The predictive effect of SDF-1 and CXCR4 on hematoma enlargement in early stage of hypertensive intracerebral hemorrhage / 临床外科杂志

Objective To explore the predictive effect of serum Stromal cell-derived factor 1(SDF-1)and C-X-C chemokine receptor type 4(CXCR4)on early hematoma enlargement in hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 79 patients with HICH in our hospital from January 2020 to June 2022 were retrospectively analyzed.According to the results of head CT reexamination after admission,the patients were divided into hematoma enlargement group and hematoma non enlargement group.The hematoma location of the first head CT examination,hematoma shape,systolic blood pressure level after admission,hematoma density uniformity,admission GCS score and serum SDF-1 and CXCR4 were compared between the two groups.Receiver operator characteristic curve(ROC)was used to evaluate the predictive value of SDF-1 and CXCR4.Results Among 79 patients with HICH,21 patients had increased bleeding.Univariate analysis showed that there were significant differences in hematoma shape,admission GCS score,systolic blood pressure and hematoma density between the two groups(all P＜0.05).Logistic multivariate analysis showed that SDF-1 and CXCR4 were independent risk factors for hematoma enlargement in early stage of hypertensive intracerebral hemorrhage(respectively OR:1.460,1.362,respectively 95％CI:1.056～2.018,1.200～1.547,all P＜0.05).ROC curve analysis showed that AUC of SDF-1 was 0.868(95％CI:0.688-1.000,P＜0.005),specificity was 0.875,sensitivity was 0.778.The AUC of CXCR4 was 0.758(95％CI:0.557-0.948,P＜0.05),the specificity was 0.750,and the sensitivity was 0.733.Conclusion The expression of SDF-1 and CXCR4 in patients with HICH is significantly increased,which is related to the early hematoma enlargement.SDF-1 and CXCR4 have high sensitivity and specificity in predicting the early hematoma enlargement in HICH.

Electromagnetic navigation technique in removal of hematoma under neuroendoscope / 中华神经医学杂志

Objective:To explore the application value of electromagnetic navigation technique in the removal of hematoma under neuroendoscope.Methods:Forty-three patients with supratentorial spontaneous cerebral hemorrhage, accepted removal of hematoma under neuroendoscope in our hospital from October 2015 to February 2019, were chosen in our study; 22 patients (navigation group) were performed the removal under the guide of real-time electromagnetic navigation, and 21 (non-navigation group) were performed the removal under neuroendoscope only. The amount of cerebral hemorrhage, operation time, residual amount of hematoma and hematoma clearance rate were compared between the two groups. Fugl-Meyer Assessment (FMA) was used to evaluate the motor function of the affected limbs two weeks after surgery. The anisotropy fraction (FA) values of fibers of affected pyramidal tracts and contralateral pyramidal tracts were examined by diffusion tensor imaging (DTI), and the relative FA (rFA) value (FA values of affected side/contralateral side) was calculated. Barthel index was used to evaluate the basic daily activities of the patients 6 months after surgery.Results:There was no significant difference between the navigation group and the non-navigation group in the amount of cerebral hemorrhage before surgery, amount of residual hematoma after surgery, hematoma clearance rate, and operation time ( P>0.05). FMA scores of upper and lower limbs, FA and rFA values of the affected side in the navigation group were significantly higher than those in the non-navigation group two weeks after surgery ( P<0.05). Barthel index of patients in the navigation group was statistically higher than that of the non-navigation group 6 months after surgery ( P<0.05). Conclusion:Electromagnetic navigation technique can guide endoscopy to effectively clear the supratentorial hypertensive cerebral hemorrhage without obviously increasing the operation time; effective protection of pyramidal fibers can improve the prognoses of patients.

