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Objective To investigate the clinical efficacy of intracranial pressure monitoring in ventricular puncture for patients with posttraumatic diffuse brain swelling under guidance of real-time intraoperative ultrasound. Methods Sixty-seven patients with posttraumatic diffuse brain swelling, admitted to and accepted intracranial pressure monitoring in ventricular puncture under real-time intraoperative ultrasound in our hospital from January 2015 to December 2017, were chosen as experimental group; and other 71 patients with posttraumatic diffuse brain swelling, admitted to and accepted traditional intracranial pressure monitoring in ventricular puncture in our hospital from January 2012 to June 2014, were chosen as control group. The clinical data were retrospectively analyzed, and the success rate of primary puncture and complications were compared between the two groups. Results The success rate of primary puncture in the experimental group was 100％ (67/67), and that in the control group was 77.5％ (55/71), with significant difference (P<0.05). No catheter-related infection was noted in either group. Only one patient in study group had puncture tract bleeding, while 9 patients in the control group had puncture tract bleeding; abnormal puncture location was noted in 8 patients of the control group, including 5 failing to be punctured in the ventricle, one puncturing to the contralateral ventricle, and two having excessive puncture depth; occurrence of postoperative complications in study group was significantly lower than that in control group (P<0.05). Conclusion Real-time intraoperative ultrasound-guided puncture ventricle drainage is superior to conventional bind-puncture in traumatic patients with diffuse brain swelling, and can be widely used in clinical practice.
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BACKGROUND:At present, scholars general y believe that the physical and chemical properties of titanium mesh are fine as easy plastic, easy cutting, good corrosion resistance and wear resistance, non-magnetic, less effect on CT or MRI results, good histocompatibility and resistance to stress. The titanium mesh is regarded as an ideal material for cranioplasty. ＜br> OBJECTIVE:To explore the clinical feasibility of primary reconstruction of comminuted and open skul fracture with titanium mesh. ＜br> METHODS:Sixty-two cases of comminuted and open skul fracture were analyzed retrospectively, including 49 males and 13 females, aged 7-69 years. Among these 62 patients, 30 patients underwent debridement and then after 6-12 months, they received titanium mesh reconstruction, serving as control group. Another 32 cases underwent debridement and titanium mesh reconstruction in the same time as observation group. Al the cases were fol owed-up for 1-2 years to observe wound healing, complications and hospitalization cost. ＜br> RESULTS AND CONCLUSION:During the fol ow-up, no wound infection and intracranial infection occurred in the two groups. The incidence of intracranial hematoma, epilepsy, and other complications was higher in the control group than the observation group (P＜0.05), and the hospitalization cost was also higher in the control group than the observation group (P＜0.05). These findings indicate that primary reconstruction with titanium mesh is feasible in the treatment of comminuted and open skul fracture and can significantly reduce the incidence of complications and hospitalization costs.