Objective To summarize the effect of surgical treatment and nursing strategies of patients with growth hormone-secreting pituitary adenoma complicated by sleep apnea syndrome. Method Forty-three cases with growth hormone-secreting pituitary adenoma complicated by sleep apnea syndrome underwent surgical treatment in our department , with their history retrospectively analyzed to compare the hormone levels and blood oxygen saturation between pre-and post-operation. Result After the operation, both levels of the hormone and blood oxygen saturation were improved than those before operation; the incidence of sleep apnea syndrome was also lower than that before operation (all P<0.05). Conclusions Surgical treatment is better for patients with growth hormone-secreting pituitary adenoma complicated by sleep apnea syndrome. Reasonable treatment and effective nursing are favorable for the recovery of patients.

Objective? To explore the pressed abdominal belt on promoting restore of brain organization structure among chronic subdural hematoma (CSDH) patients with trepanation and drainage. Methods? From January to November 2017, we selected 72 CSDH patients of neurosurgery in Beijing Tiantan Hospital, Capital Medical University. All of the patients were divided into experimental group and control group with the random number table, 36 cases in each group. Control group carried out routine treatment and nursing care. On the basis of that in control group, experimental group applied pressed abdominal belt until discharge. We compared the restore distance of brain organization structure of patients between two groups three days after surgery. Results? Three days after surgery, the restore distance of brain organization structure by imaging of CT was (17.19±7.18)mm in patients of experimental group and (12.83±8.42)mm in patients of control group with a statistical difference (t=2.26, P＜0.05). Conclusions? Pressed abdominal belt as a simple and effective adjunctive therapy can promote restore of brain organization structure among CSDH patients with trepanation and drainage.

Objective To discuss the effects of different postoperative position care on the recurrence of chronic subdural hematoma (CSH).Methods By convenience sampling method,102 patients with CSH were recruited in this study. These patients were admitted to the department of neurosurgery of Beijing Tiantan Hospital from November 2013 to October 2015,and they were divided into two groups by using random digits table method. In one group,52 patients were in the horizontal position without pillow,while in the other group, 50 patients lay in beds with their heads elevated. All patients received burr hole drainage,and were asked to keep the position that required for three days. Afterwards,specific adjustments were made according to the situations of drainage tubes. CT scans of brains were taken 12 hours,one week and three months respectively after operation. The degree of comfort,pulmonary complications,and recurrence rate were investigated during the period of hospitalization and the three-month′s follow-up.Results The recurrence rates were 7.7% and 20.0% respectively (χ2=2.304,P>0.05) for patients in horizontal position without pillow and patients lay in bed with elevation;the score of comfort were (51.6±3.7) and (62.7±3.3) respectively (t=1.919,P>0.05);and the incidences of pulmonary complications in two groups were 7.7% and 4.0%,the rates of venous thrombosis were 1.9% and 2.0% (χ2=0.138,0.471;P>0.05).Conclusions Compared with patients lying in beds with elevation,horizontal position without pillow can help to decrease the risk of recurrence for patients with CSH, but it may lead to more discomfort. Hence,specific postures should be considered for patients with horizontal position.

Objective To study the effectiveness of nursing intervention on advanced cognitive function and mood disorder in patients with cerebellum tumor and provide basis for clinical care.Methods A total of 144 patients with cerebellar tumor were selected from February 2014 to April 2016 in Neurosurgery Department,Beijing Tian Tan Hospital. Patients were divided to observation group (n=72) and control group (n=72) according to admission order. Patients of the observation received nursing intervention that could improve advanced cognitive function and mood disorder while patients of the control group underwent usual care. Mini-mental State Examination(MMSE), Memory Quotient (MQ), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were applied to evaluate patients' advanced cognitive function and mood disorder before and after intervention in both groups.Results For the observation group, score of MMSE was (19.8±1.6) points and MQ was (107.0±14.6) points which were both higher than those of the control group (t=12.834, 4.234;P< 0.01) at 90 days after operation. At 180 days after operation, for the observation group, score of HAMA was (11.6±2.1) points and HAMD was (15.0±2.8) points which were both lower than those of the control group (t=8.116, 8.583;P<0.01).Conclusions Nursing intervention could improve the advanced cognitive function and mood disorder in patients with cerebellum tumor clearly which could improve cognitive function in language and memory, relieve mood disorder like depression and anxiety, and it is suitable for clinical promotion.

