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Frequency of Transfusions and Risk Factor for Bleeding Risk to Guide a Blood-Sparing Program during Hip Arthroplasty in Gabon

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Open Journal of Anesthesiology 2023年第3期13卷 47-57页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Arthur Matsanga Pascal Christian Nze Obiang Stéphane Oliveira Léandre Nguiabanda Jean-Marcel Mandji-Lawson Romain Tchoua Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon Orthopedic surgery service Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip arthroplasty in order to guide a blood-saving program. Method: Retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion data, anesthetic and intraoperative data. The primary outcome was intraoperative or postoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 276 patients included, 179 benefited from Total Hip prosthesis (THP) and 97 from Intermediate Hip prosthesis (IHP). Spinal anesthesia was performed in 67.4% of patients. The ASA 2 score predominated (65.9%). The transfusion incidence was 56.9% (157/276). Tranexamic acid was used in 16.3% (45/276) of patients. The average bleeding was 528 ± 405 ml. Preoperative anemia (OR = 0.78, 95% CI [0.66 - 0.91]) and total hip prosthesis (OR = 2.02 95% CI [1.11 - 3.67]) were predictors of bleeding and transfusion to be significant. The average serum hemoglobin predictive of a transfusion was 11.6 ± 1.8. ASA score and operative time were not found as risk factors for bleeding and transfusion. Conclusion: The incidence of transfusion is high. Preoperative anemia remains a major but modifiable risk factor unlike the choice of implant. The implementation of a patient blood management protocol could reduce this transfusion incidence.

关键词： Arthroplasty Hip Gabon Transfusion

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肱骨近段的同种异体骨一假体复合物重建手术技术

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中华骨科杂志 2011年第3期31卷 I0019-I0025页

作者： Ayesha Abdeen, MD John H. Healey, MD 许宋锋(译) 于秀淳(译) Investigation performed at the Orthopaedic Surgery service Departnvent of Surgery Memorial Sloon-Kettering Ctuwer Center New York NY 济南军区总医院骨病科 250031

背景：肱骨近段肿瘤切除的保肢治疗面临很多挑战。由于骨与软骨缺损之外还有盂肱关节周围软组织稳定结构的丢失，使重建方法的选择受到限制。本文的目的是评价肱骨同种异体骨一假体复合物行保肢治疗后的功能结果和似体复合物的生存率。... 详细信息

背景：肱骨近段肿瘤切除的保肢治疗面临很多挑战。由于骨与软骨缺损之外还有盂肱关节周围软组织稳定结构的丢失，使重建方法的选择受到限制。本文的目的是评价肱骨同种异体骨一假体复合物行保肢治疗后的功能结果和似体复合物的生存率。方法：16年中，本中心接受36例患者肱骨近段肿瘤切除同种异体骨一假体复合物重建缺损的治疗。其中30例为原发肿瘤切除同时行重建，5例为原肿瘤切除重建失败后再次重建，1例为肿瘤局部复发切除重建。生存患者平均随访5年。评价指标包括重建后的肩关节稳定性、功能、假体生存率、骨折发生率和愈合率。根据三角肌切除范围、关节内或关节外切除、肱骨切除长度来分析其功能结果和假体生存率。结果：1例患者出现肩关节脱位。三角肌切除范围（部分或全部）影响术后肩关节屈曲、外展活动度，但不影响肌肉骨肿瘤学会评分（MSTS）。关节外切除的MSTS评分较低。最后一次随访时所有患者有轻度或无疼痛和手功能正常。，以翻修作为终止点．10年假体总生存率为88％。3例因进行性的假体松动而行假体取出。4例因骨连接部延迟愈合行植骨治疗。结论：肱骨近段肿瘤切除保肢治疗时采用同种异体骨一假体复合物重建是一种临床可行的重建方法，并发症较少。保留三角肌和关节内切除可以获得更大范围的肩关节活动度、更好的功能结果。可信水平：治疗性研究Ⅳ级。关于证据等级的完整描述详见投稿须知。

关键词：同种异体骨重建方法假体取出复合物肱骨手术技术肩关节稳定性肩关节活动度

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Determination of the Root Canal Length of Teeth of Bantu Patients Attending the Teaching Hospital of Kinshasa University

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Open Journal of Stomatology 2018年第1期8卷 16-23页

