Risk factors of incision infection and spinal canal hematoma after lumbar posterior surgery / 中华骨科杂志

Objective To analyze the risk factors of incision infection and spinal canal hematoma after lumbar spinal posterior surgery.Methods Data of 33 patients with incision infection and 25 patients with spinal canal hematoma after posterior surgery for lumbar spinal disease from January 2010 to December 2014 were retrospectively analyzed.For the patients with incision infection,20 of them were males and 13 were females,with an average age of 58.85±8.76 years (range 38-79 years).Of these patients,5 were diagnosed with lumbar disc herniation,9 with lumbar spondylolisthesis,15 with lumbar spinal stenosis and 4 with lumbar vertebral fracture.For patients with spinal canal hematoma,17 of them were males and 8 were females,with a mean age of 60.96±11.37 (range,38-77).The diagnoses of them were lumbar disc herniation in 18 patients,spondylolisthesis in 3 patients and spinal stenosis in 4 patients.From the same period database,patients who underwent lumbar posterior lumbar surgery with no postoperative complications were selected by 3:1 ratio as the control group according to age,gender and diagnosis.Results For patients with incision infection,it was found that diabetes mellitus,preoperative RBC,hemoglobin,total protein,albumin,serum calcium,operation time,number of segment fusion,intraoperative blood loss,postoperative WBC,RBC,hemoglobin and platelet were significantly different from those with non-infection group.Moreover,multivariate logistic analysis showed that diabetes mellitus (OR=3.716,P=0.032),preoperative serum calcium (OR＜ 0.001,P=0.001),intraoperative blood loss (OR=1.002,P=0.014),postoperative hemoglobin (OR=0.923,P=0.018) and postoperative platelet (OR=1.007,P=0.017) were independent risk factors for postoperative incision infection.For patients with spinal canal hematoma,it was found that patients' preoperative total protein,albumin,serum calcium,platelet,operation time,intraoperative blood loss and postoperative total protein were significantly different from non-hematoma group.Multivariate logistic analysis showed that preoperative serum calcium (OR＜ 0.001,P=0.001),preoperative total protein (OR=1.298,P=0.043),intraoperative blood loss (OR=1.003,P=0.021) and postoperative total protein (OR=1.080,P=0.028) were independent risk factors for postoperative spinal canal hematoma.Conclusion The preoperative diabetes mellitus,serum calcium,intraoperative blood loss,postoperative hemoglobin and platelet were important risk factors for lumbar incision infection.And preoperative serum calcium,total protein,intraoperative blood loss and postoperative total protein were the risk factors for spinal canal hematoma.

Comparison of serum specific IgE and skin prick test in allergic rhinitis patients sensitive to dust mite / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the correlation of serum specific IgE and skin prick test in allergic rhinitis patients sensitive to dust mite and the difference between the results.@*METHOD@#Data of 349 allergic rhinitis patients who had positive result in either Dermatophagoides pteronyssinus(Der p) or Dermatophagoides farinae (Der f) by serum specific IgE and skin prick test were statistically analyzed.@*RESULT@#Grades of Skin prick test and specific IgE levels were notably relevant in these two dust mites(Der p r= 0. 568, Der f r= 0. 506, P0.05). There was no correlation between positive degree of two methods and score of clinical symptoms in allergic rhinitis.@*CONCLUSION@#Serum specific IgE and skin prick test were notably relevant in allergic rhinitis patients sensitive to dust mites. The positive rates of the two methods were different due to different allergen. Therefore, they could not substitute for each other. The level of serum specific IgE and positive degree of skin prick test could not reflect the degree of symptom in allergic rhinitis.

The effects of subcutaneous allergen immunotherapy by Alutard SQ allergy vaccination in management of perennial allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the effects of subcutaneous allergen immunotherapy by Alutard SQ allergy vaccination in management of perennial allergic rhinitis.@*METHOD@#Thirty-eight cases of the perennial allergic rhinitis received the subcutaneous allergen immunotherapy by Alutard SQ allergy vaccination for 3 years or more than 3 years. The clinical symptoms and signs were compared before and after treatment.@*RESULT@#Good result were obtained in 21 of 38 cases, 7 cases effective, and 10 cases ineffective. Total effective rate was 73.68%.@*CONCLUSION@#The subcutaneous allergen immunotherapy by Alutard SQ allergy vaccination was very effective for the perennial allergen rhinitis.