1.The effect of early CT-guided minimally invasive positioning hole drainage in the treatment of hypertensive cerebral hemorrhage
Chinese Journal of Primary Medicine and Pharmacy 2014;(20):3089-3091
Objective To explore and analyze the safety , feasibility and efficacy of CT-guided minimally invasive positioning hole drainage in the treatment of hypertensive intracerebral hemorrhage .Methods 100 cases with hypertensive intracerebral hemorrhage were selected as the research subjects , according to a random number table method,the patients were randomly divided into the control group and observation group ,50 cases in each group.Pa-tients in the observation group were given early CT-guided minimally invasive positioning drill drainage 6-12h after the onset,and patients in the control group received conservative treatment .Results After treatment,daily living activi-ties of patients graded as grade Ⅰ,Ⅱin the observation group were 17 cases,19 cases,which were significantly more than those in the control group (6 cases,9 cases),while the number of grade Ⅲ15 cases in the control group was sig-nificantly more than 7 cases in the observation group .The excellent rate of the observation group was 86%,which was significantly higher than 60%of the control group .The time of consciousness recovery ,average catheter time ,hospital stay in the observation group were (11.2 ±2.2)h,(4.1 ±1.5)d,(6.2 ±2.4)d,which were significantly shorter than those in the control group [(17.4 ±2.8)h,(6.2 ±2.1)d,(11.1 ±1.8)d].The total effective rate of the ob-servation group was 82%,which was significantly higher than 52% of the control group (χ2 =10.15,P<0.05). Conclusion Early minimally invasive drilling drainage under CT guidance positioning in the treatment of patients with hypertensive intracerebral hemorrhage has significant effect ,it is safe and can improve the survival and life quali-ty of patients after surgery ,which is worth promoting .
2.Application of craniotomy operation in aged patients with severe craniocerebral injury
Sen CHEN ; Dunyan LENG ; Haitao SONG
Chinese Journal of Primary Medicine and Pharmacy 2014;(20):3105-3106,3107
Objective To explore and analyze the effect of standard large trauma improved operation ( slow decompression ) and standard large trauma conventional surgical procedures ( sudden decompression ) in the treatment of elderly patients with severe craniocerebral injury ( SCCI) .Methods 100 elderly patients with SCCI were randomly divided into the control group and the observation group ,50 cases in each group .The control group was treated with conventional methods ( standard large trauma traditional surgical treatment ) , the observation group was treated with standard large trauma surgery improved operation .The effects and postoperative complications were observed and recorded.Results 1d,3d,5d,15d after operation,the intracranial pressure of the two groups were (272.3 ±19.1)mmHg, (285.4 ±18.2) mmHg,(218.2 ±18.3) mmHg,(168.4 ±17.3) mmHg;(302.1 ±23.1) mmHg,(310.3 ± 19.2)mmHg,(221.1 ±19.2)mmHg,(148.2 ±16.4)mmHg,which were changed significantly compared with preop-eration,the intracranial pressure gradually decreased as time passed ,the decrease of intracranial pressure in the con-trol group was more obvious than the observation group .The incidence rates of epilepsy ,cerebral infarction ,hydroceph-alus in the observation group were 2.0%,6.0%,0.0%,which were significantly lower than those in the control group (30.0%,36.0 %,26.0%),the differences between the two groups were significant (χ2 =14.85,13.56,14.96,all P<0.05).The number of patients with good prognosis ,the residual in the observation group were significantly more than the control group , while the number of severely disabled and vegetative state patients in the observation group were significantly less than the control group ,(χ2 =4.88,3.93,4.33,7.44,all P<0.05).Conclusion Standard large trauma improved operation ( slow decompression ) can effectively reduce intracranial pressure in elderly patients with severe fluctuations ,reduce the incidence of complications ,improve treatment prognosis ,it should be popularized in clinical practice .