ABSTRACT
Objective To analyze the characteristics and influencing factors of recessive hemorrhagic loss of intertrochanteric fracture in elderly patients with PFNA .Methods The clinical data of 120 elderly patients with IFF from January 2011 to December 2017 in Rizhao Central Hospital were retrospectively analyzed .The dominant blood loss,hidden blood loss and total blood loss after PFNA were calculated ,and the influencing factors were analyzed . Results The total blood loss of 120 elderly patients with intertrochanteric fractures was (911.4 ±240.8) mL,the dominant blood loss was (255.7 ±89.7)mL,occult blood loss was (679.5 ±208.6)mL,the hidden blood loss was significantly greater than the dominant blood loss ,the difference was statistically significant (t=8.669,P<0.05). Hypertension,surgery after injury delayed more than 5d, aged >75, the preoperative use of anticoagulant drugs , unstable fracture and diabetes were the independent risk factors of hidden blood loss of PFNA (OR=2.254,1.676, 0.753,0.965,2.625,all P<0.05).Conclusion Recessive blood loss is the main cause of loss of blood in patients with intertrochanteric fracture of the femur treated with PFNA .Hypertension , surgery after injury delayed more than 5d,aged more than 75 years,the preoperative use of anticoagulant drugs ,unstable fractures and diabetes are risk factors of hidden blood loss of PFNA .
ABSTRACT
Objective@#To analyze the efficacy and safety of intervertebral endoscopy in the treatment of double segmental protrusion of lumbar intervertebral disc.@*Methods@#From February 2016 to May 2017, 126 patients with double segment lumbar disc herniation diagnosed in Rizhao Central Hospital were divided into the observation group and the control group according to the different treatment methods, with 63 cases in each group.The observation group was treated with intervertebral foramen technique, and the control group was treated with conventional fenestration.The treatment efficacy of the two groups was compared.The differences of VAS score and ODI between the two groups before and after operation were compared.@*Results@#Compared with the control group, the observation group had shorter hospitalization time[(7.1±3.1)d vs.(11.5±4.2)d], smaller incision length[(1.2±0.3)cm vs.(4.3±1.6)cm], less blood loss[(22.3±8.2)mL vs.(36.3±9.2)mL], there were statistically significant differences between the two groups (t=9.365, 3.965, 5.566, all P<0.05). From preoperation to 6 months after operation, the VAS scores of the two groups showed a significant downward trend.There were statistically significant difference in the VAS scores between the two groups at different time points, between groups and at different time points (F=5.688, 4.589, 3.998, all P<0.05). From preoperation to 6 months after operation, the ODI of the two groups decreased first and then increased, and there was statistically significant difference between the two groups of ODI in different time points (F=4.254, P<0.05). The good rate of curative effect in the observation group was 87.3%, which in the control group was 84.1%, the difference was not statistically significant (χ2=0.259, P>0.05). There was no statistically significant difference in the incidence rate of adverse reactions between the two groups (6.4% vs.9.5%) (χ2=0.434, P>0.05).@*Conclusion@#The treatment of double segment lumbar intervertebral disc herniation with intervertebral foraminoscopy is reliable, with small tissue trauma and mild pain.