Objective
To explore the effect of systematic respiratory training on lung function in patients with mild to moderate traumatic brain injury.
Methods
A total of 60 patients with craniocerebral injury who received conservative treatment from January 2015 to June 2017 were selected. These patients were randomly divided into two groups: breathing training group for systematic breathing training and conventional treatment group for conventional rehabilitation training. Pulmonary infection, length of hospital stay, lung function determination, vital capacity, percentage of maximal ventilation, patient’s oxygen saturation, arterial partial pressure of oxygen, peak airway pressure, airway resistance, and respiratory mechanics were observed.
Results
The pulmonary infection rate and the length of hospital stay in the respiratory training group were 10.0% and (8.17±0.99) days, respectively, which were significantly lower than those in the conventional treatment group [33.3% and (12.67±0.99) days, respectively]; the differences between the two groups were statistically significant (P<0.05). At the same time, pulmonary function, oxygen saturation, arterial oxygen tension, and respiratory mechanics were all better in the breathing training group than those in the conventional treatment group, the differences between the two groups were statistically significant (P<0.05).
Conclusion
Breathing training can significantly improve the recovery of lung function in patients with mild to moderate traumatic brain injury, reduce the incidence of complications and effectively improve the prognosis.
【摘要】 目的 研究改良Paine點側腦室額角穿刺的解剖基礎及臨床應用。 方法 利用MRI模型的構建，模擬改良Paine點穿刺側腦室額角。測量穿刺距離、角度及其對Broca語言功能區和尾狀核的影響。改良Paine點（Pm點）比Paine點高1 cm，更加遠離Broca語言功能區，穿刺時需要與軸面夾角20°向下，可以越過尾狀核頭從側腦室額角上壁進入腦室；與矢狀面夾角約70°向下、冠狀面夾角約20°向后穿刺。從皮層計算進針4.0~5.5 cm可進入側腦室額角。 結果 同期7例顱內動脈瘤患者術中應用Pm點穿刺成功，術后無語言功能障礙，復查頭顱CT無穿刺道及尾狀核頭出血現象。 結論 Pm點法定位方法簡便準確，能避免Broca語言功能區和尾狀核頭部的損傷，有一定臨床應用推廣價值。【Abstract】 Objective To analyze the anatomic characteristics and clinical application of modified Paine entry point (Pm) for lateral ventricular puncture through pterional approach. Methods We simulated the modified Paine entry point for lateral ventricular frontal horn puncture by reconstructing the model of MRI. Distance and angles of the puncture path were measured to evaluate the influence upon the language areas of Broca and the head of the caudate nucleus. The Pm point is 1 cm higher than the Paine point, so it is more far away from the Broca area. The direction of the puncture path should be 20° downward with the axial plane, 70° downward with the sagittal plane and 20° backward with the coronal plane. The catheter was inserted into the ventricle 4.0 to 5.5 cm deep to the cortex. Results Seven patients with intracranial aneurysms underwent ventricular puncture successfully through the Pm point in operation. None of them suffered language dysfunction or hemorrhage lesions in the caudate nucleus by the computed tomography. Conclusion The modified Paine entry point can be located accurately and has the clinical value for preventing damage of the Broca area and the caudate nucleus.
ObjectiveTo explore the value of bilateral inferior petrosal sinus sampling (BIPSS) for preoperative diagnosis of adrenocorticotropic hormone (ACTH) microadenomas.MethodsWe retrospectively analyzed the clinical date of patients with ACTH microadenomas, who were experienced BIPSS preoperatively from October 2013 to May 2017. The qualitative and localized diagnostic significance of BIPSS was evaluated based on the criteria of the plasma ACTH concentration ratio of inferior petrosal sinus to ulnar vein (≥2), and the ratio of left to right inferior petrosal sinuses (≥1.4).ResultsFive patients (1 male and 4 females) were involved in the study. The mean age was (49.6±9.2) years, and the mean disease course was (17.2±7.5) months. The plasma ACTH concentration of all the cases ran up to the criterition of the ratio of inferior petrosal sinus to ulnar vein (≥2). Three cases were found that the actual locations of the microadenomas were inconsistent with the indications from the results of BIPSS. After the BIPSS procedure, there was no intracranial infection or death case, except that one patient suffered from ecchymoma and another one suffered from transient nausea.ConclusionBIPSS is valuable for qualitative diagnosis, but not effective for localization diagnosis of the ACTH microadenomas preoperatively.
