Invasive Puncture Drainage Research Articles

Clinical application of 3DSlicer and Sina in minimally invasive puncture drainage of elderly patients with spontaneous intracerebral hemorrhage under local anesthesia

BackgroundDecreased organ function and poor physical compensatory capacity in elderly patients diagnosed with spontaneous intracerebral hemorrhage (ICH) can make surgical treatment procedures challenging and risky. Minimally invasive puncture drainage (MIPD) combined with urokinase infusion therapy is a safe and feasible method of treating ICH. This study aimed to compare the treatment efficacy of MIPD conducted under local anesthesia using either 3DSlicer + Sina application or computer tomography (CT)–guided stereotactic localization of hematomas in elderly patients diagnosed with ICH. MethodsThe study sample included 78 elderly patients (≥ 65 years of age) diagnosed with ICH for the first time. All patients exhibited stable vital signs and underwent surgical treatment. The study sample was randomly divided into two groups, either receiving 3DSlicer+Sina or CT-guided stereotactic assistance. The preoperative preparation time; hematoma localization accuracy rate; satisfactory hematoma puncture rate; hematoma clearance rate; postoperative rebleeding rate; Glasgow Coma Scale (GCS) score after 7 days; and modified Rankin scale (mRS) score 6 months after surgery were compared between the two groups. ResultsNo significant differences in gender, age, preoperative GCS score, preoperative hematoma volume (HV), and surgical duration were observed between the two groups (all p-values > 0.05). However, the preoperative preparation time was shorter in the group receiving 3DSlicer + Sina assistance compared to that receiving CT-guided stereotactic assistance (p-value < 0.001). Both groups exhibited significant improvement in GCS scores and reduction in HV after surgery (all p-values < 0.001). The accuracy of hematoma localization and puncture was 100% in both groups. There were no significant differences in surgical duration, postoperative hematoma clearance rate, rebleeding rate, postoperative GCS and mRS scores between the two groups (all p-values > 0.05). ConclusionsA combination of 3DSlicer and Sina is effective in accurately identifying hematomas in elderly patients with ICH exhibiting stable vital signs, thus simplifying MIPD surgeries conducted under local anesthesia. This procedure may also be preferred over CT-guided stereotactic localization in clinical practice due to its ease of use and accuracy in hematoma localization.

Retracted: Effect of Minimally Invasive Puncture Drainage and Conservative Treatment on Prognosis of Patients with Cerebral Hemorrhage.

[This retracts the article DOI: 10.1155/2021/2401256.].

Effect of Minimally Invasive Puncture Drainage and Conservative Treatment on Prognosis of Patients with Cerebral Hemorrhage.

The objective of this study was to explore the effect of minimally invasive puncture drainage under unsupervised learning algorithm and conservative treatment on the prognosis of patients with cerebral hemorrhage. Fifty patients with cerebral hemorrhage were selected as the research objects. The CT images of patients were segmented by unsupervised learning algorithm, and the application value of unsupervised learning algorithm on CT images of patients with cerebral hemorrhage was evaluated. According to the treatment wishes of the patients themselves and their authorizers, they were divided into 30 patients with cerebral hemorrhage in the minimally invasive group and 20 patients with cerebral hemorrhage in the conservative group. The incidence rate of complications of cerebral hemorrhage, the length of hospitalization of the two groups, hematoma volume at admission, 3 days and 7 days after operation, and the hematoma dissipation rate on the 3rd and 7th day after operation were used as the evaluation index of therapeutic effect. MRS and ADL scores were used as prognostic indicators. The results show that K-means clustering algorithm has high quality and short time for CT image segmentation. The overall incidence rate of complications in minimally invasive group was 10%, lower than that in conservative group (25%) (P < 0.05), and the length of hospitalization in minimally invasive group was longer than that in conservative group (P < 0.05). The hematoma volume of minimally invasive group was 16.5 ± 2.4 mL on the 3rd day after operation, and that of conservative group was 27.4 ± 1.8 mL. There was significant difference between the two groups (P < 0.05). In addition, CT showed that the hematoma reduction degree of minimally invasive group was higher than that of conservative group, and the hematoma dissipation rate was higher than that of conservative group on the 3rd and 7th day (P < 0.05). The good MRS score in minimally invasive group was 3.15 times that in conservative group, and the good ADL score was 1.6 times that in conservative group, and there was significant difference in the total score between the two groups (P < 0.05). Minimally invasive puncture drainage is better than conservative treatment in the clearance of hematoma, which is conducive to the recovery of neurological function and daily life of patients with cerebral hemorrhage and is of great help to the prognosis of patients.

