With a grateful heart, I wrote this heartfelt text. Although it is not necessarily very smooth, the meaning expressed is correct, because everything comes from the heart..." Recently, the Department of Spine and Bone Diseases of the First People's Hospital of Shaoguan City received a special letter of thanks.
The letter was specially handwritten by the patient's family, thanking the two less difficult surgeries. However, the object of the operation is a 93-year-old man, which is undoubtedly a huge test for doctors and patients.
Ou Guangxin (first from left) who is undergoing surgery.
Surgery is difficult in elderly patients
At the beginning of 2021, ms. Zhu, who was 93 years old, accidentally fell while playing in other places, and was diagnosed with a fracture of the right femur intertrochanterus in a foreign hospital, and was planned for surgical treatment. However, at that time, it was found that the clotting time was prolonged, and considering the advanced age of the patient, the bleeding from surgery was more, and the risk was relatively high, conservative treatment was carried out.
After 8 months of conservative treatment, Ms. Zhu could only barely move with the assistance of a walker and could not walk on the ground. In August 2021, Ms. Zhu suddenly had chest and back pain, and when she turned over and got up, she would have a painful attack, and then went to the First People's Hospital of Shaoguan City for treatment.
After diagnosis, Ms. Zhu suffered from osteoporosis with thoracic and lumbar compression fractures, old right femur intertrochanteric fractures with bone nonunion and bone non-concatenation, as well as severe osteoporosis and prolonged coagulation time.
Ou Guangxin, the doctor in charge, said that the difficulty of fracture surgery itself is not large, but the common underlying diseases of the elderly are prone to related complications during the operation period, even if there is no related basic disease, the physical function and function of the organs of the elderly patients are declined, and the tolerance to surgery and anesthesia and the ability to resist blows are weakened, and it is also easy to have related complications.
At the same time, elderly patients often choose lumbar anesthesia, which is commonly known as "semi-anesthesia", which does not require endotracheal intubation and has less impact on the patient's lungs. However, the patient has prolonged clotting time, is prone to bleeding, and cannot be anesthetized for lumbar stiff anesthesia due to concerns about epidural hematoma, and prolonged clotting time, which can also lead to an increased risk of intraoperative and postoperative bleeding. Elderly people are afraid to rehydrate too much due to concerns about dirty loads, and are prone to hemorrhagic shock.
Multidisciplinary collaboration
Considering the patient's advanced age, combined with the wishes of the patient and his family, after discussion in the department, the patient's surgery was carried out in two stages: first thoracic 12 and lumbar 1 percutaneous vertebral phylloplasty (completed under local anesthesia); the second stage was then considered to perform right hemixaphritis replacement.
According to reports, in the first phase of chest 12, waist 1 percutaneous vertebral plasty surgery was successfully completed, the patient's low back pain was significantly alleviated. For the second stage of surgery, the hospital launched a multidisciplinary cooperation model, and the anesthesiology department and hematology department and ICU physicians were consulted before the operation.
Hematologist proposed that the patient's coagulation time is prolonged, but it does not constitute a contraindication to surgery, and the suspension of red blood cells and plasma is prepared before surgery, and the plasma is rich in coagulation factors, if the patient is found to be prone to bleeding during the operation, the infusion can play a role in improving the coagulation function.
Anesthesiologists proposed that anesthesia should be anesthesia using intubation general anesthesia, which can maintain blood pressure in a stable state during surgery, properly rehydrate fluids, and maintain the stability of the patient's circulation. ICU physicians prepare beds and related rescue preparations, in case the patient's intraoperative condition is not good, they can be prepared for treatment at any time, as a backup force, to provide safety for patients.
On the 3rd day after the operation, Ms. Zhu can walk with the assistance of a walker.
"Every time I checked the room, Grandma Zhu gave us a thumbs up and smiled." Ou Guangxin said that whenever this happens, he has a strong sense of pride and achievement in his heart.
"It is no exaggeration to say that the medical care of the First People's Hospital of Shaoguan City has created miracles with hard work and sweat." The thank-you note reads.
Handwritten thank-you notes from patients' families.
High technical focus
It is understood that osteoporosis compression fracture refers to bone density and bone quality caused by osteoporosis to reduce bone density and bone quality, bone strength is reduced, and fractures occur under the slight external force (cough, sneeze) or even without obvious external force.
The data shows that the First People's Hospital of Shaoguan City receives nearly 500 cases of osteoporosis compression fracture patients a year, and about 300 cases need to undergo percutaneous vertebral plasty, and the surgical effect is good.
The Department of Orthopedics of the First People's Hospital of Shaoguan City is a key specialty in Guangdong Province, and was awarded the third "Guangdong Hospital Strongest Department Recommendation List" in the non-Greater Bay Area in 2021. Since the independent establishment of the department in 1982, after nearly 40 years of development and construction, it has become a well-known department in the province and even the national orthopedic field, with a number of high-quality professional and technical teams, all of which are graduate students or above, 6 chief physicians, 6 deputy chief physicians (including 4 doctors, 1 postdoctoral fellow in the United States), and the annual surgical volume is nearly 5,000 units.
The Department of Spine orthopedic Diseases of the First People's Hospital of Shaoguan City took the lead in carrying out "spinal endoscopic minimally invasive technology" in northern Guangdong, established a spine minimally invasive center, and carried out "spinal endoscopic fusion, cervical spine, thoracic endoscopic surgery", which can use "minimally invasive spine technology" to treat diseases related to neck, shoulder, waist and leg pain, and the minimally invasive rate of surgery has reached 70%.
For osteoporosis patients, the Department of Spine and Bone Diseases of the First People's Hospital of Shaoguan City reminds that surgery is not the end of treatment for patients, and it is not possible to "forget the pain of scars". As the saying goes, "three points, seven points", osteoporosis patients can drink milk, bask in the sun, exercise properly, eat a balanced diet, and avoid wrestling. At the same time, it is also necessary to use some anti-osteoporosis drugs, anti-osteoporosis is not only "calcium supplementation", after the operation needs to be under the guidance of a doctor to carry out standardized anti-osteoporosis treatment.
[All-media reporter] Ye Zhiqiang
[Correspondent] Yang Li
【Author】 Ye Zhiqiang
【Source】 Southern Press Media Group South + client