Objective:To study the factors influencing secondary indwelling catheterisation after cervical cancer surgery and to develop a predictive risk model.Methods:A total of 260 patients in a tertiary hospital in Chongqing ...Objective:To study the factors influencing secondary indwelling catheterisation after cervical cancer surgery and to develop a predictive risk model.Methods:A total of 260 patients in a tertiary hospital in Chongqing were selected from January 2020 to December 2021 via convenience sampling.Relevant information of patients was recorded,including age;body mass index;history of hypertension and diabetes,bladder dysfunction,postoperative urinary retention,and postoperative urinary tract infection;Histology;staging;surgical approach;Operation time;Time of first remove of catheter;indwelling catheter days;Hospitalization days.Least absolute shrinkage and selection operator was used to reduce dimensionality and select patient characteristics,and multivariate analysis was performed based on the selected variables.Based on the outcome of analysis,a line chart model was developed for predicting the risk of secondary catheterization in patients with indwelling catheterization after radical cervical cancer surgery.The coefficient of conformity index(C-index)and calibration curves were used to evaluate the accuracy and fit.The model was internally validated via bootstrapping(1000 random samples),and the clinical utility of the model was assessed via decision curve analysis(DCA).Results:Four characteristic variables were selected,including preoperative bladder function,postoperative urinary tract infection,surgical approach,and Time of first remove of catheter.They are independent risk factors affecting urinary tract.The risk prediction model exhibited good discrimination performance with a C-index of 0.722(95%CI,0.661-0.783)and was well calibrated.The C-index was 0.708 in internal validation analysis.DCA showed that the risk model was clinically useful for predicting secondary catheterization,and clinical benefits were observed at the decision threshold of≥11%.Conclusion:A novel model was developed to predict the risk of secondary catheterization.The model was based on preoperative bladder dysfunction,postoperative urinary tract infection,surgical approach,and number of days since the removal of the primary catheter.展开更多
AIM： To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine （e.g. Dahuang） in treating abdominal compartment syndrome of fulminant acute pancreatit...AIM： To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine （e.g. Dahuang） in treating abdominal compartment syndrome of fulminant acute pancreatitis. METHODS： Patients with fulminant acute pancreatitis were divided randomly into 2 groups of combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring and routine conservative measures group （group 1） and control group （group 2）. Routine non-operative conservative treatments including hemofiltration, respiration support, gastrointestinal TCM ablution were also applied in control group patients. Effectiveness of the two groups was observed, and APACHE Ⅱ scores were applied for analysis. RESULTS： On the second and fifth days after treatment, APACHE Ⅱ scores of group 1 and 2 patients were significantly different. Comparison of effectiveness （abdominalgia and burbulence relief time, hospitalization time） between groups 1 and 2 showed significant difference, as well as incidence rates of cysts formation. Mortality rates of groups 1 and 2 were 10.0% and 20.7%, respectively. For patients in group 1, celiac drainage quantity and intra-abdominal pressure, and hospitalization time were positively correlated （r = 0.552, 0.748, 0.923, P 〈 0.01） with APACHE Ⅱ scores. CONCLUSION： Combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring, short veno-venous hemofiltration （SVVH）, gastrointestinal TCM ablution, respiration support have preventive and treatment effects on abdominal compartment syndrome of fulminant acute pancreatitis.展开更多
In this review, we report on the use of indwelling pleural catheters in the treatment of malignant pleural effusions. We describe the most commonly used catheter. Also, treatment with indwelling pleuralcatheters as co...In this review, we report on the use of indwelling pleural catheters in the treatment of malignant pleural effusions. We describe the most commonly used catheter. Also, treatment with indwelling pleuralcatheters as compared to talc pleurodesis is reviewed. A comparison of efficacy, costs, effects on quality of life, and complications is made. Only one randomized controlled trial comparing the two is available up to date, but several are underway. We conclude that treatment for malignant pleural effusions with indwelling pleural catheters is a save, cost-effective, and patientfriendly method, with low complication rates.展开更多
