Objective To evaluate the effect of sensory disturbance after the sagittal split ramus osteotomy (SSRO）on quality of life. Methods From September2004 to September 2005, 21 patients undergoing SSRO were studied by using questionnaires. There were 12 males and 9 females, aging 1927 years(mean 22.6 years).The patients were followed up at 4 weeks and 24 weeks after operation. The subjective questionnaire was completed by patient to evaluate the degree of living quality descending. Results At 4 weeks,19(90.48%) patients’ living quality descended because of postoperative sensory disturbance. Among them, 7(33.33%) patients had severe descending of living quality. The average effecting time of living accounted for total time 26.9%(about 6.5 h/d). At 24 weeks, 12(6316%) patients’ living quality descended because of postoperative sensory disturbance, 7(36.84%) patients could achieve preoperative living quality. The average effecting time of living accounted for total time 15.5%(about 3.7 h/d). Conclusion Most patients have descending of living quality after SSRO because of sensory disturbance. However, this condition can be improved during the followup and more than 1/3 patients canachieve their preoperative living quality.
ObjectiveTo evaluate the influence of sidestream dark field (SDF) imaging technology in laparoscopic anterior resection (LAR) of rectal cancer on postoperative anastomotic leakage. MethodsAccording to the inclusion and exclusion criteria, the patients diagnosed with rectal cancer and underwent LAR of rectal cancer in the Sichuan Provincial People’s Hospital from October 2017 to October 2021 were retrospectively analyzed and then were divided into the study group and the control group according to whether SDF imaging technology was used during the operation. The intraoperative and postoperative data, especially the postoperative anastomotic leakage, were analyzed. ResultsA total of 90 patients were involved in this study, including 40 patients in the study group and 50 patients in the control group. There were no statistical differences in the baseline data such as gender, age, boby mass index and so on between the two groups (P>0.05). Except that the incidence of anastomotic leakage in the study group was lower than that in the control group (P<0.05), there were no statistical differences in other indexes during and after operation between the two groups (P>0.05). The operation plans were changed in 8 patients of the study group. Except for the total vessel density (P=0.962), the microvascular flow index, perfusion vessel proportion, and perfusion vessel density in the last measurement of these 8 patients were higher than those in the first measurement (P<0.05). ConclusionFrom preliminary results of this study, real-time evaluation of intestinal microcirculation by SDF imaging technology can help surgeons evaluate microcirculation perfusion at the intestinal anastomosis and provide an important reference for surgical decision-making.
【Abstract】 Objective To explore the correlation between pain grading, stage of necrosis and bone marrow edema(BME) in nontraumatic osteonecrosis of femoral head (NONFH) so as to strengthen understandings about cl inical significance of BME in NONFH. Methods From October 2004 to October 2006, 97 patients (149 hips) with NONFH were treated. There were 68 males and 29 femals with an average age of 38.8 years (19-62 years). The disease course was from 20 days to 4 years. BME was identified grade 0 to grade 2 according to MRI. Based on grading scale of pain, pain grading were divided into no pain (grade 0), mild pain (grade 1) and moderate or severe pain (grade 2). According to Association Research Circulation Osseous staging system, NONFH were divided into I-IV stages. The incidence rate of BME in each pain grading and stages of necrosis was analyzed respectively. Contingency table analyses and rank sum tests were used to compare the difference of pain grading and stages of necrosis among these groups. Results The total incidence rate of BME was 73.15% (109/149), the incidence rateswere 84.38% in pain groups (108 /128) and 94.12% in the grade 2 (32/34). Pain grading correlated with BME rating (P lt; 0.001).The results of rank sum tests for several independent samples showed significant difference in BME among pain groups(P lt; 0.001). With the advance of pain scale, the mean rank of BME increased gradually(28.19 for grade 0, 78.94 for grade 1 and 96.12 for grade 2). BME was more commonly and clearly seen in stage Ⅱ（77.05%）and stage Ⅲ（82.81%）of NONFH. Stage I-III of NONFH correlated with BME rating (P lt; 0.001). The results of rank sum tests showed significant difference in BME rating among three stages (P lt; 0.001). With the advance of disease, the rank of BME rating increased gradually (39.07 for grade 0, 60.16 for grade 1 and 86.15 for grade 2 ). Conclusion BME is a sign that is accompanied with NONFH. The probabil ity and extent of BME correlated well with the pain and stage of NONFH．The condition of BME can be used as a index for the appraisal of advancement of disease and the judgment of treatment result.