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Objective:To explore and analyze the selection of surgical methods for supratentorial intracerebral hemorrhage.Methods:A total of 260 patients with spontaneous intracerebral hemorrhage who underwent surgery in Department of Neurosurgery, Suzhou Hospital Affiliated to Nanjing Medical University from January 2017 to December 2021 were included in the study by retrospective case analysis. According to different surgical methods, they were divided into three groups: large bone flap group ( n=116), conventional bone flap group( n=89)and stereotactic group( n=55). The large bone flap group underwent standard supratentorial large bone flap craniotomy, the conventional bone flap group underwent conventional bone flap craniotomy, and the stereotactic group underwent stereotactic hematoma puncture suction + drainage. Clinical indicators such as operation time, intraoperative bleeding, pulmonary infection, length of hospital stay, and Glasgow outcome scale (GOS) at 6 months of postoperative follow-up, and the proportion of good prognosis (GOS 4-5) were calculated. Measurement data with normal distribution were expressed as mean±standard deviation( ± s), count data were expressed as cases and percentages (%). Results:In the large bone flap group, the operation time, intraoperative bleeding, hospital stay, pulmonary infection, postoperative rebleeding were(193±24) min, (625±65) mL, (46±11) d, 102 patients(87%), 9 patients(7.8%), and (124±17) min, (297±35) mL, (32±9) d, 29 patients(33%), 4 patients(4.4%)in the conventional bone flap group, and (73±11) min, (53±15) mL, (21±4) d, 10 patients(18%), 2 patients(3.6%)in stereotactic group. All patients were followed up for 6 months, and 165 patients (63.5%) had good prognosis (GOS 4-5), including 36 patients (31%) in the large bone flap group, 82 patients (93.2%) in the conventional bone flap group, and 47 patients (85.5%) in the stereotactic group.Conclusion:Standard large craniectomy has sufficient effect of decompression, and is suitable for serious life threatening hematoma; Conventional craniotomy has advantages in the treatment of secondary intracerebral hemorrhage. Stereotactic surgery has the characteristics of short operation time, less intraoperative bleeding, short hospital stay and low incidence of pulmonary infection, which is worthy of promotion in the treatment of primary intracerebral hemorrhage.
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Objective To clarify the relationship between intracranial pressure monitoring and prognosis of patients with traumatic brain injury after decompressive craniectomy.Methods From December 2015 to December 2017,48 head-injured patients in Affiliated Suzhou Hospital of Nanjing Medical University were enrolled,who were underwent decompressive craniectomy in this retrospective study.The patients were subdivided into 2 groups based on whether postoperative was monitored (n =19) or not (n =29).The prognosis was evaluated by Glasgow Outcome Scale score,with 1 point of prognosis death,2 to 3 points of poor prognosis,and 4 to 5 points of good prognosis.Count data were expressed as a percentage (％).Count data were expressed as percentage (％).The chi-square test was used to compare the difference in the rate of good prognosis and mortality between the two groups.Results The mortality of monitoring group (10.5％) was significantly lower than that of control group (37.9％) (x2 =4.365 5,P =0.036 7) during hospitalization,The rate of good prognosis in the monitoring group (68.4％) and the control group (44.8％) was not statistically significant (x2 =2.573 8,P =0.108 6).Condusion The study showed that continuous monitoring in patients with severe craniocerebral injury could reduce the mortality of patients during hospitalization,but had no significant effect on the improvement of prognosis.
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Objective To evaluate the effect of nitrous oxide-inhale combined with lidocaine-injection by Ciliao and Uterine points and single therapy in labor analgesia,and the impact on maternal and child.Methods 400 cases were randomly divided into four groups.Observation group:100 cases take the therapy of Nitrous oxide-inhale combined with lidocaine-injection in Ciliao and Uterine points in the time of active period.Control group 1:100 cases take the therapy of gas mixture-inhale( 50％ Nitrous oxide and 50％ Oxygen) in the time of active period.Control group 2:100 cases take the therapy of lidocaine-injection in Ciliao and Uterine points in the time of active period.Control group 3:100 cases do not take any analgesia.Analgesic effects,labor time,mode of delivery,neonatal conditions,the amount of bleeding in every group were observed.Results There was statistically significant differences between the observation group with the control group 1,2,3 on analgesic effects ( x2 =48.513,P ＜ 0.05 ) labor time( F =782.88,1120.81,1104.57,all P ＜ 0.05 ),mode of delivery ( x2 =85.715,P ＜ 0.05 ),neonatal conditions,the amount of bleeding( F =422.66,P ＜ 0.05 ).Conclusion Combination therapy was more effective than the single treatment.
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ObjectiveTo study on the hyperlipidemia patient plasma cause atherosclerosis index and the blood,blood serum uric acid sticks and so on thrombosis risk factors of the relationship.Methods81 patients with hyperlipidemia patient and 80 cases of normal blood fat crowd as the research object,the two groups were measured blood fat including total bravery solid alcohol ( TC ),triglycerides (TG),high-density lipoprotein cholesterol ( hdl-c ),low dense white lipoprotein LDL( solid bravery alcohol-C) levd,blood uric acid,whole blood viscosity,platelet aggregation function and serum C-reactive protein(CRP) content,and according to the TG and hdl-c than of both the logarithm of conversion values calculated the two groups of the plasma to atherosclerosis values,and by using the DuoYuan linear regression analysis with the blood acid,whole blood viscosity,platelet aggregation function and serum levels of CRP relationship.ResultsObservation group AIP(2.25 ±0.18) was significantly higher( 1.31 ±0.15 ) ( t =46.71,P ＜ 0.05 ),and AIP and LDL-C,uric acid,whole blood viscosity,platelet aggregation was positively correlated ( r =0.86,0.85,0.79,0.81,0.77,all P ＜ 0.05 ),with HDL-C was negatively correlated ( r =-0.69,P ＜ 0.05 ).ConclusionPatients with hyperlipidemia plasma cause atherosclerosis index and patients,such as blood uric acid blood viscosity thrombosis dangerous close by,by early know patients plasma to atherosclerosis index,and monitor patients early blood uric acid and blood viscosity,thrombosis risk factors level,to facilitate accurate assessment of some patients with cardiovascular disease risk,and to guide to take reasonable early intervention measures,reduce cardiovascular events.