Objective:To explore the effect of modified nasogastric tube placement and Rehabilitation New Liquid Spray in patients with indwelling gastric tube.Methods:Eighty-six cases with indwelling gastric tube in our hospital...Objective:To explore the effect of modified nasogastric tube placement and Rehabilitation New Liquid Spray in patients with indwelling gastric tube.Methods:Eighty-six cases with indwelling gastric tube in our hospital from January 2020 to May 2021 were randomly selected and divided into the reference group and the research group.The reference group was treated by modified gastric tube placement,and the research group was given the Rehabilitation New Liquid Spray intervention.The effect of the interventions on two groups was observed.Results:The incidence of nasal mucosal injury in the research group was lower than that in the reference group,and the incidence of pharyngeal mucosal injury in the research group was lower than that in the reference group(P<0.05).The pain score of the study group was lower than that of the reference group at 8 h,12 h and 24 h after replacement,and the incidence of hoarseness,swallowing discomfort and dry oropharynx was lower than that of the reference group(P<0.05).Conclusion:The application of modified gastric tube placement and Rehabilitation New Liquid Spray intervention in patients with indwelling gastric tube can effectively reduce the nasopharyngeal injury and improve the pain of catheterization.展开更多
In this study,an intravenous indwelling needle was placed in the central artery of rabbit ear for collecting blood.The results show that this method greatly improves the success rate of blood sampling and well control...In this study,an intravenous indwelling needle was placed in the central artery of rabbit ear for collecting blood.The results show that this method greatly improves the success rate of blood sampling and well controls the experimental time.The students'unanimous feedback was that the method is simple and easy to operate,which is of great help to the stability of the experimental results.展开更多
Video assisted thoracic surgery in advanced stage postpneumonic empyema aims for thorough debridement and washout of the pleural space followed by an attempt to release the entrapped lung (decortication). When the lat...Video assisted thoracic surgery in advanced stage postpneumonic empyema aims for thorough debridement and washout of the pleural space followed by an attempt to release the entrapped lung (decortication). When the latter isn’t successful, and the patient is in a poor performance status, applying tube thoracostomy is the usual routine, to avoid conversion to thoracotomy and open decortication. Tube thoracostomy, however, is associated with complications necessitating further surgery, needs long term follow up and also entails quality of life distorting issues. To overcome these disadvantages, we instead inserted a PleurX® indwelling pleural catheter in four patients in the above situation. The method brought success (lung re-expansion and complete or partial pleurodesis) without the need for further surgery or quality of life problems in either patient. Although the use of the indwelling pleural catheter in infected pleural space is not recommended by manufacturers, we noted no complications.展开更多
Objective:This paper mainly explores the effect of fine management application in maintenance of deep venous indwelling catheter in hemodialysis patients.Methods:150 hemodialysis patients with deep venous catheter ind...Objective:This paper mainly explores the effect of fine management application in maintenance of deep venous indwelling catheter in hemodialysis patients.Methods:150 hemodialysis patients with deep venous catheter indwelling in our hospital from December 2019 to September 2020 were divided into routine group and study group.The routine group was given routine nursing,and the study group was given fine management nursing.The nursing effect of the two groups was analyzed.Results:After nursing intervention,the incidence of complications in the study group was 14.66%,which was lower than that in the conventional group(53.33%),and the nursing compliance in the study group(98.66%)was higher than that in the conventional group(89.33%),all P<0.05.Conclusion:Fine management plays a significant role in the maintenance of deep venous indwelling catheter in hemodialysis patients,which can reduce the occurrence of complications.展开更多
