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China Journal of Endoscopy ; (12): 1-7, 2023.
Article in Chinese | WPRIM | ID: wpr-1024783

ABSTRACT

Objective To observe the clinical curative effect of unilateral biportal endoscopy(UBE)in the treatment of extreme lateral lumbar disc herniation(ELLDH).Methods From June 2019 to June 2022,25 patients with ELLDH were treated with UBE-guided discectomy,including 16 males and 9 females.The age ranged from 26 to 62 years with a mean of(53.67±17.45)years.History ranged from 3 d to 10 years.There were 9 cases of internal foraminal type(type Ⅰ),13 cases of external foraminal type(type Ⅱ)and 3 case of mixed type(type Ⅲ).There were 8 cases of L4/5 space and 17 cases of L5/S1 space.All the patients underwent anterior and lateral lumbar X-rays,CT and MRI scans before surgery.The visual analogue scale(VAS)pain score and Oswestry disability index(ODI)assessed lower limb and lower back pain and functional recovery before surgery and at 3 d and 3 months after surgery,respectively.Macnab criteria evaluated the immediate surgical outcome.Results The UBE technique was used to treat ELLDH.The operative time was(79.79±23.97)min,the intraoperative bleeding volume was 40~80 mL,with an average of(55.80±10.74)mL.Follow-up time was(7.02±4.26)months.Preoperative VAS of lower limb was(7.04±0.92),lower back VAS was(3.49±1.52),ODI was(35.03±2.97)%.Compared with the preoperative results,the lower limb VAS was(2.17±0.61),lower back VAS was(1.48±0.43),and ODI was(18.77±3.15)%on day 3 after surgery,lower limb VAS was(1.38±0.65),lower back VAS was(1.03±0.48)and ODI was(6.05±1.80)%on the 3 months after surgery were improved(P<0.05).The excellent and good rate was 96.0%(excellent 20,good 4,fair 1),and no obvious complications were observed during the follow-up.Conclusion UBE is effective,with little trauma,clear intraoperative visual field,good intraoperative experience,and less traumatic and safe in the treatment of ELLDH.

2.
Article in Chinese | WPRIM | ID: wpr-437039

ABSTRACT

Objective To investigate the knowledge awareness of medical staff in department of Obstetrics and Gynecology,on prevention of mother-to-child transmission of hepatitis B virus(HBV).Methods Medicatl staff,who attended national or local medical conferences of Obstetrics and Gynecology from July 29th to October 25th in 2011,were invited to complete a questionnaire containing questions on clinical implications of HBV serologic markers,relevant prevention measures and including intervention measures for both pregnant women and infants.Data were collected and analyzed by Chi-square test or Fisher's exact test.Results A total of 559 answers were analyzed.Of the 559 staff,85.0%(n=475) were doctors and 15.0%(n=84) were nurses.The percentages ofstaff from primary,secondary and tertiary hospitals were 13.2%(n=74),36.9%(n=206) and 49.9% (n=279).Overall,90.0% (503/559) participants agreed that positive hepatitis B surface antigen (HBsAg) was contagious,but 27.5% (154/559) mistook that the presence of antibody against hepatitis B e antigen (anti-HBc) and/or antibody against hepatitis B core antigens (anti-HBc) with negative HBsAg was contagious.Totally,96.3% (519/539) respondents knew that pregnant women should be screened for HBV infection,and those from secondary hospitals had more consciousness of HBV screening for pregnant women than those from tertiary hospitals [99.0% (201/203) vs94.7%(250/264),x2=6.466,P=0.011].Although,95.3% (511/536) realized that infants of mothers with positive HBsAg should receive hepatitis B immunoglobulin (HBIG) and vaccination,but 61.6% (330/536) and 80.4% (427/531) of the enrolled medical staff knew the exact regimen.With the available immunoprophylaxis,13.8% (74/536) participants mistakenly believed that cesarean section may prevent HBV mother-to-child transmission,and only 13.0% (69/532) correctly answered that neonates of women with positive HBsAg can be breast-fed.Additionally,54.4% (290/533) participants mistakenly believed that HBsAg positive pregnant women needed HBIG injection during pregnancy to reduce HBV mother to-child transmission.Conclusions Medical staff in obstetric and gynecological department has essentially mastered the strategies of prevention of mother-to-child transmission of HBV,but much more details should be stressed.

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