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Zhang L, Shen T, Zhou Y, Xie X, Wang J, Gao H. Multidisciplinary management based on clinical nursing pathway model for the treatment of hypertensive intracerebral hemorrhage: A randomized controlled trial. Medicine (Baltimore) 2024; 103:e37644. [PMID: 38517993 PMCID: PMC10956948 DOI: 10.1097/md.0000000000037644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/23/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVE To explore the effectiveness of multidisciplinary management based on a clinical nursing pathway model for the treatment of hypertensive intracerebral hemorrhage (HICH). METHODS A total of 124 patients with HICH admitted to our hospital between February 2021 and June 2023 were selected as research subjects in this randomized, controlled, unblinded study. They were divided into Control-group and Study-group using a random number table method, with 62 cases in each group. The Control-group received routine care and the Study-group adopted a multidisciplinary management approach based on the clinical nursing pathway model. A multidisciplinary intervention group including 1 attending physician, 1 psychotherapist, 1 nutritionist, 1 rehabilitation specialist, and 4 responsible nurses was constructed. From preoperative to postoperative day, patients were provided with psychological intervention, health education, respiratory tract management, and specific care for patients who were restless. One to 3 days after operation, the patients and their family members were guided in basic postoperative care and nutrition care. From the 4th day after surgery to the 1st day before discharge, patients were guided for rehabilitation exercises. Patients also received discharge advices upon discharge. Activities of daily living, neurological function, stress response indicators, incidence of complications, and nursing satisfaction before and after the intervention were compared between the 2 groups. RESULTS After the intervention, the activities of daily living and neurological function of the 2 groups were significantly improved compared to before the intervention, and the Study-group was significantly higher than the Control-group (P < .05). After intervention, the levels of stress response indicators in both groups significantly decreased compared to before the intervention, and the Study-group was significantly lower than the Control-group (P < .05). The incidence of complications in the Study-group (3.23%) was lower than that in the Control-group (15.00%) (P < .05). Nursing satisfaction in the Study-group (95.16%) was higher than that in the Control-group (83.33%) (P < .05). CONCLUSIONS Our findings indicate that adopting a multidisciplinary management approach based on clinical nursing pathways to intervene in patients with HICH can reduce stress response levels, reduce the risk of complications, and facilitate the recovery of neurological function and activities of daily living with high patient satisfaction.
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Affiliation(s)
- Lan Zhang
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Tingting Shen
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Yan Zhou
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Xing Xie
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Jing Wang
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Haixiao Gao
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
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Zhang CY, Wang B, Hua XT, Fan K, Li YF. Serum vascular endothelial growth factor and cortisol expression to predict prognosis of patients with hypertensive cerebral hemorrhage. World J Clin Cases 2023; 11:5455-5461. [PMID: 37637696 PMCID: PMC10450374 DOI: 10.12998/wjcc.v11.i23.5455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/26/2023] [Accepted: 07/14/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Cerebral hemorrhage is a common and severe complication of hypertension in middle-aged and elderly men. AIM To investigate the correlation between vascular endothelial growth factor (VEGF) and cortisol (Cor) and the prognosis of patients with hypertensive cerebral hemorrhage. METHODS A hundred patients with hypertensive intracerebral hemorrhage were enrolled from January 2020 to December 2022 and assigned to the hypertensive intracerebral hemorrhage group. Another 100 healthy people who were examined at our hospital during the same period were selected and assigned to the healthy group. Peripheral venous blood was collected, and serum Cor and VGEF levels were measured through enzyme linked immunosorbent assay. RESULTS A statistically significant difference in serum Cor and VGEF levels was observed among patients with varying degrees of neurological impairment (P < 0.05). Serum Cor and VGEF levels were significantly higher in the severe group than in the mild-to-moderate group. Cor and VEGF levels were significantly higher in patients with poor prognoses than in those with good prognoses. Multiple logistic regression analysis revealed that serum Cor and VGEF levels were independent factors affecting hypertensive intracerebral hemorrhage (P < 0.05). CONCLUSION Cor and VGEF are associated with the occurrence and development of hypertensive cerebral hemorrhage and are significantly associated with neurological impairment and prognosis of patients.