Risk factors for early hematoma enlargement in hypertensive cerebral hemorrhage and clinical predictive value of GCS score combined with blood glucose level at admission / 中风与神经疾病杂志

@#Objective　To investigate the risk factors for early hematoma enlargement in hypertensive cerebral hemorrhage （HCH） and the clinical predictive value of （Glasgow Coma Scale） GCS score combined with blood glucose level at admission. Methods　A retrospective collection was performed on 106 HCH patients who were treated in the hospital from October 2014 to October 2018.According to presence or absence of hematoma enlargement showed by examination results of brain CT after admission，they were divided into enlargement group （29 cases） and non-enlargement group （77 cases）. The general data of the two groups were compared to analyze the risk factors for hematoma enlargement in early stage of hypertensive intracerebral hemorrhage. The receiver operating characteristic （ROC） curve was performed to analyze predictive value of GCS score combined with blood glucose level at admission for early hematoma enlargement in HCH. Results　There were no significant differences in gender，age，hematoma location，diastolic blood pressure at admission or long-term smoking history between the two groups （P>0.05）. There were significant differences in GCS score，systolic blood pressure at admission，fasting blood glucose，hematoma morphology and long-term drinking history at admission （P<0.05）. The results of multivariate Logistic regression analysis showed that low GCS score，high admission systolic blood pressure，high fasting blood glucose，hematoma irregularity and long-term drinking history at admission were independent risk factors influencing early hematoma enlargement in HCH patients （P<0.05）. The areas under ROC curve （AUC） of GCS score and blood glucose level at admission for predicting early hematoma enlargement of HCH 0875 and 0.819，respectively，significantly lower than that of their combination prediction （0.886，P<0.05）. Conclusion　Low GCS score，high systolic blood pressure at admission，high fasting blood glucose，hematoma irregularity and long-term drinking history at admission are independent risk factors influencing early hematoma enlargement in HCH patients. GCS score combined with blood glucose level at admission is of relatively higher clinical value for predicting early hematoma enlargement in HCH.

Role of radiomics model in prediction of hematoma enlargement in early stage of hypertensive intracerebral hemorrhage / 中华神经医学杂志

Objective To construct a radiomics model for predicting hematoma enlargement in early hypertensive intracerebral hemorrhage and explore its predictive value.Methods A retrospective collection of 212 patients with hypertensive intracerebral hemorrhage within 6 h of onset,admitted to our hospital from February 2010 to August 2018,was performed.CT examination was performed within half an hour of admission.CT re-examination was performed 24 h after admission to determine whether there was hematoma enlargement.The regions of interest were delineated on the first CT,and 431 image indicators were extracted from the Matlab software.The LASSO regression model was used to screen out the most predictive imaging features,and the selected features and support vector machine classifier (SVM) were used to build the prediction model.Receiver operating characteristic (ROC) curve was used to evaluate the predicted effect of the model.Results After 24 h of admission,the incidence of hematoma enlargement was 18.9％ (40/212).Eighteen imaging ensemble features (including 4 first-order statistics features:standard deviation,kurtosis,uniformity,and variance;one shape-and size-based feature:surface to volume ratio;7 textual features:long run low grey level emphasis,inertia,correlation-angle 90,short run emphasis,correlation-all direction,long run emphasis,and inverse difference moment;6 wavelet features:autocorrelation-3,informational measure of correlation2-3,long run high gray level emphasis-4,short run high gray level emphasis-4,short run low gray level emphasis-7,and sum variance-3) were combined with SVM to establish a prediction model by LASSO regression model.The area under ROC curve was 0.928,enjoying sensitivity and specificity of 92.5％ and 83.5％,respectively.Conclusion The constructed radiomics model is helpful in predicting the expansion of hypertensive cerebral hemorrhage.

