1.Comparison of two surgical approaches for chronic subdural hematoma
Rulei GU ; Yao WEI ; Hongming JI ; Jianzhong GUO
Chinese Journal of Primary Medicine and Pharmacy 2017;24(9):1333-1337
Objective To compare the advantages and disadvantages of non-irrigation and irrigation in the surgical approach of chronic subdural hematoma (CSDH),thus to provide reference for clinical treatment of CSDH.Methods Clinical data of 102 patients with CSDH were retrospectively analyzed.According to the different operation methods,the patients were divided into the non-irrigation group(52 cases) and the irrigation group(50 cases).The blood loss during the procedure,operative time,length of stay and postoperative complication rate between the two groups were compared,and the causes of postoperative complications were analyzed.Results The blood loss during the procedure,operative time and length of stay in the non-irrigation group were (6.73 ± 1.17) mL,(15.06 ± 2.64) min and (10.74 ± 2.20) d,respectively,which in the irrigation group were (19.52 ± 3.18) mL,(38.54 ± 6.95) min and (10.44 ± 2.07)d,respectively,there were statistically significant differences between the two groups in the blood loss during the procedure and the operative time (t =-27.11,-22.72,all P < 0.05),there was no statistically significant difference between the two groups in the length of stay (t =0.70,P > 0.05).The incidence rates of postoperative complication in the non-irrigation group and irrigation group were 8.00% and 7.69%,respectively,there was no significant difference between the two groups (x2 =0.003,P > 0.05).Conclusion Each of the two methods has its own advantages and disadvantages in the treatment of CSDH.Compared with burr hole irrigation,burr hole non irrigation has the advantages of less blood loss and shorter operative time.However,burr hole non-irrigation is more likely to suffer serious complication.We should select suitable surgical approach by the specific circumstances of the patients.The causes of postoperative complications of CSDH are varied.In particular,there is an important relationship between the non-standard operation and postoperative complications.
2.Clinical diagnosis and treatment of inflammatory granuloma in central nervous system
Jianzhong GUO ; Yao WEI ; Hongming JI ; Gangli ZHANG ; Rulei GU
Chinese Journal of Primary Medicine and Pharmacy 2016;23(17):2617-2620
Objective To discuss the diagnosis and treatment of inflammatory granuloma in central nervous system(CNS)to provide reference for clinic.Methods Retrospective data included 8 patients with CNS inflammatory granuloma in Department of Neurosurgery,Shanxi People's Hospital,2012 -2015.We analyzed the imaging features, postoperative symptoms,blood and cerebrospinal fluid changes and prognosis.Results 8 cases all received surgical treatment.All the symptoms were improved,and the CT showed that the lesions were disappeared.All the patients had recovered to normal life and work.Conclusion The diagnosis of CNS inflammatory granuloma is difficult.Clinical manifestations are lack of specificity.The blood and cerebrospinal fluid laboratory examination have no abnormal changes.CT and MRI are the main diagnostic methods.Postoperative pathology is the gold standard for diagnosis.The large lesion,frequent episodes of epilepsy,severe neurological deficits and possibility of brain tumor all should be treated by surgery.
3.The expression of the tryptase in the plasma of the brain traumatic patients
Jianzhong GUO ; Yao WEI ; Rulei GU ; Dongliang GUO ; Hongming JI
Chinese Journal of Primary Medicine and Pharmacy 2016;23(15):2275-2277
Objective To detect the expression of the tryptase in the plasma,and study the meaning in brain traumatic patients.Methods There were two groups:the brain traumatic group(40 patients)and the control group (20 health people).The content of plasma tryptase was determined by fluorescence enzyme immunoassay..Results The level of plasma tryptase had no statistical significance in control group(2.97 ±1.05)μg/L compared with the brain traumatic group(3.03 ±1.39)μg/L,however there had statistical significance comparing with sever brain traumatic patients(3.84 ±0.52μg/L)(t =3.32,P <0.05).4 cases of death in patients with severe head injury group content of tryptase (5.85 ±1.05)μg/L,which was significantly higher than the group of 16 cases of injury in severe head injury after 2 months still alive with the content of serum tryptase (2.49 ±0.52)μg/L,the difference was statistically significant (t =8.13,P <0.01).Conclusion The plasma tryptase level in sever brain traumatic patients increased significantly,and might be of importance for treatment strategies and prognosis.