Objective To explore the effects of solution-focused approach on improving negative emotions among chronic subdural hematoma patients with trepanation and drainage.Methods From January to December 2017,a total of 100 chronic subdural hematoma inpatients in Beijing Tiantan Hospital of Capital Medical University were divided into control group and observation group by the random number table,50 cases in each group.Control group carried out routine nursing.On the basis of that in control group,observation group provided health education by five-step of solution focused approach.Patients of two groups were evaluated with the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) on admission and at discharge.Results The scores of SAS and SDS of patients in observation group were (35.00±5.222) and (37.28±5.091) respectively at discharge lower than those [(38.40±6.550) and (41.26±7.001)]in control group with significant differences (P＜0.05).Conclusions Solution-focused approach can improve negative emotions among chronic subdural hematoma patients with trepanation and drainage.It is worth to be popularized and applied in clinic.

Objective? To explore the effects of early limb functional rehabilitation and exercise on postoperative patients with high cervical spinal cord tumors. Methods? From November 2014 to July 2016, a total of 60 patients with high cervical intraspinal tumor hospitalized in the Spinal Cord Ward of Beijing Tian Tan Hospital were selected as the study subjects by convenience sampling method. All the subjects were divided into 2 groups with 30 cases in each by random number table method. The control group was given routine nursing after surgery, while the observation group was given early limb function rehabilitation training on the basis of the control group. The changes of muscle strength and the incidence of complications were compared between the two groups 12 days after operation. Results? On the 12th day after operation, the muscle strength of the observation group improved in 16 cases, unchanged in 10 cases and aggravated in 4 cases, which was better than that of the control group in 4, 14 and 12 cases. The difference was statistically significant (χ2=11.870, P=0.003). The incidence of postoperative complications in the observation group was lower than that in the control group, and the difference was statistically significant (χ2=4.455,P=0.035). Conclusions? Early limb function exercise can improve the level of muscle strength and reduce complications after operation,which is worthy of clinical application.

Objective? To explore the effects of closed sputum suction, open-closed sputum suction and open sputum suction on intracranial pressure levels in patients with severe craniocerebral injury and mechanical ventilation when the head of bed elevated by 30°. Methods? Totally 36 patients who were admitted in Beijing Tiantan Hospital, Capital Medical University from October 2016 to December 2017 and conformed to the inclusion and exclusion criteria were selected consecutively by convenient sampling. The patients received closed suction (CS), open-closed suction (OCS) and closed suction (OS) as needed. The intracranial pressure (ICP) values shown on the intracranial pressure monitor were recorded at 2 min before, during and after suction as well as 5 min and 15 min after suction. Arterial blood was collected for blood gas analysis at 15 min before and after suction. The patients' partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) were also recorded. Results? The patients intracranial pressure increased when the three different suction methods were used. ICP values for OS, OCS and CS were (20.02±4.93), (16.00±4.82) and (16.08±4.42) mmHg, respectively (F=8.523,P＜0.01). There was statistical difference in ICP values at 2 min after suction between the patients received CS, OCS and OS (F=4.082,P＜ 0.05), but there was no statistical difference in ICP values at other time points between these patients (P＞ 0.05). There was no statistical difference in PaO2 and PaO2 values before and after suction using different methods (P＞0.05). Conclusions? When the head of bed is elevated by 30°, OCS and CS show small effects on ICP values in patients with severe craniocerebral injury and mechanical ventilation and do not affect the effects of sputum suction.

