Effect of ganglioside combined with hyperbaric oxygen on mild to moderate craniocerebral trauma and its influence on serum NSE and MBP levels / 中国基层医药

Objective To study the effect of ganglioside combined with hyperbaric oxygen on mild to moderate craniocerebral trauma , and its effect on serum neuron specific enolase ( NSE ) and myelin basic protein ( MBP) levels.Methods Following the random number table method ,110 patients with mild and moderate cranioce-rebral trauma were randomly divided into the observation group and the control group ,55 cases in each group.The observation group was treated with ganglioside combined with hyperbaric oxygen therapy ,while the control group was treated with hyperbaric oxygen alone .The clinical efficacy ,the Glasgow Coma Scale ( GCS) ,the levels of serum NSE and MBP before and after treatment were compared between the two groups .Results The effective rate of the observation group was 94.55％,which was significantly higher than 81.82％ of the control group,the difference was statistically significant(χ2 =4.274,P<0.05).The D-value of GCS before and after treatment in the observation group was (2.97 ±0.59)points,which was significantly higher than that of control group (t=17.601,P<0.05). The levels of serum NSE and MBP of the observation group were significantly lower than those of the control group ( t=14.674,10.450,all P<0.05).Conclusion Ganglioside combined with hyperbaric oxygen can promote the recovery of neurological function ,has significant effect and high safety in the treatment of mild to moderate craniocerebral trauma .

The effect of early mechanical ventilation combined with mild hypothermia in the treatment of severe brain injury and its effect on serum C-reactive protein and hemorheology / 中国基层医药

Objective To explore the clinical effect of early mechanical ventilation coupled with mild hypothermia in the treatment of severe traumatic brain injury(STBI)and its effect on serum C -reactive protein (CRP)and hemorheology.Methods According to the order of admission,110 patients with STBI were divided into two groups.55 cases in the control group were given conventional symptomatic treatment and early mechanical ventilation, while 55 patients in the observation group were given early mechanical ventilation coupled with mild hypothermia.The clinical efficacy was compared between the two groups.Results The good prognosis rate was 74.55% in the observation group,which was significantly higher than 56.36% of the control group (χ2 =7.65,P <0.05).The serum CRP in the observation group admitted to hospital 2,3,5,7d were significantly decreased compared with the control group(t =7.48,8.04,7.34,7.82,all P <0.05).After treatment,the hear whole blood viscosity was (6.03 ±0.89)mPa·s, low shear whole blood viscosity was (3.18 ±0.19)mPa·s,plasma viscosity was (1.21 ±0.18)mPa·s,hematocrit was (37.56 ±3.23)%,and those were decreased compared with before treatment(t =8.45,7.54,7.04,8.02,all P <0.05).And there were significant differences compared with the control group(t =7.77,6.69,6.44,7.49,all P <0.05).Conclusion The effect of early mechanical ventilation coupled with mild hypothermia in the treatment of STBI has good effect,and it can reduce serum CRP levels,improve blood rheology,which is conducive to patients'prognosis.

Therapeutic effect of hyperbaric oxygen therapy on patients with severe craniocerebral injury and its influence ;on serum interleukin -1 beta and interleukin -6 levels / 中国基层医药

Objective To explore the clinical curative effect of hyperbaric oxygen therapy for severe cranio-cerebral injury,and its influence on the level of serum interleukin -1 beta(IL -1 )and interleukin -6(IL -6). Methods 150 patients with severe craniocerebral injury were selected and divided into two groups by random and single blind method.75 patients of the control group were treated with conventional therapy,75 patients of the observation group were given hyperbaric oxygen on the basis of the conventional treatment,and the clinical efficacy was compared between the two groups.Results The total effective rate of the observation group was 94.67%,which was significantly higher than 77.33% of the control group,the difference was statistically significant(χ2 =7.83,P 0.05).After treat-ment,the GCS and ADL scores of the observation group were (12.18 ±2.13)points,(67.46 ±12.55)points,which were significantly higher than those before treatment(t =8.01,7.76,all P 0.05).After treatment,the serum levels of IL -1 and IL -6 in the observation group were (127.48 ±16.35)pg/mL,(89.66 ±13.47)pg/mL, which were significantly lower than before treatment(t =8.34,7.89,all P <0.05),there were significant differences between the two groups(t =7.65,7.22,all P <0.05).Conclusion Implementation of hyperbaric oxygen in patients with severe traumatic brain injury on the basis of conventional symptomatic treatment can effectively improve the clinical symptoms and signs,reduce the serum IL -1 and IL -6 levels,promote the recovery of brain function and ability of daily life,and which is worth to be promoted in clinical.

Microsurgical removal of suprasellar craniopharyngioma via pterional approach / 中国基层医药

Objective To explore the microsurgical techniques for total removal of the suprasellar cranio pharyngiomas via the pterional approach.Methods The clinical data of 28 patients with suprasellar craniopharyngio mas resected by the microsurgery was analyzed retrospectively.Results The tumors were total removed in 24 cases (86%)and subtotal resected in 4 cases(14%).The frequent postoperative complications are diabetes insipidus,hy perthermy,imbalance of water and electrolyte and lower level of hormone.Conclusion It is the key to get fine operation effect that removal sclerotin of base of skull as far as possible and releasing cerebrospinal fluid sufficiently,paying attention to protect the perforating branch and nourishing artery in each operative spaces.