目的:探讨蛛网膜囊肿合并慢性硬膜下血肿的临床特点与外科治疗方法。方法:回顾分析苏州大学附属第一医院神经外科及伊犁医院自2021年1月至2024年3月收治蛛网膜囊肿合并慢性硬膜下血肿患者3例,其中1例患者行开颅囊肿剥除 + 硬膜下血肿清...目的:探讨蛛网膜囊肿合并慢性硬膜下血肿的临床特点与外科治疗方法。方法:回顾分析苏州大学附属第一医院神经外科及伊犁医院自2021年1月至2024年3月收治蛛网膜囊肿合并慢性硬膜下血肿患者3例,其中1例患者行开颅囊肿剥除 + 硬膜下血肿清除术,另1例患者行神经内镜下囊肿切除 + 硬膜下血肿清除术,最后1例患者行单侧硬膜下血肿钻孔引流术。回顾性分析患者的临床资料和疗效,并且结合文献(对PubMed、Embase、Cochrane Library、Medline、中国知网、万方、维普等数据库进行系统的文献检索)进行总结。结果:选择硬膜下血肿钻孔引流术与神经内镜下囊肿切除 + 硬膜下血肿清除术的两例患者为儿童,术后随访2年,蛛网膜囊肿与血肿均无复发;1例行开颅囊肿剥除 + 硬膜下血肿清除术患者为青年男性,术后复查CT存在少量硬膜外血肿,经引流后,患者术后恢复良好。通过文献复习蛛网膜囊肿合并慢性硬膜下血肿的病人,总结其临床特征及外科治疗方法。IAC合并CSDH少见,通常发生于青年人,常发生于囊肿的同侧,外伤、剧烈运动是发生慢性硬膜下血肿的主要诱因;蛛网膜囊肿合并慢性硬膜下血肿患者的治疗一般选择钻孔引流术;对于囊肿或者血肿复发的患者,无需急于再次钻孔或者急于行针对囊肿的手术,可随访观察;对于出血前囊肿就有症状或者囊肿反复出血的患者,可以在血肿清除同时切除囊肿。结论:蛛网膜囊肿合并慢性硬膜下血肿患者的外科治疗包括钻孔引流术、神经内镜下囊肿切除 + 硬膜下血肿清除、显微镜下囊肿切除 + 硬膜下血肿清除,可以取得较好的手术疗效。Objective: To investigate the clinical characteristics and surgical treatment of arachnoid cyst combined with chronic subdural hematoma. Methods: Review analysis of the first affiliated hospital of Suzhou university neurosurgery and Yili hospital from January 2021 to March 2024 treated arachnoid cyst with chronic subdural hematoma 3 patients, including one patient with craniotomy cyst removal + subdural hematoma removal, another patient with nerve endoscopic cyst removal + subdural hematoma removal, the last one patient with unilateral subdural hematoma drilling drainage. The clinical data and efficacy of patients were retrospectively analyzed, and the literature (systematic literature search of PubMed, Embase, Cochrane Library, Medline, CNKI, CNER, Wanfang, VIP and other databases was conducted) was summarized. Results: Two patients with drilling and drainage of subdural hematoma and neuroendoscopic cyst removal + subdural hematoma removal were selected as children, with no arachnoid cyst or hematoma recurrence;The patient was a young man, and the patient recovered well after drainage. Patients with arachnoid cysts combined with chronic subdural hematoma were reviewed through the literature, and their clinical characteristics and surgical treatment methods were summarized. IAC with CSDH is rare, usually occurs in young people, often occurring in the same side of the cyst, trauma and strenuous exercise are the main cause of chronic subdural hematoma;arachnoid cyst patients with chronic subdural hematoma generally choose drilling drainage;for patients with cyst or hematoma recurrence, there is no need to drill again or cyst surgery, follow-up observation;for patients with the cyst symptoms or repeated bleeding before bleeding, the cyst can be removed from the hematoma at the same time. Conclusion: The surgical treatment of patients with arachnoid cyst combined with chronic subdural hematoma includes drilling and drainage, neuroendoscopic cyst removal and subdural hematoma removal, microscopic cyst removal and subdural hematoma removal, which can achieve good surgical effect.展开更多
