scholarly journals Analysis of clinical distribution and drug resistance of klebsiella pneumoniae pulmonary infection in patients with hypertensive intra cerebral hemorrhage after minimally invasive surgery

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Wei Li ◽  
Li Xu ◽  
Haige Zhao ◽  
Shanshan Zhu

Objectives: To investigate the clinical distribution and drug resistance of Klebsiella pneumoniae pulmonary infection in patients with hypertensive intracerebral hemorrhage after minimally invasive surgery. Methods: A total of 658 patients with hypertensive intracerebral hemorrhage who underwent minimally invasive surgery admitted to the intensive care unit (ICU) and the Department of Neurology of Affiliated Hospital of Hebei University from January 2015 to January 2020 were enrolled and divided into two groups: the observation group and the control group. Three hundred and thirty-three cases with postoperative pulmonary infection were included into the observation group, and 325 cases without postoperative pulmonary infection were divided into the control group. The intubation time, neurological deficiency score and Glasgow coma scale (GCS) of the two groups were analyzed and compared. Automatic microbial identification system was utilized to isolate bacteria from patients in the observation group, identify Klebsiella pneumoniae, and analyze Klebsiella pneumoniae infection, clinical department distribution, and age distribution. The Kirby-Bauer method was adopted to carry out the drug susceptibility test of Klebsiella pneumoniae infection. Results: The intubation time and neurological deficiency score of patients with hypertensive cerebral hemorrhage in the observation group were significantly higher than those in the control group (p<0.05), while the GCS score was significantly lower than that in the control group (p<0.05). A total of 403 strains of pathogenic bacteria were isolated from 325 patients in the observation group, of which 52 strains of Klebsiella pneumoniae were detected in 52 patients with postoperative pulmonary infection, accounting for 12.90%. The detection rates of Klebsiella pneumoniae in ICU and neurology department were 53.85% and 46.15%, respectively. Klebsiella pneumoniae had the highest detection rate (40.38%) in people aged 70 years and above. Moreover, fifty-two strains of Klebsiella pneumoniae showed low drug resistance rate (<20%) to cefoperazone/sulbactam, piperacillin/tazobactam, cefoxitin, imipenem, meropenem, amikacin, ciprofloxacin, and levofloxacin. Conclusion: For patients with hypertensive cerebral hemorrhage who have pulmonary infection after minimally invasive surgery, risk factors causing infection should be identified in time, their Klebsiella pneumoniae infection should be correctly monitored, and antibiotics should be taken rationally to effectively promote the elimination of brain edema in patients and protect the cranial nerve function of patients. doi: https://doi.org/10.12669/pjms.38.1.4439 How to cite this:Li W, Xu L, Zhao H, Zhu S. Analysis of clinical distribution and drug resistance of klebsiella pneumoniae pulmonary infection in patients with hypertensive intra cerebral hemorrhage after minimally invasive surgery. Pak J Med Sci. 2022;38(1):---------.  doi: https://doi.org/10.12669/pjms.38.1.4439 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Chengjia Gui ◽  
Yikuan Gao ◽  
Dan Hu ◽  
Xinyu Yang

Objective: To analyze the effects of neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance through comparing clinical indicators of the two operation modes and to provide a reference for selection of proper minimally invasive surgery. Methods: One hundred and twenty-six patients with hypertensive cerebral hemorrhage who received diagnosis and treatment in our hospital between December 2015 and December 2017 were selected and grouped into an observation group (n=63) and a control group (n=63) using random number table. Patients in the observation group were treated by neuroendoscopic surgery, while patients in the control group were treated by small bone window craniotomy. The surgical condition, clinical effect and prognosis of the two groups were analyzed and compared. Results: Patients in the observation group completed surgery in a shorter time and bled less during operation compared to the control group, and the hematoma clearance rate of the observation group was obviously higher than that of the control group; the differences had statistical significance (P<0.05). The nerve deficiency scale (NDS) scores of the two groups at the postoperative 3rd month were lower than those before surgery (P<0.05), and the activity of daily life (ADL) score at the postoperative 3rd month was higher than that before surgery (P<0.05). The observation group had lower NDS score and higher ADL score compared to the control group, and the differences had statistical significance (P<0.05). The incidence of complications of the observation group was lower than that of the control group after surgery, and the rate of favourable prognosis of the observation group was higher than that of the control group at the postoperative 3rd month (P<0.05). Conclusion: Neuroendoscopic surgery is more effective and safe, causes less bleeding and has better prognosis and nerve function recovery compared to small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage. How to cite this:Gui C, Gao Y, Hu D, Yang X. Neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance in the treatment of hypertensive cerebral hemorrhage. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.463 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 7 (5) ◽  
pp. 1696-1700
Author(s):  
Ligang Chen ◽  
Hao Lin

To study and analyze the clinical effect of arthroscopic minimally invasive surgery in the treatment of knee joint trauma. Methods: A total of 80 patients with knee joint bone trauma who were treated in our hospital from July 2018 to July 2019 were selected as the research objects, and randomly divided into observation group and control group. Patients in the control group were treated in the conventional way, patients in the observation group were treated with arthroscopic minimally invasive surgery, and the treatment effect, neer score and complications of the two groups were compared. Result: The treatment efficiency of the observation group was significantly higher than that of the control group (P < 0.05); the neer score of the observation group was significantly higher than that of the control group (P < 0.05); the number of complications in the observation group was significantly lower than that of the control group (P < 0.05), the difference was statistically significant. Conclusion: The application of arthroscopic minimally invasive surgery in the treatment of knee joint trauma patients has significant effect, improve the treatment effect, the number of patients with complications is lower, with higher safety, which is worth promoting in clinical treatment.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xu Yang ◽  
Yan Zhu ◽  
Linshan Zhang ◽  
Likun Wang ◽  
Yuanhong Mao ◽  
...  

