神经内镜结合神经导航与显微手术治疗高血压脑出血患者的应用效果对比

目的神经内镜结合神经导航与显微手术治疗高血压脑出血(HICH)患者的临床应用效果对比分析。方法选择2016年6月～2019年5月于我院手术治疗的74例HICH患者作为研究对象,按照随机数字法将其分为A、B两组,每组37例。A组患者进行经神经内镜结合神经导航手术治疗,B组患者进行显微手术治疗。对比两组患者手术时间、住院时长、术中出血量及血肿清除率以及半年预后情况。结果 A组患者手术时长、住院时长、术中出血量及血肿清除率均显著优于B组(P0.05);术后半年A组患者总预后良好率为91.89%,显著高于B组72.97%(P0.05)。结论高血压脑出血患者采用神经内镜结合神经导航手术治疗,患者手术时间、住院时间均明显缩短,术中出血量少,血肿清除率高,预后佳,值得临床推广。     

钻孔引流与神经内镜治疗慢性硬膜下血肿的临床分析

目的探讨单纯钻孔引流与神经内镜辅助治疗慢性硬膜下血肿的临床效果。方法选取120例慢性硬膜下血肿患者作为研究对象,将其分为两组。观察组60例患者给予神经内镜辅助治疗,对照组60例患者给予单纯钻孔引流治疗,对比两组患者手术指标和神经功能以及治愈率与复发率。结果观察组患者手术时间、住院时间短于对照组,差异具有统计学意义(P 0.05);术后,两组患者Markwalder分级均较术前明显改善,差异具有统计学意义(P 0.05)。两种患者治愈率与复发率对比,差异具有统计学意义(P 0.05)。结论神经内镜辅助治疗慢性硬膜下血肿效果与单纯钻孔引流相似,但可神经内镜辅助在缩短手术时间、住院时间,降低复发率方面优势明显。     

慢性硬膜下血肿术后复发的相关因素分析及临床探讨

目的分析导致行慢性硬膜下血肿钻孔引流术的患者术后复发的影响因素。方法随机选取行钻孔引流术的210例慢性硬膜下血肿患者,均于2010年1月至2017年10月收治于本院,对210例患者的相关情况进行回顾性分析,包括患者的性别、年龄、脑萎缩、脑中线移位、病程、术中冲洗、血肿性质。用logistic多因素回归分析评价临床因素与术后复发的相关性。结果单因素分析结果显示慢性硬膜下血肿钻孔引流术后复发的相关因素是年龄、脑萎缩、血肿性质(P0.05)。结论导致行钻孔引流术的慢性硬膜下血肿患者术后复发的影响因素比较多,在注重以手术方式进行治疗的同时,应针对相关因素进行积极的控制,以使术后血肿复发的可能性得以降低。     

基质金属蛋白酶及组织金属蛋白酶抑制剂在鼻腔鳞状细胞癌中的表达及意义

Objective To study the expression and significance of matrix metalloproteinase (MMP)2, MMP-9, tissue inhibitor of metalloproteinase (TIMP) 1 and TIMP-2 in nasal cavity squamous cell carcinoma and their signification. Methods Fifty cases of epithelial carcinoma tissue and 50 cases of normal nasal tissue were detected for MMP-2, MMP-9, TIMP-1, TIMP-2 by immunohistochemistry technique (S-P), and their relationship between the expression of MMP-2, MMP-9, TIMP-1, TIMP-2 and some clinical symptoms were analyzed. The SPSS 12. 0 software was used to analyze the data. Results The positive ratio of expression of MMP-2 in 50 cases of epithelial carcinoma was 52. 0% (26/50), which was significantly higher ( x2 = 6. 00, P ＜0. 05 ) than those [28.0% (14/50)] in the normal nasal tissue. The positive ratio of expression of MMP-9 in 50 cases of epithelial carcinoma was 58.0% (29/50), which was significantly higher ( x2 = 12. 8, P ＜ 0. 05 ) than those [10. 0% (5/50)] in the normal nasal tissue. The positive ratio of expression of TIMP-1 in two groups was 74. 0% (37/50), 56. 0% (28/50) respectively.There was no difference between two groups ( x2 = 0. 51, P ＞ 0. 05 ). The positive ratio of expression of TIMP-2 in two groups was 26. 0% ( 13/50), 20% (10/50) respectively. There was no difference between two groups( x2 = 3.35, P ＞ 0. 05). Conclusions There was a close relationship between pathogenesis and development of nasal epithelial carcinoma and the expression of MMP-2, MMP-9 in the epithelial carcinoma tissues. Both MMP and TIMP, especially the unbalance of MMP and TIMP, have prognostic value in nasal cavity squamous cell carcinoma.