Table of Content

20 August 2012, Volume 12 Issue 04

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Influence of different doses of dexmedetomidine combined with flurbiprofen used in postoperative analgesia of breast surgery

2012, 12(04):  321-324. 

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【Abstract】 Objective To evaluate the efficacy and safety of the dexmedetomidine when it works as an adjunctive medication with flurbiprofen in the postoperative analgesia of patients undergoing breast surgery. Methods: 90 patients(ASAI-II) undergoing breast surgeries were randomly divided into three groups. The postoperative analgesia pumps consisted of normal saline and 150mg of flurbiprofen were used in group A, and that consisted of normal saline, 0.02μg/kg/h of dexmedetomidine and 150mg of flurbiprofen were used in group B, and that consisted of normal saline, 0.04μg/kg/h of dexmedetomidine and 150mg of flurbiprofen were used in group C. All the postoperative analgesia pumps were made in 100ml volume. The study recorded heart rate(HR), blood pressure(BP), oxygen saturation(SPO2), respiratory rate(RR), pain levels(VAS assessment) and sedation scores(Ramsay assessment) of the patients at different time-points which are before operations and 2 hr(T1), 4hr(T2), 8hr(T3), 24hr(T4), 48hr(T5) after operations, as well as the incidents of side effects .Results: There was no statistic difference among three groups in the patients’ general conditions. BP and HR in Group A and Group B after surgery were higher than before. BP in Group C after surgery was higher than preoperative ,while it was opposite with HR. The comparison among these three groups in BP and HR had statistic differences. The pain levels within 8hr after operations in Group B and C were lower than Group A(P﹤0.05).The sedation scores within 8hr after operations in Group C was higher than Group A and B(P<0.05).The ratio of nausea and vomiting were highest in Group A. The incidence of hypersomnia could only be observed in Group C. Respiratory depression was not found in all cases. The SPO2 of all patients were above 95%. Conclusion: The use of combination of dexmedetomidine(0.02μg/kg/h) and flurbiprofen in postoperative analgesia can offer a better effect of analgesia and sedation than that of flurbiprofen alone, and relatively decrease the incidence of nausea and vomiting, so it can be used in the postoperative analgesia of breast surgery effectively and safely.

Clinicopathological and survival analysis of 56 cases of gastric cancer in the young patients

2012, 12(04):  332-335. 

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【Abstract】 Objective To investigate the clinicopathological characteristics and prognosis of young patients with gastric carcinoma . Methods Retrospective analysis were conducted on 56 young patients with gastric carcinoma(age≤40 years)who were initial treated in our hospital from Jan.2005 to Dec.2010 in our hospital, and 56 cases had been chosen randomly from the old ones (age≥60 years))over the same period as the control group. Statistical analysis was performed by SPSS13.0 software package. Results In 56 gastric cancer patients of the young group ,the proportion of women was higher than men (χ2= 11.593, P = 0.001). In the young group, Gastric carcinoma more often arised in gastric antrum. The gastric cancer in the young group was mainly poor differentiated adenocarcinoma and anaplastic carcinoma; its proportion was higher than the control group (χ2=16.586, P < 0.001).The clinical stages of most young patients were Ⅲ and Ⅳ.The median survival time after resection was 39.56 months in the young group, and the total of 1，3，5-year survival rates were 80.0%, 52.0%, 24.0% respectively. In the young group the survival rate of patients who had got radical resection was higher than the patients who had undergone palliative surgery (χ2==5.836, P = 0.016).In this study , surgical methods , tumor size, pathological type, clinical stage were main factors affecting the prognosis of young patients with gastric carcinoma (P < 0.05). Conclusion Gastric cancer in the young patients is common in female. Its symptoms are always hidden and it is highly malignant, most cases are diagnosed in later period, early diagnosis and early radical resection is helpful to improve the prognosis of gastric cancer.

Diagnostic value of CT in mechanical small-bowel obstruction caused by intraluminal foreign bodies.

2012, 12(04):  335-337. 