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Affiliation(s)
- Chao-Yong Zhang
- Department of Neurosurgery, Taihe Hospital Affiliated to Wannan Medical College, Taihe County People’s Hospital, Fuyang 236600, Anhui Province, China
| | - Bin Wang
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
| | - Xiang-Ting Hua
- Department of Neurosurgery, Taihe Hospital Affiliated to Wannan Medical College, Taihe County People’s Hospital, Fuyang 236600, Anhui Province, China
| | - Kui Fan
- Department of Neurosurgery, Taihe Hospital Affiliated to Wannan Medical College, Taihe County People’s Hospital, Fuyang 236600, Anhui Province, China
| | - Yu-Feng Li
- Department of Neurosurgery, Taihe Hospital Affiliated to Wannan Medical College, Taihe County People’s Hospital, Fuyang 236600, Anhui Province, China
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Xu H, Hu X, Wang W, Chen H, Yu F, Zhang X, Zheng W, Han K. Clinical Application and Evaluation of Metagenomic Next-Generation Sequencing in Pulmonary Infection with Pleural Effusion. Infect Drug Resist 2022; 15:2813-2824. [PMID: 35677528 PMCID: PMC9167844 DOI: 10.2147/idr.s365757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/27/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Huifen Xu
- Department of Respiratory and Critical Medicine, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Xiaoman Hu
- Department of Respiratory and Critical Medicine, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Wenyu Wang
- Department of Respiratory and Critical Medicine, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Hong Chen
- Department of Respiratory and Critical Medicine, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Fangfei Yu
- Department of Respiratory and Critical Medicine, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Xiaofei Zhang
- Department of Respiratory and Critical Medicine, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Weili Zheng
- Department of Respiratory and Critical Medicine, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Kaiyu Han
- Department of Respiratory and Critical Medicine, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, People’s Republic of China
- Correspondence: Kaiyu Han, Tel +86-451-86605736, Email
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Wu J, Zhang S. Analysis of the Therapeutic Effect and Prognostic Factors of 126 Patients With Hypertensive Cerebral Hemorrhage Treated by Soft-Channel Minimally Invasive Puncture and Drainage. Front Surg 2022; 9:885580. [PMID: 35574537 PMCID: PMC9098988 DOI: 10.3389/fsurg.2022.885580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Surgery is the main method for the clinical treatment of hypertensive cerebral hemorrhage. Traditional craniotomy faces the disadvantages of the long operation time, easy to cause secondary injury to patients during the operation, and prone to infection after the operation, which is not conducive to the rehabilitation of patients. At present, it is urgent to find a surgical scheme, which can clear hematoma in time, protect brain tissue, and effectively reduce surgical trauma in the clinic. Materials and Methods The case database of our hospital was consulted, and the clinical data of patients with hypertensive intracerebral hemorrhage (HICH) treated with soft channel minimally invasive puncture and drainage from February 2018 to October 2021 were retrospectively analyzed. Patients were evaluated for efficacy, and the changes in serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), homocysteine (Hcy), endothelin (ET), and vasopressin (AVP) levels before surgery, 3 days after surgery, and 7 days after surgery were analyzed. Clinical data were collected and Logistic regression was used to analyze the prognostic factors. Results Finally, according to the inclusion and exclusion criteria, 126 patients were selected as the research object. Among them, there were 24 cases (19.05%) of recovery, 47 cases (37.30%) of markedly effective, 34 cases (26.98%) of effective, 11 cases (8.73%) of ineffective, and 10 cases (7.94%) of death. The total effective rate was 83.33%. The hematoma was basically removed in 116 cases (92.06%). The average evacuation time of hematoma was (7.82 ± 1.63) days. Post-operative intracranial infection occurred in 2 cases (1.59%) and post-operative rebleeding occurred in 5 cases (3.97%). The average hospital stay was (34.16 ± 16.59) days. Serum CRP, TNF-α, IL-6, Hcy, ET, and AVP levels of all patients on the third and seventh days after surgery were lower than those before surgery, and those on the seventh day after surgery were lower than those on the third day after surgery (p < 0.05). The differences in pre-operative Glasgow Coma Scale (GCS) score, bleeding volume, ventricular rupture, complicated cerebral hernia, and attack time to surgery between the good prognosis group and the bad prognosis group were statistically significant (p < 0.05). Pre-operative GCS score, bleeding volume, ventricular rupture, complicated cerebral hernia, and onset time to surgery were all independent factors that affect the prognosis of patients (p < 0.05). Conclusion Soft-channel minimally invasive puncture and drainage treatment of HICH has a significant effect, which is conducive to the complete removal of hematoma, reducing hospitalization time, while adjusting the balance and stability of various cytokines, and improving patient prognosis. Pre-operative GCS score, bleeding volume, rupture into the ventricle, complicated cerebral hernia, and time from onset to operation are all independent factors that affect the prognosis of patients.
