Safety and feasibility of ultra-early lumbar puncture in patients with aneurysmal subarachnoid hemorrhage

Objective:to evaluate the clinical efficacy and safety of ultra-early lumbar puncture drainage of cerebrospinal fluid(CSF)in patients with aneurysmal subarachnoid hemorrhage(SAH).Methods:patients(n=140)with aneurysmal SAH were randomly divided into observation group(n=70)and control group(n=70).After admission,CSF was drained by ultra-early lumbar puncture in the observation group and intermittent lumbar puncture after aneurysm operation in the control group.The incidences of early aneurysm rupture,acute hydrocephalus and delayed hydrocephalus were compared between the two groups.Results:there was no significant diflerence in the incidence of early-ruptured aneurysm and acute hydrocephalus between the two groups,but the incidence of delayed hydrocephalus in the observation group was significantly lower than that in the control group.Conclusion:ultra-early lumbar puncture drainage of CSF in anexirysmal SAH can effectively reduce the incidence of long-term delayed hydrocephalus and it is a safe and effective treatment.

翼点后颞肌下开颅与大骨瓣开颅手术治疗高血压超早期壳核脑出血的对比研究

目的对比翼点后颞肌下开颅与大骨瓣开颅手术治疗超早期壳核脑出血的临床疗效。方法回顾分析2013年1月~2019年2月我院和佛山市禅城区中心医院收治的76例超早期壳核脑出血患者的临床资料,根据不同术式分组,分为两组,观察组行翼点后颞肌下开颅,对照组行大骨瓣开颅术,对比两组手术情况及住院时间、术后随访6个月以及预后情况。结果观察组的术中出血量、手术时间和住院时间较对照组显著降低,而术后6个月ADL的有效率显著增高,差异有统计学意义(P <0.05)。结论相比于大骨瓣开颅手术,超早期壳核脑出血采用翼点后颞肌下开颅,可明显缩短手术时间、有效减少术中出血量,改善患者预后。

骨瓣开颅血肿清除术联合通窍活血汤治疗高血压壳核出血的效果

目的:观察骨瓣开颅血肿清除术联合通窍活血汤治疗高血压壳核出血的效果。方法:选取笔者所在医院2018年7月-2019年6月收治的70例高血压壳核出血患者,使用随机、单盲法完成平均分组,对照组35例接受骨瓣开颅血肿清除术,观察组35例在其基础上联合通窍活血汤治疗,对比两组死亡率、术后1周内GCS的评分及并发症发生情况。结果:观察组术后的死亡率及术后1周内GCS的评分及并发症发生率均优于对照组,差异均有统计学意义(P<0.05)。结论:高血压壳核出血患者完成手术治疗后,接受通窍活血汤治疗,能够有效修复神经功能缺损,降低并发症,提升生活质量,在临床治疗中可加以借鉴和研究。