Objective:To investigate the clinical value of using preoperative nutritional risk screening and support in gastric cancer patients.Methods:In this paper,70 gastric cancer patients selected from July 2017 to July 2020...Objective:To investigate the clinical value of using preoperative nutritional risk screening and support in gastric cancer patients.Methods:In this paper,70 gastric cancer patients selected from July 2017 to July 2020 treated in our hospital were grouped concerning the lottery method,and the reference group(n=35)used conventional nutritional support,while the experimental group(n=35)used preoperative dietary risk screening and support,comparing the clinical treatment differences between gastric cancer patients in the experimental group and the reference group.Results:After the intervention,IgA,IgM,IgG,serum albumin,complication rate,NRS score,hospitalization time and anal exhaust time of gastric cancer patients in the experimental group were compared with those in the reference group,P<0.05,and there was statistical validation analysis significance between the data indicators.P<0.05 for the comparison of IgA,IgM,IgG,serum albumin after the intervention and pre-intervention for gastric cancer patients in the experimental group and the reference group,with statistical validation analysis significance between the data indicators.Conclusion:Preoperative nutritional risk screening and support is of significant value in gastric cancer patients and can improve patients’nutritional status.展开更多
The predictive value of the initial procalcitonin(PCT)level was explored in the perioperative peniod of citically ill cancer patients.Background:It is quite important to predict infections in patients in the intensive...The predictive value of the initial procalcitonin(PCT)level was explored in the perioperative peniod of citically ill cancer patients.Background:It is quite important to predict infections in patients in the intensive care unit (ICU).Cancer surgery is characterized by large trauma,long duration,and wide operation scope;and there are many inflammatory factors in the tumor.Common manifestations of systermic inflammatory response syndrome(SIRS)。such as fever,elevated white blood cells,and elevated infammatory indicators,frequently occur in patients during the penioperative period as a result of the above factors.These factors are diverse and complex;additionally,advanced cancer and the trauma of major surgery are important factors that influence PCT blood levels.Because all of the aforementioned factors make it dificult to distinguish the postoperative inflammatory response fom the true infection in clinical practice,conventional methods cannot prediet disease sevenity or disease course.Methods:A total of 53 patients with endotracheal intubation admitted to the ICU of Tianjin Medical University Cancer Institute and Hospital from January 2020 to May 2020,were retrospectively selected.According to the patient source,35 cases were assigned to ORIG(Operating Room to ICU Group),and 18 cases were assigned to General Ward to ICU group(GWO).At the ICU admission,the patient's age,sex,surgical site of tumor,reason for ICU and other data were recorded to form a database;PCT,B-type natiuretic peptide(BNP),high sensitivity toponin I(hsTni),serumn creatinine(Cr),serum cystatin C(Cys-c)and other laboratory indicators were detected;scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA)were marked 24 h after ICU admission;Proportion of Antibiotics,Time Antibiotic Application,and Time Indicators(Ventilator support Time,Endotracheal Intubation Time,ICU Stay Time)were recorded during the period from ICU admission to ICU discharge.Results:APAHCE Ⅱ score and SOFA score increased significantly in the GWIG,compared with the ORIG,and the differences were statistically significant(P<0.01);the GWIG had a significantly longer Time Antibiotic Application than the ORIG,and the difference was statistically significant(P<0.01);in tems of blood indicators,the PCT,BNP,and hsTNi levels were elevated in the GWIG compared with the ORIG,and the differences were statistically significant(p<0.01);no statistical differences were found in Cr and Cys-C levels(P>0.05).In terms of time indicators,the Ventilator support Time,Endotracheal Intubation Time,and ICU Stay Time were prolonged in the GWIG compared with the ORIG,and the differences were statistically significant(P<0.01).The PCT level was statistically signifcant(P<0.01)when correlated with the Ventilator Supporting Time and Endotracheal Intubation Time;however,the PCT level was negatively correlated with the ICU Stay Time,with a small r(correlation cofficient)value and no statistical significance(P>0.05)when correlated with the ICU Stay Time.Conclusion:The initial PCT level can predict the disease severity in critically ill cancer patients treated with mechanical ventilation during the perioperative period.展开更多
Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from ...Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from 11 healthy adults were used展开更多
Objective To investigate current surgical site infection and perioperative antibiotics in inpatients and explore the controlling aim and methods. Methods The infection rates of surgical sites of 287 operated cases fro...Objective To investigate current surgical site infection and perioperative antibiotics in inpatients and explore the controlling aim and methods. Methods The infection rates of surgical sites of 287 operated cases from May to Dec 31,2007 were studied and compared with展开更多
Myasthenia gravis(MG)is an autoimmune disorder that affects the neuromuscular junction.The primary pathology in MG involves the presence of autoantibodies to acetylcholine receptors(AChRs),which results in qualitative...Myasthenia gravis(MG)is an autoimmune disorder that affects the neuromuscular junction.The primary pathology in MG involves the presence of autoantibodies to acetylcholine receptors(AChRs),which results in qualitative and quantitative reductions in the availability of functional AChRs.Cardiac muscles are also affected,resulting in various perioperative cardiac complications.Antistriational antibodies are commonly reported in MG cases with cardiac involvement.In the presence of thymoma,the prevalence of cardiac manifestations in patients with MG increases to approximately 10%-15%.Cardiac involvement in MG may range from asymptomatic electrocardiogram changes to ventricular tachycardia,myocarditis,conduction disorders,heart failure,and sudden death.Increased incidence of atrial fibrillation,ventricular and supraventricular extra systoles,and prolonged QTc have also been reported in patients with MG.Clinicians should consider the evaluation of autonomic dysfunction and risk of cardiovascular disease in patients with MG.展开更多
[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and ...[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.展开更多
Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE)....Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE). Methods: A total of 150 patients who underwent RAMIE from January 2020 to January 2022 at our hospital were randomly assigned to either the observation group or the control group, with 75 patients in each. The control group received standard perioperative management and nursing care, while the observation group was treated with ERAS nursing strategies. Interventions continued until discharge, and outcomes such as postoperative complications, quality of life, and nutritional status were compared between the groups. Results: The observation group exhibited a significantly lower incidence of postoperative adverse reactions compared to the control group (P ionally, all dimension scores of the Short-Form 36 Health Survey (SF-36), including the total score, were higher in the observation group (P < 0.05). Furthermore, the Nutritional Risk Screening (NRS) scores for impaired nutritional status and disease severity, along with the total NRS score, were significantly lower in the observation group compared to the control group (P Conclusion: Implementing ERAS nursing in the perioperative care of patients undergoing RAMIE is associated with reduced postoperative complications and enhanced postoperative quality of life and nutritional status. .展开更多