背景:全球有超过10亿人患有偏头痛。外部联合枕神经和三叉神经神经刺激设备(eCOT-NS)正在开发作为偏头痛治疗手段。因此,我们进行了这项荟萃分析,以明确eCOT-NS设备的疗效和安全性。方法:两名研究者系统地检索了MEDLINE、ClinicalTrials...背景:全球有超过10亿人患有偏头痛。外部联合枕神经和三叉神经神经刺激设备(eCOT-NS)正在开发作为偏头痛治疗手段。因此,我们进行了这项荟萃分析,以明确eCOT-NS设备的疗效和安全性。方法:两名研究者系统地检索了MEDLINE、ClinicalTrials.gov、EMBASE和Cochrane临床试验中央注册(CENTRAL),寻找截至2024年10月25日已发表的相关文献。根据纳入标准筛选了符合条件的文章。采用风险比(RR)和95%置信区间(CI)评估结果。结果:共筛选出来自MEDLINE (n = 27)、EMBASE (n = 150)、Cochrane临床试验中央注册(CENTRAL) (n = 4)和ClinicalTrials.gov (n = 0)共181篇文章。eCOT-NS治疗组有16例(20.8%)患者报告发生不良事件(AEs),而安慰剂组有12例(13.8%)患者报告发生不良事件。eCOT-NS治疗组与安慰剂组在1小时、2小时和24小时无痛患者比例上,与基线相比,均显示出显著差异(1小时:RR = 2.94,P = 0.015;2小时:RR = 3.10,P Background: Globally, more than 1 billion people are suffering from migraines. An external combined occipital and trigeminal neurostimulation (eCOT-NS) device is being developed as a treatment for migraine. Therefore, we conducted this meta-analysis to clarify the effectiveness and safety of the eCOT-NS device. Methods: Two investigators systematically searched the MEDLINE, Clinical Trials.gov, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant articles published up to October 25, 2024. Articles were included following the inclusion criteria. Risk ratios (RR) and 95% confidence intervals (CI) were used to evaluate the results. Results: A total of 181 articles from MEDLINE (n = 27), EMBASE (n = 150), the Cochrane Central Register of Controlled Trials (CENTRAL) (n = 4), and Clinical Trials.gov (n = 0) were identified. 16 (20.8%) patients at the eCOT-NS treatment group and 12 (13.8%) patients at the sham group were reported to have AEs. A significant difference was found separately in the 1 h, 2 h, and 24 h pain-free subjects versus baseline between the eCOT-NS treatment group and the sham group (RR = 2.94, P = 0.015;RR = 3.10, P < 0.001;RR = 1.82, P = 0.001) and 1 h, 2 h, and 24 h in those with moderate to severe migraine at baseline (RR = 3.45, P = 0.021;RR = 4.51, P < 0.001;RR = 1.72, P = 0.011). Conclusion: Our meta-analysis demonstrated that eCOT-NS device is of great effectiveness and safety for patients with migraine. And the treatment is better for patients with moderate to severe migraine than the overall population.展开更多
目的:通过回顾和总结临床中选择微骨窗神经内镜清除血肿的脑出血病例,并与选择开颅血肿清除术的病例进行比较,分析神经内镜下脑血肿清除术在临床中的应用优势。方法:采用回顾性研究,分析苏州大学附属第一医院2022年10月至2024年10月共8...目的:通过回顾和总结临床中选择微骨窗神经内镜清除血肿的脑出血病例,并与选择开颅血肿清除术的病例进行比较,分析神经内镜下脑血肿清除术在临床中的应用优势。方法:采用回顾性研究,分析苏州大学附属第一医院2022年10月至2024年10月共80例脑出血患者的临床资料、手术过程、术后预后情况,将其分为观察组(n = 40例)和对照组(n = 40例),观察组实施微骨窗神经内镜脑血肿清除术,对照组采用传统开颅脑血肿清除术。比较两种术式的差异。选择2例临床中具备代表性的神经内镜脑血肿清除术的病例,展示该术式的优势。结果:纳入本次研究的患者共计80位,男性42位,女性38位,平均年龄50.2 ± 10.8岁。在年龄、性别、出血部位等基线资料上两组不具备显著性差异。观察组在手术耗时、骨窗大小、术中出血量、术后住院时间、术后并发症发生率均低于对照组(p 0.05)。结论:微骨窗神经内镜清除血肿治疗脑出血,是一种安全、高效、精确的微创术式,对于特定类型的脑出血患者明显改善其预后,值得推广。Objective: Through a review and synthesis of clinical cases involving the treatment of intracerebral hemorrhage with minimally invasive neuroendoscopic hematoma removal, and a comparative analysis with cases treated using traditional craniotomy for hematoma evacuation, the application advantages of neuroendoscopic hematoma removal in clinical practice are examined. Method: This study employed a retrospective approach to analyze the clinical data, surgical procedures, and postoperative outcomes of 80 patients with intracerebral hemorrhage treated at the Affiliated