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Chen L, Yue Y, Luo P, Qu Y, Fang J, Xin C, Lv L, Luan J, Cheng Z, Yang Z, Sun Y. Clinical analysis of hyperbaric oxygen combined with subdural drilling and drainage in the management of subdural effusion type IV with intracranial infection in infant patients. Front Neurol 2024; 15:1340650. [PMID: 38469593 PMCID: PMC10925761 DOI: 10.3389/fneur.2024.1340650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/12/2024] [Indexed: 03/13/2024] Open
Abstract
Background To explore the therapeutic effect of hyperbaric oxygen combined with subdural drilling and drainage (SDD) on subdural effusion type IV with intracranial infection in infant patients. Methods This retrospective controlled study included 328 infant patients with subdural effusion type 4 with intracranial infection between January 2005 and January 2023. 178 patients were treated by hyperbaric oxygen combined with SDD (group A). 142 cases were treated with SDD (group B). 97 infants were only received hyperbaric oxygen (group C). Clinical outcomes, the control time of intracranial infection, complications, and the degree of brain re-expansion after 6 months of treatment were compared among the three groups. According to the comprehensive evaluation of treatment effectiveness and imaging results, it is divided into four levels: cured, significantly effective, improved, and ineffective. Results No patient died during follow-up. The three groups were similar regarding age, sex, the general information, and clinical symptoms (p > 0.05). All intracranial infections in the children were effectively controlled. There was no difference in infection control time between group A and group B, and there was no statistical significance. However, the control time of intracranial infection between the two groups was different from that of group C, which was statistically significant. Compared with group B and group C, the degree of brain re-expansion in group A has obvious advantages and significant differences. The effective rates of the three groups were 83.7%, 58.5%, and 56.7%, respectively. There were 28 cases of subcutaneous hydrops in group A and 22 cases of subcutaneous hydrops in group B after operation, and no other serious complications. Conclusion The SDD is safe and effective for infant patients with intracranial infections through fluid replacement and intrathecal antibacterial. Hyperbaric oxygen is effective as an adjuvant therapy to promote brain re-expansion.
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Affiliation(s)
- Liuyin Chen
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Yanke Yue
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Pengyuan Luo
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Yi Qu
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Jiangshun Fang
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Chaojun Xin
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Lige Lv
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Jimei Luan
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Zhenghai Cheng
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Zhiguo Yang
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
| | - Yaning Sun
- Department of Neurosurgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei, China
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Huang W, Zhou B, Li Y, Shao Y, Peng B, Jiang X, Xiang T. Effectiveness and Safety of Pressure Dressings on Reducing Subdural Effusion After Decompressive Craniectomy. Neuropsychiatr Dis Treat 2021; 17:3119-3125. [PMID: 34703231 PMCID: PMC8524178 DOI: 10.2147/ndt.s332653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Decompressive craniectomy as a treatment is often used in the rescue treatment of critically ill patients in neurosurgery; however, there are many complications after this operation. Subdural effusion is a common complication after decompressive craniectomy. Once it occurs, it can cause further problems for the patient. Therefore, the purpose of this study was to explore the safety and effectiveness of pressure dressings for subdural effusion after decompressive craniectomy. METHODS Patients who underwent decompressive craniectomy in our hospital from January 2016 to January 2021 were included in this study, and all patients were followed up for 6 months or more. After the operation, the patients were divided into two groups according to whether they received a pressure dressing or a traditional dressing. Subdural effusion, cerebrospinal fluid leakage, hydrocephalus and other complications were compared between the two groups, and the differences in hospital duration, cost and prognosis between the two groups were analyzed. RESULTS A total of 123 patients were included in this study. Among them, 62 patients chose pressure dressings, and 61 patients chose traditional dressings. The incidence of subdural effusion in the pressure dressing group was significantly lower than that in the traditional dressing group (P<0.05). There was no difference between the two groups in cerebrospinal fluid leakage and hydrocephalus (P > 0.05). In addition, the length of hospital stay and the total cost in the pressure dressing group were significantly lower (P<0.05). CONCLUSION Pressure dressing can effectively reduce the occurrence of subdural effusion after decompressive craniectomy, and it does not increase the occurrence of other cerebrospinal fluid-related complications.
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Affiliation(s)
- Wanyong Huang
- Department of Neurosurgery, People's Hospital of Guanghan City, Guanghan City, Sichuan Province, People's Republic of China
| | - Bo Zhou
- Department of Neurosurgery, People's Hospital of Guanghan City, Guanghan City, Sichuan Province, People's Republic of China
| | - Yingwei Li
- Department of Neurosurgery, People's Hospital of Guanghan City, Guanghan City, Sichuan Province, People's Republic of China
| | - Yuansheng Shao
- Department of Neurosurgery, People's Hospital of Guanghan City, Guanghan City, Sichuan Province, People's Republic of China
| | - Bo Peng
- Department of Neurosurgery, People's Hospital of Guanghan City, Guanghan City, Sichuan Province, People's Republic of China
| | - Xianchun Jiang
- Department of Neurosurgery, People's Hospital of Guanghan City, Guanghan City, Sichuan Province, People's Republic of China
| | - Tao Xiang
- Department of Neurosurgery, People's Hospital of Guanghan City, Guanghan City, Sichuan Province, People's Republic of China
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