Influencing factors of cerebral infarction in elderly patients with hypertensive intracerebral hemorrhage after hematoma clearance / 中华行为医学与脑科学杂志

Objective To investigate the influencing factors of cerebral infarction in elderly patients with hypertensive intracerebral hemorrhage after hematoma clearance.Methods A total of 197 elderly patients with hypertensive intracerebral hemorrhage were selected and treated with craniotomy hematoma removal and decompression of bone flap.Cerebral infarction was checked by craniocerebral CT after operation.Univariate and multivariate Logistic regression analysis was used to identify the independent risk factors for cerebral infarction.Results The incidence of cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage was 26.90％(53/197).There was no significant difference in the incidence of cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage on gender and age (P＞ 0.05),while the differences were statistically significant in diabetes (x2 =7.986),hypertension history (x2 =10.399),hematoma volume(x2=10.396),edema(x2=12.436),systolic blood pressure(x2 =12.128),diastolic blood pressure(x2 =13.040) and GCS score(x2 =3.940) (all P＜0.05).Logistic regression analysis showed that history of diabetes mellitus(β=1.472,0R=2.174,95％CI=1.092-2.981),history of hypertension (β =1.894,OR =2.819,95 ％ CI =1.309-3.973),volume of hematoma ＞ 35 ml (β =2.36 l,OR =3.890,95％CI=1.792-5.132),area of brain edema (＞ 65 cm3) (β=2.471,OR=4.321,95％CI=1.879-5.487),systolic pressure (＞ 150 mm Hg,1 mmHg =0.133 kPa) (β=2.073,OR=3.172,95％ CI=1.428-4.768),diastolic pressure (＞ 90 mm Hg) (β=1.715,OR=2.498,95％ CI =1.276-3.451) and GCS score ＜ 8 (β=2.592,OR=4.871,95％ CI=1.974-5.798)were independent risk factors for cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage.Conclusion Elderly patients with cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage is affected by diabetes mellitus,hypertension,hematoma volume,edema,systolic blood pressure,diastolic blood pressure and other factors.Early intervention on these factors may effectively reduce the incidence of cerebral infarction.

Clinical outcomes of endoscopic and microsurgical treatments in patients with hypertensive basal ganglia hemorrhage / 中华神经医学杂志

Objective To evaluate the clinical outcomes of endoscopic and microsurgical treatments in patients with hypertensive basal ganglia hemorrhage (HBGH).Methods A retrospective analysis of clinical features of 37 patients received microsurgical treatment via transsylvian-transinsular approach or 32 patients received endoscopic treatment for evacuation of HBGH in our hospital from January 2011 to January 2015 was performed.The operation time,hematoma clearance rate,re-bleeding rate and prognoses of the patients were investigated.Results As compared with patients accepted microsurgical treatment,patients accepted endoscopic treatment had significantly shorter operation time,smaller peroperative bleeding volume,and shorter hemostatic time (P＜0.05).The preoperative Glasgow coma scale (GCS) scores in patients accepted endoscopic treatment and microsurgical treatment were 8.63±1.24 and 8.67±1.31,without significant difference (P＞0.05);24 h after operation,GCS scores in patients accepted endoscopic treatment increased to 12.79±1.20,which had significant difference as compared with those in patients accepted microsurgical treatment (11.23±1.29,P＜0.05).The cerebral edema volume in patients accepted endoscopic treatment and microsurgical treatment was (11.83±4.08) mL and (18.76±7.92) mL,with significant difference (t=6.460,P=0.000).The hematoma clearance and prognosis in patients accepted endoscopic treatment were better than those in patients accepted microsurgical treatment.Conclusion Endoscopic evacuation ofhematoma for HBGH is efficient and safe,enjoying better efficacy than microsurgery.

Controlled decompression under intracranial pressure monitoring for patients with hypertensive intracerebral hemorrhage and long-term aspirin use treated with soft channel puncture and drainage / 中华神经医学杂志