Objective:This paper expounds and analyzes the effect of cluster nursing in preventing urinary tract infection in postoperative patients with indwelling urinary catheter.Methods:A total of 400 postoperative patients w...Objective:This paper expounds and analyzes the effect of cluster nursing in preventing urinary tract infection in postoperative patients with indwelling urinary catheter.Methods:A total of 400 postoperative patients with indwelling urinary catheter,treated in Yancheng No.1 People’s Hospital in recent two years,were recruited as research subjects.The patients were equally divided into group A and group B,with 200 patients in each group,and all received routine anti-infectives.The patients in group A(200 cases)received routine nursing.On the basis of group A,cluster nursing was implemented for patients in group B(200 cases).Results:The indwelling time of urinary catheter,the disappearance time of bladder irritation symptoms,and the probability of urinary tract infection were compared between both groups,which showed that the nursing effect of group B was better than that of group A(P<0.05).Conclusion:The implementation of cluster nursing in postoperative patients with indwelling urinary catheter can improve the deficiency of routine nursing,consolidate the treatment effect,and reduce the complication rate of urinary tract infection.展开更多
Tracheal intubation by tracheotomy or by placing a tracheal tube through larynx into trachea,is not only one of important measures which are taken to rescue critically ill patients with respiratory failure etc.,but a ...Tracheal intubation by tracheotomy or by placing a tracheal tube through larynx into trachea,is not only one of important measures which are taken to rescue critically ill patients with respiratory failure etc.,but a commonly used method to prevent patients from airway obstruction in the postoperative period and facilitate mechanical ventilation.Meanwhile,the incidence rate of pulmonary infection,a complication caused by indwelling tracheal tubes,especially the incidence rate of hospital acquired pulmonary infection is apparently increasing.Particularly,pulmonary infection of this kind has characteristics of easily recurrent seizures,long treatment period and high drug-resistance.Hence,it is required for medical personnel to summarize,analyze and study not only general nursing,airway nursing and prevention of pulmonary infection,but also antibiotic selection as well as how and when to use those drugs after the incidence of pulmonary infection for the benefit of patients with indwelling tracheal tube.This article is based on a case collected from Comprehensive Surgery Department of the Third Affiliated Hospital of Inner Mongolia Medical University.The patient’s history is as follows:1.Pulmonary infection;2.Indwelling tracheal catheter after tracheotomy;3.Carbon monoxide toxic cerebrosis,mute state.By means of this case analysis,it is expected to make an early detection,and give an early and proper treatment to patients with pulmonary infection caused by indwelling tracheal tubes in clinical practice.展开更多
Objective:To analyze the effect of enteral nutrition and nursing intervention in patients with indwelling nasojejunal tube in acute severe pancreatitis.Methods:Sixty cases of patients with indwelt nasojejunal tubes tr...Objective:To analyze the effect of enteral nutrition and nursing intervention in patients with indwelling nasojejunal tube in acute severe pancreatitis.Methods:Sixty cases of patients with indwelt nasojejunal tubes treated in our hospital from August 2019 to August 2020 were divided into routine group and observation group as research subjects.Patients in both groups received enteral nutrition,patients in the routine group received routine care,and patients in the observation group received quality care.The recovery time of gastrointestinal function,length of hospital stay,hospitalization cost,nutritional indicators and incidence of complications in the two groups were compared.Results:The recovery time of gastrointestinal function in observation group was lower than that in routine group,P<0.05;The length and cost of hospitalization in observation group were lower than those in routine group,P<0.05;The nutritional indexes in observation group were higher than those in routine group,P<0.05;The incidence of complications in observation group was lower than that in routine group,P<0.05.Conclusion:Quality nursing service improve the effect of enteral nutrition,so as to ensure that patients get sufficient nutritional support.Its effect is remarkable and it is worthy of widespread clinical application.展开更多
BACKGROUND Long-term abdominal drains(LTAD)are a cost-effective palliative measure to manage malignant ascites in the community,but their use in patients with end-stage chronic liver disease and refractory ascites is ...BACKGROUND Long-term abdominal drains(LTAD)are a cost-effective palliative measure to manage malignant ascites in the community,but their use in patients with end-stage chronic liver disease and refractory ascites is not routine practice.The safety and cost-effectiveness of LTAD are currently being studied in this setting,with preliminary positive results.We hypothesised that palliative LTAD are as effective and safe as repeat palliative large volume paracentesis(LVP)in patients with cirrhosis and refractory ascites and may offer advantages in patients’quality of life.AIM To compare the effectiveness and safety of palliative LTAD and LVP in refractory ascites secondary to end-stage chronic liver disease.METHODS A retrospective,observational cohort