Objective To investigate the differences of efficacy and economic efficiency between neuroendoscope and microscope for intracerebral hematomas cleaning operation. Methods From August 2014 to August 2015, clinical data of 68 cases with intracerebral hemorrhage were analyzed retrospectively. Hematoma evacuation was carried out by microscope in 37 cases (microscope group) received and 31 cases (endoscope group) underwent neuroendoscope. Following parameters were compared: the operation related index (hematoma clearance rate , intraoperative blood loss , the operation time , skin incision , bone window size ) , Glasgow Outcome Scale at 6 months after the operation, complications (intracranial infection, lung infections, gastrointestinal bleeding), medical economic parameters (the postoperative hospital stay, drug cost, cost other than drug, and total hospital cost). Results The hematoma clearance rate, Glasgow Outcome Scale at 6 months after the operation in the endoscope group were significantly better than those in the microscope group (P <0.05). The intraoperative blood loss, the operation time, skin incision, bone window size the postoperative hospital stay , drug costs , no drug costs , and total hospital cost in the neuroendoscope group were significantly lower than those in the microscope group (P < 0.01). The intracranial infection, lung infections in the neuroendoscope group were lower those in the microscope group (P < 0.05). There was no statistical difference in the incidence of gastrointestinal bleeding between the two groups (P > 0.05). The postoperative hospital stay, drug costs , no drug costs , and total hospital cost were significantly less in neuroendoscope group than that in microscope group (P< 0.01). Conclusion Neuroendoscopy has less trauma,there are some advantages of neuroendoscopy for intracerebral hematomas cleaning operation , such as minimal trauma , prominent effect , good prognosis and low cost. It should be widely applied in clinical practice.

Objective To evaluate the clinical application and nursing effect of implantable venous access ports via the axillary vein.Methods From September 2014 to December 2015,1 263 cases of malignant tumor patients were implanted implantable venous access ports via the axillary vein under ultrasound guidance in Oncology Department of our hospital.The effects of the application of implantation method and nursing were observed.Results The 1 325 cases underwent implantable venous access ports via the axillary vein with 1 263 cases catheterization succeeded,and the success rate is 95.3%.For 62 failed cases,the internal jugular vein catheterization were carried out instead.The average time of implantation time was 10.5 minutes.For the 3 cases of catheter blockage,they were reused after recanalization using thrombolysis under negative pressure with urokinase;for the 2 cases localized infection,the ports were removed and the drug were injected through PICC;no serious complications,namely thrombosis,pinch-off syndrome,catheter disconnection,port body flips et al,happened.Conclusions Implantable venous access ports via the axillary vein with the features of high success ratio,short operating time,can be used as a new selection of port implantation.By establishing the standardization and homogenization of the whole catheter management system postoperatively,strengthening catheter maintenance training for nursing staff,and focusing on the details of the process of operation and maintenance,the complications of infusion port can be reduced,so as to keep the port using for a longer time.

Objective To summary the nursing methods of patients who use ultrasound-guided thermal ablation to treat severe secondary hyperparathyroidism.Methods Retrospective analysis was used to analyze the nursing process of 10 patients who use ultrasound-guided thermal ablation to treat severe secondary hyperparathyroidism. Ultrasound-guided thermal ablation was applied to patients with significant cardiopulmonary dysfunction and cannot undergo general anaesthesia operation, and patients suffering from recurrent forearm grafting after parathyroidectomy. So, in the nursing of these patients, we should pay special attention to the observation and management of specific complications in thermal ablation including dyspnea, apnea, laryngeal and recurrent laryngeal nerve injury and hemorrhage, besides the routine psychological care, diet nursing and medication nursing.Results Ten patients in the study who underwent ultrasound-guided thermal ablation, the intact serum parathyroid hormone ( intact parathyroid hormone, iPTH ) , calcium and phosphorus were all decreased, and symptoms like itching, general bone pain also were released. The frequency of precordial pain was reduced and we gain good therapeutic effect.Conclusions Rigorous nursing after ultrasound-guided thermal ablation can promote the recovery of patients with severe secondary hyperparathyroidism.