Observations on the Effects of Opening Side Crack Pool and Basal Cistern for the Treatment of Lateral Fissure Hedge Brain Contusion
10.3969/j.issn.0253-9896.2014.07.023
- VernacularTitle:开放侧裂池、基底池治疗外侧裂区对冲性脑挫伤的疗效观察
- Author:
Yonghan CHEN
;
Linwei JIA
;
Gang ZHANG
- Publication Type:Journal Article
- Keywords:
brain injuries;
endothelin-1;
cerebrospinal fluid;
vasospasm,intracranial;
subarachnoid hemorrhage;
open side crack pool;
lateral fissure area hedge;
ET-1
- From:
Tianjin Medical Journal
2014;(7):704-706
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the therapeutic effect of the lateral fissure opened intraoperative cerebral con-tusion sylvian cistern , basal cistern for improving the cerebral vasospasm. Methods A total of 106 patients with cerebral contusion in lateral fissure area were randomly divided into 2 groups. The control group was given conventional craniotomy to clear focal cerebral contusion of hematoma. And the experimental group was further to fully open sylvian cistern, jugular vein pool, endplate pool and basal cistern on the basis of the conventional craniotomy to remove the brain contusion and hemato-ma. The levels of endothelin 1 (ET-1) in plasma and cerebrospinal fluid (CSF) were detected postoperative 3, 7 and 14 days. The Glasgow coma scale (GCS) score, ICU guardianship time and total length of hospital stay were observed on discharge and followed up for 3 months in two groups. The rate of good prognosis was compared between two groups. Results There were significant differences in ET-1 levels of plasma and CSF at different time points (plasma Ftime = 603.436 and CSF Ftime =684.276 ) between two groups of patients (plasma Fgroup=272.531 and CSF Fgroup=317.641). The ET-1 levels were signifi-cantly lower after 7 d and 14 d treatment in experimental group, but no significant difference 3d after operation between two groups (P<0.01). The GCS score was significantly higher on discharge in experimental group than that of control group. The values of ICU guardianship time and the total hospitalization time were both significantly lower in experimental group than those of control group (P<0.01). The rate of good prognosis was significantly higher in experimental group than that of con-trol one [78.85%(41/52) vs 51.85%(28/54),χ2=8.496, P<0.01]. Conclusion Openning side crack pool and basal cistern in the surgical treatment of traumatic brain injury can improve the cerebral vasospasm and prognosis.