Objective? To explore the effects of bundle care protocols on artificial airway management in critical neurosurgical patients. Methods? Totally 100 critical neurosurgical patients with artificial airways from June 2017 to June 2018 were selected by convenient sampling and divided into the observation group (n=50) and the control group (n=50) according to the random number table. Patients in the control group received conventional nursing care, while patients in the observation group received bundle care. The pulmonary infection rate, comfort and average length of hospital stay were compared between the two groups. Results? The pulmonary infection rate of the observation group was 8%, while that of the control group was 24% (χ2=4.762, P＜ 0.05) ; the comfort rate of the observation group was 64%, while that of the control group was 30% (χ2=11.60,P＜ 0.01); the length of hospital stay of the observation group was (14.34±2.88) d, whereas that of the control group was (17.28±2.70) d (t=20.617, P＜ 0.01). Conclusions? The bundle care protocol can reduce the incidence of infection and the length of hospital stay and improve the comfort among critical neurosurgical patients.

Objective? To analyze the risk factors of intracranial infection among children after fourth ventricle tumor resection and to summarize the effective nursing intervention. Methods? Retrospective analysis was carried out in 153 children with fourth ventricle tumor in neurosurgery at Beijing Tiantan Hospital of Capital Medical University from June 2013 to June 2017. All of the children were divided into infection group (n=45) and non-infection group (n=108) according to whether complicated with intracranial infection after surgery. From nursing viewpoint, we compared the differences in related factors of children with fourth ventricle tumor resection between two groups before, during and after surgery. Logistic regression was used to analyze the risk factors of intracranial infection. Results? Single factor analysis showed there were statistical differences in the hospital day before surgery ＞ 5 days (χ2=5.418, P=0.020), operative time ≥4 hours (χ2=4.189, P=0.041) and subcutaneous hydrops (χ2=4.452, P=0.049) among children between two groups. However, there were no statistical differences in ages, types of tumor, diameter of tumor, remains after tumor resection, adhesion between tumor and fourth ventricle, operative season, history of brain surgery, distributary of ventriculoperitoneal before surgery, setting external drainage, hypoalbuminemia and usage of glucocorticoid after surgery (P＞ 0.05). Logistic regression analysis showed that the risk factors influencing intracranial infection of children after fourth ventricle tumor resection included the hospital day before surgery＞ 5 days (OR=4.340, P=0.010) and subcutaneous hydrops (OR=9.169,P=0.011). Conclusions? Hospital day before surgery ＞ 5 days and subcutaneous hydrops can increase the incidence of intracranial infection among children after fourth ventricle tumor resection. Medical staff should improve their cognition on risk factors of infection among children after fourth ventricle tumor resection and take targeted nursing intervention.

Objective To provide the clinical evidences for intervening the depression and anxiety in patients with chronic subdural hematoma, we investigated the incidence and the influencing factors of anxiety and depression in these patients.Methods Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to investigate 100 patients with chronic subdural hematoma in Department of Neurosurgery, Beijing Tian Tan Hospital of Capital Medical University from October 2015 to May 2016 at admission and discharged. Results The score of SAS was (45.16±8.423) and the detection rate of anxiety was 25% on admission; the score of SDS was (38.86±7.906) and the detection rate of anxiety was 29%; the scores of SAS and SDS both were higher than the national norm (t=17.227, 4.891;P<0.05). The detection rate of anxiety was 10% and the detection rate of depression was 12% at discharged; the scores of SAS (38.86±7.906) and SDS (44.15±6.772) both were also higher than the national norm (t=10.756,3.047;P<0.05).Conclusions Patients with chronic subdural hematoma have high detection rates of anxiety and depression, so we should pay sufficient attention. The doctors and nurses should regard the psychological problems when implement diagnosis and treatment of the physical diseases in patients with chronic subdural hematoma, and promptly provide clinical intervention to against anxiety, depression and other psychological problems for promoting the physical and mental health of patients.