First Hospital of Soochow University from October 2022 to October 2024. These patients were divided into an observation group (n = 40) and a control group (n = 40). The observation group underwent minimally invasive neuroendoscopic hematoma removal via a small bone window, while the control group received traditional craniotomy for hematoma evacuation. The study aimed to compare the differences between these two surgical approaches. Two representative cases of neuroendoscopic hematoma evacuation from clinical practice are selected to demonstrate the advantages of this surgical approach. Result: A total of 80 patients were included in this study, comprising 42 males and 38 females with a mean age of 50.2 ± 10.8 years. There were no significant differences between the two groups in baseline characteristics such as age, gender, and site of hemorrhage. In the observation group, parameters such as operative time, bone flap size, intraoperative blood loss, postoperative hospital stay, and postoperative complication rates were all lower than those in the control group (p 0.05). Conclusion: Micro bone window neuroendoscopic removal of hematoma for cerebral hemorrhage is a safe, efficient and precise minimally invasive surgery, which significantly improves the prognosis of patients with specific subtypes of intracerebral hemorrhage. It merits broader clinical application.展开更多
文摘目的:探讨蛛网膜囊肿合并慢性硬膜下血肿的临床特点与外科治疗方法。方法:回顾分析苏州大学附属第一医院神经外科及伊犁医院自2021年1月至2024年3月收治蛛网膜囊肿合并慢性硬膜下血肿患者3例,其中1例患者行开颅囊肿剥除 + 硬膜下血肿清除术,另1例患者行神经内镜下囊肿切除 + 硬膜下血肿清除术,最后1例患者行单侧硬膜下血肿钻孔引流术。回顾性分析患者的临床资料和疗效,并且结合文献(对PubMed、Embase、Cochrane Library、Medline、中国知网、万方、维普等数据库进行系统的文献检索)进行总结。结果:选择硬膜下血肿钻孔引流术与神经内镜下囊肿切除 + 硬膜下血肿清除术的两例患者为儿童,术后随访2年,蛛网膜囊肿与血肿均无复发;1例行开颅囊肿剥除 + 硬膜下血肿清除术患者为青年男性,术后复查CT存在少量硬膜外血肿,经引流后,患者术后恢复良好。通过文献复习蛛网膜囊肿合并慢性硬膜下血肿的病人,总结其临床特征及外科治疗方法。IAC合并CSDH少见,通常发生于青年人,常发生于囊肿的同侧,外伤、剧烈运动是发生慢性硬膜下血肿的主要诱因;蛛网膜囊肿合并慢性硬膜下血肿患者的治疗一般选择钻孔引流术;对于囊肿或者血肿复发的患者,无需急于再次钻孔或者急于行针对囊肿的手术,可随访观察;对于出血前囊肿就有症状或者囊肿反复出血的患者,可以在血肿清除同时切除囊肿。结论:蛛网膜囊肿合并慢性硬膜下血肿患者的外科治疗包括钻孔引流术、神经内镜下囊肿切除 + 硬膜下血肿清除、显微镜下囊肿切除 + 硬膜下血肿清除,可以取得较好的手术疗效。Objective: To investigate the clinical characteristics and surgical treatment of arachnoid cyst combined with chronic subdural hematoma. Methods: Review analysis of the first affiliated hospital of Suzhou university neurosurgery and Yili hospital from January 2021 to March 2024 treated arachnoid cyst with chronic subdural hematoma 3 patients, including one patient with craniotomy cyst removal + subdural hematoma removal, another patient with nerve endoscopic cyst removal + subdural hematoma removal, the last one patient with unilateral subdural hematoma drilling drainage. The clinical data and efficacy of patients were retrospectively analyzed, and the literature (systematic literature search of PubMed, Embase, Cochrane Library, Medline, CNKI, CNER, Wanfang, VIP and other databases was conducted) was summarized. Results: Two patients with drilling and drainage of subdural hematoma and neuroendoscopic cyst removal + subdural hematoma removal were selected as children, with no arachnoid cyst or hematoma recurrence;The patient was a young