Short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.

BACKGROUNDHypertensive intracerebral hemorrhage is a common critical disease of the nervous system, comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate. It severely affects the patients’ quality of life.AIMTo analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage. METHODSFrom March 2018 to May 2020, 118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan. The control group used a hard-channel minimally invasive puncture and drainage procedure. The observation group underwent minimally invasive neuroendoscopic surgery. The changes in the levels of serum P substances (SP), inflammatory factors [tumor necrosis factor-α, interleukin-6 (IL-6), IL-10], and the National Hospital Stroke Scale (NIHSS) and Barthel index scores were recorded. Surgery related indicators and prognosis were compared between the two groups.RESULTSThe operation time (105.26 ± 28.35) of the observation group was min longer than that of the control group, and the volume of intraoperative bleeding was 45.36 ± 10.17 mL more than that of the control group. The hematoma clearance rates were 88.58% ± 4.69% and 94.47% ± 4.02% higher than those of the control group at 48 h and 72 h, respectively. Good prognosis rate (86.44%) was higher in the observation group than in the control group, and complication rate (5.08%) was not significantly different from that of the control group (P > 0.05).The SP level and Barthel index score of the two groups increased (P < 0.05) and the inflammatory factors and NIHSS score decreased (P < 0.05). The cytokine levels, NIHSS score, and Barthel index score were better in the observation group than in the control group (P < 0.05).CONCLUSIONNeuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage; however, hematoma clearance is more thorough, and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.

Modern approaches to diagnosis and treatment of bacterial liver abscesses

Modern notions about etiology, pathogenesis and microbiological characteristics of bacterial liver abscesses are analyzed. Cholangiogenic abscess is a prevailing type among the incidences of liver abscesses. Today Klebsiella pneumoniae strains are the predominant cause of pyogenic hepatic abscess. Diagnosis of liver abscesses is based on a combination of clinical and laboratory findings and visualization survey methods. Success in the treatment of liver abscesses is provided by a multimodal approach, including sanation of purulent focus, rational antibacterial therapy and elimination of the main etiologic factor. Effective antibiotic therapy is based on the results of permanent microbiological monitoring of the abscess cavity, bile and blood contents. The question remains about what is the optimal time frame for antibiotic therapy. The main method of treatment of liver abscess is surgical. In the vast majority of cases, minimally invasive puncture-drainage under ultrasound or CT guidance proves to be an effective and sufficient method of treatment, regardless of the size, location and number of purulent foci. There is no consensus, however, on a differentiated choice of minimally invasive sanitation techniques, drainage periods and removal criteria in medical literature. An algorithm for treatment of cholangiogenic liver abscesses must include methods that ensure restoration of the bile ducts patency, relief of biliary hypertension and cholangitis. If the minimally invasive drainage techniques proves ineffective, as well as in cases of complicated abscess or presence of large sequesters in the destruction cavity, it is recommended to perform laparoscopic or traditional open surgery (including liver resections).

The clinical research of mammotome minimally invasive puncture drainage in the treatment of breast abscess in lactation

Objective To investigate the value of mammotome minimally invasive puncture drainage in the treatment of breast abscess. Methods 53 patients with the breast abscess were divided into minimally invasive group(27 cases) and open group(26 cases) according to the principle of completely random.The patients in the minimally invasive group were treated with mammotome minimally invasive puncture drainage under the ultrasound guidance.The patients in the open group underwent conventional breast abscess incision and drainage.All the patients were treated with systemic anti-infection and symptomatic treatment.Then, we collated and analyzed the statistical data from the operation time, postoperative pain time, pain degree, number of dressing, healing time, postoperative breast feeding and breast appearance aspects. Results There was no significant difference in operation time between the two groups.In the minimally invasive group, the time of pain, the degree of pain, the time of dressing change, the healing time, the proportion of nursing and the appearance of the breast were (2.6±0.8)d, (2.1±0.2)min, (7.3±0.6)times, (18.0±0.1)d, 81.5%, (3.5±0.2)points respectively.Those in the open group were (5.2±0.2)d, (3.3±0.3)min, (28.0±0.2)times, (30.0±0.8)d, 26.9%, (2.1±0.2)points respectively.The differences between the two groups were statistically significant(t=-3.38, -5.12, -5.61, -5.39, χ2=32.25, t=-6.12, all P<0.05). Conclusion Minimally invasive treatment is a good method in the treatment of breast abscess, and deserved to be promoted clinically. Key words: Mammary abscess; Mammotome minimally invasive puncture; Catheter drainage; Rinsing