BACKGROUND:The present study aimed to explore the relationship between surgical methods,hemorrhage position,hemorrhage volume,surgical timing and treatment outcome of hypertensive intracerebral hemorrhage(HICH).METHOD...BACKGROUND:The present study aimed to explore the relationship between surgical methods,hemorrhage position,hemorrhage volume,surgical timing and treatment outcome of hypertensive intracerebral hemorrhage(HICH).METHODS:A total of 1 310 patients,who had been admitted to six hospitals from January 2004 to January 2008,were divided into six groups according to different surgical methods:craniotomy through bone fl ap(group A),craniotomy through a small bone window(group B),stereotactic drilling drainage(group C1 and group C2),neuron-endoscopy operation(group D) and external ventricular drainage(group E) in consideration of hemorrhage position,hemorrhage volume and clinical practice. A retrospective analysis was made of surgical timing and curative effect of the surgical methods.RESULTS:The effectiveness rate of the methods was 74.12% for 1 310 patients after onemonth follow-up. In this series,the disability rate was 44.82% 3–6 months after the operation. Among the 1 310 patients,241(18.40%) patients died after the operation. If hematoma volume was >80 mL and the operation was performed within 3 hours,the mortality rate of group A was signifi cantly lower than that of groups B,C,D,and E(P<0.05). If hematoma volume was 50–80 mL and the operation was performed within 6–12 hours,the mortality rate of groups B and D was lower than that of groups A,C and E(P<0.05). If hematoma volume was 20–50 mL and the operation was performed within 6–24 hours,the mortality rate of group C was lower than that of groups A,B and D(P<0.05).CONCLUSIONS:Craniotomy through a bone f lap is suitable for patients with a large hematoma and hernia of the brain. Stereotactic drilling drainage is suggested for patients with hematoma volume less than 80 mL. The curative effect of HICH individualized treatment would be improved via the suitable selection of operation time and surgical method according to the position and volume of hemorrhage.展开更多
In China interventional therapy of liver cancer started in the 1980s. It is well-known that Professor Lin Gui is the founding father of Interventional radiology. Under the leadership of Lin Gui and other professors, i...In China interventional therapy of liver cancer started in the 1980s. It is well-known that Professor Lin Gui is the founding father of Interventional radiology. Under the leadership of Lin Gui and other professors, interventional therapy of liver cancer has swiftly progressed in China. Indeed, TAI, TAE, TACE and ablation therapy have witnessed great innovations in hardware facil ities, technical means, and therapeutic philosophy, while incorporating Chinese characteristics. As with the development of combined interventional therapy in China, interventional treatment of liver cancer has gradually started the process of precision and individualization. Actually, multidisciplinary, multimodal, and polymorphic treatments will be the most suitable pattern for liver cancer in the future, among which combination of interventional therapy with targeted, immunological treatments and information technology(IT) tools may bring a revolutionary breakthrough in liver cancer treatment.展开更多
目的:探讨快速康复理念(enhanced recovery after surgery,ERAS)个体化围手术期管理方案对超高龄髋部骨折这一特殊类型患者的应用价值。方法:将湘潭市中心医院骨科2016年1月1日至2018年1月1日期间外伤致髋部骨折并行人工双极头置换手术...目的:探讨快速康复理念(enhanced recovery after surgery,ERAS)个体化围手术期管理方案对超高龄髋部骨折这一特殊类型患者的应用价值。方法:将湘潭市中心医院骨科2016年1月1日至2018年1月1日期间外伤致髋部骨折并行人工双极头置换手术的43例超高龄(≥90岁)患者(股骨颈骨折及转子间骨折)分为ERAS组(n=25)和常规组(n=18)。ERAS组股骨颈骨折12例,转子间骨折13例,在ERAS个体化干预下行手术治疗;常规组股骨颈骨折8例,转子间骨折10例,常规手术治疗。比较两组术后疼痛(VAS评分)、并发症发生率、住院期间病死率及髋关节功能状态(Harris功能评分)及平均住院时间,随访并比较两组出院后3,6,12个月的病死率及髋关节功能状态。结果:ERAS组术后第1,3,7天VAS评分明显低于常规组(P<0.05);ERAS组25例患者住院期间无死亡,1例术后出现肺部感染,1例术后出现胃肠道反应;而常规组住院期间死亡3例,1例出现深静脉血栓,2例出现肺部感染,2例术后出现胃肠道反应。住院期间ERAS组病死率及并发症发生率明显低于常规组;ERAS组住院时间为(14.13±2.55)d,明显低于常规组手术组(25.13±3.68)d,差异均有统计学意义(P<0.05)。ERAS组出院当天及出院后第3个月髋关节Harris功能评分显著高于常规手术组(P<0.05),但出院后第6,12个月差异无统计学意义(P>0.05)。术后随访3,6,12个月两组新增病死率差异无统计学意义(P>0.05)。结论:对于超高龄髋部骨折患者,人工双极头置换是一种很好的选择,个体化ERAS围手术期管理方案能显著减轻术后疼痛、降低术后并发症发生率、改善术后功能、缩短住院时间,降低住院期间病死率。展开更多