Objective:To explore and analyze the effect of implementing a precise education model on the nursing care of perioperative patients in the interventional catheterization room.Methods:We selected 70 patients who were g...Objective:To explore and analyze the effect of implementing a precise education model on the nursing care of perioperative patients in the interventional catheterization room.Methods:We selected 70 patients who were going to undergo surgical intervention in our hospital from August 2020 to December 2022 as the subjects for this study through random sampling.The patients were divided into a control group and an observation group,with 35 cases in each group.The control group underwent basic nursing intervention,and the observation group was given precise patient education.The nursing effects of both groups were observed.Results:After the intervention,all compliance indicators of the observation group were better than those of the control group(P<0.05).Besides,the incidence of complications in the observation group(2.86%)was lower than that of the control group(17.14%)with P<0.05.Furthermore,the patient satisfaction of the observation group(97.14%)was higher than that of the control group(82.86%),with P<0.05.Conclusion:A precise propaganda and education model facilitates the nursing of perioperative patients in the interventional catheterization room.Therefore,this practice should be popularized.展开更多
Objective Dexmedetomidine is a highly selective alpha-2 adrenergic receptor agonist with sedative and analgesic properties but without respiratory depression effect and has been widely used in perioperative anesthesia...Objective Dexmedetomidine is a highly selective alpha-2 adrenergic receptor agonist with sedative and analgesic properties but without respiratory depression effect and has been widely used in perioperative anesthesia.Here we performed a systematic review and meta-analysis to evaluate the effect of dexmedetomidine on maintaining perioperative hemodynamic stability in elderly patients.Methods PubMed,Web of Science,the Cochrane Library,China National Knowledge Infrastructure(CNKI),and Wanfang Data were searched for randomized-controlled trials(RCTs)on the application of dexmedetomidine in maintaining perioperative hemodynamic stability in elderly patients from their inception to September,2021.The standardized mean differences(SMD)with 95%confidence interval(CI)were employed to analyze the data.The random-effect model was used for the potential clinical inconsistency.Results A total of 12 RCTs with 833 elderly patients(dexmedetomidine group,546 patients;control group,287 patients)were included.There was no significant increase in perioperative heart rate(HR),mean arterial pressure(MAP),and diastolic blood pressure(DBP)in the dexmedetomidine group before and during the operation.In addition,the variations of hemodynamic indexes including HR,MAP,SBP(systolic blood pressure),and DBP were significantly lower in the dexmedetomidine group compared with the control group(HR:SMD=-0.87,95%CI:-1.13 to-0.62;MAP:SMD=-1.12,95%CI:-1.60 to-0.63;SBP:SMD=-1.27,95%CI:-2.26 to-0.27;DBP:SMD=-0.96,95%CI:-1.33 to-0.59).Subgroup analysis found that with the prolongation of 1.0μg/kg dexmedetomidine infusion,the patient’s heart rate declined in a time-dependent way.Conclusion Dexmedetomidine provides more stable hemodynamics during perioperative period in elderly patients.However,further well-conducted trials are required to assess the effective and safer doses of dexmedetomidine in elderly patients.展开更多
The association between glucose variability(GV)and adverse perioperative outcomes in type 2 diabetes mellitus(T2DM)patients undergoing orthopedic surgery was investigated.A retrospective cohort study was performed by ...The association between glucose variability(GV)and adverse perioperative outcomes in type 2 diabetes mellitus(T2DM)patients undergoing orthopedic surgery was investigated.A retrospective cohort study was performed by analyzing data on T2DM patients receiving continuous blood glucose(BG)monitoring and continuous subcutaneous insulin infusion treatment due to poorly controlled preoperative BG prior to orthopedic surgery.GV was assessed with coefficient of variation(CV).Postoperative and perioperative CV,hypoglycemia cases,and other perioperative outcomes(diabetes preparation time[DPT],length of stay[LOS],and perioperative and infective complication cases)were analyzed.Results showed that a total of 168 patients were grouped into preoperative CV tertiles:1st(n=56):0–0.2921,2nd(n=58):0.2922–0.3779,and 3rd(n=54):0.3780–0.5750.Fasting blood glucose(FBG),perioperative CV,rate of hypoglycemia cases(OR:5.53,95%CI:2.43–12.59)(all P<0.001)and DPT(P=0.024)were higher in the 3rd than in the 1st tertile.After adjustments of covariates,regression analysis indicated that the 3rd tertile was associated with increased perioperative CV(adjusted coefficient=0.515,P<0.001),DPT(adjusted coefficient=0.169,P=0.073),rate of hypoglycemia cases(OR:6.72,95%CI:2.69−16.82,P<0.001)and perioperative complication cases(OR:2.50,95%CI:0.90−7.01,P=0.080).In conclusion,preoperative GV is associated with increased perioperative GV and adverse perioperative outcomes including longer DPT and higher rates of hypoglycemia and perioperative complications.展开更多
AIM: To evaluate the medical quality of ophthalmologic perioperative period during 2010-2012 in our hospital.·METHODS: The relevant data of perioperative period were collected in our hospital during 2010-2012, an...AIM: To evaluate the medical quality of ophthalmologic perioperative period during 2010-2012 in our hospital.·METHODS: The relevant data of perioperative period were collected in our hospital during 2010-2012, and the medical quality of perioperative period was evaluated by using the traditional evaluation indexes and adverse events. Whereby, the traditional indicators include vision changes, improving of intraocular pressure, diagnostic accordance rate before and after operation, cure improvement rate, successful rescue rate, and incidence of surgical complications, etc. Adverse events are associated with ophthalmologic perioperative events including pressure sores, postoperative wound infection,drug adverse events, and equipment related adverse events.·RESULTS: There were 1483, 1662 and 1931 ophthalmic operations in our hospital in the year 2010, 2011 and2012, respectively. From traditional index analysis, the proportions of vision improvement for each year were96.43%, 96.76% and 97.32%, respectively; the rates of intraocular pressure improvement were 87.50%, 85.72%and 90.17%, respectively(P <0.05); the diagnostic accordance rates before and after operation were 99.86%,99.94% and 99.90%, respectively; cure improvement rates were 99.73%, 99.93% and 99.84%, respectively; the successful rescue rates were 82.98%, 81.46% and76.66%, respectively; the complications incidence rates were 18.44%, 17.52% and 17.97%, respectively. The negative factor analysis results showed that: among all the patients of ophthalmic surgeries in our hospitalduring 2010 and 2012, only one case of postoperative wound infection was found in 2011, and also only one case of tumbling in 2010. The adverse drug events for each year were 1 case(0.07%), 2 cases(0.12%), and 4cases(0.21%), respectively; the medical device adverse events for each year were 3 cases(0.20%), 5 cases(0.30%), and 6 cases(0.31%), respectively. Noticeably,only one case with postoperative infection of endophthalmitis was found in 2011. Moreover, no pulmonary infection or pulmonary embolism occurred during the three years. The perioperative adverse event rates for each year were 0.34%(5/1483), 0.48%(8/1662)and 0.52%(10/1931), respectively. Though incidence was rising during the three years, no statistical significance was observed(P >0.05). It is the same case with drugs and medical devices adverse events(P >0.05).·CONCLUSION: Traditional indicators reflect an excellent operation of the perioperative ophthalmologic quality, whereas adverse events analysis indicates some underlying problems. Compared with the traditional indexes for medical quality evaluation, the index of adverse events is more reasonable and easier to make an objective evaluation for medical quality of ophthalmologic perioperation, facilitating further refine analysis. Reasonable application of the adverse events indicators helps hospital to make the detailed quality control measures.展开更多