Objective To explore the application of controlled decompression under intracranial pressure (ICP) monitoring for the patients with hypertensive intracerebral hemorrhage and long-term aspirin use in the treatment with soft channel puncture and drainage.Methods This prospective study enrolled 87 patients with hypertensive intracerebral hemorrhage and long-term aspirin use from the Department of Neurosurgery,The First People's Hospital of Huzhou from February 2013 to February 2017.They were divided into a control group (43 cases) and a treatment group (44 cases) according to their wishes.The control group was treated by conventional soft channel puncture and drainage while the treatment group by controlled depression under ICP monitoring in addition to soft channel puncture drainage.Results In the treatment group,the volume ofhematoma aspiration (ICP) was (10.38±3.24) mL,accounting for about 20％ of the initial hematoma.The time for retention of endovascular drainage tube in the treatment group (90.0±4.2 h) was significantly longer than that in the control group (73.0±3.8 h),and the hematoma clearance rate in the treatment group (80.0％±1.2％) was significantly lower than that in the control group (91.0％± 1.9％) (P＜0.05).The incidences of such postoperative complications as rebleeding,scalp leachate and intracranial infection (11.4％,9.1％ and 4.5％,respectively) in the treatment group were significantly lower than in the control group (34.9％,25.6％ and 11.6％,respectively) (P＜ 0.05).The recovery rate in the treatment group (77.3％) was significantly higher than in the control group (60.5％);the mortality rate in the former (9.1％) was significantly lower than in the latter (18.6％) (P＜ 0.05).Conclusion For patients with hypertensive intracerebral hemorrhage and long-term aspirin use,controlled decompression combined with soft channel puncture drainage under ICP monitoring can effectively improve their quality of life and prognosis.

Effect of mobile phone-based health education on independent living ability of postoperative patients with hypertensive intracerebral hemorrhage / 现代临床护理

Objective To explore the effect of mobile phone-based health education on independent living ability of postoperative patients with hypertensive intracerebral hemorrhage. Methods Sixty patients with postoperative hypertensive intracerebral hemorrhage who underwent craniotomy in our hospital during March 2016 and December 2017 were divided into experimental and control groups, 30 cases in each group, according to the random number table method. Functional training conducted during hospitalization in both groups. After discharge, the control group used a telephone for follow-ups every 2 weeks and took part in a face-to-face training in the first month to implement continuous nursing intervention for a total of 3 months. After discharge, in the experimental group, various information forms of rehabilitation training for hypertensive intracerebral hemorrhage were comprehensively integrated, and mobile phone education was used for a total of 3 months in addition to the training as in the control group. The two groups were compared in terms of independent living ability between the two groups. Result The scores of independent living ability and self-care ability, action ability, metastatic ability, social cognitive ability and communication ability of the experimental group were significantly higher than those of the control group (P＜0.05). Conclusion The mobile phone-based education can promote the effect of rehabilitation exercise in patients with hypertensive intracerebral hemorrhage, so as to promote the independent living ability of patients.

Risk factors of postoperative rebleeding after hypertensive cerebral hemorrhage / 局解手术学杂志

Objective To analyze the risk factors of postoperative rebleeding after hypertensive cerebral hemorrhage,and provide a basis for clinical prevention of postoperative recurrent hemorrhage. Methods The clinical data of 413 patients with hypertensive intracerebral hemorrhage in our hospital from January 2007 to December 2017 were retrospectively analyzed.The possible correlation factors of postopera-tive recurrent hemorrhage and the high-risk factors were collected and summarized. Results According to univariate unconditional logistic regression analysis, there was a significant correlation between systolic blood pressure, GCS score, bleeding volume, coagulation dysfunction and the use of sedative analgesics with the hypertensive cerebral hemorrhage after surgery(P<0.05);they were also the risk factors of post-operative rebleeding after hypertensive cerebral hemorrhage according to the multivariate unconditional logistic regression analysis (P<0.05). Conclusion The results indicate that there are many factors influencing postoperative rebleeding in patients with hypertensive cerebral hemorrhage.In the perioperative period,higher systolic blood pressure,deeper consciousness disorder,more bleeding,and coagulation dysfunction are independent factors influencing postoperative re-bleeding, and more attention should be paid to it.

