Chronic subdural hematoma (CSDH) is a common neurosurgical condition that is frequently encountered in neurosurgery practice. Its etiologies are dominated by traumatic head injury, and clinical presentations are vario...Chronic subdural hematoma (CSDH) is a common neurosurgical condition that is frequently encountered in neurosurgery practice. Its etiologies are dominated by traumatic head injury, and clinical presentations are various. The prognosis is generally good, but complications can be seen. Some of these complications can lead to the death of the patient. We report the rare case of a 70-year-old man admitted to the emergency room for the management of bilateral CSDH revealed by severe headache, vomiting, and loss of consciousness. He underwent a successful evacuation of both hematomas but had a stroke in both posterior cerebral artery territories, which was lethal 72 hours after surgery. We present and try to find an explanation for this exceptional post-operative complication of CSDH.展开更多
BACKGROUND The complexity and refractory of brain glioma requires treatment that should involve a multidisciplinary approach to improve quality of care and fulfill patients’needs.AIM To explore the effects of compreh...BACKGROUND The complexity and refractory of brain glioma requires treatment that should involve a multidisciplinary approach to improve quality of care and fulfill patients’needs.AIM To explore the effects of comprehensive nursing on postoperative complications,psychological state and quality of life in patients with brain glioma.METHODS A total of 106 patients with confirmed brain gliomas admitted to Nanchong Central Hospital between January 2019 and May 2021 were selected by random sampling.They were categorized into an observation group and a control group using a random number table with 53 patients in each group.Patients in the observation group were given comprehensive nursing in addition to conventional nursing and patients in the control group were given conventional nursing.The overall incidence of postoperative complications including limb dysfunction,high fever and epilepsy was compared between the two groups.The mental status was evaluated in the two groups before and after intervention using self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Quality of life was assessed and compared using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire between the two groups before and after the intervention.RESULTS After intervention,the overall incidence of postoperative complications was significantly lower in the observation group(7.55%)than that in the control group(20.75%)(P<0.05).Before intervention,there was no significant difference in SAS and SDS scores between the two groups(P>0.05).However,after intervention,scores of SAS and SDS decreased in the two groups compared with those before intervention,and the scores of SAS and SDS were lower in the observation group than in the control group(all P<0.05).There was no significant difference in quality of life between the two groups before the intervention(P>0.05).In contrast,quality of life increased in the two groups compared with those before intervention,and it was higher in the observation group than in the control group(P<0.05).CONCLUSION Comprehensive nursing can reduce the incidence of postoperative complications,improve the psychological state of anxiety and depression and improve quality of life in patients with brain glioma.展开更多
BACKGROUND Otogenic brain abscess caused by middle ear cholesteatoma is a potentially serious and life-threatening complication in the ear,nose,and throat clinic.The mortality rate associated with otogenic brain absce...BACKGROUND Otogenic brain abscess caused by middle ear cholesteatoma is a potentially serious and life-threatening complication in the ear,nose,and throat clinic.The mortality rate associated with otogenic brain abscesses is 8%–26.3%.Recently,in China,the incidence of brain abscess secondary to middle ear cholesteatoma has started to increase due to antibiotic resistance.CASE SUMMARY A 55-year-old male presented hearing loss in the right ear and headache for 1 mo in 2018.Computed tomography(CT) showed an area of low density in the right middle ear and mastoid and auditory ossicle defects and a small amount of soft tissue density in the left middle ear.The parietal wall of the right tympanic cavity and the posterior wall of the mastoid sinus were thin and less continuous.Cranial magnetic resonance imaging revealed an area of low intensity encapsulated by an area of high intensity in the right temporal lobe.We diagnosed him with a brain abscess secondary to middle ear cholesteatoma.He received surgery to drain the abscess followed by a modified radical mastoidectomy.The patient visited our department 3 years later because of intermittent otorrhea in the left ear.CT revealed that the area of the soft tissue density in the left middle ear and mastoid was significantly increased.The posterior wall of the mastoid sinus was destroyed,leaving the left middle ear connecting with the brain.The patient underwent a modified radical mastoidectomy in the left ear CONCLUSION Regular follow-up and timely treatment of contralateral ear disease are vital for the prevention of otogenic complications in patients with otogenic abscesses secondary to middle ear cholesteatoma in the unilateral ear.展开更多
Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute my...Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.展开更多
Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patie...Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patients were randomly divided into observation group and control group,with 40 cases in each group.The observation group used disposable skin stapler to suture the scalp incision,and the control group used conventional silk suture to suture the incision.Statistical analysis was carried out on 6 indicators including suturing speed,healing under-scab,incision necrosis,incision cerebrospinal fluid(CSF)leakage,incision infection,and postoperative“centipede-shaped”scar incidence rate of the two suture methods.Results:There was no significant difference between the groups in terms of postoperative healing under-scab,incision necrosis,incision CSF leakage,and intracranial infection(P>0.05).The suturing speed in the observation group was 15.2±0.7 cm/min,which was significantly faster than 7.4±0.3 cm/min in the control group(P<0.05).The incidence of“centipede-shaped”scars in the observation group was significantly lower than that in the control group at 1 to 6 months after operation(P<0.05).Conclusion:Compared with traditional silk suture,skin staple suture has obvious advantages in suture speed and cosmetic effect.展开更多
Aspirin is widely used for primary or secondary prevention of ischemic events.At the same time,chronic aspirin consumption can affect blood clot formation during surgical intervention and increase intraoperative blood...Aspirin is widely used for primary or secondary prevention of ischemic events.At the same time,chronic aspirin consumption can affect blood clot formation during surgical intervention and increase intraoperative blood loss.This is especially important for high-risk surgery,including neurosurgery.Current European Society of Cardiology guidelines recommend aspirin interruption for at least 7 d before neurosurgical intervention,but this suggestion is not supported by clinical evidence.This narrative review presents evidence that challenges the necessity for aspirin interruption in neurosurgical patients,describes options for aspirin effect monitoring and the clinical implication of these methods,and summarizes current clinical data on bleeding risk associated with chronic aspirin therapy in neurosurgical patients,including brain tumor surgery,cerebrovascular procedures,and spinal surgery.展开更多
文摘Chronic subdural hematoma (CSDH) is a common neurosurgical condition that is frequently encountered in neurosurgery practice. Its etiologies are dominated by traumatic head injury, and clinical presentations are various. The prognosis is generally good, but complications can be seen. Some of these complications can lead to the death of the patient. We report the rare case of a 70-year-old man admitted to the emergency room for the management of bilateral CSDH revealed by severe headache, vomiting, and loss of consciousness. He underwent a successful evacuation of both hematomas but had a stroke in both posterior cerebral artery territories, which was lethal 72 hours after surgery. We present and try to find an explanation for this exceptional post-operative complication of CSDH.
文摘BACKGROUND The complexity and refractory of brain glioma requires treatment that should involve a multidisciplinary approach to improve quality of care and fulfill patients’needs.AIM To explore the effects of comprehensive nursing on postoperative complications,psychological state and quality of life in patients with brain glioma.METHODS A total of 106 patients with confirmed brain gliomas admitted to Nanchong Central Hospital between January 2019 and May 2021 were selected by random sampling.They were categorized into an observation group and a control group using a random number table with 53 patients in each group.Patients in the observation group were given comprehensive nursing in addition to conventional nursing and patients in the control group were given conventional nursing.The overall incidence of postoperative complications including limb dysfunction,high fever and epilepsy was compared between the two groups.The mental status was evaluated in the two groups before and after intervention using self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Quality of life was assessed and compared using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire between the two groups before and after the intervention.RESULTS After intervention,the overall incidence of postoperative complications was significantly lower in the observation group(7.55%)than that in the control group(20.75%)(P<0.05).Before intervention,there was no significant difference in SAS and SDS scores between the two groups(P>0.05).However,after intervention,scores of SAS and SDS decreased in the two groups compared with those before intervention,and the scores of SAS and SDS were lower in the observation group than in the control group(all P<0.05).There was no significant difference in quality of life between the two groups before the intervention(P>0.05).In contrast,quality of life increased in the two groups compared with those before intervention,and it was higher in the observation group than in the control group(P<0.05).CONCLUSION Comprehensive nursing can reduce the incidence of postoperative complications,improve the psychological state of anxiety and depression and improve quality of life in patients with brain glioma.
