ObjectiveTo evaluate the efficacy, safety, and feasibility of fecal drainage technique on rectal anastomosis for preventing anastomotic leakage after operation for middle-low rectal cancer.MethodsThe retrospective analysis was used to collect the middle-low rectal cancer which completed operation in this hospital from 2014 to 2019. According to the way of preventing annstomotic leakage, the patients were divided into two groups: fecal drainage on rectal anastomosis group (Abbreviation: fecal drainage group) and end ileum prophylactic stoma group (Abbreviation: ileostomy group). The incidence of anastomotic leakage after operation and the different treatment methods following leakage were compared between the two groups.ResultsA total of 231 cases were recorded, including 84 cases in the fecal drainage group, 147 cases in the ileostomy group. There were no significant differences in the baseline data such as the gender, age, preoperative complications, operation mode, etc. between the two groups (P>0.050). There were no significant differences in the operation time, intraoperative blood loss, incision infection, postoperative intestinal obstruction, total hospitalization cost, death, anastomotic leakage (overall, each grade, treatment, and outcome) between the two groups (P>0.050). Although the length of hospital stay except the patients with anastomotic leakage in the fecal drainage group was significantly longer than that in the ileostomy group (P<0.001), there was no significant difference in the total length of hospital stay between the two groups (P>0.050), and the incidence of anastomotic stenosis in the fecal drainage group was significantly lower than that in the ileostomy group (P=0.029).ConclusionAccording to the results of this study, fecal drainage technique on rectal anastomosis is effective, safe, and feasible in preventing anastomotic leakage after operation for middle-low rectal cancer.
【摘要】 目的 比較脛骨平臺骨折術后輔助與不輔助持續被動運動（continuous passive motion，CPM）的臨床療效。 方法 對2008年6月-2009年6月86例行手術治療的閉合性、無合并損傷的脛骨平臺骨折患者進行回顧性分析。根據是否輔助CPM分為CPM組27例和非CPM組（對照組）59例。對兩組患者的傷口愈合情況，膝關節屈曲、伸直角度，以及膝關節功能恢復情況進行比較。 結果 兩組傷口甲級愈合率差異無統計學意義（P=0.566）。在術后2周和6周，CPM組患者的膝關節屈曲角度明顯大于對照組（Plt;0.001），但在術后3個月和12個月，兩組的差異無統計學意義（P=0.219，P=0.512）。在術后2、6周，3、12個月，CPM組和對照組患者的膝關節伸直角度差異無統計學意義。在術后12個月的Rasmussen膝關節功能評分方面，CPM組和對照組的差異無統計學意義。 結論 脛骨平臺骨折術后輔助CPM能早期提升膝關節屈曲角度，但并不能提高遠期的膝關節活動度和最終的膝關節功能。【Abstract】 Objective To compare the therapeutic effect of continuous passive motion (CPM) treatment after tibial plateau fractures operation. Methods From June 2008 to June 2009, 86 patients were treated due to closed tibial plateau fractures without combined injuries. The patients were treated with (27 patients, CPM group) and without (59 patients, control group) CPM. The wound healing rates, range of motion and the knee function were compared between the two groups. Results There was no significant difference between the two groups in wound healing rates (P=0.566). Two and six weeks after the operation, there were significant differences between the two groups in flexion degree (Plt;0.001); three and 12 months after the operation, there were no significant differences between the two groups (P=0.219, P=0.512). At the 2nd and 6th week, 3rd and 12th month postoperatively, there were no significant differences between the groups in extension degree. Twelve months after the operation, there were no significant differences between the groups in functional recovery of the knee. Conclusion CPM in the post-operative treatment of tibial plateau fractures is effective increasing knee flexion in the early stage, but is not effective increasing range of motion or knee function in a long term.
ObjectiveTo explore the related factors, responsible lesions, and prognosis of transient global amnesia (TGA).MethodsWe retrospectively collected TGA patients admitted to Zhongshan Hospital Xiamen University between October 1st 2011 and October 31st 2018 and age- and sex-matched health examinees in the Department of Physical Examination in the same period as a control group. We recorded the relevant clinical information of the two groups, such as sex, age, hypertension, diabetes, hyperlipidemia, atrial fibrillation, stroke, migraine, TGA and epilepsy, and the imaging data of the TGA patients. The occurrences of cerebral infarction, cerebral hemorrhage, recurrence of TGA, and myocardial infarction of the two groups were followed up.ResultsA total of 73 TGA patients and 73 age- and sex-matched controls were included. The difference in the history of migraine was statistically significant (χ2=4.000, P=0.038), while there was no significant difference in the history of hypertension, diabetes or other medical history between the two groups (P>0.05). It was found that the responsible focus of TGA was in the hippocampal CA1 region, while the fornix column and the hippocampal CA1 region existed in the same functional loop. The mean follow-up time was (36.0±22.6) months. Sixty-nine TGA patients and 67 healthy controls were followed up. During the follow-up, there was no significant difference in the incidence of cerebral infarction, cerebral hemorrhage, myocardial infarction, or TGA attacks between the two groups (P>0.05). There was no statistically significant difference (P>0.05) in the clinical or follow-up data between the TGA patients with lesion on DWI (n=9) and the ones without lesion on DWI (n=58).ConclusionsMigraine may be a risk factor for TGA. The responsible brain area of TGA may involve a memory loop, including hippocampal CA1 region, fornix column and so on. After the attack of TGA, the long-term prognosis is well.
