1.The Influence of Different Wrap Method on the Intracranial Pressure of Patients after Standard Craniectomy
Bohu LIU ; Gang MA ; Junyan LI ; Jun LIU ; Jun PU ; Jianchang CEN
Journal of Kunming Medical University 2016;37(6):65-68
Objective To explore the influence of different methods of bandaging on the postoperative intracranial pressure of patients with severe brain injury patients after decompression craniectomy. Methods The standard decompressive craniectomy was use for the 36 cases of severe traumatic brain injury patients, and the intracranial pressure monitoring sensor probe was indwelled in operaion. Two different dressing methods of elasticity mesh cap and applicator were used for the patients respectively at 0h, 72h, 120h and 168h after operation, and the value of intracranial pressure was monitored and recorded. Result The intracranial pressure of elastic cap were significantly higher than the applicator respectively in operation immediate postoperative 72h, 120h and 168h (P<0.05), the difference was statistically significant. Conclusions The intracranial pressure of elastic cap is significantly higher than the applicator at different times after the surgery group.
2.Long-term clinical outcomes of patients with aneurysmal subarachnoid hemorrhage in Yunnan Province.
Jie SUN ; Zeyi WANG ; Ping SU ; Jun LIU ; Junyan LI ; Gang MA ; Jianchang CEN ; Qian CHANG ; Xinghai LIU ; Nan ZHAO
Journal of Southern Medical University 2020;40(9):1353-1358
OBJECTIVE:
To investigate the clinical outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH) after surgeries in Yunnan Province.
METHODS:
We retrospectively analyzed the demographic features, vascular risk factors, severity at admission, and aneurysm locations in 85 patients with aSAH receiving surgical interventions in Yunnan Province. All the patients were treated by aneurysm clipping or coiling and followed up for clinical outcomes and recovery of daily activities evaluated by modified Rankin Scale (mRS) and Activities of Daily Living (ADL) scale, respectively.
RESULTS:
Thirty-four of the patients (40.0%) underwent aneurysm clipping and 51 (60.0%) underwent aneurysm coiling. During a median follow- up period of 66.23 months (IOR, 12.03 months), 84.7% of the patients had low mRS scores, and 78.8% lived independently. The WFNS grade at admission was significantly correlated with the follow-up mRS scores (95%: 1.48-19.09, =0.011) and ADL (95%: 2.55-28.77, < 0.001). Multivariate analysis showed that age (95%: 1.02-1.23, =0.017; 95%: 1.00-1.15, =0.038) and a high WFNS grade at admission (95%: 2.19-141.48, =0.007; 95%: 2.84-82.61, =0.002) were independent predictors of both mRS and ADL scores at follow-up. There was no significant difference in clinical outcomes or the length of hospital stay between the two treatment strategies ( > 0.05), but the cost of hospitalization was significantly higher in coiling group than in the clipping group ( < 0.001).
CONCLUSIONS
Both aging and a high WFNS grade at admission are associated with a poor prognosis of aSAH, for which aneurysm clipping and coiling have similar long- term outcomes, but for patients with a high WFNS score, aneurysm clipping is favored over coiling in terms of health economics.