man, and the patient recovered well after drainage. Patients with arachnoid cysts combined with chronic subdural hematoma were reviewed through the literature, and their clinical characteristics and surgical treatment methods were summarized. IAC with CSDH is rare, usually occurs in young people, often occurring in the same side of the cyst, trauma and strenuous exercise are the main cause of chronic subdural hematoma;arachnoid cyst patients with chronic subdural hematoma generally choose drilling drainage;for patients with cyst or hematoma recurrence, there is no need to drill again or cyst surgery, follow-up observation;for patients with the cyst symptoms or repeated bleeding before bleeding, the cyst can be removed from the hematoma at the same time. Conclusion: The surgical treatment of patients with arachnoid cyst combined with chronic subdural hematoma includes drilling and drainage, neuroendoscopic cyst removal and subdural hematoma removal, microscopic cyst removal and subdural hematoma removal, which can achieve good surgical effect.
文摘背景:全球有超过10亿人患有偏头痛。外部联合枕神经和三叉神经神经刺激设备(eCOT-NS)正在开发作为偏头痛治疗手段。因此,我们进行了这项荟萃分析,以明确eCOT-NS设备的疗效和安全性。方法:两名研究者系统地检索了MEDLINE、ClinicalTrials.gov、EMBASE和Cochrane临床试验中央注册(CENTRAL),寻找截至2024年10月25日已发表的相关文献。根据纳入标准筛选了符合条件的文章。采用风险比(RR)和95%置信区间(CI)评估结果。结果:共筛选出来自MEDLINE (n = 27)、EMBASE (n = 150)、Cochrane临床试验中央注册(CENTRAL) (n = 4)和ClinicalTrials.gov (n = 0)共181篇文章。eCOT-NS治疗组有16例(20.8%)患者报告发生不良事件(AEs),而安慰剂组有12例(13.8%)患者报告发生不良事件。eCOT-NS治疗组与安慰剂组在1小时、2小时和24小时无痛患者比例上,与基线相比,均显示出显著差异(1小时:RR = 2.94,P = 0.015;2小时:RR = 3.10,P Background: Globally, more than 1 billion people are suffering from migraines. An external combined occipital and trigeminal neurostimulation (eCOT-NS) device is being developed as a treatment for migraine. Therefore, we conducted this meta-analysis to clarify the effectiveness and safety of the eCOT-NS device. Methods: Two investigators systematically searched the MEDLINE, Clinical Trials.gov, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant articles published up to October 25, 2024. Articles were included following the inclusion criteria. Risk ratios (RR) and 95% confidence intervals (CI) were used to evaluate the results. Results: A total of 181 articles from MEDLINE (n = 27), EMBASE (n = 150), the Cochrane Central Register of Controlled Trials (CENTRAL) (n = 4), and Clinical Trials.gov (n = 0) were identified. 16 (20.8%) patients at the eCOT-NS treatment group and 12 (13.8%) patients at the sham group were reported to have AEs. A significant difference was found separately in the 1 h, 2 h, and 24 h pain-free subjects versus baseline between the eCOT-NS treatment group and the sham group (RR = 2.94, P = 0.015;RR = 3.10, P < 0.001;RR = 1.82, P = 0.001) and 1 h, 2 h, and 24 h in those with moderate to severe migraine at baseline (RR = 3.45, P = 0.021;RR = 4.51, P < 0.001;RR = 1.72, P = 0.011). Conclusion: Our meta-analysis demonstrated that eCOT-NS device is of great effectiveness and safety for patients with migraine. And the treatment is better for patients with moderate to severe migraine than the overall population.
