ABSTRACT
Objective To compare the clinical effect of the two surgical methods of posterior pedicle screw fixation decompression in treatment of thoracolumbar burst fractures,and in order to provide the basis for choosing the rational treatment.Methods Retrospectively analyzed the clinical data of 98 patients with thoracolumbar burst fractures underwent surgery of posterior pedicle screw fixation decompression from January 2007 to January 2011.Fifty-six patients were given posterior fixed indirect decompression surgery (indirect decompression group) and 42 patients were given posterior fixed direct decompression (direct decompression group).The patients were followed up for (1.03 ± 0.36) years after surgery,the image,recovery of neurological function,postoperative complications and capacity for independent living of the two groups were compared and evaluated.Results After surgery,the vertebral height ratio,Cobb angle,canal compromise rate in indirect decompression group were (91.67 ± 26.19)％,(10.10 ± 2.89)°,(18.61 ±5.32)％,in direct decompression group were(86.23 ± 24.64)％,(11.98 ± 3.42)°,(22.37 ± 6.39)％.There was significant difference compared with before surgery (P ＜ 0.05) and no significant difference between two groups (P ＞0.05).After surgery,the neurological function of the two groups were improved,and the improvement in indirect decompression group was better than that in direct decompression group (P ＜ 0.05).The postoperative complications ratio in indirect decompression group was 23.2％ (13/56),significantly lower than that in direct decompression group[83.3％(35/42)](x2 =10.370,P＜ 0.01).There was 60.7％(34/56)patients with capacity for independent living in indirect decompression group,significantly higher than that in direct decompression group [40.5％ (17/42)] (x2 =4.329,P ＜ 0.05).Conclusion The posterior pedicle screw fixation indirect decompression in treatment of thoracolumbar burst fractures is a feasible operation method,and is worth to utilize in clinic.
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ObjectiveTo compare the clinical effects of laparoscopically assisted vaginal hysterectomy (LAVH) and transabdominal hysterectomy (TAH).MethodsOne hundred and twenty-six cases operated with hysterectomy were classified into LAVH group and TAH group by random digits table with 63 cases each.The operation time,intraoperative bleeding amount,exhaust time,hospitalization time and postoperative complications were observed and compared.ResultsThe operation time,intraoperative bleeding amount,exhaust time and hospitalization time was ( 115.6 ± 13.8 ) min,(92.5 ± 11.3 ) ml,(21.8 ±4.8) d and (6.1 ± 1.7) d in LAVH group,( 82.5 ± 8.7) min,( 112.3 ± 17.8) ml,(28.9 ± 6.2) d and (9.6 ±2.2) d in TAH group,there were significant differences between two groups (P＜0.05).The incidence of incision pain,delayed wound healing,vaginal stump infection,thrombophlebitis,and gastrointestinal disorders was 9.5％(6/63),0,1.6％(1/63),0 and 7.9％(5/63) in LAVH group,which was significantly lower than that in TAH group [52.4％(33/63),7.9％(5/63),11.1％(7/63),7.9％(5/63) and 22.2％ ( 14/63 ) ] (P ＜ 0.05).ConclusionCompared with TAH,LAVH can shorten exhaust time,hospitalization time,reduce intraoperative bleeding amount,decrease complication rate,which can be further applied in clinic.
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@# ObjectiveTo discuss the clinical value of serum CA125 and endometrial antibody (EMAb) for the diagnosis of endometriosis.Methods216 patients were determined by the presences of CA125 and EMAb before operation.ResultsAll cases were diagnosed by pathology after operation. CA125 positive rate in the endometriosis group was 58.3% and that in the control group was 12.5%. The difference between two groups was significant (P<0.01).EMAb positive rate in the endometriosis group was 31.3% and that in the control group was 14.3%. The difference between two groups was also significant (P<0.01). When determining CA125 alone to diagnose endometriosis, the sensitivity rate was 58.3% and specificity rate was 87.5%. If determining EMAb alone to diagnose endometriosis, the sensitivity rate was 31.3% and specificity rate was 85.7%. When one of them was used as diagnostic criterion, the sensitivity and specificity were 64.6% and 73.2% respectively. If combining use of both CA125 and EMAb as diagnostic criterion, the sensitivity and specificity were 25.0% and 100% respectively.Conclusions The determination of serum CA125 or EMAb levels is helpful for the qualitative diagnosis of endometriosis, especially using them combined, the diagnostic accuracy may be enhanced.