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Wang W, Lv W, Yang J. Analysis of Efficacy and Safety of Modified Transfrontal Puncture Drainage in Hypertensive Basal Ganglia Hemorrhage Patients. Front Surg 2022; 9:837008. [PMID: 35425803 PMCID: PMC9001930 DOI: 10.3389/fsurg.2022.837008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe study aimed to explore the efficacy and safety of modified transfrontal puncture drainage in patients with hypertensive basal ganglia hemorrhage.MethodsThe study enrolled 102 patients with hypertensive basal ganglia hemorrhage who received treatment at our hospital between April 2020 and June 2020. They were divided into a control group (51 cases, burr hole evacuation of intracranial hematoma) and a study group (51 cases, modified transfrontal puncture drainage) using the random number table method. The operative time, hematoma evacuation rate, time to recovery of consciousness, postoperative Glasgow coma scales (GOS), and the length of hospital stay were compared between the two groups. The postoperative recovery of neurological function in the two groups was observed, and activities of daily living at 3 months postoperatively in the two groups were statistically analyzed. The postoperative complications and recurrent bleeding, as well as prognosis in the two groups, were recorded.ResultsThe operative time, hematoma evacuation rate, time to recovery of consciousness, postoperative GOS scores, time to extubation, and the length of hospital stay of the two groups were compared postoperatively, and the difference was statistically significant (p < 0.05). The preoperative neurological function of the two groups was compared, and the difference was statistically insignificant (P > 0.05). The postoperative neurological function of the study group was lower than that of the control group, and the difference was statistically significant (P < 0.05). The postoperative incidence of stress ulcer, renal failure, and recurrent bleeding in the two groups was compared, and the difference was statistically insignificant (p > 0.05). The rate of pulmonary infections and gastrointestinal bleeding in the study group was lower than that of the control group, and the difference was statistically significant (P < 0.05). The mortality rate of the study group was 1.96% (1/51) and that of the control group was 3.92% (2/51), and the difference was statistically insignificant (p > 0.05). The activities of daily living in the two groups were compared and the difference was statistically insignificant (p > 0.05).ConclusionModified transfrontal puncture drainage can effectively treat hypertensive basal ganglia hemorrhage patients and has relatively good safety.
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Affiliation(s)
- Wenxin Wang
- Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Wei Lv
- Department of Neurosurgery, Wuhan Asia General Hospital, Wuhan, China
| | - Jianquan Yang
- Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, China
- *Correspondence: Jianquan Yang
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Shi J, Zhao G, Liu P, Bai Y, Chen Y. Effects of Dexmedetomidine Combined with Intravenous Anesthesia on Oxidative Stress Index, Postoperative Sleep Quality, and Brain Function in HICH Patients. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:5463986. [PMID: 35345654 PMCID: PMC8957430 DOI: 10.1155/2022/5463986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/06/2022] [Accepted: 02/15/2022] [Indexed: 11/17/2022]
Abstract
To investigate the effects of dexmedetomidine combined with intravenous anesthesia on oxidative emergency indicators, postoperative sleep quality, and brain function in patients with hypertensive cerebral hemorrhage (HICH), a total of 285 HICH patients admitted to our hospital from February 2020 to February 2021 were selected. The combined anesthesia group (n = 142) and the control group (n = 143) were established by the random number table method. The control group received conventional intravenous anesthesia, and the combined anesthesia group received dexmedetomidine combined intravenous anesthesia. Two groups of patients before and after operation was observed vital signs, oxidative stress index difference, comparing each time, the change of the two groups of brain function index, adverse reactions occurred between observation group, and the postoperative period of Pittsburgh Sleep Quality Index Scale (PSQI) score as a result, the Pearson correlation coefficient analysis of oxidative stress level and the correlation of HICH patients sleep quality. After operation, the mean arterial pressure (MAP) and heart rate (HR) of patients in both groups decreased significantly. The MAP level in the combined anesthesia group significantly increased compared to the control group, and the HR level decreased significantly than