influence on neurological functional recovery, serum levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8(IL-8), tumor necrosis factor-alpha (TNF-α).@*Methods@#From January 2016 to December 2017, 100 patients with cerebral hemorrhage admitted to Zhejiang Xin'an International Hospital were selected and randomly divided into two groups according to the digital table, with 50 cases in each group.The control group was given routine symptomatic treatment, the observation group received minimally invasive intracranial hematoma removal combined with conventional treatment.The curative effect, restoration of nerve function, the levels of hs-CRP, IL-6, IL-8 and TNF- were observed in the two groups.@*Results@#After treatment, the blood loss and edema volume around the hematoma in the two groups were declined significantly (t=5.74, 9.32, 7.41, 9.32, all P<0.05), and the improvements of the observation group was better than those of the control group (t=8.29, 5.28, all P<0.05). The excellent and good rate of the observation group was 90%(45/50), which was significantly higher than 72%(36/50) of the control group (χ2=3.62, P<0.05). After treatment, the NDS scores of the two group were significantly lower than those before treatment (t=4.64, 5.75, all P<0.05), the GCS scores of the two groups were significantly improved (t=5.41, 7.86, all P<0.05). The NDS score of the observation group was significantly lower than that of the control group (t=5.31, P<0.05), the GCS score of the observation group was significantly higher than that of the control group(t=3.84, P<0.05). After treatment, the levels of inflammatory factors in the two groups were significantly reduced compared with those before treatment (t=3.27, 3.75, 3.38, 3.61, 5.74, 4.39, 6.52, 8.26, all P<0.05), the levels of inflammatory factors in the observation group were significantly lower than those in the control group (t=4.37, 3.92, 8.52, 4.28, all P<0.05).@*Conclusion@#Minimally invasive removal of intracranial hematoma combined with conventional treatment in the treatment of patients with cerebral hemorrhage can obtain satisfactory clinical effect, can promote neural functional recovery, improve inflammatory factor levels (hs-CRP, IL-6, IL-8, TNF alpha), it is worthy of application.
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Objective@#To explore the effect of 3D-slicer assisted soft channel drainage on the surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage (HICH).@*Methods@#Seventy-six HICH patients treated in Zhejiang Xin'an International Hospital from January 2016 to December 2018 were randomly divided into the control group and the observation group, with 38 cases in each group. Both groups of patients underwent percutaneous cone cranial soft channel drainage.The control group patients used CT hematoma localization, and the observation group patients used 3D-slicer software hematoma localization. The perioperative related data, surgical results, complications and prognosis of patients in the two groups were observed and compared.@*Results@#The operation time and hospitalization time of patients in observation group were (76.24 ± 11.24) min and (15.21 ± 4.01) d, significantly shorter than those in control group [(103.17 ± 17.43) min and (18.63 ± 4.75) d], and there were significant differences (P < 0.05). The blood loss during operation and hematoma residual amount 7 d after operation in observation group were (77.21 ± 11.35) ml and (4.24 ± 0.87) ml, significantly lower than those in control group [(115.35 ± 21.22) ml and (18.63 ± 4.75) ml], and there were significant differences (P < 0.05). The hematoma clearance of patients 1 d and 3 d after operation in observation group were (83.24 ± 11.21) ml and (92.24 ± 15.63) ml, significantly higher than those in control group [(69.67 ± 10.73) ml and (85.57 ± 13.11) ml], and there were significant differences (P < 0.05). The incidence rates of intracranial rebleeding, intracranial infection and pulmonary infection in observation group were significantly lower than those in control group [2.63%(1/38) vs. 21.05%(8/38), 0 vs. 15.79% (6/38), 2.63%(1/38) vs. 21.05%(8/38)](P < 0.05). After treatment for 3 months, the good prognosis rate in observation group was significantly higher than that in control group [86.84%(33/38) vs. 65.79% (25/38)] (P < 0.05).@*Conclusions@#3D-slicer software based on percutaneous soft-channel puncture and drainage for HICH patients can achieve better surgical results, reduce the incidence of complications and improve the prognosis of patients.
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Objective To explore the effect of 3D-slicer assisted soft channel drainage on the surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage (HICH). Methods Seventy-six HICH patients treated in Zhejiang Xin 'an International Hospital from January 2016 to December 2018 were randomly divided into the control group and the observation group, with 38 cases in each group. Both groups of patients underwent percutaneous cone cranial soft channel drainage.The control group patients used CT hematoma localization, and the observation group patients used 3D-slicer software hematoma localization. The perioperative related data, surgical results, complications and prognosis of patients in the two groups were observed and compared. Results The operation time and hospitalization time of patients in observation group were (76.24 ± 11.24) min and (15.21 ± 4.01) d, significantly shorter than those in control group [(103.17 ± 17.43) min and (18.63 ± 4.75) d], and there were significant differences (P < 0.05). The blood loss during operation and hematoma residual amount 7 d after operation in observation group were (77.21 ± 11.35) ml and (4.24 ± 0.87) ml, significantly lower than those in control group [(115.35 ± 21.22) ml and (18.63 ± 4.75) ml], and there were significant differences (P < 0.05). The hematoma clearance of patients 1 d and 3 d after operation in observation group were (83.24 ± 11.21) ml and (92.24 ± 15.63) ml, significantly higher than those in control group [(69.67 ± 10.73) ml and (85.57 ± 13.11) ml], and there were significant differences (P < 0.05). The incidence rates of intracranial rebleeding, intracranial infection and pulmonary infection in observation group were significantly lower than those in control group [2.63%(1/38) vs. 21.05%(8/38), 0 vs. 15.79% (6/38), 2.63%(1/38) vs. 21.05%(8/38)](P<0.05). After treatment for 3 months, the good prognosis rate in observation group was significantly higher than that in control group [86.84% (33/38) vs. 65.79% (25/38)] (P<0.05). Conclusions 3D-slicer software based on percutaneous soft-channel puncture and drainage for HICH patients can achieve better surgical results, reduce the incidence of complications and improve the prognosis of patients.