Clinical effect of minimally invasive operation that alteplase assisted for the patients with moderate amount of cerebral basilar hemorrhage / 临床神经病学杂志

Objective To investigate the clinical effect and safety of the treatment of cerebral hemorrhage of basal ganglia regionin middle volume with minimally invasive surgery combined with alteplase .Methods Sixty-three patients with moderate amount of cerebral basilar hemorrhage and their GCS scores were between 8 to 10 in our hospital from 2012 to 2016 were divided into experimental group and control group .The experimental group were taken by minimally invasive surgery for intracranial hematoma combined with alteplase , otherwise, the patients in the control group were treated by medical conservative treatment .GCS,NIHSS,activities of daily living ( ADL), mRS were used to evaluated the efficacy ,the results were compared .Results The amount of bleeding in two groups had no significant difference before treatment .However, the experimental group of hematoma was neaely clear up or almost all absorped , the control group was not significantly reduced after treatment according to review of CT , there was statistical significance between the two groups (P<0.05).In the experimental group, NIHSS score was significantly decreased after treatment than before treatment ( P<0.05 ) , while there was no statistically significant difference in the control group .In the experimental group , GCS score was significantly decreased after treatment than before treatment(P<0.05).Three months after discharge, the ADL score of the experimental group was significantly higher than that of the control group ( P<0.05 ) , the mRS score of the experimental group after 3 months was significantly lower than that of the control group ( P<0.05 ) .Conclusion Treatment to basal ganglia cerebral hemorrhage of minimally invasive surgery combined with alteplase is more safe and effective by removing intracranial hematoma quickly , reducing brain damage caused by hematoma compression and thereby deseasing morbidity and mortality.

Intracranial hematoma micro-invasive craniopuncture scavenging technique in patients with hypertensive cerebral hemorrhage: a Meta-analysis / 中国中西医结合急救杂志

Objective To evaluate the therapeutic efficacy and safety of micro-invasive craniopuncture scavenging technique (MPST) for treatment of intracranial hematoma in patients with hypertensive cerebral hemorrhage (HICH).Methods All the clinical randomized controlled trial (RCT) studies published on MPST and internal medicine conservative treatment of HICH were searched via computer screening of databases including Cochrane clinical trials database, the Chinese biomedical literature database (CBM), Chinese periodical network full-text special topic database, Chinese science and technology periodical database and electronic periodicals database of Wanfang from January 2006 to January 2017. The study group was given the MPST plus basic treatment, and the control group was given conservative treatment. The studies collected meeting the eligible criteria were sorted and analyzed by the software RevMan 5.0, the differences in therapeutic effect and mortality were compared between the two groups, and a funnel chart was plotted to analyze the potential publication bias.Results A total of 13 RCTs published studies consistent with the eligible criteria were found, including1556 patients. The Meta-analysis showed that the effective rate in the study group was significantly higher than that in the control group [odds ratio (OR) = 4.29, 95% confidence interval (95%CI) 3.33 - 5.53,P < 0.01]; the fatality rate was markedly lower than that of the control group (OR = 0.25, 95%CI 0.19 - 0.35,P < 0.01). The funnel graph showed that each study had asymmetrical scatter plot of the variable quantity of research results, indicating a publication bias being present, which might be related to the subjectivity of the researchers in publishing their results.Conclusions Using MPST to treat HICH can significantly improve the therapeutic efficiency and reduce deterioration rate. However, due to the low quality of clinical research, it is necessary to carry out rigorous andmulti-center randomized controlled studies to further confirm the results.

Effect of ecological nutrition in postoperative patients with hypertensive cerebral hemorrhage / 中国实用护理杂志

Objective To observe the application effect of ecological nutrition nasogastric enteral nutrition support in postoperative patients with hypertension cerebral hemorrhage. Methods 80 cases of postoperative patients with hypertensive cerebral hemorrhage were randomly divided into ecological nutrition group and control group (n = 40).40 patients of ecological nutrition group were supported by enteral nutrition with probiotics, which started from 24-48 h postoperatively. 40 patients of control group were supported by enteral nutrition without probiotics, which started from 24-48 h postoperatively. Data was collected and analyzed before and after 2 weeks nutrition support. Results Compared with control group, ecological nutrition group' s serum albumin was raised from (33.5 ± 1.3)g/L to (36.3 ± 1.7) g/L, hemoglobin was raised from (124.7±6.8)g/L to (129.4±5.6)g/L, lymphocyte count was raised from (1.61± 0.36)×109/L to (1.97±0.41)×109/L, pulmonary infection were reduced from 8 cases to 1 case, stress ulcer were reduced from 12 cases to 4 cases, GCS (Glasgow Coma Scale) was raised from (9.2 ± 1.3) to (11.4 ± 1.2). All differences were statistically significant (P<0.05). Conclusions Ecological nutrition support could improve nutritional status, enhance immunity, reduce complication, contribute to consciousness resuming and increase efficiency of medical care, which was worthy of popularizing.