study comparing the effectiveness and safety outcomes of palliative LTAD and regular palliative LVP as a treatment for refractory ascites in consecutive patients with end-stage chronic liver disease followed-up at our United Kingdom tertiary centre between 2018 and 2022 was conducted.Fisher’s exact tests and the Mann-Whitney U test were used to compare qualitative and quantitative variables,respectively.Kaplan-Meier survival estimates were generated to stratify time-related outcomes according to the type of drain.RESULTS Thirty patients had a total of 35 indwelling abdominal drains and nineteen patients underwent regular LVP.The baseline characteristics were similar between the groups.Prophylactic antibiotics were more frequently prescribed in patients with LTAD(P=0.012),while the incidence of peritonitis did not differ between the two groups(P=0.46).The incidence of acute kidney injury(P=0.014)and ascites/drain-related hospital admissions(P=0.004)were significantly higher in the LVP group.The overall survival was similar in the two groups(log-rank P=0.26),but the endpoint-free survival was significantly shorter in the LVP group(P=0.003,P<0.001,P=0.018 for first ascites/drain-related admission,acute kidney injury and drain-related complications,respectively).CONCLUSION The use of LTAD in the management of refractory ascites in palliated end-stage liver disease is effective,safe,and may reduce hospital admissions and utilisation of healthcare resources compared to LVP.展开更多
BACKGROUND Chronic obstructive pulmonary disease(COPD)combined with spontaneous pneumothorax,is characterized by significant decline in lung function,and even cause cardiopulmonary failure and hypoxia.AIM To evaluate ...BACKGROUND Chronic obstructive pulmonary disease(COPD)combined with spontaneous pneumothorax,is characterized by significant decline in lung function,and even cause cardiopulmonary failure and hypoxia.AIM To evaluate the clinical effectiveness of central venous catheters and indwelling pleural catheters(IPC)in managing closed thoracic drainage in patients diagnosed with COPD with concomitant by spontaneous pneumothorax.METHODS Retrospective analysis was conducted on the clinical information of 60 elderly patients with COPD complicated by spontaneous pneumothorax admitted to the Shexian Branch of the second affiliated hospital of Zhejiang university school of medicine between March 2020 and March 2023.The clinical efficacy,complications,hospitalization duration,and costs were compared between patients with an indwelling thoracic catheter and those with a central venous catheter.Univariate logistic regression was used to analyze the causes of catheter displacement.RESULTS According to our findings,there were significant differences in the IPC group’s clinical efficacy,catheter operation time,and lung recruitment time(P<0.05).Comparing the complications after catheter treatment between the two groups revealed statistically significant variations in the incidence of postoperative analgesics,catheter abscission,catheter blockage,and subcutaneous emphysema in the IPC group(P<0.05).Univariate analysis demonstrated significant differences between patients with and without catheter dislodgement regarding duty nurse’s working years(less than three),Acute Physiology and Chronic Health Evaluation II(APACHE II)scores(less than 15),lack of catheter suture fixation,and the proportion of catheters not fixed twice(P<0.05).CONCLUSION Our results demonstrated that when treating elderly COPD patients with spontaneous pneumothorax,indwelling thoracic catheters are more effective than the central venous catheter group.Patients’catheter shedding is influenced by the primary nurse’s working years,APACHE II scores,and catheter fixation technique.展开更多
Objective: To investigate the application value of midline catheters in patients with larynx cancer during the postoperative period. Methods: 150 patients with larynx cancer treated in our hospital from May 2019 to Ma...Objective: To investigate the application value of midline catheters in patients with larynx cancer during the postoperative period. Methods: 150 patients with larynx cancer treated in our hospital from May 2019 to May 2022 were selected as the study objects. According to the random number method, 75 cases were divided into a control group and a study group. The study group used a midline catheter during treatment, and the control group used a Peripheral venous indwelling needle during treatment. The indwelling time, puncture times, complication rate, daily catheter maintenance cost and catheterization satisfaction rate of the two groups were compared. Result: The retention time of the study group (11.53 ± 6.91 days) was significantly higher than that of the control group (2.92 ± 1.41 days) (P . The total puncture times were significantly lower than that of the control group (P cidence of complications such as catheter blockage, catheter detachment, drug extravasation and phlebitis were lower than those of the control group. The difference was statistically significant (P < 0.05), the average daily maintenance cost of the two groups was not statistically significant (P > 0.05), and the satisfaction rate of the study group was significantly higher than that of the control group, the difference was statistically significant (P Conclusion: Compared with the Peripheral venous indwelling needle, postoperative application of a midline catheter in patients with larynx cancer can effectively reduce the number of puncture times and the incidence of catheter-related adverse reactions, and has higher economic benefits and satisfaction rate, which is worthy of clinical application.展开更多
BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive ca...BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive care unit(EICU)in order to provide the beneficial reference.METHODS:From January 2008 to December 2010,a total of 1 363 patients were subjected to catheterization.In these patients,the peak CRI rate of the patients was determined by bacterial cultivation and blood bacterial cultivation.RESULTS:CRI happened in 147 of the 1 363 patients using the central venous catheter.The peak rate of CRI was 10.79%,with an incidence of 3.05 episodes per 1 000 catheter days.Of the147 patients,46.94%had gram-negative bacilli,40.14%had gram-positive cocci,and 12.92%had fungi.Unconditional logistic regression analysis suggests that multiple catheterization,femoral vein catheterization,the application of multicavity catheter,and the duration of catheterization were the independent risk factors for CRI.CONCLUSION:The risk factors for catheter-related infections should be controlled to prevent the occurrence of nosocomial infection.展开更多
Benign prostatic hyperplasia(BPH)is one of the most common conditions experienced by aging males and a frequent cause of bladder outlet obstruction and macroscopic haematuria.Giant prostatic hyperplasia(GPH)is an extr...Benign prostatic hyperplasia(BPH)is one of the most common conditions experienced by aging males and a frequent cause of bladder outlet obstruction and macroscopic haematuria.Giant prostatic hyperplasia(GPH)is an extremely rare form of prostatic hyperplasia.We present a case of a patient with GPH of 800 mL.To our knowledge,this is the fourth largest prostatic hyperplasia ever reported in the literature.展开更多
We describe three cases of inadvertent placement of the urinary catheter into the ureter.An 85-year-old gentleman on long-term indwelling catheter(IDC)for neurogenic bladder presented with fever and right flank pain.C...We describe three cases of inadvertent placement of the urinary catheter into the ureter.An 85-year-old gentleman on long-term indwelling catheter(IDC)for neurogenic bladder presented with fever and right flank pain.CT of abdomen and pelvis demonstrated the tip of the IDC to be located within the right vesicoureteric junction with acute right hydronephrosis and acute pyelonephritis.A 74-year-old woman,on long-term IDC for neurogenic bladder was found to have hydronephrosis on ultrasound imaging.Contrast-enhanced CT intravenous pyelography done subsequently showed the IDC was in the right distal ureter.A 47-year-old lady,on IDC for urinary retention and voiding dysfunction likely secondary to schizophrenia and anti-psychotic medications,presented with raised creatinine.A non-enhanced CT of her abdomen and pelvis was done and showed that the tip of the urethral IDC was located up to the left vesicoureteric junction.In all patients,the hydronephrosis resolved after changing the catheter and they were well on discharge.We also review the literature to identify the incidence,outcomes and possible risk factors.To our knowledge,only 20 cases have been reported thus far in the English literature.Although serious complications can occur,the incidence is very low.One risk factor that has been identified is long-term catheterization in patients with neurogenic bladder.We do not recommend routine imaging after catheterization in this group of patients.However,we should still be mindful of the possibility of this occurrence and evaluate and treat as necessary when clinical suspicion arises.展开更多
Objective: The study aims to compare the application value of midline catheter and indwelling needle in patients with oral cavity malignancies during perioperative period. Methods: 146 patients with oral cavity malign...Objective: The study aims to compare the application value of midline catheter and indwelling needle in patients with oral cavity malignancies during perioperative period. Methods: 146 patients with oral cavity malignancies admitted to our hospital from January 2019 to July 2021 were selected as the research subjects. 