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Objective To explore the risk factors of hip fracture in elderly patients from Yongkang.Methods From August 2014 to August 2016,468 elderly patients with hip fracture admitted to Department of Orthopedics, Orthopedics Hospital of Yongkang were prospectively collected as study group,and 150 elderly people admitted to Orthopedics Hospital of Yongkang and Community Health Service Center for health examination were randomly selected as control group.The complications,daily living habits,bone density and menstruation of the female were observed between the two groups.Results Compared with the control group,the incidence rate of diabetes in the study group increased significantly(28.63% vs.12.67%,χ2 =15.544,P =0.000),the rate of height decreased more than 3cm increased significantly (16.88% vs.8.00%,χ2 =7.134,P =0.008),the proportion of long -term use of hormone significantly increased (18.59% vs.10.00%,χ2 =6.082,P =0.014),the rate of physical exercise decreased signif-icantly (14.32% vs.22.67%,χ2 =5.793,P =0.016),the rate of bed ridden increased significantly (5.34% vs 1.33%,χ2 =4.369,P =0.037),the bone density of femoral neck decreased significantly[(0.99 ±0.12)g/cm2 vs. (1.10 ±0.12)g/cm2 ,t =10.139,P =0.000].When it came to the females,the rate of menopause before the age of 45 years in the study group was higher than that in the control group (33.23% vs.22.22%,χ2 =4.299,P =0.038).Conclusion Diabetes,height decrease >3 cm,long -term use of hormones,lack of physical exercise,bed ridden and bone density decrease are risk factors of hip fracture in elderly people from Yongkang,and menopause before the age of 45 is a risk factor for hip fracture in elderly women.
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ObjectiveTo explore the effects of different anesthesia approaches on hemorheology in patients with pregnancy-induced hypertension (PIH) during cesarean section.MethodsOne hundred and sixty-five patients with PIH were divided into epidural anesthesia (81 cases,control group) and combined spinal epidural anesthesia (84 cases,experiment group).The hemorheology and Apgar score were compared.Results The anesthesia and post-parturition,the levels of whole blood low shear viscosity,whole blood middle shear viscosity,whole blood high shear viscosity,erythrocyte aggregation index,plasma viscosity,fibrinogen were improved compared with those before anesthesia [experiment group:(6.3 ± 0.7 ),(6.6 ± 0.6)mPa·s vs.(8.1 ± 1.8) mPa·s,(3.8±0.6),(3.9±0.4) mPa·s vs.(5.2±0.9) mPa·s,(3.1 ±0.8),(3.2±0.7) mPa·s vs. (4.5 ± 1.2) mPa·s,3.0 ±0.4,3.1 ±0.7 vs.2.8 ±0.7,(1.2 ±0.2),(1.1 ±0.5) mPa·s vs.(1.8 ±0.6) mPa·s,(5.3 ± 0.8),(5.3 ±0.7) g/L vs.(4.7 ±0.8) g/L;control group:(7.9 ±0.8),(7.5 ±0.7)mPa·s vs.(8.2± 1.3) mPa·s,(4.5±0.4)、(4.5 ±0.4) mPa·s vs.(5.4±0.7) mPa·s,(3.7±0.8),(3.5±0.8 ) mPa· s vs. (4.6 ± 0.5 ) mPa· s,2.8 ± 0.6,2.9 ± 0.3 vs.2.7 ± 0.6,( 1.6 ± 0.4),( 1.7 ± 0.1 ) mPa· s vs.(1.9 ±0.8) mPa ·s,(5.0 ±0.9),(4.8 ±0.8) g/L vs. (4.7 ±0.5) g/L,P ＜0.05],and all the level of hemorheology in experiment group were improved compared with control group (P ＜ 0.05).There was no significant difference in 1,5 min Apgar scores between two groups (P ＞ 0.05).ConclusionThe epidural anesthesia and combined spinal epidural anesthesia can improve hemorheology of patients with PIH during cesarean section,but the combined spinal epidural anesthesia is more effective and favorable for pregnancy outcome.
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Objective To compame the lumbar hemp-epidural block anesthesia choose different combination puncture point in pregnancy on laboratory intraoperative anesthetic effect.Methods 110 maternals classified for ASA Ⅰ～Ⅱof lactation,according to random number tables were divided into two groups,Ⅰ group lumbar puncture points for L2-3 clearance,Ⅱ group of lumbar puncture points to L3-4 clearance.Both groups the waist hemp-epidural joint block anesthesia downlink cesarean section,and two sets of anesthesia effect-acting period,after the baby born of 1 min Apgar score before anesthesia,the average arterial blood pressure(MAP)change,the lowest rate,adjust the number,surgical operation bed at the start of the plane,need anesthesia epidural anesthesia,medication found during hypotension and breathing difficulties incidence,intraoperative nausea and vomiting adverse events were compared.Results The operations of the two groups were successful,and there were no complications in postoperation maternal and newborn.Difficulty breathing rate,hypotension incidence,the incidence of nausea and vomiting were obviously higher than Ⅱ groups was statistically significant lying-in woman,difference(2 cases,1 case,x2=14.7,11.5,all P＜0.01).Need to adjust surgery beds in the number,epidural drugs significantly higher than the average Ⅱ group Ⅰ group(38.2%,47.3%,25.5%,x2=12.5,14.8,18.4,all P＜0.01).Conclusion In cesarean section in the operation,lumbar hemp-epidural joint block anesthesia choose L3-4 puncture,can reduce anesthesia cause nausea,vomiting hypotension,spinal cord injury and taper adverse reactions such as the incidence,in safer surgery under general anesthesia successfully completed cesarean section.
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Objective To study the effects of different anesthesia methods on postoperative changes in T-lymphocyte subsets and IL-6、IL-10、TNF-α in the patients undergoing operation of stomach carcinoma.Methods 60 patients with stomach carcinoma were randomly divided into group I(general anaesthesia)and Ⅱ(general combined epidural anesthesia).The level of T-lymphocyte subsets and IL-6、IL-10、TNF-αt were respectively detected and compared before anesthesia,2 h after anesthesia,ld and 6 d after operation.Results CD3+ 、CD4+ 、CD4+/CD3+ decreased,but IL-6 increased at the end of 2 h after anesthesia,l d after operation compared with those before anesthesia(all P＜0.05).While IL-10、TNF-α had no statistical significance(all P＞0.05).At 6 d after operation,the values recovered to the level before anesthesia in two groups.Conclusion The immune function in patients with gastric cancer decreaseed after anesthesia,it was more serious in geteral anaesthesia than that of general combined epidural anesthesia.But anesthesia had little influence on inflammatory response.