1.Analysis of delayed cerebral ischemia after coiling and clipping of intracranial aneurysms
Pengran LIU ; Zhangning JIN ; Xinwang CAI ; Zhen ZHANG ; Nannan GAO ; Zhe WANG ; Xinyu YANG
Tianjin Medical Journal 2017;45(2):176-179
Objective To compare and analyze the occurrence of delayed cerebral ischemia(DCI)after coiling and clipping of intracranial aneurysms, and explore the risk factors of DCI. Methods A total of 236 patients with aneurysms diagnosed by CT angiography (CTA) or digital subtraction angiography (DSA) in Department of Neurosurgery, Tianjin Medical University General Hospital were enrolled in this study from March 2011 to May 2014. Patients were divided into clipping group(n=135) and coiling group(n=101). The clinical characteristics were compared between two groups, including gender, age, medical history, GCS score, Hunt-Hess grade, Fisher grade, WFNS grade, aneurysm location, prognosis and incidence of DCI. Risk factors for DCI were investigated by Logistic regression analysis. Results DCI was occurred in 36 patients (26.7%) underwent clipping operation while in 11 patients (10.9%) underwent coiling operation. The incidence was significantly higher in clipping group compared with that of coiling group (P <0.01). The patients were followed up for 6 months. The poor prognosis rates were 17.0%and 25.7%in clipping group and coiling group, respectively (P>0.01). The overall mortality was 11.0%, the former had a lower mortality rate (5.9% vs. 17.8%, P <0.01). According to Logistic regression analysis, Fisher Grade 3-4, postoperative pulmonary infection and surgical procedure were independent risk factors for DCI (P<0.01). Conclusion DCI is one of the most significant factors for high fatality and morbidity of postoperative aneurysm patients. There is a low occurrence of DCI after coiling compared with that of clipping. If we pay more attention to risk factors associated with the DCI, it will improve the prognosis of postoperative aneurysm patients greatly.
2. Clinical experience of 302 cases with brain abscess
Xiaopeng CUI ; Xinwang CAI ; Zhen ZHANG ; Nannan GAO ; Pengran LIU ; Jia LI ; Shuyuan YANG ; Jianning ZHANG ; Xinyu YANG
Chinese Journal of Surgery 2017;55(2):151-155
Objective:
To compare the diagnosis and treatment experience of brain abscesses and improve prognosis.
Methods:
The data of 302 patients of brain abscess at Department of Neurosurgery in Tianjin Medical University General Hospital from 1980 to 2014 was analyzed retrospectively. There were 215 male and 87 female patients aged from 11 to 82 years with mean age of (30±8) years. The patients was divided into 1980-2001 group and 2002-2014 group according to different diagnosis and the treatment methods. The therapy methods include operation and conservative treatment. There were 196 cases received operation, including 95 cases of excision, 89 cases of ventriculopuncture, 12 cases of excision after ventriculopuncture, 106 cases received drug conservative therapy. Two groups of information including clinical manifestation, abscess location, therapeutic effect and prognosis were compared by χ2 test.
Results:
Compared to 1980-2001 group, adjacent infection incidence declined(χ2=8.000,
3.Clinical experience of optimal clipping method of middle cerebral artery bifurcation aneurysm
Xiaopeng CUI ; Yuanlei LI ; Yan ZHAO ; Zhen ZHANG ; Xinwang CAI ; Nannan GAO ; Xinyu YANG ; Wei WEI ; Shuyuan YUE ; Liang XUE ; Bing LIU ; Jianning ZHANG
Chinese Journal of Neuromedicine 2017;16(7):734-737