RESUMO
Objective To compare the clinical application of endoscope system and dimensional disc hole mirror, and its advantages of percutaneous transforaminal endoscopic discectomy TESSY technology. Methods Two hundred and eighty patients with lumbar disc herniation randomly divided into foraminal mirror group and endoscopic group(140 cases for each groups). Patients in foraminal mirror group were given TESSY removal of nucleus pulposus through lateral approach road,while in endoscopic group were given posterior approach discectomy. The operation time,bleeding volume,postoperative time,incision length,waist and leg waist pain and functional recovery were recorded. Results The operation incision length in foraminal mirror group was(0. 8 ± 0. 1)mm,significantly shorter in the endoscopic group((1. 7 ± 0. 2)mm),the amount of bleeding in foraminal mirror group was( 9. 8 ± 4. 3 )ml,significantly less than the endoscopic group(( 78. 6 ± 18. 8)ml). The above data were statistically significant difference( t =21. 753,19. 280;P ﹤0. 01 ). The getting out of bed time after operation was(0. 3 ± 0. 1)d,significantly earlier than that in the endoscopic group ((3. 5 ± 0. 8)d;t=21. 451;P﹤0. 01). VAS scores of patients in two group at postoperative were(7. 4 ± 1. 8) and(7. 3 ± 1. 6),significantly decreased than that of preoperative((2. 7 ± 1. 7)and(2. 5 ± 1. 6);t=10. 259, 11. 465;P﹤0. 01),But there were no significant differences between the two groups before and after treatment ( P﹥ 0. 05 ). After treatment,waist function recovery in the two groups were 97. 1%( 136/140 ),95. 7%(134/140),and the difference was significant(χ2 =0. 415,P﹥0. 05). Conclusion Foraminal mirror TESSY technique in the treatment of lumbar disc herniation with microendoscopy discectomy with small incision is proved a good approach with less bleeding,postoperative early rehabilitation.
RESUMO
Objective To study the clinical treatment methods for properties of unknown in elderly patients with atypical squamous cell of undertermind significant and above cervical lesions.Methods According to the clinical grouping of ASCUS in elderly patients with cervical lesions of different treatment methods,observation group 1 (348 cases) underwent colposcopy;observation group 2(316 cases) for high-risk human papillomavirus(HPV) detection,HPV positive colposcopy ;observation group 3 (129 cases) of cervical cytology examination regularly,squamous intraepithelial lesion colposcopy,compared three groups of clinical treatment.Results Liquid based cytology and three groups of 574 patients (TCT) and colposcopy and cervical biopsy,the results of intraepithelial neoplasia(C IN) above cervical lesions in 223 cases(38.9%),in which CIN Ⅰ 136 cases(23.7%),CIN Ⅱ in 64 cases(11.2%),CIN Ⅲ 20 cases(3.5%),3 cases of carcinoma in situ(0.5%) ;the group1 were observed in 348 cases,348 cases underwent colposcopy biopsy(100%),CIN Ⅱ above 36 cases(10.3%) were observed in the group 2;213 cases of colposcopy biopsy(67.4%),CIN Ⅱ above 38 cases (12%) were observed in the group 3 ; colposcopy examination in 13 cases (10.1%),3 cases of biopsy CIN Ⅱ of the cases(2.3%).Biopsy of CIN Ⅱ above the detection rate,the observation group 1,observation of the 2 groups had no significant differences(P ＞ 0.05),and observe the difference between the 3 groups was statistically significant(x2 =7.014,9.156,all P ＜ 0.05).Conclusion High-risk HPV detection of shunt ASCUS can reduce cervical lesions treatment process misdiagnosis,missed diagnosis and treatment of the problem of excessive.