Abstract Background The initial CT blend sign is an imaging marker that has been used to predict haematoma expansion and poor outcomes in patients with small-volume intracerebral haemorrhage (ICH). However, the association of the blend sign with the outcomes of patients undergoing surgery remains unclear. The present study aimed to retrospectively evaluate the influence of the initial CT blend sign on short-term outcomes in patients with hypertensive ICH after stereotactic minimally invasive surgery (sMIS). Methods We enrolled 242 patients with spontaneous ICH. The patients were assigned to the blend sign group (91 patients) or non-blend sign (control) group (151 patients) based on the initial CT features. The NIHSS, GCS and mRS were used to assess the effects of sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups. Results Statistically significant differences in the NIHSS and GCS scores were not observed between the blend sign group and the control group. No significant differences in the proportion of patients with good outcomes during the follow-up period were observed between the two groups. A higher rate of re-haemorrhage was noted in the blend sign group. Significant differences in the rates of severe pulmonary infection and cardiac complications were not observed between the two groups. Conclusions The initial CT blend sign is not associated with poor outcomes in patients with hypertensive ICH after sMIS. ICH patients with the CT blend sign should undergo sMIS if they are suitable candidates for surgery.


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tianhui Liu ◽  
Xiaoying Gao ◽  
Jianmin Cui

Objective: To study and evaluate the incidence of pain and complications in patients with spinal trauma after minimally invasive treatment. Methods: The research period was selected from January 2018 to December 2020, and 40 patients with spinal trauma were selected. According to the random number table scheme, they were divided into the study group and the control group. The treatment scheme of the control group was traditional surgery, and the treatment scheme of the study group was minimally invasive surgery. The indicators of the two groups were compared and analyzed. Results: Compared with the two groups of surgery and postoperative recovery related indicators, the study group had more advantages (P<0.05); Compared two groups of postoperative NRS score, VAS score and the incidence of complications, the study group had more advantages(P<0.05). Conclusion: Minimally invasive treatment of spinal trauma has significant clinical effect, which can effectively relieve postoperative pain and reduce the incidence of various complications.


2021 ◽  
Author(s):  
Xu Yang ◽  
Yan Zhu ◽  
Linshan Zhang ◽  
Likun Wang ◽  
Yuanhong Mao ◽  
...  

Abstract Background: The initial computed tomography (CT) blend sign has been used as an imaging marker to predict haematoma expansion and poor outcomes in patients with a small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and outcomes remains elusive. The present study aimed to retrospectively measure the impact of initial CT blend signs on short-term outcomes in patients with hypertensive ICH who underwent stereotactic minimally invasive surgery (sMIS). Methods: We enrolled 242 patients with spontaneous ICH. Based on the initial CT features, the patients were assigned to a blend sign group (91 patients) or a nonblend sign (control) group (151 patients). The NIHSS, GCS and mRS were used to measure the effects of sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS scores were observed between the two groups. The proportion of patients with good outcomes during follow-up was not different between the two groups. The rate of rehaemorrhaging increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions: The initial CT blend sign was not associated with poor outcomes in patients with hypertensive ICH who underwent sMIS. ICH patients with CT blend signs should undergo sMIS if they are suitable candidates for surgery.


2020 ◽  
Author(s):  
Xu Yang ◽  
Linshan Zhang ◽  
Likun Wang ◽  
Yuanhong Mao ◽  
Yinghui Li ◽  
...  

Abstract Backgrounds: The initial CT blend sign has been used as an imaging maker to predict haematoma expansion and poor outcome in patients with small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and the outcome of patients remains elusive. The present study aimed to retrospectively observe the impact of initial CT blend signs on the short-term outcome of patients with hypertensive ICH underwent a stereotatic minimally invasive surgery (sMIS). Methods: Two hundreds and forty-two patients with spontaneous ICH were enrolled. Based on the initial CT features, the patients were assigned to a blend sign group (including 91 patients) or a non-blend sign group (control group, including 151 patients). The NIHSS, GCS and the mRS were used to observe the efficacy of the sMIS. The rates of severe pulmonary infection, cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS in one week or two weeks after surgery were observed between the two groups. The proportion of patients with good outcome during follow-up did not show any difference between the two groups. However, both the two groups displayed good functional outcome over admission. The rate of rehaemorrhage increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions:The initial CT blend sign are not associated with poor outcome of patients with hypertensive ICH underwent sMIS. ICH patients with CT blend sign should be also treated by performing sMIS if they are candidates for surgery.


2020 ◽  
Author(s):  
Xu Yang ◽  
Yan Zhu ◽  
Linshan Zhang ◽  
Likun Wang ◽  
Yuanhong Mao ◽  
...  

Abstract Background: The initial CT blend sign has been used as an imaging marker to predict haematoma expansion and poor outcomes in patients with a small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and outcomes remains elusive. The present study aimed to retrospectively measure the impact of initial CT blend signs on short-term outcomes in patients with hypertensive ICH who underwent stereotactic minimally invasive surgery (sMIS). Methods: We enrolled 242 patients with spontaneous ICH. Based on the initial CT features, the patients were assigned to a blend sign group (91 patients) or a non-blend sign (control) group (151 patients). The NIHSS, GCS and mRS were used to measure the efficacy of the sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS at one week or two weeks after surgery were observed between the two groups. The proportion of patients with good outcomes during follow-up was not different in the two groups. Both groups displayed good functional outcomes relative to the state at admission. The rate of re-haemorrhaging increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions: The initial CT blend sign was not associated with poor outcome in patients with hypertensive ICH who underwent sMIS. ICH patients with CT blend signs should undergo sMIS if they are suitable candidates for surgery.


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