Objective To explore whether there is enough clinical evidence to confirm that stereotactic aspiration does more good than harm in patients with cerebral hemorrhage. Method A systematic review of all relevant clinical studies on stereotactic aspiration in the treatment of cerebral hemorrhage. Results Eight randomized controlled trials (RCTs) including 757 patients and 17 nonrandomized controlled studies including 1 766 patients, as well as 20 uncontrolled studies including 1 244 patients were identified . All studies reported positive results regarding the effects. However, the quality of the included studies were generally poor. The main problem was that most trials reported them as a RCT, but no description of the method of randomization. Conclusions Stereotactic aspiration in the treatment of cerebral hemorrhage is promising based on present evidence. However, at present, we can not draw definite conclusion whether the treatment does more good than harm compared with noninvasive medical treatment because of the poor quality of included studies. Therefore, more high quality RCTs are required.
【摘要】 目的 探讨血管内治疗颅内动脉瘤围手术期并发症的原因及护理对策。 方法 对2007年3月-2011年1月收治的365例采用血管内治疗动脉瘤患者中22例围手术期出现并发症者的临床资料进行回顾性分析。 结果 22例患者围手术期出现并发症，占6%。动脉瘤破裂再出血6例，其中发生于术前2例，术中3例，术后1例；脑血管痉挛 10例；脑血管血栓形成 4例，穿刺部位血肿 2例。 结论 血管内治疗颅内动脉瘤围手术期，采取预见性护理措施预防及观察主要并发症的发生和正确处理并发症，可降低其病死率和致残程度。【Abstract】 Objective To study and discuss the reasons for and clinical nursing of perioperative complications for patients undergoing endovascular treatment for intracranial aneurysms. Methods Twenty-two of 365 aneurysm patients who had undergone endovascular treatment between March 2007 and January 2010 in our hospital had perioperative complications. We retrospectively analyzed their clinical data. Results Twenty-two patients had perioperative complications, accounting for about 6%. The aneurysm was ruptured in 6 cases, which occurred before surgery in 2 patients, during the surgery in 3, and after the surgery in 1. There were 10 cases of cerebrovascular spasm, 4 cases of cerebrovascular thrombosis, and 2 cases of puncture site hematoma. Conclusion During the perioperative period of endovascular treatment for intracranial aneurysms, prognostic prevention measures, observation of the occurrence of major complications and proper management of complications can effectively reduce mortality and the degree of disability.
OBJECTIVE: To review the methods of end-to-side anastomosis in repair of peripheral nerve injury and to analyze the difficulty faced. METHODS: By index of recent literature, the kind of experimental model, observation criteria and the clinical data were collected and analyzed. RESULTS: For different methods of end-to-side anastomosis in repair of peripheral nerve defect, the clinical outcomes were reported differently. The clinical application was fewer. There was lack of case summary and assessment criteria. CONCLUSION: The superiority of end-to-side anastomosis made it necessary to further study the mechanism and improvement of quality.
目的 评价国产吻合器和闭合器在食管癌消化道重建术中的应用价值。 方法 回顾性分析2005年3月-2008年4月期间收治的387例食管癌手术患者的临床资料，根据不同消化道重建方式分为手工吻合组（n=172）和器械吻合组（n=215），对两组患者吻合时间、术中出血量及术后并发症发生情况进行对比分析。 结果 全组无手术死亡。器械吻合组和手工吻合组术中出血量的差别无统计学意义（Pgt;0.05），但前者的吻合时间、住院时间均少于后者（Plt;0.05）。手工吻合组术后吻合口出血多于器械吻合组（5.2%比1.4%，Plt;0.05），发生吻合口漏亦多于器械吻合组（6.4%比2.8%，Plt;0.05）。随访1.5～2年，排除失访患者后，器械吻合组吻合口狭窄发生率低于手工吻合组（4.6%比10.3%，Plt;0.05）。 结论 国产吻合器与和缝合器用于食管癌的消化道重建安全有效，值得在基层医院推广应用。
ObjectiveTo discuss the key points of nursing care for enhanced abdominal CT examination. MethodsA retrospective analysis of the clinical data of 1 500 patients receiving abdominal enhanced CT scan between March 2013 and March 2014 was carried out. Then, we summarized the nursing experiences before, during and after scanning, and various complications and accidents occurring during the examination. ResultsAll the patients completed the examination safely. Ten patients had mild adverse reactions, and the symptoms relieved or disappeared after active treatment; no medium or severe adverse reactions occurred. Two patients had extravasation of contrast medium, and the allergic symptoms gradually improved after the dressing of 50% wet magnesium sulfate. Five patients had poor image quality, including 2 with contrast agent extravasation, and 3 with respiratory motion artifacts. ConclusionGood nursing work is an important guarantee for the success of abdominal enhanced CT examination.
Objective To summarize the research progress in the diagnosis and treatment of pancreatic cystic neoplasms (PCNs). Method The guidelines and literatures related to the diagnosis and treatment of PCNs were collected and reviewed. Results At present, there was still no clear method to distinguish the types of PCNs and their benign and malignant, and there was still a dispute between domestic and foreign guidelines on the diagnosis and treatment of PCNs. Conclusion Clinical researchers still need to carry out more research, provide higher quality evidence, resolve the disputes existing in different guidelines, standardize the diagnosis and treatment process of PCNs, thus, PCNs can be identified early, diagnosed accurately and intervened in time.
ObjectiveTo review the research progress of the role of seed cells and related cytokines in angiogenesis of the vascularized tissue engineered bone. MethodsThe latest literature of tissue engineered bone angiogenesis was reviewed, including the common source of seed cells, biological characteristics, transformation mechanism, related cytokines, and signaling pathways in re-vascularization. ResultsMicrosurgery technique, genetic technique, and co-culture system of vascularized tissue engineered bone have developed to a new level. Moreover, both the induction of introduced pluripotent stem cells and vascular endothelial growth factor-angiopoietins 1 transfected mesenchymal stem cells and endothelial progenitor cells have some advantages for bone regeneration and vascularization. However, all the techniques were not used in clinical practice. ConclusionUsing techniques of genetically modified seed cells, related cytokines, and scaffolds may have bright prospects for building vascularized tissue engineered bone.