文摘目的:通过回顾和总结临床中选择微骨窗神经内镜清除血肿的脑出血病例,并与选择开颅血肿清除术的病例进行比较,分析神经内镜下脑血肿清除术在临床中的应用优势。方法:采用回顾性研究,分析苏州大学附属第一医院2022年10月至2024年10月共80例脑出血患者的临床资料、手术过程、术后预后情况,将其分为观察组(n = 40例)和对照组(n = 40例),观察组实施微骨窗神经内镜脑血肿清除术,对照组采用传统开颅脑血肿清除术。比较两种术式的差异。选择2例临床中具备代表性的神经内镜脑血肿清除术的病例,展示该术式的优势。结果:纳入本次研究的患者共计80位,男性42位,女性38位,平均年龄50.2 ± 10.8岁。在年龄、性别、出血部位等基线资料上两组不具备显著性差异。观察组在手术耗时、骨窗大小、术中出血量、术后住院时间、术后并发症发生率均低于对照组(p 0.05)。结论:微骨窗神经内镜清除血肿治疗脑出血,是一种安全、高效、精确的微创术式,对于特定类型的脑出血患者明显改善其预后,值得推广。Objective: Through a review and synthesis of clinical cases involving the treatment of intracerebral hemorrhage with minimally invasive neuroendoscopic hematoma removal, and a comparative analysis with cases treated using traditional craniotomy for hematoma evacuation, the application advantages of neuroendoscopic hematoma removal in clinical practice are examined. Method: This study employed a retrospective approach to analyze the clinical data, surgical procedures, and postoperative outcomes of 80 patients with intracerebral hemorrhage treated at the Affiliated First Hospital of Soochow University from October 2022 to October 2024. These patients were divided into an observation group (n = 40) and a control group (n = 40). The observation group underwent minimally invasive neuroendoscopic hematoma removal via a small bone window, while the control group received traditional craniotomy for hematoma evacuation. The study aimed to compare the differences between these two surgical approaches. Two representative cases of neuroendoscopic hematoma evacuation from clinical practice are selected to demonstrate the advantages of this surgical approach. Result: A total of 80 patients were included in this study, comprising 42 males and 38 females with a mean age of 50.2 ± 10.8 years. There were no significant differences between the two groups in baseline characteristics such as age, gender, and site of hemorrhage. In the observation group, parameters such as operative time, bone flap size, intraoperative blood loss, postoperative hospital stay, and postoperative complication rates were all lower than those in the control group (p 0.05). Conclusion: Micro bone window neuroendoscopic removal of hematoma for cerebral hemorrhage is a safe, efficient and precise minimally invasive surgery, which significantly improves the prognosis of patients with specific subtypes of intracerebral hemorrhage. It merits broader clinical application.