With the explosive spread of novel coronavirus pneumonia, a major public major public health emergency has been declared around the world. Our country has come to a crucial stage of “external defense input, internal ...With the explosive spread of novel coronavirus pneumonia, a major public major public health emergency has been declared around the world. Our country has come to a crucial stage of “external defense input, internal defense rebound” and strict quarantine measures are taken in all ports of entry throughout the country. Operations on patients with cervical spine during the quarantine, which not only increases the risk of surgical treatment, but also increases the difficulty of perioperative nursing. The objective is to explore the result of application of the modality of multiple disciplinary team for a perioperative patient with suspected novel coronavirus pneumonia and cervical spine fracture in nursing. The patient’s condition and nursing measures are studied and discussed from various specialist angle through the multidisciplinary team established by the isolation ward, orthopedics department, emergency department, anesthesiology department, operating room, rehabilitation department, psychology department and so on, and the overall and personalized surgical and nursing planning is formed through interdisciplinary advice. The nursing experience is summarized in this paper.展开更多
Anesthesia is mainly a kind of reversible functional inhibition of the central nervous system and(or)peripheral nervous system through drugs or other methods.In modern clinical medicine,modern anesthesiology is a comp...Anesthesia is mainly a kind of reversible functional inhibition of the central nervous system and(or)peripheral nervous system through drugs or other methods.In modern clinical medicine,modern anesthesiology is a comprehensive subject,which mainly includes clinical anesthesia,pain diagnosis and treatment,intensive care treatment,first aid and resuscitation,etc.Electroacupuncture is developed based on acupuncture therapy which is an important part of traditional Chinese medicine.It uses the comprehensive efficacy of acupuncture and electrical stimulation to deliver electrical energy through acupoints to achieve therapeutic effects.It has been widely used in recent years in clinical.This article summarizes the analgesic mechanism of electroacupuncture and its application in different anesthesia methods,so that clinicians have a deeper understanding of the clinical application of electroacupuncture and promote its clinical application.展开更多
BACKGROUND Venous thromboembolism(VTE)is a major cause of unexpected and perioperative in-hospital deaths.It is characterized by high morbidity,high mortality,high misdiagnosis rate,and high missed diagnosis rates.VTE...BACKGROUND Venous thromboembolism(VTE)is a major cause of unexpected and perioperative in-hospital deaths.It is characterized by high morbidity,high mortality,high misdiagnosis rate,and high missed diagnosis rates.VTE is a common postoperative complication in cancer patients.VTE is preventable,and early identification of risk factors leading to VTE and appropriate early preventive actions can reduce its occurrence and mortality.Presently,there is no uniform standard for the prevention and control of VTE in clinical practice,and hospitals in China lack mature and effective protocols for the assessment,prevention,and treatment of VTE.AIM To explore whether an early warning program could influence the occurrence of deep vein thrombosis(DVT)postoperatively.METHODS This is a comparative retrospective cohort study,which enrolled patients who underwent laparotomic or laparoscopic gastrointestinal tumor resection for gastrointestinal cancer between January 2016 and December 2019.Patients were divided into a control group and an early warning group depending on whether or not the early warning program was implemented.A venous thromboembolism prevention and control team was established.The outcomes included the occurrence of DVT,the correct rate of VTE assessment,the coagulation indicators,and the mastery of VTE knowledge by the nurses.RESULTS A total of 264 patients were included in this study,with 128 patients in the control group and 136 patients in the early warning group.The occurrence rate of DVT in the early warning group was 6.6%(9/136),compared with 14.1%(18/128)in the control group(P<0.05).The correct rates of VTE risk assessment by the nurses and standard implementation rate of VTE preventive measures were 86.8%vs 65.6%and 80.2%vs 57.8%in early warning and control groups,respectively(all P<0.001).The independent factors associated with postoperative DVT occurrence were age(OR=1.083,95%CI:1.070-3.265,P=0.032),Hyperlipidemia(OR=1.127,95%CI:1.139-2.564,P=0.042),preoperative high VTE risk(OR=2.131,95%CI:1.085-5.178,P=0.001),time of operation(OR=2.268,95%CI:2.005-5.546,P=0.026)and not adoption of early warning prevention(OR=3.747,95%CI:1.523-6.956,P=0.017).CONCLUSION The early warning strategy was independently associated with the decreasing occurrence of VTE,and it might be suitable for protection from VTE in patients undergoing gastrointestinal cancer surgery.展开更多
Objective:To explore the perioperative nursing of a newborn with Beckwith-Wiedemann syndrome.Methods:We observed the blood glucose of the child and prevent infection of omphalocele before transpor tation and before th...Objective:To explore the perioperative nursing of a newborn with Beckwith-Wiedemann syndrome.Methods:We observed the blood glucose of the child and prevent infection of omphalocele before transpor tation and before the operation;after the operation,we performed airway nursing,blood glucose monitoring,urination observation,and tumor marker monitoring;finally,at the time of discharge from the hospital,we provided health education.Results:After a series of perioperative nursing measures,the child was discharged smoothly from hospital 34 d after operation.Conclusions:Beckwith-Wiedemann syndrome is a rare congenital malformation.Timely and accurate observation and evaluation of the child during perioperative period and targeted nursing measures can effectively reduce or avoid the occurrence of postoperative complications.展开更多
