目的探讨血必净配合经皮肝胆道穿刺引流术(Percutaneous Transhepatic Cholangial Drainage,PTCD)治疗急性重症胆管炎(Acute Cholangitis of Severe Type,ACST)临床疗效。方法回顾性选取2019年1月-2020年12月湛江中心人民医院收治的103...目的探讨血必净配合经皮肝胆道穿刺引流术(Percutaneous Transhepatic Cholangial Drainage,PTCD)治疗急性重症胆管炎(Acute Cholangitis of Severe Type,ACST)临床疗效。方法回顾性选取2019年1月-2020年12月湛江中心人民医院收治的103例ACST患者的临床资料,按不同治疗方案分为4组:PTCD+抗菌素+血必净组31例、PTCD+抗菌素组25例、抗菌素+血必净组25例、单纯抗菌素组22例。观察各组患者治疗前后血清白细胞(White Blood Cells,WBC)、血小板(Platelets,PLT)、降钙素原(Procalcitonin,PCT)、C反应蛋白(Creactive Protein,CRP)、总胆红素(Total Bilirubin,TBIL)、住院时间等相关指标变化,并比较各组患者的疗效,从而进一步探讨血必净治疗ACST的临床意义。结果治疗前,4组ACST患者血清WBC、PLT、PCT、CRP及TBIL各项指标比较,差异无统计学意义(P均>0.05)。治疗后4组患者的TBIL、PCT、CRP比较,差异有统计学意义(P均<0.05),其中PTCD+抗菌素+血必净组患者的TBIL平均(23.3±12.9)μmol/L、PCT平均(3.4±1.8)ng/L和CRP平均(16.6±7.3)mg/L,较其余3组均显著降低,差异有统计学意义(P均<0.05)。治疗后4组患者的血清WBC、PLT比较,差异无统计学意义(P均>0.05)。单纯抗菌素组平均住院(7.1±2.0)d,较其余3组显著减少,差异有统计学意义(P<0.05)。4组疗效比较,差异有统计学意义(P<0.05),其中PTCD+抗菌素组及PTCD+抗菌素+血必净组的总有效率更高。结论血必净配合PTCD能明显缓解ACST患者的病情,血必净对促进病情恢复具有积极的临床意义。展开更多
高血压脑出血是(hypertensive intracerebral hemorrhage, HICH)神经外科较常见的危急重症,其多发于丘脑、基底节区等部位,有较高的致死率和致残率;目前,微创穿刺引流术因手术创伤小且预后良好在我国HICH治疗中应用广泛,随着医学技术不...高血压脑出血是(hypertensive intracerebral hemorrhage, HICH)神经外科较常见的危急重症,其多发于丘脑、基底节区等部位,有较高的致死率和致残率;目前,微创穿刺引流术因手术创伤小且预后良好在我国HICH治疗中应用广泛,随着医学技术不断发展,目前追求微创、精准、简单、快捷的手术方式,神经导航在高血压脑出血中能精准定位血肿部位和边界,规划手术路线,从而减少手术创伤,在外科手术中应用广泛,本文对神经导航在高血压基底节区脑出血微创穿刺引流进行综述。Hypertensive intracerebral hemorrhage (HICH) is a common critical condition in neurosurgery. It is mostly located in thalamus, basal ganglia, and has a high mortality and disability rate. At present, minimally invasive puncture and drainage is widely used in the treatment of HICH in China due to low surgical trauma and good prognosis. With the continuous development of medical technology, minimally invasive, accurate, simple and fast surgical methods are currently pursued. Neuronavigation can accurately locate the site and boundary of hematoma in hypertensive cerebral hemorrhage and plan surgical routes, thus reducing surgical trauma, and is widely used in surgical operations. This article reviews the minimally invasive puncture drainage of neuronavigation in hypertensive basal ganglia cerebral hemorrhage.展开更多
文摘高血压脑出血是(hypertensive intracerebral hemorrhage, HICH)神经外科较常见的危急重症,其多发于丘脑、基底节区等部位,有较高的致死率和致残率;目前,微创穿刺引流术因手术创伤小且预后良好在我国HICH治疗中应用广泛,随着医学技术不断发展,目前追求微创、精准、简单、快捷的手术方式,神经导航在高血压脑出血中能精准定位血肿部位和边界,规划手术路线,从而减少手术创伤,在外科手术中应用广泛,本文对神经导航在高血压基底节区脑出血微创穿刺引流进行综述。Hypertensive intracerebral hemorrhage (HICH) is a common critical condition in neurosurgery. It is mostly located in thalamus, basal ganglia, and has a high mortality and disability rate. At present, minimally invasive puncture and drainage is widely used in the treatment of HICH in China due to low surgical trauma and good prognosis. With the continuous development of medical technology, minimally invasive, accurate, simple and fast surgical methods are currently pursued. Neuronavigation can accurately locate the site and boundary of hematoma in hypertensive cerebral hemorrhage and plan surgical routes, thus reducing surgical trauma, and is widely used in surgical operations. This article reviews the minimally invasive puncture drainage of neuronavigation in hypertensive basal ganglia cerebral hemorrhage.
