ABSTRACT
Objective To compare the clinical effect between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) via Quadrant minimally invasive system and open transforaminal lumbar interboday fusion(TLIF) in treating lumbar degeneration disease.Methods Clinical data of 46 patients in the First Affiliated Hospital of Xinxiang Medical University from April 2016 to April 2017 with lumbar degenerative diseases who were given operation treatment were analyzed retrospectively.Twenty patients underwent MIS-TLIF via Quadrant minimally invasive system(MIS-TLIF group) and twenty-six patients underwent open-TLIF(open TLIF group).The blood loss,operative time,length of incision,volume of drainage after operation,time of ambulation,hospitalization time,hospitalization cost,postoperative complications,visual pain simulation (VAS) score and Oswestry disability index(ODI) at 1,3,6 and 12 months after operation were compared between the two groups.Results The blood loss,length of incision,volume of drainage after operation,time of ambulation,hospitalization time,hospitalization cost in the MIS-TLIF group were less than those in the open TLIF group (P ＜0.05);there was no significant difference in operative time between the two groups(P ＜0.05).The VAS score and ODI of the MIS-TLIF group were lower than those of the open TLIF group at 1 and 3 months after surgery (P ＜ 0.05);there was no significant difference in the VAS score and ODI between the two groups at 6 and 12 months after surgery (P ＜ 0.05).There was no complication such as dural and nerve injury and internal fixation rupture in the two groups.In the open TLIF group,postoperative wound healing was delayed in two cases,postoperative incision infection occurred in one cases,the incidence of postoperative complication was 11.5％ (3/26).In the MIS-TLIF group no postoperative complication occurred,the incidence of postoperative complication was 0.0％ (0/20);the incidence of postoperative complications was not statistically significant between the two groups (x2 =2.471,P ＜ 0.05).Conclusion MIS-TLIF via Quadrant minimally invasive system has the advantages of less blood loss,incision and volume of drainage after operation in treating lumbar degenerative disease,and it can be used as the first choice for the treatment of lumbar degenerative disease.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of enhanced nutritional therapy on wound healing after endoscopic therapy in patients with liver cirrhosis and esophageal varices.</p><p><b>METHODS</b>Fifty patients with liver cirrhosis and esophageal varices were randomly divided into an enhanced nutritional therapy group (n = 25) and a control group (n = 25). The enhanced nutritional therapy group received one week of enhanced nutritional supplementation, including liver nutritional elements, prior to routine endoscopic therapy. The routine without any change to their diet. The rate of transformation and status of wound healing of esophageal varices were compared between the two groups.</p><p><b>RESULTS</b>The ratio of ulcers occurring at the injection site was lower in the enhanced nutrition group than in the control group (16/25 vs. 23/25; x2 = 5.711, P = 0.017). The enhanced nutrition group had only one case of minimal bleeding occurring during endoscopy as compared to the seven cases of bleeding in the control group (x2 = 5.357, P = 0.021). On average, the enhanced nutrition group required less sessions of endoscopic treatment to achieve eradication of esophageal varices than the control group (3.8 vs. 4.1; t = 2.069, P = 0.044).</p><p><b>CONCLUSION</b>Pre-endoscopic enhanced nutritional therapy may benefit patients with liver cirrhosis and esophageal varices by promoting recovery of procedure-related local tissue injury and occlusion of varices.</p>