Clinical study of minimally invasive punctural evacuation in the treatment of basal ganglion region cerebral hemorrhage / 中国医师进修杂志

ObjectiveTo study the clinical effect of YL-1 type hematoma puncture needle in the treatment of basal ganglion region cerebral hemorrhage.MethodsSixty-two patients with hypertensive basal ganglion region cerebral hemorrhage were treated by YL-1 type hematoma puncture needle from January 2007 to May 2011 (minimally invasive punctural evacuation group),of which,60 patients were treated by conservative treatment(conservative treatment group) as control,compared two groups of neural function defect score,hematoma clearance rate on admission,after 3 weeks treatment,and quality of life after 6 months.ResultsNeural function defect score on admission of minimally invasive punctural evacuation group was (23.6 ± 18.4) scores,while (23.4 ± 17.8) scores in conservative treatment group,the difference was not statistically significant(P ＞ 0.05).After 3 weeks' treatment,neural function defect score and hematoma clearance rate of minimally invasive punctural evacuation group was superior to conservative treatment group [ (14.6 ± 12.4) scores vs.(20.1 ± 18.4) scores,(92.3 ± 5.4)％ vs.(79.5 ± 13.8)％ ] (P ＜0.05 ).After 6 months' treatment,the good rate of quality of life in minimally invasive punctural evacuation group was 81.7％(49/60),which was significantly increased compared with that of conservative treatment group [67.2％ (39/58)] (P ＜ 0.05).ConclusionsThe minimally invasive punctural evacuation in the treatment of basal ganglion region cerebral hemorrhage has small invasion,better prognosis,effective and fast decompression of intracranial hematoma,reducing disability rates,improvement of the quality of life,which could be a beneficial complement for traditional therapies.

Comparison of Angioseal closure device with manual compression / 中国医师进修杂志

Objective To assess the safety and efficiency of Angioseal device in patients undergoing percutaneous femoral artery puncture in brain angiograph or interventional therapy. Methods A prospective trial was carried out in 128 patients undergoing brain angiograph and interventional therapy,in which 93undergoing brain angiography and 35 interventionsl therapy. All patients were divided into pure compression group by manual compression (83 cases) and vascular blocking group by Angioseal device (45 cases)according to different hemostatic measures. Results In angiography, hemostasis time of vascular blocking group and pure compression group was (1.8 ±0.8) min and(20.2 ±9.4) min (P＜0.01 ),ambulation time was (3.8 ± 0.8) h and (19.4 ± 2.2) h (P ＜ 0.01). In interventional therapy,hemostasis time of vascular blocking group and pure compression group was (2.0 ± 1.1) min and (24.5 ± 10.3) min (P ＜ 0.01), ambulation time was (4.3 ± 1.5) h and (24.3 ± 3.2) h (P＜ 0.01). Pure compression group had higher complication rate (such as bleeding,hematoma,skin ulceration and blister) than vascular blocking group (P＜0.01).Conclusion Angioseal closure device is safe, efficient and easy to use.

Modulatory effect of Rho kinase on the cerebral vasospasm following subarachnoid hemorrhage / 中国医师杂志

Objective To investigate the dynamical changes of Rho kinase in the cerebrospinal fluid (CSF) and its relationship with cerebral vascular spasm CVS. Methods CSF were collected on the ist, 3rd, 7th, 10th and 14th day after subarachnoid hemorrhage. The expression of Rho-kinase mRNA in CSF was determined by RT-PCR. The expression of endothelin-1 in CSF was determined by radioimmuno-assay. TCD was used to measure the velocity of the cerebral artery. Results The levels of ET-1 and Rho-kinase mRNA in CSF were re-markably increased on the 3rd day, and reached at the peak on the 7th day after subarachnoid hemorrhage, which were significantly higher than those without CVS. Conclusion There is a positive correlation between the level of Rho-kinase mRNA and ET-1 in CSF. Rho-kinase may participate in the development of CVS.