基金supported by a grant from Shanghai Pudong New Area(PWZxkq2011-01)
文摘BACKGROUND:The present study aimed to explore the relationship between surgical methods,hemorrhage position,hemorrhage volume,surgical timing and treatment outcome of hypertensive intracerebral hemorrhage(HICH).METHODS:A total of 1 310 patients,who had been admitted to six hospitals from January 2004 to January 2008,were divided into six groups according to different surgical methods:craniotomy through bone fl ap(group A),craniotomy through a small bone window(group B),stereotactic drilling drainage(group C1 and group C2),neuron-endoscopy operation(group D) and external ventricular drainage(group E) in consideration of hemorrhage position,hemorrhage volume and clinical practice. A retrospective analysis was made of surgical timing and curative effect of the surgical methods.RESULTS:The effectiveness rate of the methods was 74.12% for 1 310 patients after onemonth follow-up. In this series,the disability rate was 44.82% 3–6 months after the operation. Among the 1 310 patients,241(18.40%) patients died after the operation. If hematoma volume was >80 mL and the operation was performed within 3 hours,the mortality rate of group A was signifi cantly lower than that of groups B,C,D,and E(P<0.05). If hematoma volume was 50–80 mL and the operation was performed within 6–12 hours,the mortality rate of groups B and D was lower than that of groups A,C and E(P<0.05). If hematoma volume was 20–50 mL and the operation was performed within 6–24 hours,the mortality rate of group C was lower than that of groups A,B and D(P<0.05).CONCLUSIONS:Craniotomy through a bone f lap is suitable for patients with a large hematoma and hernia of the brain. Stereotactic drilling drainage is suggested for patients with hematoma volume less than 80 mL. The curative effect of HICH individualized treatment would be improved via the suitable selection of operation time and surgical method according to the position and volume of hemorrhage.
文摘In China interventional therapy of liver cancer started in the 1980s. It is well-known that Professor Lin Gui is the founding father of Interventional radiology. Under the leadership of Lin Gui and other professors, interventional therapy of liver cancer has swiftly progressed in China. Indeed, TAI, TAE, TACE and ablation therapy have witnessed great innovations in hardware facil ities, technical means, and therapeutic philosophy, while incorporating Chinese characteristics. As with the development of combined interventional therapy in China, interventional treatment of liver cancer has gradually started the process of precision and individualization. Actually, multidisciplinary, multimodal, and polymorphic treatments will be the most suitable pattern for liver cancer in the future, among which combination of interventional therapy with targeted, immunological treatments and information technology(IT) tools may bring a revolutionary breakthrough in liver cancer treatment.
文摘目的:探讨快速康复理念(enhanced recovery after surgery,ERAS)个体化围手术期管理方案对超高龄髋部骨折这一特殊类型患者的应用价值。方法:将湘潭市中心医院骨科2016年1月1日至2018年1月1日期间外伤致髋部骨折并行人工双极头置换手术的43例超高龄(≥90岁)患者(股骨颈骨折及转子间骨折)分为ERAS组(n=25)和常规组(n=18)。ERAS组股骨颈骨折12例,转子间骨折13例,在ERAS个体化干预下行手术治疗;常规组股骨颈骨折8例,转子间骨折10例,常规手术治疗。比较两组术后疼痛(VAS评分)、并发症发生率、住院期间病死率及髋关节功能状态(Harris功能评分)及平均住院时间,随访并比较两组出院后3,6,12个月的病死率及髋关节功能状态。结果:ERAS组术后第1,3,7天VAS评分明显低于常规组(P<0.05);ERAS组25例患者住院期间无死亡,1例术后出现肺部感染,1例术后出现胃肠道反应;而常规组住院期间死亡3例,1例出现深静脉血栓,2例出现肺部感染,2例术后出现胃肠道反应。住院期间ERAS组病死率及并发症发生率明显低于常规组;ERAS组住院时间为(14.13±2.55)d,明显低于常规组手术组(25.13±3.68)d,差异均有统计学意义(P<0.05)。ERAS组出院当天及出院后第3个月髋关节Harris功能评分显著高于常规手术组(P<0.05),但出院后第6,12个月差异无统计学意义(P>0.05)。术后随访3,6,12个月两组新增病死率差异无统计学意义(P>0.05)。结论:对于超高龄髋部骨折患者,人工双极头置换是一种很好的选择,个体化ERAS围手术期管理方案能显著减轻术后疼痛、降低术后并发症发生率、改善术后功能、缩短住院时间,降低住院期间病死率。