Effect of Naoxuekang Oral Liquid Combined with Nimodipine on Hypertensive Cerebral Hemorrhage and the Influence on Serum Tau Protein,IGF-1 and Hs-CRP in Patients / 中国药师

Objective:To observe the effects of Naoxuekang oral liquid combined with nimodipine on hypertensive cerebral hemorrhage and the influence on serum Tau protein,IGF-1 and hs-CRP in the patients. Methods:Totally 98 patients with hypertensive cerebral hemorrhage were randomly divided into two groups(n = 49). The patients in the control group were given nimodipine,while those in the observation group were given nimodipine and Naoxuekang oral liquid at the same time,and all the patients received 4-week treatment. The serum levels of Tau protein,IGF-1 and hs-CRP before and after the treatment were detected,and the national institutes of health stroke scale(NIHSS)score,hematoma volume and curative effect and adverse drug reaction were recorded as well. Results:Before the treatment,there was no significant differences in Tau protein,hs-CRP, IGF-1,NIHSS score and hematoma volume between the two groups(P > 0. 05). After the treatment,the levels of Tau protein and hs-CRP,NIHSS score and hematoma volume in both groups were decreased,and those in the observation group were lower than those in the control group;the IGF-1 level in both groups was increased,and that in the observation group was higher than that in the control group;and all the differences had statistical significance(P 0. 05),while the effective rate of the observation group was significantly higher than that of the control group(89. 8% vs 73. 5% ,P < 0. 05). Conclusion:Naoxuekang oral liquid combined with nimodipine can significantly reduce the serum levels of Tau protein and hs-CRP,and increase the serum level of IGF-1,and improve the symptoms of patients with hypertensive cerebral hemorrhage,which is beneficial to the rehabilitation of patients.

The Clinical effect of craniotomy versus sphenotresia drainage for treatment patients with hypertensive ce-rebral hemorrhage / 中国神经精神疾病杂志

Objective To compare the clinical effect of craniotomy versus sphenotresia drainage for treatment pa?tients with hypertensive cerebral hemorrhage. Methods Retrospective analysis the patients with hypertensive cerebral hemorrhage in our hospital, and divided into the group of craniotomy(n=39) and the group of sphenotresia drainage(n=50). The operating time, hematoma clearance rate, complications after operation and intracranial pressure at 4h, 24h, 48h, 72h, 5d and 7d after operation between the two groups were record. Results The intracranial pressure in both groups are raised gradually in the 48 h after surgery and gradually declined at 48 h after surgery. The increasing amplitude in craniotomy group is less than the group of sphenotresia drainage. Between the two groups of group, different point, and between groups and the interaction of the different point difference had statistical significance (P<0.05). The hematoma clearance rate in the group of craniotomy is less than the group of sphenotresia drainage. However, the operating time and the infection rates in the group of craniotomy is greater than the group of sphenotresia drainage, the difference is statistically significant (P<0.05). Conclusion Craniotomy can increase the hematoma clearance rate, decrease intracranial pressure as well as the oc?currence of rehaemorrhagia, however, it also will prolong operation time and increase the risk of lung infection and gastro?intestinal bleeding. It is depend on the general characteristic of patients to determine which operation methods to adopt.

