探讨脑外手术薄膜在腔内泌尿外科微创手术中的应用

探讨脑外科袋式手术薄膜在经尿道电切术中的应用。方法 选取2021年3月-2023年3月本院收治的120例行经尿道前列腺电切术患者为研究对象,采用随机分组方法,将患者分成两组,观察组和对照组。对照组60例,观察组采用囊袋式脑手术膜治疗60例。观察两组患者术中术野周边无菌巾、被单及患者血液污染的次数,以及术后清洗时间;并对样本是否能够完全采集,进行对比分析。结果 治疗组的平均操作时间比对照组稍短,但没有显著性差异(P>0.05)。而观察组患者术中清洁时间、无菌单子及操作人员受污染情况均显著少于对照组,而完成标本采集的病例数显著高于对照组(P<0.05)。结论 采用脑外科袋式薄膜可有效地减少冲洗液和血液对无菌单和操作人员的污染,且能较好地采集标本,大大减少了手术后的清洗时间。

脑外手术薄膜巾在经腹会阴直肠癌根治术中的应用

手术薄膜巾是20世纪70年代在西方国家开始使用的用于手术野中的铺巾.它可以提供一个无菌的工作环境.同时由于脑外手术薄膜巾的袋式回收与它的防水性能很好,可以有效地防止经腹会阴直肠癌根治术中,在使用大量的冲洗液时,冲洗液打湿手术切口周围的布类手术巾,甚至溅湿手术人员的手术衣等引起的医源性感染,阻止了手术人员和患者所携带的细菌通过潮湿的衣被、巾单等,直接或间接的传入手术野.防止术中低体温.我院自2011年~2012年巧妙将脑外手术薄膜巾应用于经腹会阴直肠癌根治术,有效地预防了在冲洗时冲洗液打湿手术巾布单及手术人员的手术的状态,使手术区无菌区能得到了有效的保护,同时,避免了病员受凉,预防病员术中低体温.取得了良好的效果.

高龄患者脑外手术的康复护理策略分析

目的:探讨有关高龄患者脑外手术康复护理的策略分析。方法:选择75岁以上的高龄患者150例,对其进行脑外手术康复护理,并分析其临床资料,总结康复护理策略。结果:通过脑外手术治疗和后期的康复护理之后,全部病情好转并出院,好转率到达了100%,有15例患者致残,平均住院时间50 d,没有出现死亡病例,取得了良好的治疗效果。结论:对高龄患者进行脑外手术以后,及时有效的进行康复护理是非常必要的,可明显降低致残率,并取得理想的疗效。

回顾性分析我院高龄患者脑外手术161例的康复护理措施

本文回顾性分析我院两年来脑外手术75岁以上患者161例临床资料,对康复护理方法进行总结和分析,结果显示:好转率99.4%,致残率10.5%,平均住院时间46.7±3.2d。康复护理训练可有效降低高龄脑外手术患者的并发症发生率,提高其生活和生存质量。

早期康复护理对脑外手术老年患者的影响探讨

目的探讨早期康复护理对脑外科手术老年患者的影响。方法选取我院进行脑外科手术的老年患者共计138例,平均分为对照组和研究组各69例,给予对照组术后常规康复护理,而研究组实行早期康复护理。对比2组的护理效果。结果研究组患者的护理有效率大于对照组,差异具有统计学意义(P<0.05)。结论早期康复护理对脑外科手术中老年患者的护理效果良好,值得临床推广。

高龄患者脑外手术的康复护理策略

目的分析高龄患者行脑外手术康复护理策略。方法回顾性分析2013年2月—2015年2月收治的行脑外手术110例高龄患者临床资料,按数字表法分为观察组和对照组,每组55例。对照组行常规护理,观察组在其基础上行康复护理,观察两组护理效果。结果护理后,观察组康复率、致残率与满意度均优于对照组,且Barthel评分(78.68±8.69)分高于对照组(60.30±7.50)分,比较差异均有统计学意义(P<0.05)。结论高龄患者脑外手术行康复护理的效果显著,可促进其早日康复,并提高满意度与日常生活能力,值得推广。

改良足部穴位艾灸疗法干预脑外手术患者术中低体温的临床研究

目的 探讨改良足部穴位艾灸疗法干预脑外手术患者术中低体温的临床效果.方法 选取赣南医学院第一附属医院2021年1月-2022年12月择期行脑外手术的患者88例,按随机数字表法分为对照组(44例)与观察组(44例);对照组予常规干预,观察组予改良足部穴位艾灸疗法干预;对比两组体温、围术期相关指标、低体温与寒颤发生情况及手术部位感染情况.结果 观察组术中30min、术中60min、术毕时体温较对照组高,差异有统计学意义(P<0.05);观察组术中30min时足末梢皮肤温度较对照组高,术中出血量较对照组低,术中寒颤消退时间、术中寒冷感觉消失时间、术后复苏时间较对照组短,差异有统计学意义(P<0.05);观察组术中低体温与寒颤、手术部位感染发生率较对照组低,差异有统计学意义(P<0.05).结论 改良足部穴位艾灸疗法干预脑外手术患者可减少术中低体温与寒颤发生,促使患者尽快苏醒,且可降低手术部位感染发生率.

