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Objective To discuss the effect ofrivaroxaban in preventing deep venous thrombosis after large orthopedic operation of lower extremity.Methods Totally 80 patients after lower extremity of large orthopedic operation were selected,they were divided into two groups randomly.The patients in control group (39 cases) were sc injected with enoxaparin through.The patients in observation group (41 cases) were given rivaroxaban orally.The effect of rivaroxaban in preventing deep venous thrombosis after large orthopedic operation of lower extremity were evaluated by hemodynamic indexes,diagnosis index,and complications during 1 months follow-up.Results Before operation,there was no statistical significance on platelet,hemoglobin,and PT values between two groups.Compared with the value before operation,the value ofplatelet and hemoglobin had no significantly change after 3 d of operation.But the PT was increased (P ＜ 0.05).After 3 d of operation,there was no statistical significance on platelet and hemoglobin between two groups.But the PT value of observation was higher than that of control group (P ＜ 0.05).After 1 h operation,there was no statistical significance on D-dimer,Hcy,and hs-CRP between two groups.Compared with the value after 1 h of operation,the values of D-dimer,Hcy,and hs-CRP were decreased significantly (P ＜ 0.05).And the indexes of observation group were lower than those of control group (P ＜ 0.05).After 1 months of operation,although there was no statistical significance on complications between two groups,the incidence rate of secondary bleeding and DVT of control group was higher than that of the observation group.Conclusion The rivaroxaban could prevent DVT well,which is suitable for the anticoagulation therapy after lower extremity of large orthopedic operation with little influence on platelet and hemoglobin.It is worthy of clinical application.
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Objective To explore the effect of autologous blood transfusion on cytoimmunity during orthopedic operation.Methods Two hundred and twenty-six patients undertaken selective operation from June 2007 to October 2011 were divided into observation group ( 154 cases) and control group (72 cases).The observation group was received autologous blood transfusion and the control group was given homologous transfusion.T lymphocyte subsets and natural killer (NK) cell counts in blood samples were detected by flow cytometry before operation and 1,6 days after operation.Results CD3+,CD4+,CD4+/CD8+,NK cell of the observation group and control group on 1st day of postoperation were 0.7184 ±0.0921,0.3878 ±0.0611,1.64 ± 0.27,0.1627 ± 0.0633 and 0.6548 ± 0.0852,0.3137 ± 0.0726,1.18 ± 0.31,0.1465 ± 0.0514,respectively,which decreased obviously compared with those of preoperation in both groups (0.7436 ± 0.1069,0.4301 ±0.0818,1.68 ±0.31,0.1945 ±0.0572 and 0.7537 ±0.0940,0.4453 ±0.0608,1.62 ± 0.32,0.1821 ± 0.0571 ) (P ＜ 0.05 ).The above parameters of the observation group were significandy higher than those of the control group on 1 st day of postoperation (P ＜ 0.05 ).There were no significant differences of CD3+,CD4+,CD4+/CD8+ and NK cell on the 6th day of postoperation compared with the preoperation in the observation group (P ＞ 0.05).But CD3+,CD4+,CD4+/CDs+ and NK cell on the 6th day of the postoperation were 0.6266 ± 0.0905,0.3048 ± 0.0425,1.07 ± 0.27,0.1408 ± 0.0716,which were significantly lower than the preoperation in the control group (P ＜ 0.05).Conclusions Intraoperative autologous blood transfusion have less inhibitory effect on cytoimmunity than homologous transfusion.The patients having autologous blood transfusion have a rapid recovery of cytoimmunity.
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[Objective]To explore the clinical efficiency,operative methods,apparatus assembly and postoperative administration of Ilizarov technique in the correction of talipes equinovarus.[Method]From January 2003 to May 2006,32 patients were corrected with QIN Si-he's orthotics devices on the Ilizarov principle of tension-stress,which involved 15 males and 17 females,the age ranged from 10 to 25 years.Among these patients,2 were caused by peroneal nerve injury,l by tumor in the vertebral canal,5 by meningocele,11 were caused by poliomyelitis,13 by congenital talipes equino-varus.In accordance with deformities,external fixator and limitied operative methods were dertermined.The limited release of soft tissue were performed in 7 patients,limited osteotomy in 25 patients.The dynamic muscle balance operation were performed in 9 patients with imbalance of muscle strength.According to the Ilizarov technique,the fixative rods were installed.The telescopic rods on the apparatus were rotated one week after the operation,the divices had corrective function in three-dimensional directions.The deformity of talipes equinovarus,internal rotation and drooping of the forefoot were gradually corrected,and the patients could bear weight and walked on the deformed foot.The mean duration of traction were 42 days,then removed the external fixator maintained with plaster for a site time.[Result]All patients were followed up from 12 months to 37 months with an average of 17 months.There was no recurrence of the deformity and feet function was good while walking on full weight-bearing.None of the complication occurred postoperatively sush as infection in the incision,neurovascular injury and ankle dislocation.[Conclusion]With Ilizarov technique to correct talipes equinovarus is a safe,minimally invasive and effective method.Combined with limited operation Ilizarov technique can correct severe talipes equinovarus which is unattainable by traditional orthopedic surgery,and shorten the treatment period,avoid severe complications.