文摘BACKGROUND Otogenic brain abscess caused by middle ear cholesteatoma is a potentially serious and life-threatening complication in the ear,nose,and throat clinic.The mortality rate associated with otogenic brain abscesses is 8%–26.3%.Recently,in China,the incidence of brain abscess secondary to middle ear cholesteatoma has started to increase due to antibiotic resistance.CASE SUMMARY A 55-year-old male presented hearing loss in the right ear and headache for 1 mo in 2018.Computed tomography(CT) showed an area of low density in the right middle ear and mastoid and auditory ossicle defects and a small amount of soft tissue density in the left middle ear.The parietal wall of the right tympanic cavity and the posterior wall of the mastoid sinus were thin and less continuous.Cranial magnetic resonance imaging revealed an area of low intensity encapsulated by an area of high intensity in the right temporal lobe.We diagnosed him with a brain abscess secondary to middle ear cholesteatoma.He received surgery to drain the abscess followed by a modified radical mastoidectomy.The patient visited our department 3 years later because of intermittent otorrhea in the left ear.CT revealed that the area of the soft tissue density in the left middle ear and mastoid was significantly increased.The posterior wall of the mastoid sinus was destroyed,leaving the left middle ear connecting with the brain.The patient underwent a modified radical mastoidectomy in the left ear CONCLUSION Regular follow-up and timely treatment of contralateral ear disease are vital for the prevention of otogenic complications in patients with otogenic abscesses secondary to middle ear cholesteatoma in the unilateral ear.
文摘Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.
文摘Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patients were randomly divided into observation group and control group,with 40 cases in each group.The observation group used disposable skin stapler to suture the scalp incision,and the control group used conventional silk suture to suture the incision.Statistical analysis was carried out on 6 indicators including suturing speed,healing under-scab,incision necrosis,incision cerebrospinal fluid(CSF)leakage,incision infection,and postoperative“centipede-shaped”scar incidence rate of the two suture methods.Results:There was no significant difference between the groups in terms of postoperative healing under-scab,incision necrosis,incision CSF leakage,and intracranial infection(P>0.05).The suturing speed in the observation group was 15.2±0.7 cm/min,which was significantly faster than 7.4±0.3 cm/min in the control group(P<0.05).The incidence of“centipede-shaped”scars in the observation group was significantly lower than that in the control group at 1 to 6 months after operation(P<0.05).Conclusion:Compared with traditional silk suture,skin staple suture has obvious advantages in suture speed and cosmetic effect.
文摘Aspirin is widely used for primary or secondary prevention of ischemic events.At the same time,chronic aspirin consumption can affect blood clot formation during surgical intervention and increase intraoperative blood loss.This is especially important for high-risk surgery,including neurosurgery.Current European Society of Cardiology guidelines recommend aspirin interruption for at least 7 d before neurosurgical intervention,but this suggestion is not supported by clinical evidence.This narrative review presents evidence that challenges the necessity for aspirin interruption in neurosurgical patients,describes options for aspirin effect monitoring and the clinical implication of these methods,and summarizes current clinical data on bleeding risk associated with chronic aspirin therapy in neurosurgical patients,including brain tumor surgery,cerebrovascular procedures,and spinal surgery.
