BACKGROUND Chronic subdural hematoma(CSDH)is a common disease in neurosurgery.The traditional treatment methods include burr hole drainage,bone flap craniectomy and other surgical methods,and there are certain complic...BACKGROUND Chronic subdural hematoma(CSDH)is a common disease in neurosurgery.The traditional treatment methods include burr hole drainage,bone flap craniectomy and other surgical methods,and there are certain complications such as recurrence,pneumocephalus,infection and so on.With the promotion of neuroendoscopic technology,its treatment effect and advantages need to be further evaluated.AIM To study the clinical effect of endoscopic small-bone approach in CSDH.METHODS A total of 122 patients with CSDH admitted to our hospital from August 2018 to August 2021 were randomly divided into two groups using the digital table method:the neuroendoscopy group(n=61 cases)and the burr hole drainage group(n=61 cases).The clinical treatment effect of the two groups of patients with CSDH was compared.RESULTS At the early postoperative stage(1 d and 3 d),the proportion of 1/2 re-expansion of brain tissue in the hematoma cavity and the proportion of complete reexpansion was higher in the neuroendoscopy group than in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).The recurrence rate of hematoma in the neuroendoscopy group was lower than that in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).No intracranial hematoma,low cranial pressure,tension pneumocephalus or other complications occurred in the neuroendoscopy group.CONCLUSION The neuroendoscopic approach for the treatment of CSDH can clear the hematoma under direct vision and separate the mucosal lace-up.The surgical effect is apparent with few complications and definite curative effect,which is worthy of clinical promotion and application.展开更多
目的探讨不同胆道引流方式对高位恶性胆道梗阻(malignant high biliary obstruction,MHBO)疗效的影响,为临床治疗方式的选择提供参考。方法随访MHBO患者164例,其中行胆道完全外引流18例(A组)、胆道单支架植入并对侧外引流48例(B组)、胆...目的探讨不同胆道引流方式对高位恶性胆道梗阻(malignant high biliary obstruction,MHBO)疗效的影响,为临床治疗方式的选择提供参考。方法随访MHBO患者164例,其中行胆道完全外引流18例(A组)、胆道单支架植入并对侧外引流48例(B组)、胆道优势侧引流34例(C组)、胆道双支架植入64例(D组),观察术后近、远期疗效。结果 4组患者术前ALT、AST、TBIL、DBIL与术后第3、7、14天比较,差异均有统计学意义(均P<0.05);4组患者术后第7天的组间比较,A、B、D三组下降程度高于C组,差异均有统计学意义(均P<0.05);4组患者术后第14天的组间比较,D组下降程度明显高于A、B、C三组,B组高于A、C两组,A组高于C组,差异均有统计学意义(均P<0.05)。4组患者术后第21天TBIL均值与术前比较,D组下降程度明显高于A、B、C三组,B组高于A、C两组,A组高于C组,差异均有统计学意义(均P<0.05)。4组患者术后生存期比较,D组中位生存期为(355.00±22.21)天,远高于A、B、C三组,差异均有统计学意义(均P<0.05)。结论胆道双支架植入实现了胆汁的充分内引流,对迅速消除黄疸具有明显的优越性,明显的提高了患者的生存质量及延长了生存期。展开更多
基金the Science and Technology Program of Nantong Health Committee,No.MA2019003,No.MA2021017,No.MB2021026,and No.MB2021027Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040and Kangda College of Nanjing Medical University,No.KD2021JYYJYB025。
文摘BACKGROUND Chronic subdural hematoma(CSDH)is a common disease in neurosurgery.The traditional treatment methods include burr hole drainage,bone flap craniectomy and other surgical methods,and there are certain complications such as recurrence,pneumocephalus,infection and so on.With the promotion of neuroendoscopic technology,its treatment effect and advantages need to be further evaluated.AIM To study the clinical effect of endoscopic small-bone approach in CSDH.METHODS A total of 122 patients with CSDH admitted to our hospital from August 2018 to August 2021 were randomly divided into two groups using the digital table method:the neuroendoscopy group(n=61 cases)and the burr hole drainage group(n=61 cases).The clinical treatment effect of the two groups of patients with CSDH was compared.RESULTS At the early postoperative stage(1 d and 3 d),the proportion of 1/2 re-expansion of brain tissue in the hematoma cavity and the proportion of complete reexpansion was higher in the neuroendoscopy group than in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).The recurrence rate of hematoma in the neuroendoscopy group was lower than that in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).No intracranial hematoma,low cranial pressure,tension pneumocephalus or other complications occurred in the neuroendoscopy group.CONCLUSION The neuroendoscopic approach for the treatment of CSDH can clear the hematoma under direct vision and separate the mucosal lace-up.The surgical effect is apparent with few complications and definite curative effect,which is worthy of clinical promotion and application.
文摘目的探讨不同胆道引流方式对高位恶性胆道梗阻(malignant high biliary obstruction,MHBO)疗效的影响,为临床治疗方式的选择提供参考。方法随访MHBO患者164例,其中行胆道完全外引流18例(A组)、胆道单支架植入并对侧外引流48例(B组)、胆道优势侧引流34例(C组)、胆道双支架植入64例(D组),观察术后近、远期疗效。结果 4组患者术前ALT、AST、TBIL、DBIL与术后第3、7、14天比较,差异均有统计学意义(均P<0.05);4组患者术后第7天的组间比较,A、B、D三组下降程度高于C组,差异均有统计学意义(均P<0.05);4组患者术后第14天的组间比较,D组下降程度明显高于A、B、C三组,B组高于A、C两组,A组高于C组,差异均有统计学意义(均P<0.05)。4组患者术后第21天TBIL均值与术前比较,D组下降程度明显高于A、B、C三组,B组高于A、C两组,A组高于C组,差异均有统计学意义(均P<0.05)。4组患者术后生存期比较,D组中位生存期为(355.00±22.21)天,远高于A、B、C三组,差异均有统计学意义(均P<0.05)。结论胆道双支架植入实现了胆汁的充分内引流,对迅速消除黄疸具有明显的优越性,明显的提高了患者的生存质量及延长了生存期。