<strong>Background</strong><b><span style="font-size:12px;font-family:Verdana;">:</span></b><span style="font-size:10.0pt;font-family:;" "=""&g...<strong>Background</strong><b><span style="font-size:12px;font-family:Verdana;">:</span></b><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;"> Coronary artery bypass grafting (CABG) is an important modality of treatment for ischemic heart disease. Both off-pump and on-pump CABG have direct effect on the level cardiac biomarkers in the perioperative period. The use of cardiopulmonary bypass (CPB) and aortic cross-clamping may cause additive myocardial damage leading to further elevation of blood markers. The present study is aimed at measuring and comparing the cardiac biomarker levels in immediate post-operative period after on-pump CABG (ONCAB) and off-pump CABG (OPCAB). </span><b><span style="font-family:Verdana;font-size:12px;">Methods</span></b></span><b><span style="font-size:12px;font-family:Verdana;">:</span></b><span style="font-size:12px;font-family:Verdana;"> All the patients who underwent CABG from January 2015 to June 2016 on elective or emergency basis at Nilratan Sircar Medical College & Hospital have been included in the study. Total 106 patients were operated for CABG of which 75 patients were operated for OPCAB and 31 patients were operated for ONCAB.</span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;">For the comparison of data the blood markers Troponin-T (Trop-T) and Creatine Kinase-MB (CK-MB) are measured during anesthesia before surgery, </span><span style="font-family:Verdana;font-size:12px;">post-operatively after 1</span></span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:12px;font-family:Verdana;">hour, post-operatively after 4</span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:12px;font-family:Verdana;">hours and post-operatively</span><span style="font-size:12px;font-family:Verdana;"> after 20</span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;">hours. All recorded data are analyzed using standard statistical methods. </span><b><span style="font-family:Verdana;font-size:12px;">Results</span></b></span><b><span style="font-size:12px;font-family:Verdana;">:</span></b><b><i><span style="font-size:10.0pt;font-family:;" "=""> </span></i></b><span style="font-size:12px;font-family:Verdana;">We found the markers are elevated immediately after surgery and gradually come down within 24 hours after surgery</span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:12px;font-family:Verdana;">in both OPCAB and ONCAB groups. The elevation is more after ONCAB than OPCAB group in immediate post-operative period but the difference is not significant after 20 hours of surgery.</span><span style="font-size:10.0pt;font-family:;" "=""> </span><b><span style="font-size:12px;font-family:Verdana;">Conclusion</span></b><b><span style="font-size:12px;font-family:Verdana;">:</span></b><span style="font-size:12px;font-family:Verdana;"> Elevated levels of cardiac biomarkers in the immediate post-operative period indicate myocardial damage during surgery, especially after ONCAB in comparison to OPCAB. This may attribute to the better hemodynamic stability in the immediate post-operative period after OPCAB than ONCAB assuming comparable and adequate revascularization in patients of both groups. The avoidance of CPB and cross-clamp may explain better myocardial functioning immediately after </span><span style="font-family:Verdana;">OPCAB. But after 20 hours, the level of cardiac markers is comparable in both groups indicating little difference in post-operative recovery and long-term prognosis.</span>展开更多
Objective:To explore the effects of perioperative clinical pathway of accelerated rehabilitation surgery strategy in patients undergoing cholangiopancreatography(ERCP).Methods:Randomly selected 40 patients undergoing ...Objective:To explore the effects of perioperative clinical pathway of accelerated rehabilitation surgery strategy in patients undergoing cholangiopancreatography(ERCP).Methods:Randomly selected 40 patients undergoing ERCP from our hospital which is People's Hospital,Jingjiang City,for research,and divided the patients into two groups.The 20 patients who were given conventional education methods were set as the reference group,and the 20 patients who were given perioperative clinical pathway care with accelerated rehabilitation surgery strategies were the research group,where the clinical nursing effect of the two groups was statistically compared.Results:According to clinical observation and statistics,the study group's postoperative time to eat for the first time,time to get out of bed,hospitalization time,and surgical blood loss were better than those of the reference group,P<0.05;the anxiety and depression scores of the study group were lower than those after nursing in the reference group,P<0.05;the incidence of complications in the study group was lower than that in the reference group,and patient satisfaction was higher than that in the reference group,where both P<0.05.Conclusion:The application of perioperative clinical pathway care based on the strategy of accelerated rehabilitation surgery can achieve significant results in ERCP patients,which can effectively improve the surgical indicators of patients and reduce the risk of complications.展开更多
Objective:To study the nursing effect of liposuction and volume reduction in the treatment of lymphedema during the perioperative period.Method:A total of 68 patients treated with liposuction volume reduction surgery ...Objective:To study the nursing effect of liposuction and volume reduction in the treatment of lymphedema during the perioperative period.Method:A total of 68 patients treated with liposuction volume reduction surgery for pseudo-lymphedema of lower limbs admitted from May 2019 to May 2020 in a tertiary hospital in Xi’an,Shaanxi Province were selected,and they were divided into observation group and control group by random grouping method.There were 34 cases in each group.The control group took routine care during the perioperative period,while the observation group performed full care during the perioperative period.The complication rate and pain degree of the two groups were compared.Results:The complication rate of the study group was 5.88%,while that of the control group was 26.67%.Compared with the study group,the complication rate was significantly higher than that of the control group,and the gap was statistically significant(P>0.05).The pain scores of patients in the study group were significantly lower than those in the control group at 3 and 6 days after surgery,and the gap was statistically significant(P>0.05).Conclusion:Lymphedema should be taken care of during the perioperative period of liposuction and volume reduction,which can effectively reduce the occurrence of pain and complications.It is worthy of extensive clinical promotion.展开更多
Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews th...Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews the definition,incidence,risk factors,preventive measures,and management of perioperative patients of perioperative stroke,to provide a theoretical basis for clinical work,to reduce the incidence of perioperative stroke.展开更多
文摘Objective:To investigate the clinical value of using preoperative nutritional risk screening and support in gastric cancer patients.Methods:In this paper,70 gastric cancer patients selected from July 2017 to July 2020 treated in our hospital were grouped concerning the lottery method,and the reference group(n=35)used conventional nutritional support,while the experimental group(n=35)used preoperative dietary risk screening and support,comparing the clinical treatment differences between gastric cancer patients in the experimental group and the reference group.Results:After the intervention,IgA,IgM,IgG,serum albumin,complication rate,NRS score,hospitalization time and anal exhaust time of gastric cancer patients in the experimental group were compared with those in the reference group,P<0.05,and there was statistical validation analysis significance between the data indicators.P<0.05 for the comparison of IgA,IgM,IgG,serum albumin after the intervention and pre-intervention for gastric cancer patients in the experimental group and the reference group,with statistical validation analysis significance between the data indicators.Conclusion:Preoperative nutritional risk screening and support is of significant value in gastric cancer patients and can improve patients’nutritional status.
