Small Bone Window With Ventriculoscope Treatment Subdural Hydroma And Analysis Of Fluid Inflammation

Objective: Traumatic subdural hydroma(TSH)is a kind of closed craniocerebral injury. This research through the ventriculoscope aided by small bone window treatment of subdural hydroma, by observation of ventriculoscope into the hydroma cavity effusion coated, and find the evidence of flapper formation; Looking for hydroma to form new envelope and thecal sac new blood vessels hemorrhage evidence to promote the development of hydroma; Looking for the evidence of local inflammation promote hydroma formation and development; Take biopsy by ventriculoscope,looking for the reasons of capsule formation, pathological analysis and extraction of subdural effusion detection of inflammatory markers,such as interleukin-6(IL-6)、interleukin-8(IL-8) 、 Tumor necrosis factor-α(TNF-α),and testing related protein content and composition, at the same time from a patient’s blood corresponding inspection comparison, further explore the pathogenesis of subdural hydroma.Method:Select the 36 cases of that by strict excluded screening criteria to select patients who meet indications for surgery, For patients with CT imaging examination,Combined with its history of patients divided into subdural hydroma stable of 17 people,19 people were progressive.The same period and normal reference 19 people as normal group.To conform to the surgical indications in patients with small bone window craniotomy to clear fluid, through the ventriculoscope observation hydroma, through the ventriculoscope pumping fluid as a specimen, and strip coated send pathology.Extract the 36 patients with peripheral venous blood and 19 normal peripheral venous blood in comparison.Corresponding inspection methods detecting proteins in the specimen、IL- 6、IL- 8 TNF-α to compare to each other.Result:(1) After the ventriculoscope observation found in 36 cases of surgically treated patients with 7 cases of subdural fluid leaks are found in, A few valve-like structure and the rest had no obvious structural. While obvious after the ventriculoscope observation effusion full of new blood capillaries, but no bleeding.(2)by deposition ventriculoscope stripping liquid space capsule, and upon cases found is a thin layer of connective tissue, a large number of new capillaries with infiltration of inflammatory cells, similar to the granulation tissue.(3) extraction fluid by biochemical tests can be found positive for protein, its concentration slightly above the cerebrospinal fluid.(4) Includes stability and progressive patients in the case group, IL-6, IL-8, and TNF-α levels in serum and serum content of normal control group difference was not statistically significant(P>0.05).(5) The IL-6, IL-8, as well as TNF-alpha levels in the effusion of progress cases, with the patient’s own blood serum,the IL-6, IL-8, and compared concentrations of TNF-α content is high, the difference was statistically significant(P<0.01), stable groups had no significant differences. the IL-6, IL-8, TNF-αlevel in traumatic subdural hydroma correlation analysis results show correlation between(r=0.416 P<0.05).(7)by the treatment of the ventriculoscope,there is no recurrenceConclusion:Observed in this experiment found that subdural hydroma is difficult to use a single theory to explain the pathogenesis of which may be formed in the pathogenesis of various mutually reinforcing.(1) by ventriculoscope observation, few cases have found similar unidirectional, suggesting that valve theory there is some clinical evidence. 2) by ventriculoscope observation fluid formation in patients with of coated capillary proliferation, throw pathological findings thin film is proliferation of granulation tissue, Prompt fluid formation may be new capillary seepage.(3) progresseffusion in patients with the edema fluid protein content increased, IL-6, IL-8, TNF-αconcentration higher than IL-6, IL-8, TNF-α of blood serum, local inflammatory reaction in the edema fluid very exuberant, almost no systemic reactions, and local inflammatory reactions in fluid around formation inflammation of thin films with a large number of new capillaries(4) IL-6, IL-8, TNF-α concentration in serum of patients no differences with normal control serum to prove that subdural effusion in patients does not exist the systemic inflammatory response.(5) by ventriculoscope can repair the valve hole, and can be observed directly stripping inflammatory capsule. And local anti-inflammatory therapy may become an effective means of treatment 、prevention relapse and development for some subdural effusion patients.