1.Clinical analysis of 62 cases of ischemic colitis
Yu WEN ; Haoliang ZHAI ; Pingfang MA
Chinese Journal of Primary Medicine and Pharmacy 2015;(24):3742-3744
Objective To investigate the clinical and endoscopic features of ischemic colitis (IC),to provide a reference for clinical diagnosis and treatment.Methods A retrospective analysis of 62 inpatients who were diag-nosed as IC was performed.The patients'clinical data,clinical manifestations,complications,laboratory tests,imaging tests,colonoscopy,pathology,diagnosis,treatment,follow -up and other information were analyzed.Results Of 62 patients,there were 1 7 males and 45 females,mean age was (66.1 ±1 0.7)years old,more than 60 years of age there were 47 cases (75.81 %),of which 38 cases (61 .29%)showed the presence of one or more underlying disea-ses.All patients had acute onset,57 cases (91 .94%)had abdominal pain,bloody stools occurred in 56 cases (90.32%).Colonoscopy revealed 60 cases as a transient type,2 cases of stenosis,no gangrene type,lesions were mainly left colon.All patients were given fasting,anti -infection,microcirculation improvement and intravenous nutri-tional support,with no serious complications or transfer surgery occurred,colonoscopy was reviewed 4 -8weeks, 62 cases were healing or had improvement,2 patients in the 3 -year observation period was readmitted attack,the recurrence rate was 3.23%.Conclusion Ischemic colitis is more common in older people,to strengthen the aware-ness and vigilance of the disease,early diagnosis based on colonoscopy as a primary diagnostic modality and prompt treatment has positive significance.
2.Different surgical methods for the treatment of bisphosphonate-related osteonecrosis of the jaw
Mei TIAN ; Guowen SUN ; Danni WANG ; Haoliang CHEN ; Yiwei ZHAI
Chinese Journal of Plastic Surgery 2020;36(5):540-545
Objective:To investigate the clinical effect of different surgical methods in the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ).Methods:A total of 20 cases of BRONJ who were treated for surgical treatment from January 2013 to March 2019 were included for the retrospective analysis in this study. There were 14 males and 6 females in this study. The average age of onset was 65.4 years, including 67.4 years for males and 60.7 years for females. There were 9 patients in stage 1, 7 in stage 2, 3 in stage 3, and 1 patient with maxillary lesions in stage 2 and mandibular lesions in stage 3. For patients in stage 1 or stage 2 who had poor systemic conditions and could not tolerate general anesthesia or surgical trauma. Different surgical treatments should be performed according to the results of imaging evaluation. If completely dead bones were formed locally, sequestrectomy under local anesthesia was performed. For patients whose dead bones were not completely separated, partial jaw resection was performed. For stage 3 BRONJ patients with severe symptoms occurring in the mandible, such as the formation of intraoral and external fistulas, pathological fractures, or lesions involving the lower margin of the mandible, segmental osteotomy was usually performed when general conditions were stable.Results:Of the 20 patients, 6 cases (including 1 patient with lesions involving both maxilla and mandible) underwent sequestrectomy, 11 cases partial jaw resection and 4(including 1 patient with lesions involving both maxilla and mandible) mandibular segmental osteotomy. The patients were followed up for 1-67 months (mean 32.8 months). All the patients who underwent mandibular segmental osteotomy were recovered well and discharged. 6 patients were clinically asymptomatic after partial jawbone resection. The symptoms of the rest of the patients were alleviated, showing relieved pain, disappeared dead bone and so on, while the course of disease was significantly slowed down.Conclusions:Sequestrectomy and partial jaw resection can relieve symptoms and improve quality of life of patients, so that some patients can achieve clinical cure. Mandibular segmental osteotomy as a more effective treatment method, can be considered as the preferred treatment for stage 3 patients with lesions in the mandible and with good systemic condition.
3.Different surgical methods for the treatment of bisphosphonate-related osteonecrosis of the jaw
Mei TIAN ; Guowen SUN ; Danni WANG ; Haoliang CHEN ; Yiwei ZHAI
Chinese Journal of Plastic Surgery 2020;36(5):540-545
Objective:To investigate the clinical effect of different surgical methods in the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ).Methods:A total of 20 cases of BRONJ who were treated for surgical treatment from January 2013 to March 2019 were included for the retrospective analysis in this study. There were 14 males and 6 females in this study. The average age of onset was 65.4 years, including 67.4 years for males and 60.7 years for females. There were 9 patients in stage 1, 7 in stage 2, 3 in stage 3, and 1 patient with maxillary lesions in stage 2 and mandibular lesions in stage 3. For patients in stage 1 or stage 2 who had poor systemic conditions and could not tolerate general anesthesia or surgical trauma. Different surgical treatments should be performed according to the results of imaging evaluation. If completely dead bones were formed locally, sequestrectomy under local anesthesia was performed. For patients whose dead bones were not completely separated, partial jaw resection was performed. For stage 3 BRONJ patients with severe symptoms occurring in the mandible, such as the formation of intraoral and external fistulas, pathological fractures, or lesions involving the lower margin of the mandible, segmental osteotomy was usually performed when general conditions were stable.Results:Of the 20 patients, 6 cases (including 1 patient with lesions involving both maxilla and mandible) underwent sequestrectomy, 11 cases partial jaw resection and 4(including 1 patient with lesions involving both maxilla and mandible) mandibular segmental osteotomy. The patients were followed up for 1-67 months (mean 32.8 months). All the patients who underwent mandibular segmental osteotomy were recovered well and discharged. 6 patients were clinically asymptomatic after partial jawbone resection. The symptoms of the rest of the patients were alleviated, showing relieved pain, disappeared dead bone and so on, while the course of disease was significantly slowed down.Conclusions:Sequestrectomy and partial jaw resection can relieve symptoms and improve quality of life of patients, so that some patients can achieve clinical cure. Mandibular segmental osteotomy as a more effective treatment method, can be considered as the preferred treatment for stage 3 patients with lesions in the mandible and with good systemic condition.