基金supported by the Oncology Translational Medicine Seed Fund Project of Tianjin Medical University Cancer Institute and Hospital(No.1910).
文摘The predictive value of the initial procalcitonin(PCT)level was explored in the perioperative peniod of citically ill cancer patients.Background:It is quite important to predict infections in patients in the intensive care unit (ICU).Cancer surgery is characterized by large trauma,long duration,and wide operation scope;and there are many inflammatory factors in the tumor.Common manifestations of systermic inflammatory response syndrome(SIRS)。such as fever,elevated white blood cells,and elevated infammatory indicators,frequently occur in patients during the penioperative period as a result of the above factors.These factors are diverse and complex;additionally,advanced cancer and the trauma of major surgery are important factors that influence PCT blood levels.Because all of the aforementioned factors make it dificult to distinguish the postoperative inflammatory response fom the true infection in clinical practice,conventional methods cannot prediet disease sevenity or disease course.Methods:A total of 53 patients with endotracheal intubation admitted to the ICU of Tianjin Medical University Cancer Institute and Hospital from January 2020 to May 2020,were retrospectively selected.According to the patient source,35 cases were assigned to ORIG(Operating Room to ICU Group),and 18 cases were assigned to General Ward to ICU group(GWO).At the ICU admission,the patient's age,sex,surgical site of tumor,reason for ICU and other data were recorded to form a database;PCT,B-type natiuretic peptide(BNP),high sensitivity toponin I(hsTni),serumn creatinine(Cr),serum cystatin C(Cys-c)and other laboratory indicators were detected;scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA)were marked 24 h after ICU admission;Proportion of Antibiotics,Time Antibiotic Application,and Time Indicators(Ventilator support Time,Endotracheal Intubation Time,ICU Stay Time)were recorded during the period from ICU admission to ICU discharge.Results:APAHCE Ⅱ score and SOFA score increased significantly in the GWIG,compared with the ORIG,and the differences were statistically significant(P<0.01);the GWIG had a significantly longer Time Antibiotic Application than the ORIG,and the difference was statistically significant(P<0.01);in tems of blood indicators,the PCT,BNP,and hsTNi levels were elevated in the GWIG compared with the ORIG,and the differences were statistically significant(p<0.01);no statistical differences were found in Cr and Cys-C levels(P>0.05).In terms of time indicators,the Ventilator support Time,Endotracheal Intubation Time,and ICU Stay Time were prolonged in the GWIG compared with the ORIG,and the differences were statistically significant(P<0.01).The PCT level was statistically signifcant(P<0.01)when correlated with the Ventilator Supporting Time and Endotracheal Intubation Time;however,the PCT level was negatively correlated with the ICU Stay Time,with a small r(correlation cofficient)value and no statistical significance(P>0.05)when correlated with the ICU Stay Time.Conclusion:The initial PCT level can predict the disease severity in critically ill cancer patients treated with mechanical ventilation during the perioperative period.
文摘Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from 11 healthy adults were used
文摘Objective To investigate current surgical site infection and perioperative antibiotics in inpatients and explore the controlling aim and methods. Methods The infection rates of surgical sites of 287 operated cases from May to Dec 31,2007 were studied and compared with
文摘Myasthenia gravis(MG)is an autoimmune disorder that affects the neuromuscular junction.The primary pathology in MG involves the presence of autoantibodies to acetylcholine receptors(AChRs),which results in qualitative and quantitative reductions in the availability of functional AChRs.Cardiac muscles are also affected,resulting in various perioperative cardiac complications.Antistriational antibodies are commonly reported in MG cases with cardiac involvement.In the presence of thymoma,the prevalence of cardiac manifestations in patients with MG increases to approximately 10%-15%.Cardiac involvement in MG may range from asymptomatic electrocardiogram changes to ventricular tachycardia,myocarditis,conduction disorders,heart failure,and sudden death.Increased incidence of atrial fibrillation,ventricular and supraventricular extra systoles,and prolonged QTc have also been reported in patients with MG.Clinicians should consider the evaluation of autonomic dysfunction and risk of cardiovascular disease in patients with MG.
基金Supported by Science and Technology Innovation Plan for Medical Workers in Shandong Province(SDYWZGKCJH2023095)Clinical Pharmacy Research Project of Shandong Provincial Medical Association(YXH2022ZX010)+1 种基金Traditional Chinese Medicine Science and Technology Development Project of Shandong Province(2019-0400&2021Q097)Traditional Chinese Medicine Research Program of Qingdao City(2020-zyy031)Medical Research Guidance Plan of Qingdao City(2020-WJZD087).
