Objective To investigate the risk factors of delirium in elderly patients with intertrochanteric fracture after internal fixation.Methods The data of 160 patients with intertrochanteric fractures who received internal fixation in our hospital from January 2012 to July 2014 were analyzed retrospectively.The risk factors such as age,sex,preoperative complications,preoperative cognitive function,fracture location,operation mode,operation time,anesthesia method,hospital-to-operation time and intraoperative blood loss were summarized.Results The incidence of postoperative delirium was 28.15％ in postoperative elderly patients with intertrochanteric fractures.Univariate analysis showed that delirium had correlated with preoperative cognitive impairment,preoperative preparation time,serum sodium,fentanyl,atrial fibrillation,anesthesia method,operation time and perioperative blood loss (P ＜ 0.05).The multivariate Logistic regression analysis showed that the independent risk factors of postoperative delirium were preoperative cognitive dysfunction,operative time more than 2 hours and preoperative preparation time more than 4 days.Conclusion The occurrence of postoperative delirium was associated with anesthesia method,cognitive deficits,preoperative preparation time and perioperative blood loss.The anesthesia method which had less effect on the whole body condition and less time of operation preparation can decrease the occurrence of postoperative delirium in a certain extent,which is conducive to improving the prognosis.

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.