作者： Jean Marie Kayembe Bukama Jean Paul Sekele Issourdi Fidele Nyimi Bushabu Augustin Mantshumba Milolo Steve Sekele Masin M. A. Agbor Dieudonne Nyembue Tshipukana Alain Nyengele Kayembe Hubert Ntumba Mulumba Endodontic Unit Service of Operative Dentistry Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of Congo Prosthodontics services Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of Congo Oral and Maxillofacial Surgery Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of Congo Department of Oral Maxillofacial Head and Neck Oncology School and Hospital of Stomatology Wuhan University Wuhan China Department of Mathematics and Computer Science Faculty of Science University of Kinshasa Kinshasa Democratic Republic of Congo Universite des Montagne Dental School Bangangté Cameroon Department of Otorhinolaryngology (ENT) Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of Congo

Background: There is paucity of literature on the determination of the root canal length of Bantu subjects in dental professional practicing in Africa and Democratic Republic of Congo in particular. Aims: The aim of the present study was to determine the root canal length of teeth of Bantu patients extracts attending the Teaching Hospital of Kinshasa University. Methods and Material: Prospective cross-sectional study was carried out in the service of Conservative Dentistry. The patients suffering with pulpitis of permanent teeth which were selected for root canal treatment during the period of January 2014 to December 2016 were included. All patients whose main root canals were inaccessible, teeth carrying prosthesis, teeth with large coronal decay, teeth having periapical periodontitis, supernumerary teeth, wisdom and primary teeth were excluded. Results: The upper canines presented some significant longer canals compared to the lower canine (23.4 ± 2.3 mm and 21.6 ± 1.8 mm). Palatal canals of the first and second molar were respectively longer as compared to the superior teeth canals (21.5 ± 1 mm, 21.3 ± 2 mm). The distal canals of the first and second molar were the longest in the mandibular arch respectively measuring 20.7 ± 2.0 mm and 21.5 ± 1.7 mm. Conclusion: Data obtained from Bantu patients show slightly shorter roots compared to some European populations, but longer than some Asian populations.

关键词： Bantu Length Root Canal X-Ray

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盆腔脱垂修补术后经阴道途径的修补增强(法)

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世界核心医学期刊文摘（妇产科学分册） 2006年第5期2卷 60-60页

作者： Belot F Collinet P Debodinance P 党慧敏 service de Gyné cologie Obsté trique Clinique de Chirurgie Gyné cologique CHRU de Lille 2 avenue Oscar-Lambret 59037 Lille Cedex

Introduction. Prosthetic reinforcement by the vaginal approach for surgical repair of pelvic prolapse is experiencing increasing popularity despite problems with tolerance. The most frequently described complication is prosthesis exposure, also known as erosion or granuloma. The mechanism is associated with defective vaginal healing and is independent of major infection such as pelvic cellulitis. The purpose of our study was to define the course of this complication and the best therapeutic strategy for patients with prosthesis exposure. Materials and method. Our continuous and retrospective study conducted over a period of 24 months between January 2002 and December 2003 recorded 34 files. These patients underwent prosthetic treatment via the vaginal approach of genital prolapse associated with prosthesis exposure. The procedure, known as TVM (Tension free Vaginal Mesh), involves the insertion without fixing of a synthetic prosthesis in areas of bladder-vagina and rectum-vagina detachment. Results. In 33 cases out of 34, the exposure site was located on the anterior colpotomy scar (97% ). These prosthesis exposures were managed in two stages, using antiseptic treatment first. This treatment cured 9 patients (26.47% ). In the event of failure, a procedure was carried out under brief general anesthesia on an outpatient basis or during a 24- hour hospital stay. This single resection was sufficient for 20 patients (88% ). Two patients nevertheless required a second removal procedure (8% ) and one patient a third procedure (4% ). To notice, one patient presented with a bladder-vagina fistula after resection. This observation of a bladder-vagina fistula following partial removal led us to recommend a blue test and/or cystoscopy as routine practice for each procedure. Conclusion. With this new vaginal approach for prolapse repair, it is important to monitor prosthesis exposure. To manage exposures, it is necessary to begin with antiseptic or estrogenic treatment. In the e

关键词：生殖器脱垂雌激素治疗蜂窝织炎切除术病历记录发病机制防腐处理

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