ICU脑外患者术后低分子肝素抗凝治疗的探析

探讨ICU脑外患者术后低分子肝素抗凝治疗的临床效果。方法 筛选2021年9月至2022年8月我院重症监护室收治的39例患者作为观察对象,患者均诊断为ICU脑外科疾病,根据治疗方案分为手术组和对照组。选取患者的凝血功能指标、疗效评价以及不良反应作为观察指标。结果 ICU脑外患者手术术后应用低分子肝素,能够有效改善患者的凝血指标,疗效较高,治疗期间较少发生不良反应,与对照组比较由统计学差异。结论 低分子肝素应用于ICU脑外患者手术术后,抗凝效果显著,安全性较高,值得推广实施。

脑外粘贴手术巾在经窦道胆道镜取石中的应用

肝内胆管结石是我国常见的难治性胆道疾病，近年发病率逐步上升，约占整个胆结石群体的16％～18％左右［1］。纤维胆道镜为术后胆管残余结石的治疗开辟了一个理想的途径，Campagnacci报道使用胆道镜可以将术后残石率下降到10％以下，安全、有效且术后并发症发生率低［2］。利用胆道镜经窦道进入胆道取石，患者住院时间短，无需麻醉，创伤小，并发症少，安全易行等优点，但在手术操作过程中，无菌手术巾常常被灌洗液打湿或污染，需反复加铺无菌中单，这样既不易保持无菌，而且造成浪费，延长手术时间［3］。是长期以来困扰手术者的一个问题，我科将脑外粘贴手术巾运用于窦道胆道镜取石中来改善这一现状，较好地解决了这一问题。

老年患者在脑外手术治疗中的舒适护理疗效对比实践

目的:分析在接受脑外手术治疗的老年患者临床护理当中,舒适护理的应用效果。方法:选择我院在2016年一整年期间收治的76例接受脑外手术治疗的老年患者为主要对象,根据患者护理方式的不同将其均匀分成常规组与舒适组,常规组患者单纯接受临床常规护理,舒适组患者则需要在常规护理的基础上需要接受舒适护理,对两组患者的护理满意度进行对比观察。结果:舒适组患者的护理满意度明显高于常规组,两组患者的相关数据在接受组间比较后存在明显差异(P<0.05)。结论:在接受脑外手术治疗的老年患者临床护理当中,舒适护理的应用效果较好,该护理方法值得推广。

脑外粘贴手术巾的妙用

脑外粘贴手术巾,型号C-P型,45cmX45cm,是用于脑外科的手术,主要是保护手术切口的清洁干燥无菌。根据这一特点,我科将脑外粘贴手术巾运用于其它手术,同样取得满意效果,特总结工作中应用情况如下。

急性硬膜外巨大血肿围手术期的治疗分析

目的分析急性巨大硬膜外血肿合并脑疝的治疗方法。方法尽量缩短术前的准备时间,开通快速绿色通道,药物降低颅内压等相关处理。争取早期手术,术中彻底清除血肿,止血及其相关处理亦非常关键,术后防止脑梗死,减少并发症.结果40例本组病人经治疗获得良好效果。结论把握围手术期的各个环节,是抢救病人成功的关键。

Therapy for non-small-cell lung cancer patients with brain metastasis

Brain metastasis is a major cause of poor prognosis and high mortality for non-small cell lung cancer patients. The prognosis of non-small-cell lung cancer(NSCLC) patients with brain metastasis is generally poor and more effective treatment is required to improve their prognosis. Whole-brain radiotherapy, surgery, stereotactic radiosurgery, chemotherapy and targeted therapy are the main treatment for brain metastasis. This review focuses on the five therapeutic strategy and in particular, on targeted therapy.

