| Therapeutic Effect Analysis of Balloon Channel Technology and Traditional Cerebral Pressure Plate Retraction TechnologyObjectiveTo study the application of balloon channel technology under the microscope and traditional cerebral pressure plate retraction technology in the clinical treatment of deep brain lesions,and to explore the effect of balloon channel technology on brain tissue injury,brain function protection,clinical efficacy and prognosis.MethodsA retrospective analysis of 32 patients with deep brain lesions admitted to the Department of Neurosurgery,Zhujiang Hospital,Southern Medical University from January 2018 to December 2019.According to the different surgical paths revealed by the lesion from the cortex to the surgical field,it is divided into two groups,the balloon channel technology group(experimental group)and the cerebral pressure plate retraction group(control group).Both groups established surgical channels under the microscope and were operated by the same senior neurosurgeon with extensive surgical experience,including 15 cases in the experimental group and 17 cases in the control group.The age,sex,nature of the lesion,operation time,intraoperative blood loss,postoperative hospital stay,complications and postoperative follow-up for 3 months were counted to observe the prognosis of the two groups.Compare and analyze the advantages and disadvantages of the clinical application of the balloon channel technology and the traditional cerebral pressure plate technology,and the clinical efficacy.Results1.There were no statistical differences in gender,age and lesion nature between the two groups(P>0.05).2.The operation time of the patients in the experimental group was significantly shorter than that of the control group,which were(234.8±75.3)minutes and(303.5±69.8)minutes.The operation time of the experimental group was shorter than that of the control group,with statistically significant differences(P<0.05).3.The intraoperative blood loss in the experimental group was significantly less than that in the control group,which were(166.7±129.1)ml and(309.4±236.9)ml,with statistically significant differences(P<0.05).4.The hospital stay in the experimental group was significantly shorter than that in the control group,which were(9.3±2.3)days and(12.4±4.8)days respectively.Compared with the control group,the experimental group was able to shorten the hospital stay of patients significantly,and the hospital stay had statistically significant differences.Significance(P<0.05).5.The total number of complications in the experimental group was 1 and the incidence rate was 6.67%.The total number of complications in the control group was 3 and the incidence rate was 17.65%.The incidence of complications between the two groups was not statistically significant(P=0.4687).One case of lung infection occurred in the experimental group,and he was discharged after anti-infective treatment.Complications in the control group:2 cases of intracranial infection,the incidence rate was 11.7%,both were cured after anti-infection and lumbar cistern drainage;1 case had delayed intracranial bleeding,the incidence rate was 5.88%,and healed after clearing the hematoma in the emergency department.6.The number of patients with GOS score grades from 5 to 1 were:experimental group 13 cases,1 case,1 case,0 cases,0 cases;control group 13 cases,3 cases,1 case,0 cases,In 0 cases,by statistically comparing the grades of GOS scores,there was no statistical difference in GOS scores between the experimental group and the control group at 3 months after surgery(P=0.8702).Conclusion1.Compared with the traditional cerebral intension group,the balloon channel group has the advantages of shorter operation time,less intraoperative bleeding and shorter hospital stay in the treatment of deep brain lesions;2.The risk of intracranial infection and intracranial hemorrhage after the treatment of deep brain lesions under the microscope with balloon channel technology is not significantly different from that of traditional brain pressure plate retraction technology for deep brain lesions,suggesting that the use of balloon channel technology for deep brain lesions does not increase Risk of complications after surgery.An experimental study of balloon channel technique on brain tissue injury ObjectiveEvaluate and compare the damage to the brain tissue caused by the balloon channel technique and the cerebral pressure plate retraction techniqueMethodsThirty-six New Zealand white rabbits were male and randomly divided into the open bone flap group(sham operation group,group A),the balloon channel technology group(experiment group,group B)and the cerebral pressure plate retraction technology group(control group,group C).According to the different ways of establishing the surgical channel after craniotomy,the skull was simply opened and closed,the balloon channel was used to expand the cortex,and the cerebral pressure plate was retracted to establish the animal model.Observe the physiological and pathological changes of the experimental New Zealand white rabbit 1 hour after the end of the intervention.By comparing the content of brain water(BWC)to compare whether there is a significant difference in brain edema after the end of the intervention;the content of S100? and NSE protein was determined by ELISA,To determine the degree of brain injury;and observe and compare the expression differences of related apoptotic proteins Caspase-3 and Bcl-2 at the wound site by immunoblotting.ResultsExperimental results:For the brain injury caused by different surgical methods,three sets of observation indexes were set in this experiment.1.Comparing the water content in brain tissue(BWC),the results showed that there was no significant difference in the degree of brain tissue edema between the two intervention methods.2.The results of ELISA tests on injury-related proteins S100? and NSE showed that the serum S100? concentration of New Zealand white rabbits in each group was compared before operation(P>0.05).Compared with group A,serum S100?concentration in both groups B and C were With different degrees of increase(P<0.05),the serum S100? concentration of rabbits in groups B and C continued to increase within 12 hours after surgery,and showed a downward trend after 12 hours.Compared with group C,group B decreased significantly at 6h,12h,and 24h postoperatively,with statistical significance(P<0.05);there was no significant difference in serum NSE concentration between New Zealand white rabbits before operation(P>0.05).Compared with group A,postoperative serum NSE concentrations in groups B and C increased to varying degrees(P<0.05).The serum NSE concentration of New Zealand white rabbits in each group continued to increase within 24 hours after surgery.Compared with group C,B At 6h,12h,and 24h postoperatively,the group was significantly reduced and had statistical significance(P<0.05).3.The WB results of apoptosis-related proteins Caspase-3 and Bcl-2 indicate that craniocerebral injury is one of the stimulating factors for inducing apoptosis of nerve cells,and the expression of apoptosis-related gene Caspase-3 around the surgical area in the experimental group is reduced,And the expression of Bcl-2 increased.ConclusionBoth the balloon channel technique and the cerebral pressure plate retraction technique can cause postoperative brain injury,but the balloon channel technique has less damage than the cerebral pressure plate retraction technique,and has clinical promotion value. |
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