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Objective To study the efficacy of two different modes of surgical intervention for the treatment of hypertensive intracerebral hemorrhage (HICH):YL-1 type hematoma removed by needle aspiration plus bio-enzyme liquefaction versus conventional craniectomy plus hematoma evacuation.Methods Medical records of 23 patients with HICH treated from December 2012 to February 2017 were retrospectively analyzed.The differences in demographics,length of operation time,costs and length of hospital stay,Glasgow Outcome Scale scores and 3-month follow-up results were compared between the YL-1 type hematoma removed by needle aspiration plus bio-enzyme liquefaction in 12 patients and conventional craniectomy plus hematoma evacuation in 11 patients.Results There were no significant differences in the gender (male 58.33％ vs.63.64％,femal 41.67％ vs.36.36％),age (65.5±11.8 years vs.56.8±10.1 years),preoperative GCS (6.83±3.93 vs.5.82±3.40),intracranial hematoma volume (50.52±23.07 mL vs.68.77±11.18 mL) and length of hospital stay (15.58±14.72 days vs.22.45±18.37 days) (P＞0.05);There were statistically significant differences in length of operation time (0.73±0.21 h vs.3.92±0.67 h) and hospitalization costs (45 230.50±36 566.88 yuan of RMB vs.79 857.90±34 916.48 yuan of RMB) between two groups (P＜0.05);Follow-up 3 months,there were no significant differences in rate of good recovery 33.3％ vs.18.1％,severe disability rate (25.0％ vs.27.3％) and mortality rate (41.7％ vs.54.6％) between two groups (P＞0.05).Conclusions The minimally invasive YL-1 type hematoma aspiration procedure with bio-enzyme liquefaction as a minimally invasive surgery may be superior to conventional craniectomy for treating HICH because it can offer shorter operation time,more accurate hematoma localization,lower risk of injury,and lower hospitalization costs.In particular,the procedure is suitable for elderly,frail,and poor general condition patients.It can also be applied as emergency treatment for HICH.
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Objective To evaluate the efficacy of the operation in the treatment of postoperative re-hemorrhage after splenec-tomy with periesophagogastric devascularization for advanced schistosomiasis. Methods Forty-three re-hemorrhage patients,who received varicose ligation combined with pericardial devascularization through left thoracic cavity with esophageal incision from Oc-tober 2002 to October 2011,after splenectomy with periesophagogastric devascularization due to portal vein hypertension,were in-vestigated retrospectively and followed up for 1 to 9 years. Results Forty-three re-hemorrhage patients operated included 27 cas-es of selective operation and 16 cases of emergency operation. The mean follow-up time was 6.8 years. The hemostasis rate was 100%. 0ne died after the operation because of engaging in heavy labor,two had melena and were completely relived with the con-servative treatment,and all the rest had a good recovery. Conclusion The operation of varicose ligation combined with pericardi-al devascularization through left thoracic cavity with esophageal incision in the treatment of postoperative re-hemorrhage after sple-nectomy with periesophagogastric devascularization for advanced schistosomiasis has a satisfied efficacy.
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Objective To study the reasons and nursing care methods of rehemorrhage in patients with subarachnoid hemorrhage(SAH).Methods The risk factors were compared between the rebleeding in subarachnoid hemonhage patients group and the non-rebleeding group.Results In the rebleeding patients,more patients had the risk factors as being over 60 years-old,hypertension,aneurysm,drinking alcohol,mood swing,defecation and out-of-bed activity,with a significant difference compared with non-rebleeding patients.Conclusions According to the risk factors of subarachnoid hemorrhage,to strengthen the health education to subarachnoid hemorrhage patients is important to the treatment,nursing and rehabilitation of this disease.
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Objective To study the causes of rehematomas after operations of traumatic hematomas of perisylvian area.Methods The causes of 50 cases of rehematoma after operation were analyzed retrospectively.Results The big hematoma in primary contusion and laceration of brain happened in 19 cases(38%),delayed epidural hematoma in opposite side in 15 cases(30%),increased intracerebral hematoma in 9 cases(18%),epidural hematoma in primary area in 3 cases(6%),subdural hematoma caused by postoperative lumbaropuncture in 3 cases(6%),hematoma in encephalonecrosis in 1 case(2%).Conclusion Insuitable operation and hemostasis are the main causes of rehemorrhage,and fracture line in the opposite side,and thrombocytopenia are high risk factors of rehematoma.