文摘[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.
文摘Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE). Methods: A total of 150 patients who underwent RAMIE from January 2020 to January 2022 at our hospital were randomly assigned to either the observation group or the control group, with 75 patients in each. The control group received standard perioperative management and nursing care, while the observation group was treated with ERAS nursing strategies. Interventions continued until discharge, and outcomes such as postoperative complications, quality of life, and nutritional status were compared between the groups. Results: The observation group exhibited a significantly lower incidence of postoperative adverse reactions compared to the control group (P ionally, all dimension scores of the Short-Form 36 Health Survey (SF-36), including the total score, were higher in the observation group (P < 0.05). Furthermore, the Nutritional Risk Screening (NRS) scores for impaired nutritional status and disease severity, along with the total NRS score, were significantly lower in the observation group compared to the control group (P Conclusion: Implementing ERAS nursing in the perioperative care of patients undergoing RAMIE is associated with reduced postoperative complications and enhanced postoperative quality of life and nutritional status. .
文摘Objective:To explore and analyze the effect of implementing a precise education model on the nursing care of perioperative patients in the interventional catheterization room.Methods:We selected 70 patients who were going to undergo surgical intervention in our hospital from August 2020 to December 2022 as the subjects for this study through random sampling.The patients were divided into a control group and an observation group,with 35 cases in each group.The control group underwent basic nursing intervention,and the observation group was given precise patient education.The nursing effects of both groups were observed.Results:After the intervention,all compliance indicators of the observation group were better than those of the control group(P<0.05).Besides,the incidence of complications in the observation group(2.86%)was lower than that of the control group(17.14%)with P<0.05.Furthermore,the patient satisfaction of the observation group(97.14%)was higher than that of the control group(82.86%),with P<0.05.Conclusion:A precise propaganda and education model facilitates the nursing of perioperative patients in the interventional catheterization room.Therefore,this practice should be popularized.
基金Supported by National High Level Hospital Clinical Research Funding(2022 GSP-QN-16)Yunnan Provincial Cardiovascular Disease Clinical Medical Center Project(FZX2019-06-01).
文摘Objective Dexmedetomidine is a highly selective alpha-2 adrenergic receptor agonist with sedative and analgesic properties but without respiratory depression effect and has been widely used in perioperative anesthesia.Here we performed a systematic review and meta-analysis to evaluate the effect of dexmedetomidine on maintaining perioperative hemodynamic stability in elderly patients.Methods PubMed,Web of Science,the Cochrane Library,China National Knowledge Infrastructure(CNKI),and Wanfang Data were searched for randomized-controlled trials(RCTs)on the application of dexmedetomidine in maintaining perioperative hemodynamic stability in elderly patients from their inception to September,2021.The standardized mean differences(SMD)with 95%confidence interval(CI)were employed to analyze the data.The random-effect model was used for the potential clinical inconsistency.Results A total of 12 RCTs with 833 elderly patients(dexmedetomidine group,546 patients;control group,287 patients)were included.There was no significant increase in perioperative heart rate(HR),mean arterial pressure(MAP),and diastolic blood pressure(DBP)in the dexmedetomidine group before and during the operation.In addition,the variations of hemodynamic indexes including HR,MAP,SBP(systolic blood pressure),and DBP were significantly lower in the dexmedetomidine group compared with the control group(HR:SMD=-0.87,95%CI:-1.13 to-0.62;MAP:SMD=-1.12,95%CI:-1.60 to-0.63;SBP:SMD=-1.27,95%CI:-2.26 to-0.27;DBP:SMD=-0.96,95%CI:-1.33 to-0.59).Subgroup analysis found that with the prolongation of 1.0μg/kg dexmedetomidine infusion,the patient’s heart rate declined in a time-dependent way.Conclusion Dexmedetomidine provides more stable hemodynamics during perioperative period in elderly patients.However,further well-conducted trials are required to assess the effective and safer doses of dexmedetomidine in elderly patients.
基金This study was supported by Science and Technology Program of Guangzhou,China(No.201604020007)。
文摘The association between glucose variability(GV)and adverse perioperative outcomes in type 2 diabetes mellitus(T2DM)patients undergoing orthopedic surgery was investigated.A retrospective cohort study was performed by analyzing data on T2DM patients receiving continuous blood glucose(BG)monitoring and continuous subcutaneous insulin infusion treatment due to poorly controlled preoperative BG prior to orthopedic surgery.GV was assessed with coefficient of variation(CV).Postoperative and perioperative CV,hypoglycemia cases,and other perioperative outcomes(diabetes preparation time[DPT],length of stay[LOS],and perioperative and infective complication cases)were analyzed.Results showed that a total of 168 patients were grouped into preoperative CV tertiles:1st(n=56):0–0.2921,2nd(n=58):0.2922–0.3779,and 3rd(n=54):0.3780–0.5750.Fasting blood glucose(FBG),perioperative CV,rate of hypoglycemia cases(OR:5.53,95%CI:2.43–12.59)(all P<0.001)and DPT(P=0.024)were higher in the 3rd than in the 1st tertile.After adjustments of covariates,regression analysis indicated that the 3rd tertile was associated with increased perioperative CV(adjusted coefficient=0.515,P<0.001),DPT(adjusted coefficient=0.169,P=0.073),rate of hypoglycemia cases(OR:6.72,95%CI:2.69−16.82,P<0.001)and perioperative complication cases(OR:2.50,95%CI:0.90−7.01,P=0.080).In conclusion,preoperative GV is associated with increased perioperative GV and adverse perioperative outcomes including longer DPT and higher rates of hypoglycemia and perioperative complications.
