摘要
Objective To observe the treatment effect of edaravone plus mild hypothermia treatment on patients with acute severe traumatic brain injury (TBI).Methods One hundred and forty-three patients with TBI,admitted to our hospital from February 2008 to September 2012,were randomly divided into 4 groups:control group (group A,routine treatment,n=35),mild hypothermia treatment group (group B,routine treatment plus temperature control at the range of33～34 ℃ for 2-14 days,n=36),edaravone treatment group (group C,routine treatment plus edaravone up to 14 days,30 mg per time,twice per day,n=36) and mild hypothermia plus edaravone treatment group (group D,routine treatment combined with mild hypothermia plus edaravone n=36).Intracranial pressure (ICP) and arterial blood glucose were determined at admission,and 24 and 72 h after admission; Glasgow Outcome Scale (GOS) scores were assessed 3 months after the treatment.Results At 24 and 72 h after admission,the mean ICP of group B and group C was significantly lower than that of group A (P＜0.05); that of group D was significantly lower than that of group B and group C (P＜0.05).The mean blood glucose of group B and group C was obviously lower than that of group A (P＜0.05); group D was obviously lower than group B and group C (P＜0.05).The rate of good neurologic function (GOS scores 4-5) in group D was better than that of group B and group C (P＜0.05),which was significantly better than that of group A (P＜0.05).Conclusion It is much more effective to use mild hypothermia plus edaravone treatment than simple mild hypothermia or edaravone treatment in the early treatment of acute severe TBI.
摘要
Objective To choose the appropriate operation for patients with Sylvian fissure arachnoid cysts.Methods The data of 87 patients with intracranial arachnoid cysts(67 male,20 female,mean age 13.4 years),admitted to out hospital from March 2003 to August 2008,were retrospectively analyzed.Forty of them accepted simple endoscopic neurosurgery;19 of them accepted endoscope-controlled neurosurgery;22 of them accepted microsurgery.The efficacy and complications of these 3 methods were analyzed and compared.Results No significant differences on age,the size of the cysts,postoperative complications,the decreased size of the cysts and the improvement were found among these 3 methods(P>0.05).The operation time and bleeding volume of the simple endoscopic neurosurgery group were 97±26.8 min and 15±4.8 mL;the endoscope-controlled neurosurgery group were 87±27.6 min and 18±5.7 mL;the microsurgery group were 143±36.0 min and 160±39.6 mL.As compared with those in the first 2 groups,the operation time was statistically longer and the bleeding volume was obviously increased in the later group(P<0.05);while no significant difference of those was found between the first 2 groups(P>0.05).Conclusion Endoscopic neurosurgery is an effective method with shorter operation time and less bleeding than craniotomy in treating the Sylvian fissure arachnoid cysts.
摘要
Objective To evaluate the value of CT cisternography (CTC) in the diagnosis and treatment of intracranial arachnoid cysts (IAC). Methods CTC was performed on 23 patients with IAC, admitted to our hospital from October 2006 to October 2009. Patients with non-communicating intracranial arachnoid cysts (NCIAC) accepted endoscopic neurosurgery and those with communicating intracranial arachnoid cysts (CIAC) accepted conservative treatment. CT, MRI and CTC were performed on these patients before and after the treatment; the value of CTC in the diagnosis and treatment of IAC and the effect of neurosurgery in the treatment of NCIAC were analyzed, respectively. Results CTC conformed that 17 patients (17/23) had NCIAC and 6 (6/23) had CIAC. All of the NCIAC patients were performed neuroendoscopic surgery: the cyst of 1 patient disappeared; that of 13 shrunk and that of 3 did not changed. Postoperative CTC demonstrated that all the cysts of the 8 patients communicated well with the cistern. Conclusion CTC is very important in the diagnosis of IAC,especially in the differentialdiagnosis of NCIAC and CIAC. The result of CTC can be an indicator in determining the necessity of operation in patients with cranial cysts and give a primary evaluation on the effect of cranial cyst surgery.