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[Abstract] Objective To evaluate the value of CT in diagnosis of rare mechanical small-bowel obstruction (SBO) caused by intraluminal foreign bodies. Methods The CT imaging features of 8 patients with mechanical SBOs caused by intraluminal foreign bodies were reviewed retrospectively. Results The presence of mechanical SBOs in 7 cases were diagnosed by CT imaging before operation, including the ingested foreign bodies in 3 cases, bezoars in 2 cases and gallstones in 2 cases. Another one was misdiagnosed the bezoars as tumor. All cases were confirmed by open abdomen operation. SBO-related complications such as ischemia and perforation were not found in all patients. Conclusion CT examination are effective for diagnosis of mechanical small-bowel obstruction (SBO) caused by intraluminal foreign bodies by the typical CT signs.

Laparoscopic versus open appendectomy in aged patients with acute appendicitis in basic hospital

2012, 12(04):  346-347. 

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Objective To compare the advantages and disadvantages of laparoscopic versus open appendectomy in aged patients with acute appendicitis. Methods 83 patients were divided into laparoscopic group (n=43) and open appendectomy grup (n=40) according to individual willing. Prospective non-randomized study was performed to compare the operative time, operative bleeding, recovery period, bowel exhaust time, hospitalizition time, anesthetic usage rate and wound infection rate. Results There were significant differences between laparoscopic group and open appendectomy group in these indexes except the operative bleeding(P<0.05). Conclusion The laparoscopic appendectomy possesses more advantages in treating aged patients with acute appendicitis and can decrease hospitalization time. It should be applicated and popularized in basic hospita1.

Effect of RPH combined with external hemorrhoids resection in the treatment of mixed hemorrhoids

2012, 12(04):  348-349. 

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Objective To evaluate the effect on the automatic ligation of hemorrhoids ( RPH ) combined with external hemorrhoids resection in the treatment of mixed hemorrhoids. Methods A retrospective data of patients with mixed hemorrhoids from January 2008 to January 2010 were studied. Of all patients, 160 cases were underwent combined RPH and external hemorrhoids resection (treatment group), and 156 were received milligan-morgan procedure alone (control group). The curative effect was evaluated between two group. Results The cure rates of treatment group and the control group were respectively 98% and 85%, however the former was more effective than the latter in treatment of mixed hemorrhoids ( P<0.05 ). Conclusion RPH plus external hemorrhoids resection can improve the curative effect in the treatment of mixed hemorrhoids.

Analysis of therapeutic effects of treating senile lumbar degeneration by posterior lumbar interbody fusion autogenous morselized bone graft impaction

2012, 12(04):  366-368. 

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【Abstract】 Objective To investigate the curative effect of posterior lumbar interbody fusion autogenous morselized bone graft impaction for senile lumbar degeneration Methods A retrospective study was performed for 54 cases of senile lumbar degeneration and all cases were undergone posterior lumbar interbody fusion autogenous morselized bone graft impaction .The efficacy evaluation through follow-up. Results 54 cases were followed up of 6 to 30 months, an average of l4 months. All cases with lumbar interbody fusion had good bone graft fusion, normal disc space and no loss of spondylolisthesis reduction. During the follow-up, the total success rate was 89.72%. Conclusion It is a good method for posterior lumbar interbody fusion autogenous morselized bone graft impaction to cure senile lumbar degeneration.

Respiratory cardiac arrest resulted from emphysematous pyelonephritis ( report of 1 case)

2012, 12(04):  373-374. 

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Objective To report a case of respiratory cardiac arrest resulted from emphysematous pyelonephritis and review of literature. Methods The data of a case of respiratory cardiac arrest resulted from emphysematous pyelonephritis was retrospectively analyzed and the literature is reviewed. Results The patient with severe renal parenchymal infection was proposed to receive nephrectomy, but respiratory cardiac arrest occurred and died. Conclusion Nephrectomy is advised in case of severe emphysematous pyelonephritis. Imbalanced electrolyte and toxin absorption can lead to respiratory cardiac arrest. Intensive care is needed for prevention.