Effect of ganglioside on nerve function in hypertensive cerebral hemorrhage after operation / 中国生化药物杂志

Objective To investigate the effect of ganglioside on nerve function in patients with hypertensive cerebral hemorrhage after operation. Methods 90 cases with hypertensive cerebral hemorrhage after operation from March 2014 to March 2016 in our hospital were divided into control group and observation group, the control group was treated with routine treatment, the observation group was given ganglioside nerve cell nutrition therapy, the two groups of patients after treatment of clinical efficacy, neurological function score, ADL score, hematoma, edema were observed.Result The total effective rate(91.11%) in the observation group was significantly higher than that in the control group(66.67%)(P <0.05), the difference was statistically significant.After 7 days and 28 days after treatment, the volume of hematoma and edema in the observation group was significantly decreased, and the control group had obvious advantages compared with the control group ( P <0.05 ).Compared with seventh days and twenty-eighth days after treatment, the NIHSS score and ADL score of the observation group were significantly better than the control group ( P <0.05 ) , the difference was statistically significant.Conclusion The application of the ganglioside in the treatment of hypertensive cerebral hemorrhage can significantly improve the neurological function, improve the quality of life of patients and clinical treatment effect, has good clinical application value.

Curative effect of minimally invasive surgery for patients with medium volume of hypertensive criatocapsular hemorrhage / 中国基层医药

Objective To observe the mini -invasive treatment for patients with medium volume of hyper-tensive criatocapsular hemorrhage.Methods 59 patients with medium volume of hypertensive criatocapsular hemor-rhage(20 -30mL)were selected and randomly divided into mini -invsasive surgery group and conservative treatment group.Two groups were compared the average length of stay,hospital costs and clinical effect.Results The avergae hospital stay (14 ±3.26)days and avergae cost (1.1 ±0.33)ten thousand yuan of the mini -invsasive surgery group was lower than those of the conservative treatment group (25 ±6.58)days and (1.8 ±0.56)ten thousand yuan],the differences were statistically significant (t =7.999,5.768,all P <0.01).After 3 months follow -up,the recovery of self -care ability after operation estimated by ADL scores in the mini -invsasive surgery group was significantly better than that in the conservative treatment group(12 /31 vs.25 /28,χ2 =16.093,P <0.01).Conclusion For patients with medium volume of hypertensive criatocapsular hemorrhage(20 -30mL),minimally invasive surgery can shorten hospital stay,reduce the financial burden of patients,and improve the prognosis significantly.

Clinical Observation of the Effects of Yinxing Damo Injection on Recovery of Neural Function after Hyper-tension Intracerebral Hemorrhage Minimally Invasive Surgery / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of Yinxing damo injection for neural function recovery af-ter hypertensive intracerebral hemorrhage (HICH) minimally invasive surgery. METHODS:84 HICH patients were randomly di-vided into control group and observation group with 42 patients in each group. Both groups received CT guiding minimally inva-sive aspiration. Control group was given western medicine baseline therapy,such as dehydration and intracranial decompression, controlling blood pressure,preventing infection,alimenting never,symptomatic treatment. Observation group was additionally giv-en Yinxing damo injection 20 ml,ivgtt,bid. Treatment course lasted for 14 d. NIHSS score,GCS score and Fugl-Meyer motor function assessment scale score were comducted before and after treatment. The serum levels of NSE,serum C3,C4 and hs-CRP were determined in 2 groups before and after treatment. RESULTS:After treatment,the effective rate of observation group (85.71%)was better than that of control group(66.67%),with statistical significance(P<0.05);after treatment,NIHSS score, Fugl-Meyer score and GCS score of 2 groups were all better than before,the observation group was better than the control group, the levels of C3 and C4 in observation group were lower than in control group,with statistical significance(P<0.01). There was one case of allergic reaction that the patient can tolerate. Magnesium sulfate for external use was given,which did not affect the treatment. CONCLUSIONS:Yinxing damo injection could improve neurologic impairment,promote the recovery of patients and have good safety.