文摘AIM: To evaluate the medical quality of ophthalmologic perioperative period during 2010-2012 in our hospital.·METHODS: The relevant data of perioperative period were collected in our hospital during 2010-2012, and the medical quality of perioperative period was evaluated by using the traditional evaluation indexes and adverse events. Whereby, the traditional indicators include vision changes, improving of intraocular pressure, diagnostic accordance rate before and after operation, cure improvement rate, successful rescue rate, and incidence of surgical complications, etc. Adverse events are associated with ophthalmologic perioperative events including pressure sores, postoperative wound infection,drug adverse events, and equipment related adverse events.·RESULTS: There were 1483, 1662 and 1931 ophthalmic operations in our hospital in the year 2010, 2011 and2012, respectively. From traditional index analysis, the proportions of vision improvement for each year were96.43%, 96.76% and 97.32%, respectively; the rates of intraocular pressure improvement were 87.50%, 85.72%and 90.17%, respectively(P <0.05); the diagnostic accordance rates before and after operation were 99.86%,99.94% and 99.90%, respectively; cure improvement rates were 99.73%, 99.93% and 99.84%, respectively; the successful rescue rates were 82.98%, 81.46% and76.66%, respectively; the complications incidence rates were 18.44%, 17.52% and 17.97%, respectively. The negative factor analysis results showed that: among all the patients of ophthalmic surgeries in our hospitalduring 2010 and 2012, only one case of postoperative wound infection was found in 2011, and also only one case of tumbling in 2010. The adverse drug events for each year were 1 case(0.07%), 2 cases(0.12%), and 4cases(0.21%), respectively; the medical device adverse events for each year were 3 cases(0.20%), 5 cases(0.30%), and 6 cases(0.31%), respectively. Noticeably,only one case with postoperative infection of endophthalmitis was found in 2011. Moreover, no pulmonary infection or pulmonary embolism occurred during the three years. The perioperative adverse event rates for each year were 0.34%(5/1483), 0.48%(8/1662)and 0.52%(10/1931), respectively. Though incidence was rising during the three years, no statistical significance was observed(P >0.05). It is the same case with drugs and medical devices adverse events(P >0.05).·CONCLUSION: Traditional indicators reflect an excellent operation of the perioperative ophthalmologic quality, whereas adverse events analysis indicates some underlying problems. Compared with the traditional indexes for medical quality evaluation, the index of adverse events is more reasonable and easier to make an objective evaluation for medical quality of ophthalmologic perioperation, facilitating further refine analysis. Reasonable application of the adverse events indicators helps hospital to make the detailed quality control measures.
文摘With the explosive spread of novel coronavirus pneumonia, a major public major public health emergency has been declared around the world. Our country has come to a crucial stage of “external defense input, internal defense rebound” and strict quarantine measures are taken in all ports of entry throughout the country. Operations on patients with cervical spine during the quarantine, which not only increases the risk of surgical treatment, but also increases the difficulty of perioperative nursing. The objective is to explore the result of application of the modality of multiple disciplinary team for a perioperative patient with suspected novel coronavirus pneumonia and cervical spine fracture in nursing. The patient’s condition and nursing measures are studied and discussed from various specialist angle through the multidisciplinary team established by the isolation ward, orthopedics department, emergency department, anesthesiology department, operating room, rehabilitation department, psychology department and so on, and the overall and personalized surgical and nursing planning is formed through interdisciplinary advice. The nursing experience is summarized in this paper.
基金This study was supported by grants from the National Natural Science Foundation of China(No.81801175)the China Postdoctoral Science Foundation(No.2019M662179)+1 种基金the Anhui Province Postdoctoral Science Foundation(No.2019B324)the Fundamental Research Funds for the Central Universities(No.WK9110000044).
文摘Anesthesia is mainly a kind of reversible functional inhibition of the central nervous system and(or)peripheral nervous system through drugs or other methods.In modern clinical medicine,modern anesthesiology is a comprehensive subject,which mainly includes clinical anesthesia,pain diagnosis and treatment,intensive care treatment,first aid and resuscitation,etc.Electroacupuncture is developed based on acupuncture therapy which is an important part of traditional Chinese medicine.It uses the comprehensive efficacy of acupuncture and electrical stimulation to deliver electrical energy through acupoints to achieve therapeutic effects.It has been widely used in recent years in clinical.This article summarizes the analgesic mechanism of electroacupuncture and its application in different anesthesia methods,so that clinicians have a deeper understanding of the clinical application of electroacupuncture and promote its clinical application.
文摘BACKGROUND Venous thromboembolism(VTE)is a major cause of unexpected and perioperative in-hospital deaths.It is characterized by high morbidity,high mortality,high misdiagnosis rate,and high missed diagnosis rates.VTE is a common postoperative complication in cancer patients.VTE is preventable,and early identification of risk factors leading to VTE and appropriate early preventive actions can reduce its occurrence and mortality.Presently,there is no uniform standard for the prevention and control of VTE in clinical practice,and hospitals in China lack mature and effective protocols for the assessment,prevention,and treatment of VTE.AIM To explore whether an early warning program could influence the occurrence of deep vein thrombosis(DVT)postoperatively.METHODS This is a comparative retrospective cohort study,which enrolled patients who underwent laparotomic or laparoscopic gastrointestinal tumor resection for gastrointestinal cancer between January 2016 and December 2019.Patients were divided into a control group and an early warning group depending on whether or not the early warning program was implemented.A venous thromboembolism prevention and control team was established.The outcomes included the occurrence of DVT,the correct rate of VTE assessment,the coagulation indicators,and the mastery of VTE knowledge by the nurses.RESULTS A total of 264 patients were included in this study,with 128 patients in the control group and 136 patients in the early warning group.The occurrence rate of DVT in the early warning group was 6.6%(9/136),compared with 14.1%(18/128)in the control group(P<0.05).The correct rates of VTE risk assessment by the nurses and standard implementation rate of VTE preventive measures were 86.8%vs 65.6%and 80.2%vs 57.8%in early warning and control groups,respectively(all P<0.001).The independent factors associated with postoperative DVT occurrence were age(OR=1.083,95%CI:1.070-3.265,P=0.032),Hyperlipidemia(OR=1.127,95%CI:1.139-2.564,P=0.042),preoperative high VTE risk(OR=2.131,95%CI:1.085-5.178,P=0.001),time of operation(OR=2.268,95%CI:2.005-5.546,P=0.026)and not adoption of early warning prevention(OR=3.747,95%CI:1.523-6.956,P=0.017).CONCLUSION The early warning strategy was independently associated with the decreasing occurrence of VTE,and it might be suitable for protection from VTE in patients undergoing gastrointestinal cancer surgery.