the control group (all P < 0.05). The levels of TNF-α, IL-6 and MDA in both groups increased significantly on day 7 after operation compared with before operation, but the indexes in the combined anesthesia group significantly decreased compared with the control group (P < 0.05). The level of superoxide dismutase (SOD) in both groups significantly decreased compared to that before operation, and the index value in combined anesthesia group significantly increased compared to that in the control group (P < 0.05). After surgery, the levels of central nerve specific protein (S100-β) and neuron specific enolase (NSE) in 2 groups increased with time, and the indexes in the combined anesthesia group significantly decreased compared to the control group (all P < 0.05). The incidence of adr in combined anesthesia group decreased significantly than that in control group (P < 0.05). After surgery, PSQI scores of the two groups showed a downward trend with time extension, and scores of the combined anesthesia group decreased significantly than those of the control group at 24 h, 48 h and 7 d after surgery (all P < 0.05). Pearson's correlation coefficient was used to analyze that TNF-α, IL-6, and MDA levels were positively correlated with PSQI score, while SOD level was negatively correlated with PSQI score (all P < 0.05). Dexmedetomidine combined with intravenous anesthesia can significantly improve the vital signs and oxidative stress response of HICH patients, effectively reduce the risk of adverse reactions, have little impact on the brain function of patients, and can improve the postoperative sleep quality of patients. This operation is worthy of clinical application. In addition, this study further analyzed the influence mechanism of postoperative sleep quality in patients with HICH and showed that TNF-α, IL-6, MDA, and SOD were all correlated with sleep quality in patients with HICH, suggesting that follow-up detection of these indicators has positive significance in improving the prognosis of patients.
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Affiliation(s)
- Jiong Shi
- Anesthesiology Department, Handan Central Hospital, Handan 056001, China
| | - Guangping Zhao
- Anesthesiology Department, Handan Central Hospital, Handan 056001, China
| | - Panpan Liu
- Anesthesiology Department, Handan Central Hospital, Handan 056001, China
| | - Yuwei Bai
- Anesthesiology Department, Handan Central Hospital, Handan 056001, China
| | - Yongxue Chen
- Anesthesiology Department, Handan Central Hospital, Handan 056001, China
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Epidemiology and prediction of multidrug-resistant bacteria based on hospital level. J Glob Antimicrob Resist 2022; 29:155-162. [DOI: 10.1016/j.jgar.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/23/2022] [Accepted: 03/05/2022] [Indexed: 11/18/2022] Open
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Zheng P, Wang J, Ma Y, Xu J, Zhu Q. Analysis of the Effect of Cluster Nursing in Postoperative Hypertensive Cerebral Hemorrhage. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:3448979. [PMID: 34900183 PMCID: PMC8660208 DOI: 10.1155/2021/3448979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 11/18/2022]
Abstract
Hypertensive intracerebral hemorrhage is a common condition in clinic. Due to the improvement of minimally invasive technology, its therapeutic effect is good, but there are still postoperative complications. The corresponding routine nursing intervention is not effective in the rehabilitation of postoperative patients with hypertensive intracerebral hemorrhage. In this paper, cluster nursing was applied to the treatment of postoperative patients with hypertensive intracerebral hemorrhage. For this purpose, a retrospective study or experiment was conducted on 150 patients with hypertensive intracerebral hemorrhage in the hospital specifically from January 2019 to December 2020. According to the nursing strategy, patients were divided into experimental (n = 75) and control groups (n = 75), respectively. The control group adopted routine nursing mode, whereas the experimental group adopted cluster nursing mode. The treatment compliance of patients in the experimental group was 86.67%, while that in the control group was 73.33% (P < 0.05). The total incidence of postoperative complications in the experimental group was 3.2%, which was lower than 25% in the control group (P < 0.05). The motor function score of the experimental group was better than that of the control group (P < 0.05). The application of cluster nursing in postoperative patients with hypertensive intracerebral hemorrhage is feasible, and its nursing effect is significant, which can not only reduce the incidence of postoperative complications but also improve patients' compliance and quality of life. It has good application value.
