ABSTRACT
Objective To investigate the prognostic value of serum neutrophil gelatinase associated protein lipocalin (NGAL) and S-100β protein level on postoperative delirium (POD) in patient underwent gynecological laparoscopic tumor resection. Methods 256 patients underwent gynecological laparoscopic tumor resection from March 2015 to June 2016 were enrolled the study and divided into POD group (n = 31) and non-POD group (n = 225). Serum levels of NGAL, S-100β protein, creatinine (Scr) and cystatin C (Cys-c) were compared between the two groups at 5 min before anesthesia induction, immediately after extubation, during their stay in post anesthesia care unit (PACU) and at 24, 48, 72 h after operation. The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in POD. Results Serum levels of NGAL and S-100βafter anesthesia in the two groups were all significantly higher than those before anesthesia (P < 0.05). Serum levels of NGAL in POD group immediately after extubation, during their stay in PACU and at 24 h after operation were significantly higher than those in non-POD group (P < 0.05). Serum levels of S-100β protein in POD group immediately after extubation, durng their stay in PACU and at 24, 48, 72 h after operation were significantly higherthan those in non-POD group (P < 0.05). There was no acute renal injury in all patients. There were no significant difference in serum levels of Scr and Cys-C between two groups at every time points (P > 0.05). The AUC of serum NGAL and S-100 protein immediately after extubation, durng their stay in PACU and at 24h after operation were 0.75, 0.77, 0.66 and 0.85, 0.83, 0.80 respectively (P < 0.05). Conclusions Serum NGAL and S-100β protein levels could be used as predictors of POD in patients undergoing gynecological laparoscopic tumor resection, and prediction effect of the latter was better, especially immediately after extubation and durng their stay in PACU.
ABSTRACT
Objective To investigate the prognostic value of serum neutrophil gelatinase associated protein lipocalin (NGAL) and S-100β protein level on postoperative delirium (POD) in patient underwent gynecological laparoscopic tumor resection. Methods 256 patients underwent gynecological laparoscopic tumor resection from March 2015 to June 2016 were enrolled the study and divided into POD group (n = 31) and non-POD group (n = 225). Serum levels of NGAL, S-100β protein, creatinine (Scr) and cystatin C (Cys-c) were compared between the two groups at 5 min before anesthesia induction, immediately after extubation, during their stay in post anesthesia care unit (PACU) and at 24, 48, 72 h after operation. The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in POD. Results Serum levels of NGAL and S-100βafter anesthesia in the two groups were all significantly higher than those before anesthesia (P < 0.05). Serum levels of NGAL in POD group immediately after extubation, during their stay in PACU and at 24 h after operation were significantly higher than those in non-POD group (P < 0.05). Serum levels of S-100β protein in POD group immediately after extubation, durng their stay in PACU and at 24, 48, 72 h after operation were significantly higherthan those in non-POD group (P < 0.05). There was no acute renal injury in all patients. There were no significant difference in serum levels of Scr and Cys-C between two groups at every time points (P > 0.05). The AUC of serum NGAL and S-100 protein immediately after extubation, durng their stay in PACU and at 24h after operation were 0.75, 0.77, 0.66 and 0.85, 0.83, 0.80 respectively (P < 0.05). Conclusions Serum NGAL and S-100β protein levels could be used as predictors of POD in patients undergoing gynecological laparoscopic tumor resection, and prediction effect of the latter was better, especially immediately after extubation and durng their stay in PACU.
ABSTRACT
PURPOSE: To study the effects of percutaneous reconstruction plate internal fixation in the treatment of unstable sacral fractures. METHODS: Percutaneous reconstruction plate internal fixation was applied on 21 cases of unstable sacral fracture (15 males and six females, at age range of 16-65 years, mean 38.3 years) including four cases of Denis Zone I, 14 cases of Zone II and three cases of Zone III. In operation, an arc incision (about 3-5 cm long) was made along the iliac crest on the outside border of posterior superior iliac spine (PSIS) on both sides, and then the plate was transported from the wounded side to the opposite one through the subcutaneous tunnel. RESULTS: The mean incision length, operation time, intraoperative blood loss was 4.3cm, 45.2min, and 160.8ml respectively. All these patients were followed up for 12-33 months (average 16.3 months), which showed no incision infection, intraoperative neurovascular injury, internal fixation loose or breakage, disunion, or obvious lower limb length inequality. The function result was rated as excellent in six cases, good in 12 and fair in 3, with excellence rate of 85.7%, according to the Majeed scoring system. CONCLUSION: Percutaneous reconstruction plate internal fixation is an ideal surgical approach to unstable sacral fractures, as it is easy, safe, causing less trauma and fewer complications, and conducive to quicker recovery.
OBJETIVO: Estudar os efeitos da reconstrução percutânea com fixação de placa interna no tratamento de fraturas sacrais instáveis. MÉTODOS: A reconstrução percutânea com fixação de placa interna foi aplicada em 21 casos de fratura sacral instável (15 homens e seis mulheres, com idade variando entre 16 e 65 anos, média de 38,3 anos) incluindo quatro casos de Zona I de Denis, 14 casos de Zona II e três casos de Zona III. No ato operatório, uma incisão arqueada (cerca de 3 a 5cm de comprimento) foi feita ao longo da crista ilíaca na borda externa da espinha ilíaca supero-posterior (PSIS) em ambos os lados, e então a placa foi transportada do lado da ferida para o lado oposto através do túnel subcutâneo. RESULTADOS: O comprimento médio da incisão, tempo operatório e perda sanguínea intra-operatória foram, respectivamente, 4,3cm, 45,2min e 160,8ml. Todos estes pacientes foram acompanhados por 12 a 33 meses (média 16,3 meses), o que mostrou nenhuma infecção de ferida operatória, lesão neurovascular intraoperatória, perda da fixação interna ou quebra, desunião ou desigualdade nos comprimentos dos membros inferiores. O resultado funcional foi excelente em seis casos, bom em doze e falho em três, com taxa excelente de 85,7%, de acordo com o sistema de escore de Majeed. CONCLUSÃO: Reconstrução percutânea com fixação de placa interna é uma abordagem cirúrgica ideal para fraturas sacrais instáveis, sendo fácil e segura, causando menos trauma e poucas complicações, conduzindo a uma recuperação mais rápida.