文摘Objective:To explore the perioperative nursing of a newborn with Beckwith-Wiedemann syndrome.Methods:We observed the blood glucose of the child and prevent infection of omphalocele before transpor tation and before the operation;after the operation,we performed airway nursing,blood glucose monitoring,urination observation,and tumor marker monitoring;finally,at the time of discharge from the hospital,we provided health education.Results:After a series of perioperative nursing measures,the child was discharged smoothly from hospital 34 d after operation.Conclusions:Beckwith-Wiedemann syndrome is a rare congenital malformation.Timely and accurate observation and evaluation of the child during perioperative period and targeted nursing measures can effectively reduce or avoid the occurrence of postoperative complications.
文摘<strong>Background</strong><b><span style="font-size:12px;font-family:Verdana;">:</span></b><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;"> Coronary artery bypass grafting (CABG) is an important modality of treatment for ischemic heart disease. Both off-pump and on-pump CABG have direct effect on the level cardiac biomarkers in the perioperative period. The use of cardiopulmonary bypass (CPB) and aortic cross-clamping may cause additive myocardial damage leading to further elevation of blood markers. The present study is aimed at measuring and comparing the cardiac biomarker levels in immediate post-operative period after on-pump CABG (ONCAB) and off-pump CABG (OPCAB). </span><b><span style="font-family:Verdana;font-size:12px;">Methods</span></b></span><b><span style="font-size:12px;font-family:Verdana;">:</span></b><span style="font-size:12px;font-family:Verdana;"> All the patients who underwent CABG from January 2015 to June 2016 on elective or emergency basis at Nilratan Sircar Medical College & Hospital have been included in the study. Total 106 patients were operated for CABG of which 75 patients were operated for OPCAB and 31 patients were operated for ONCAB.</span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;">For the comparison of data the blood markers Troponin-T (Trop-T) and Creatine Kinase-MB (CK-MB) are measured during anesthesia before surgery, </span><span style="font-family:Verdana;font-size:12px;">post-operatively after 1</span></span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:12px;font-family:Verdana;">hour, post-operatively after 4</span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:12px;font-family:Verdana;">hours and post-operatively</span><span style="font-size:12px;font-family:Verdana;"> after 20</span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;">hours. All recorded data are analyzed using standard statistical methods. </span><b><span style="font-family:Verdana;font-size:12px;">Results</span></b></span><b><span style="font-size:12px;font-family:Verdana;">:</span></b><b><i><span style="font-size:10.0pt;font-family:;" "=""> </span></i></b><span style="font-size:12px;font-family:Verdana;">We found the markers are elevated immediately after surgery and gradually come down within 24 hours after surgery</span><span style="font-size:10.0pt;font-family:;" "=""> </span><span style="font-size:12px;font-family:Verdana;">in both OPCAB and ONCAB groups. The elevation is more after ONCAB than OPCAB group in immediate post-operative period but the difference is not significant after 20 hours of surgery.</span><span style="font-size:10.0pt;font-family:;" "=""> </span><b><span style="font-size:12px;font-family:Verdana;">Conclusion</span></b><b><span style="font-size:12px;font-family:Verdana;">:</span></b><span style="font-size:12px;font-family:Verdana;"> Elevated levels of cardiac biomarkers in the immediate post-operative period indicate myocardial damage during surgery, especially after ONCAB in comparison to OPCAB. This may attribute to the better hemodynamic stability in the immediate post-operative period after OPCAB than ONCAB assuming comparable and adequate revascularization in patients of both groups. The avoidance of CPB and cross-clamp may explain better myocardial functioning immediately after </span><span style="font-family:Verdana;">OPCAB. But after 20 hours, the level of cardiac markers is comparable in both groups indicating little difference in post-operative recovery and long-term prognosis.</span>
文摘Objective:To explore the effects of perioperative clinical pathway of accelerated rehabilitation surgery strategy in patients undergoing cholangiopancreatography(ERCP).Methods:Randomly selected 40 patients undergoing ERCP from our hospital which is People's Hospital,Jingjiang City,for research,and divided the patients into two groups.The 20 patients who were given conventional education methods were set as the reference group,and the 20 patients who were given perioperative clinical pathway care with accelerated rehabilitation surgery strategies were the research group,where the clinical nursing effect of the two groups was statistically compared.Results:According to clinical observation and statistics,the study group's postoperative time to eat for the first time,time to get out of bed,hospitalization time,and surgical blood loss were better than those of the reference group,P<0.05;the anxiety and depression scores of the study group were lower than those after nursing in the reference group,P<0.05;the incidence of complications in the study group was lower than that in the reference group,and patient satisfaction was higher than that in the reference group,where both P<0.05.Conclusion:The application of perioperative clinical pathway care based on the strategy of accelerated rehabilitation surgery can achieve significant results in ERCP patients,which can effectively improve the surgical indicators of patients and reduce the risk of complications.
文摘Objective:To study the nursing effect of liposuction and volume reduction in the treatment of lymphedema during the perioperative period.Method:A total of 68 patients treated with liposuction volume reduction surgery for pseudo-lymphedema of lower limbs admitted from May 2019 to May 2020 in a tertiary hospital in Xi’an,Shaanxi Province were selected,and they were divided into observation group and control group by random grouping method.There were 34 cases in each group.The control group took routine care during the perioperative period,while the observation group performed full care during the perioperative period.The complication rate and pain degree of the two groups were compared.Results:The complication rate of the study group was 5.88%,while that of the control group was 26.67%.Compared with the study group,the complication rate was significantly higher than that of the control group,and the gap was statistically significant(P>0.05).The pain scores of patients in the study group were significantly lower than those in the control group at 3 and 6 days after surgery,and the gap was statistically significant(P>0.05).Conclusion:Lymphedema should be taken care of during the perioperative period of liposuction and volume reduction,which can effectively reduce the occurrence of pain and complications.It is worthy of extensive clinical promotion.
文摘Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews the definition,incidence,risk factors,preventive measures,and management of perioperative patients of perioperative stroke,to provide a theoretical basis for clinical work,to reduce the incidence of perioperative stroke.
