A Groove Technique for Securing an Electrode Connector on the Cranial Bone: Case Analysis of Efficacy

Objective

A groove technique for securing an electrode connector was described as an alternative surgical technique in deep brain stimulation (DBS) surgery to avoid electrode connector-related complications, such as skin erosion, infection, and migration.

Methods

We retrospectively reviewed 109 patients undergoing one of two techniques; the standard technique (52 patients using 104 electrodes) and the groove technique (57 patients using 109 electrodes) for securing the electrode connector in DBS surgery, regardless of patient disease. In the standard percutaneous tunneling technique, the connector was placed on the vertex of the cranial surface. The other technique, so called the groove technique, created a groove (about 4 cm long, 8 mm wide) in the cranial bone at the posterior parietal area. Wound erosion and migration related to the connectors were compared between the two techniques.

Results

The mean follow-up period was 73 months for the standard method and 46 months for the groove technique. Connector-related complications were observed in three patients with the groove technique and in seven patients with the standard technique. Wound erosion at the connector sites per electrode was one (0.9%) with the groove technique and six (5.8%) with the standard technique. This difference was statistically significant. The electrode connector was migrated in two patients with the groove technique and in one patient with the standard technique.

Conclusions

The groove technique, which involves securing an electrode using a groove in the cranial bone at the posterior parietal area, offers an effective and safe method to avoid electrode connector-related complications during DBS surgery.     

无针输液接头临床应用的最佳证据总结

目的 全面检索和分析无针输液接头临床应用相关证据,并对最佳证据进行总结。 方法 首先通过计算机检索循证资源数据库,包括BMJ最佳临床实践（British Medical Journal best practice）、Uptodate等源数据库;再补充检索中英文综合数据库,纳入2014年—2019年5月内容涉无针输液接头包括临床决策、证据总结、指南、专家共识类型的中英文相关文献,由3名研究者对相关文献进行独立质量评价,并结合专业判断对最终纳入文献进行标准化的资料提取。结果 共筛选证据13篇,包括1篇临床决策、5篇证据总结、5篇指南、2篇专家共识。汇总了36条证据,总结为无针输液接头的政策管理、消毒、冲封管、接头类型及更换、使用注意事项6个方面的最佳证据。 结论 医护人员应该按照相关级别的循证医学证据,针对无针输液接头的临床应用制订规范,细化其管理与培训的内容,优化实践中对无针输液接头类型选择、更换、消毒、冲封管的临床行为标准,保证患者安全。     

假单胞菌医院感染的回顾性调查

目的研究影响假单胞菌医院感染发生的危险因素及防治对策,降低医院感染率。方法分析１９９５～１９９６年发生假单胞菌感染５１例,对照组１０７例在住院期间接受检查治疗的各项资料进行监测研究,通过单因素分析和Ｌｏｇｉｓｔｉｃ回归分析筛选。结果使用广谱抗生素时间,住院天数、性别、引流管的应用是有显著联系的因素。５１例假单胞菌、铜绿假单胞菌占８０．４％,并对第一代和第三代头孢菌素耐药率明显增高,对氧哌嗪青霉素和氟哌酸敏感。从医院环境微生物学监测发现墙式氧气吸入器连接口污染严重也是危险因素之一。结论严格遵守抗生素使用原则,坚持环境微生物学监测,缩短住院天数,假单胞菌所引起的医院感染是可以预防。     

Mid-term follow up of patients using the St. Jude Medical Aortic Connector System for proximal vein graft in CABG

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Academic health sciences libraries as connectors to knowledge beyond literature

美国大型学术型医疗中心的图书馆正在经历从传统知识存储库到知识连接者这一新角色的转变。这种转变的推动力源于研究者、临床医生和学生使用的主要信息来源已经不再是以往图书馆的纸质资源。当前对实现学术型医疗中心使命至关重要的知识资源现在包括在线书籍和期刊、大型数据集、软件工具和远远超出图书馆壁垒的专业知识。阐述了华盛顿大学-圣路易斯Bernard Becker医学图书馆如何抓住机会,重塑自己作为超越文献而存在的知识纽带作用,并加强其在大学中作为学习和发现的催化剂的重要作用。     

下颌后牙固定义齿连接体受力的三维有限元分析

目的：研究固定义齿连接体的受力情况。方法：建立下颌后牙固定义齿三维有限元模型。设计成5种连接体形式，在垂直载荷作用下，计算邮其应力最大值。结果：连接体受力与面积成反比，面积越大，受力越小；当面积相等时圆形比椭圆形连接体受力小；当两侧连接体面积不等时，就历程最大值发生在面积较小的一侧，且出现应力集中现象，结论，固定义齿连接体应设计成为园形。面积尽可能增大，各连接体之间面积大小相等。     

不同尺寸铸瓷连接体的抗折强度分析

目的:通过体外实验探讨不同连接体尺寸与铸瓷材料抗折强度的关系.方法:按照全瓷材料和模拟连接体面积不同分为5组,A组采用铸瓷材料模拟连接体,截面为2 mm×3 mm;B组采用铸瓷材料模拟连接体,截面为2 mm×4 mm;C组采用铸瓷材料模拟连接体,截面为3 mm×3 mm;D组采用铸瓷材料模拟连接体,截面为3 mm×4 ...     

冠状动脉搭桥术中Symmetry主动脉近端吻合器的实验研究

目的利用Symmetry主动脉近端吻合器进行静脉移植物与升主动脉吻合的动物实验,评价其吻合时间、吻合口血流量和通畅率,为临床应用提供科学依据。方法以犬作为实验对象,取自体股静脉作为移植血管,在非体外循环心脏不停跳下完成主动脉至冠状动脉的冠状动脉旁路手术(OPCABG)。以Symmetry主动脉近端吻合器完成的近端吻合口作为实验组(N=10),以5～0Prolene缝线手工缝合的近端吻合口作为对照组(N=10)。测量、比较两组的吻合时间;术中应用多谱勒血流量仪测量吻合口的血流量;静脉内注射新福林提高血压,观察不同压力下吻合口的渗漏。结果实验组吻合时间为98.30士9.63s,对照组为200.50士7.54s,P0.05。实验组所能承受的最大血压平均为180士7.0mmHg,明显高于对照组160士8.0mmHg,P相似文献   

How to connect a pedicle screw construct to a Ransford Loop: technical note

This technical note describes how a standard pedicle screw system can be connected to the 4 mm rod of a Ransford Loop. This report may be of interest for spinal surgeons who need to perform similar add-on stabilizations.     

无针密闭输液操作系统在肿瘤内科的应用

为了预防静脉炎，减轻患者的痛苦，1994年我们采用周围静脉留置针进行静脉输液，在输液守毕封管时，最常用的方法是肝素盐水封管，但长期化疗的病人每日肝素盐水封管，既给护士增加了工作量，同时又存在许多弊病，为了满足临床护理的需要和适应静脉输液技术的发展，我科于2000年9月开始使用可来福接头，采用无针密闭输液方式地病人进行输液治疗，取得了良好的临床效果。