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Affiliation(s)
- Pingxia Zheng
- Department of Thoracic Surgery, Zhejiang Hospital, Hangzhou 310012, Zhejiang, China
| | - Jia Wang
- Brain Center, Zhejiang Hospital, Hangzhou 310012, Zhejiang, China
| | - Yan Ma
- Department of Thoracic Surgery, Zhejiang Hospital, Hangzhou 310012, Zhejiang, China
| | - Jingjing Xu
- Department of Thoracic Surgery, Zhejiang Hospital, Hangzhou 310012, Zhejiang, China
| | - Qianping Zhu
- Brain Center, Zhejiang Hospital, Hangzhou 310012, Zhejiang, China
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Wu C, Zhang Y, Yang L, Shen F, Ma C, Shen M. Effect of Capsaicin Atomization-Induced Cough on Sputum Excretion in Tracheotomized Patients After Hemorrhagic Stroke: A Randomized Controlled Trial. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4085-4095. [PMID: 34694869 DOI: 10.1044/2021_jslhr-21-00151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Timely and effective removal of respiratory secretions is of great significance for tracheotomized patients. The purpose of this study is to investigate the effectiveness of capsaicin nebulization to stimulate cough to promote early clearance of respiratory secretions in tracheotomized patients after hemorrhagic stroke. Method This study implemented a randomized controlled design. Sixty-three patients who were tracheotomized following a hemorrhagic stroke completed this randomized controlled trial. In the control group, 33 cases were given a routine care after tracheotomy. In the intervention group, 30 cases were given a capsaicin solution nebulization in addition to the routine care. The daily sputum output and the number of sputum suctioning were observed. The differences in sputum viscosity, cough function, and Clinical Pulmonary Infection Score (CPIS) were compared between the two groups before and after the intervention. Vital sign changes during capsaicin nebulization and suctioning were compared between the two groups in a pilot study. Results The daily sputum output of the capsaicin intervention group was significantly higher than that of the control group (p < .05). The number of sputum suctioning of capsaicin group was less than that of the control group after intervention (p < .05). The CPIS score of the capsaicin group was lower than that of the control group (p < .05) after a 1-week intervention. Patients' heart rate, respiratory rate, and oxygen saturation during capsaicin nebulization were not statistically different from those during routine sputum suctioning (p > .05). Conclusions Capsaicin atomization-induced cough can effectively promote sputum excretion of hemorrhagic stroke patients undergoing tracheotomy and has a good safety profile. The Clinical Trial registration number of this study is ChiCTR2000037772 (http://www.chictr.org.cns). Supplemental Material https://doi.org/10.23641/asha.16821352.
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Affiliation(s)
- Chao Wu
- Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yijie Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Li Yang
- Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fang Shen
- Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chen Ma
- Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meifen Shen
- Nursing Department, Dushu Lake Affiliated Hospital of Soochow University, Suzhou, China
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Ling M, Zhang Q, Zang L, Li X, Liu Q. Decompressive craniectomy can improve the recovery of neurological function, daily living ability and life quality of patients with intracerebral hemorrhage after surgery. Am J Transl Res 2021; 13:11364-11374. [PMID: 34786064 PMCID: PMC8581915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To determine the effect of decompressive craniectomy (DC) on the recovery of neurological function, daily living ability and life quality of patients with intracerebral hemorrhage (ICH) after surgery. METHODS Totally 290 patients with ICH admitted to our hospital from January 2018 to June 2020 were retrospectively enrolled and assigned to two groups according to different surgical methods. Among them, 138 patients who received craniotomy evacuation of hematoma (CEH) only were assigned to a control group (Con group), while the other 152 who received CEH combined with DC to a research group (Res group). The two groups were compared in the total effective rate, hematoma clearance rate, and complication rate. Additionally, the ICP and MMP-9 levels after surgery, National Institutes of Health Stroke Scale (NIHSS), activities of daily living (ADL), Fugl-Meyer Assessment of motor function (FMA), Glasgow outcome scale (GOS), Glasgow coma scale (GCS), and MOS 36-Item Short-Form Health Survey (SF-36) scores before and after surgery were also compared between the two groups. RESULTS After treatment, the Res group showed a notably higher total effective rate, hematoma clearance rate, and a notably lower complication rate than the Con group. On postoperative day 3 and 7, the Res group showed notably lower ICP than the Con group, and on postoperative day 7, the Res group showed a notably lower MMP-9 level as compared with the Con group. Additionally, 6 months after the surgery, the Res group got notably lower NIHSS scores and higher ADL, GOS, and SF-36 scores as compared with the Con group, and at 1 month after surgery, the Res group got notably higher FMA scores as compared to the Con group. Moreover, on postoperative day 7, the Res group got notably higher GCS scores than the Con group. CONCLUSION DC can improve the recovery of neurological function, daily living ability and life quality of patients with ICH after surgery.