Electrocorticography-Guided Surgical Treatment of Solitary Supratentorial Cavernous Malformations with Secondary Epilepsy

Objective To evaluate the efficacy of electrocorticographic(ECoG) monitoring and the application of different surgical approaches in the surgical treatment of solitary supretentorial cavernous malformations with secondary epilepsy. Methods This study enrolled a consecutive series of 36 patients with solitary supratentorial cavernous malformations and secondary epilepsy who underwent surgery with intraoperative ECoG monitoring in the Department of Neurosurgery between January 2004 and January 2008. The patients were composed of 15 males and 21 females, aged between 8 and 52 years(mean age 27.3±2.8 years) at the time of surgery. Epilepsy history, the type of epilepsy at the presentation, lesion location, the incidence of residual epileptiform discharges, and postoperative outcomes were evaluated. Results Histopathological examination indicated cavernous malformations and hippocampal sclerosis in 36 and 5 cases, respectively. Neuronal degeneration, glial cell proliferation, and neurofibrillary tangles were found in all the resected cerebral tissues of extended lesionectomy of residual epileptic foci. Lesionectomy, anterior temporal lobectomy, anterior temporal lobectomy plus cortical thermocoagulation, extended lesionectomy, extended lesionectomy plus cortical thermocoagulation were performed in 4, 4, 1, 14, and 13 cases, respectively. Residual epileptiform discharges were captured in 9 out of the 14 patients who had additional cortical thermocoagulation. According to Engle class for postoperative outcomes, 27 cases were class I(75.00%), 5 were class II(13.89%), 2 were class III(5.56%), and 2 were class IV(5.56%), thus the total effective rate(class I+class II) was 88.89%. Neither of epilepsy history, the type of epilepsy, and the location of cavernous malformation was significantly related to outcomes(P>0.05). A significant relationship was found between the incidence of residual epileptiform discharges and outcomes(P=0.041). Conclusions Intraoperative ECoG monitoring, the application of different surgical approaches, and the resection of residual epileptic foci could produce good result in the surgical treatment of supratentorial cavernous malformation with secondary epilepsy. Postoperative residual epileptiform discharges could be a useful predictor for evaluating the outcomes.

Carotid endoarterectomy for extracranial cerebrovascular disease in 26 patients

To evaluate the effects of carotid endoarterectomy in the treatment of extracranial cerebrovascular disease, 26 cases with internal carotid stenosis were performed by three different kinds of surgical endoarterectomy. The satisfactory results were achieved in all the patients, with no complications and mortality occurring. Endoarterectomy is the effective way to treat the extracranial cerebrovascular disease.

Electrocorticography with Direct Cortical Stimulation for a Left Temporal Glioma with Intractable Epilepsy

ELECTROCORTICOGRAPHY (ECoG), the intraoperative recording of cortical potentials, has played an important role in the surgical management of patients with medically intractable epilepsy. This technique is useful in epilepsy surgery to delineate margins of epileptogenic zones, guide resection,

Surgery of pineal region meningioma combining obstructive hydrocephelus

Objective:The aim of our study was to find out the best operative therapeutic regimen by reviewing the comprehension of operation,the improvement of operative method and the selection of operative approach concerning pineal region meningioma combining obstructive hydrocephalus.Methods:We retrospected the clinic data,comprehension of operation and prognosis of 6 cases of pineal region meningioma.Results:Six tumors were all removed,after that the back wall of the third ventricle was cut open.The 6 tumors were defined as meningioma by pathological examination.After 4-48 months follow-up,the manifestation of hydrocephalus disappeared,other symptoms were relieved more or less without any complication with one patient dismissing.The regular MRI examination indicated that the lesions had not reoccur and the cerebral ventricles had been normal.Conclusion:We identify the nourish arteries of the tumor and anatomy relationship between the tumor and its peripheral blood vessels through modern imaging devices,to select reasonable operative method are the premier therapy of pineal region meningioma.The back wall of the third ventricle becomes thin and the suprapineal recess develops shallow and wide,so the third ventricle-quadrigeminal cistern fistulation can effectively eliminate the obstructive hydrocephalus due to the long-term compression on the aqueduct after removing the tumor.

A young and booming approach:the extreme lateral supracerebellar infratentorial approach

Surgical accesses to lesions of the posterolateral pontomesencephalic junction（PMJ）region and the posterolateral tentorial gap remain a challenge in the field of neurosurgery.Since the first report of application of the extreme lateral supracerebellar infratentorial（ELSI）approach in resecting the PMJ lesions in 2000,a few articles concerning the ELSI approach have been published.The present review mainly provided an intimate introduction of the ELSI approach,and evalu- ated it in facets of patient position,skin incision,craniectomy,draining veins,retraction against the cerebellum,exposure limits,patient healing,as well as advantages and limitations compared with other approaches.The ELSI approach is proposed to be a very young and promising approach to access the lesions of posterolateral PMJ region and the posterolateral tentorial gap.Besides,it has several advantages such as having a shorter surgical pathway,causing less surgical complications,laborsaving,etc.Still,more studies are needed to improve this approach.