Dexmedetomidine combined with remifentanil used for sedation and analgesia in ICU patients with hypertensive cerebral hemorrhage / 中华急诊医学杂志

Objective To explore the administration of Dexmedetomidine combined with remifentanil for sedation and analgesia of ICU patients with hypertensive cerebral hemorrhage after operation.Methods A total of 60 patients with hypertensive cerebral hemorrhage treated with hematoma removal under craniotomy were selected from May 2013 to June 2015.The patients were randomly (random number) divided into the Dexmedetomidine combined with remifentanil group (D + R, n =30), and Midazolam combined with remifentanil group (M + R, n =30).The blood pressure, respiration rate, oxygen saturation, heart rate, ICP (intracranial pressure), Ramsay sedation scores, and IL-1, and TNF-α levels were recorded after sedation and analgesia in ICU, and 6 h, 24 h, 48 h after operation (T0-T3).Results Compared with M +R group, the MAP, RR, HR, ICP, IL-1β, TNF-α, rate of reoperation for check bleeding, and mortality were significantly decreased in D + R group (P ＜ 0.05), and Ramsay sedation score was significantly increased at the same time (P ＜ 0.05) without excessive sedation and analgesia noticed.Conclusions Dexmedetomidine combined with remifentanil exhibits significant benefit in many respects including control of great fluctuations of blood pressure and intracranial pressure after craniotomy, reduce the production and release of inflammatory mediators, reduce the occurrence of rebleeding after operation.It shows good controllability and safety, it is an optimal method producing sedation and analgesia in ICU patients with hypertensive cerebral hemorrhage after operation.

Effect of serf-made laser assisted stereotactic head frame on putaminal hemorrhage / 中华神经医学杂志

Objective To study the effect of self-made stereotactic head frame on hypertensive cerebral hemorrhage.Methods Sixty-seven patients with putamen hemorrhage,admitted to our hospital from January 1,2013 to January 1,2014,were enrolled as minimally invasive group;a self-made laser assisted stereotactic head frame was used to putaminal intracranial catheter.Another 53 patients with putaminal hemorrhage,performed traditional craniotomy at the same time period,were enrolled as control group.Systemic analysis and evaluation of effect of these two methods were performed.Results As compared with the control group,minimally invasive group had significantly lower mortality rate 6 months after surgery (22.6％ vs.8.9％) and re-bleeding rate (15.1％ vs.2.99％),significantly increased percentage of favorable outcomes (43.4％ vs.68.7％),statistically shorter surgical times ([203.2±38.6] min vs.[41.2±8.1] min) and hospital stays ([28.1±7.2] d vs.[18.2±4.4] d),and significantly decreased medical expenses ([23647.7±5503.2] yuan vs.[51678.6±7524.2] yuan,P＜0.05).Conclusion Treating putaminal hemorrhage using self-made laser assisted stereotactic head frame enjoys advantages as simple operation,lower cost and good efficacy.

Perioperative nursing intervention efficacy for hypertensive cerebral hem-orrhage row of small bone window hematoma evacuation / 中国现代医生

Objective To explore the perioperative nursing intervention in hypertensive cerebral hemorrhage of small bone window craniotomy in clinical nursing effect. Methods All 80 cases of patients with cerebral hemorrhage in our hospital data were analyzed,selected patients underwent small bone window craniotomy treatment,depending on the pe-rioperative care program patients were divided into a control group and the experimental group and the control group conventional methods of care,implementation of the experimental group perioperative nursing intervention, nursing re-sults were compared. Results 95% of the experimental group for perioperative care program had significant effect,sig-nificantly better than the control group(efficacy rate was 85%)(P<0.05);the experimental group,95% for periopera-tive nursing satisfactory, significantly higher than the control group (satisfaction rate of 65%) (P<0.05); the experi-mental group operative time was(3.53±1.34)h,the average hospital stay was(22.89±1.23)days,were significantly less than the control group (P<0.05);two groups of complications occurrence rate comparison, with statistically significant difference (10% vs 40%, P<0.05),experiments group ADL score was (16.2±3.7) points, physical function score was(59.6±7.5)points,psychological function score was(65.8±9.2)points,social function score was(57.2±6.5)points,were higher than the control group (P<0.05). Conclusion Hypertensive intracerebral hemorrhage patients with small bone window craniotomy treatment of perioperative nursing interventions implemented the desired effect, should be intro-duced.