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Affiliation(s)
- Min Ling
- Deapartment of Neurosurgery, Xiangya Hospital, Central South UniversityChangsha 410013, China
| | - Qilei Zhang
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South UniversityChangsha 410013, China
| | - Longjun Zang
- Department of Hepatopancreatobiliary Surgery, Third Xiangya Hospital, Central South UniversityChangsha 410013, China
| | - Xuan’an Li
- Department of Orthopedics, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityChangsha 410013, China
| | - Qing Liu
- Deapartment of Neurosurgery, Xiangya Hospital, Central South UniversityChangsha 410013, China
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Ma J, Wang M, Zhao X, Chen D, Wang F, Wang L, Han J. Nursing intervention of patients with pulmonary infection after tracheotomy in intensive care unit. Minerva Surg 2021; 77:306-308. [PMID: 34472774 DOI: 10.23736/s2724-5691.21.09038-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jiajia Ma
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Minna Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xuan Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dongli Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fang Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lijuan Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juan Han
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China -
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Wang Y, Yao W, Wang L, Xv D. The effect of butylphthalide injection on the cognitive function and the TLRs/NF-κB pathway in hypertensive intracerebral hemorrhage. Am J Transl Res 2021; 13:9578-9585. [PMID: 34540081 PMCID: PMC8430162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study explored and analyzed the effects of butylphthalide injection on the cognitive function and on the TLRs/NF-κB pathway in hypertensive intracerebral hemorrhage patients. METHODS A total of 115 patients admitted to our hospital with hypertensive intracerebral hemorrhages were recruited as the study cohort and randomly placed in the observation group (n=60) or the control group (n=55). In addition to the routine treatment administered in both groups, the control group was additionally administered oral nimodipine tablets, and the observation group was administered intravenous butylphthalide injections. Both groups were treated continuously for 14 days. Subsequently, the changes in the clinical efficacy, the NIHSS scores, the extremity motor function, the Fugl-Meyer scores, the blood-brain barrier (BBB) and the peripheral blood mononuclear cells (PBMCs), the TLR2, TLR9, and the NF-κB mRNA levels in the two groups before and after the treatment were compared, and any adverse reactions were observed. RESULTS The total effective rate in the observation group was significantly superior to the total effective rate in the control group (P<0.05). The post-treatment NIHSS scores in the two groups were dramatically lower (P<0.05), and the post-treatment scores in the observation group were significantly lower than they were in the control group (P<0.05). The post-treatment cerebral spinal fluid (CSF) albumin and BBB indexes in the two groups were decreased significantly compared to their pre-treatment levels (P<0.05), and the post-treatment indexes in the observation group were significantly lower than the post-treatment indexes in the control group (P<0.05). The post-treatment relative TLR2, TLR9, and NF-κB mRNA expressions in the two groups were apparently lower than their in pre-treatment levels (P<0.05), and the relative expressions in the observation group after the treatment were clearly lower than they were in the control group (P<0.05). CONCLUSION Butylphthalide injection has a high clinical efficacy in treating hypertensive intracerebral hemorrhages. The drug can effectively improve patients' cognitive functions, extremity motor functions, and BBB indexes, and its mechanism may connect with the expressive suppression of the TLRs/NF-κB signaling pathway. The treatment is safe and effective, so it is worthy of clinical promotion.
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Affiliation(s)
- Yuhui Wang
- Department of Pharmacy, People's Hospital of Anji Huzhou 313000, Zhejiang Province, China
| | - Wentao Yao
- Department of Pharmacy, People's Hospital of Anji Huzhou 313000, Zhejiang Province, China
| | - Li Wang
- Department of Pharmacy, People's Hospital of Anji Huzhou 313000, Zhejiang Province, China
| | - Dan Xv
- Department of Pharmacy, People's Hospital of Anji Huzhou 313000, Zhejiang Province, China
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