73 patients treated with midline catheters during the treatment were the experimental group, and another 73 patients were treated with indwelling needles as the control group. The indwelling time, total number of puncturing times, and incidence of adverse reactions of two catheterization methods were compared between the two groups. Meanwhile, each patient was investigated for treatment satisfaction. Result: The indwelling time was significantly longer in the experimental group than in the control group (P < 0.0001), and the total number of puncturing times in the experimental group was significantly lower than that in the control group (P < 0.0001). The incidence of adverse reactions in the experimental group (χ<sup>2</sup> = 4.960, P = 0.0259) was significantly lower than that in the control group in terms of catheter occlusion (χ<sup>2</sup> = 12.56, P = 0.0004), catheter detachment (χ<sup>2</sup> = 8.46, P = 0.0036), drug extravasation (χ<sup>2</sup> = 3.27, P = 0.0011), phlebitis (χ<sup>2</sup> = 3.62, P = 0.0003), and bleeding from the puncture point (χ<sup>2</sup> = 14.98, P = 0.0001). The satisfaction rate (χ<sup>2</sup> = 33.45, P < 0.0001) and fundamental satisfaction rate (χ<sup>2</sup> = 16.57, P < 0.0001) in the experimental group were significantly higher than those in the control group, while the dissatisfaction rate was significantly lower than that in the control group (χ<sup>2</sup> = 11.38, P = 0.0007). The difference is statistically significant. Conclusion: Compared with indwelling needle, the application of midline catheters in patients with oral cavity malignancies during perioperative period can effectively reduce the number of puncturing times and the incidence of catheter-related adverse reactions, with a high satisfaction rate, which is worthy of clinical promotion and application. 展开更多
Objective: The objective of this study is to assess the outcome of port-a-cath (PAC) maintenance every three months in patients with gynecologic malignancies with the goal of standardizing a safe and appropriate inter...Objective: The objective of this study is to assess the outcome of port-a-cath (PAC) maintenance every three months in patients with gynecologic malignancies with the goal of standardizing a safe and appropriate interval that would maintain patency and minimize side effects. Methods: We performed a retrospective medical record review and evaluation of all patients with a Bard? PAC who were noted to have no evidence of disease (NED) during the years 2003 to 2010. The interval between accessions and any complications related to the presence of the PAC were recorded. Relevant complications included skin infections, bacteremia, thrombosis, and occlusions. Statistical analysis was done using the Fisher’s exact test. Results: A total of 201 patients had PAC placed and 43 patients underwent PAC accessions to maintain patency. The total number of accessions was 150 with a median number per patient of 2.0 (range 1 - 10). The mean time between flushes was 112 days (SD = 57). When comparing women in maintenance who had flushes within 90 days versus those who had flushes over 90 days apart, there was no difference in infection or occlusion rates between these groups (p = 0.515). In the Conclusion: Infections and occlusions are rare in women with gynecologic malignancies undergoing maintenance of their PAC. Longer intervals between PAC flushes do not appear to affect the outcome in our patients. Our ongoing data and follow-up confirm that extending the interval of PAC accession to every 3 months, rather than monthly, is safe, effective and convenient in the patient population with gynecologic malignancies.展开更多
Objective： The study aimed to explore a lien secure trocar as an effective method to prevent blood spills. Methods： This study included 1200 patients, who had a safety catheter from March to April in 2012, from the ...Objective： The study aimed to explore a lien secure trocar as an effective method to prevent blood spills. Methods： This study included 1200 patients, who had a safety catheter from March to April in 2012, from the emergency department of the Shengjing Hospital of China Medical University. The patients were randomly divided into an experimental group and a control group. Using a conventional method, we compressed the vein at the tip of catheter to prevent blood spillage in the control group. We raised the patient＇s upper limb, while compressing the vein at the tip of catheter in the experimental group. Results： The results showed that the experimental group was better than the control group not only in quantity but also in quality regarding blood pollution. The results reached a level of statistical signifi- cance （P 〈 0.01）. Conclusions： Raising the patient＇s upper limb and occluding the vein distal to the catheter can effectively interrupt blood spillage while withdrawing the steel needle （i.e., pulling out the trocar）.展开更多
OBJECTIVE: To evaluate the clinical efficacy of interventional therapy in the treatment of hepatocellular carcinoma (HCC). METHODS: Thirty-three patients with HCC were synthetically treated by systematic measures. Amo...OBJECTIVE: To evaluate the clinical efficacy of interventional therapy in the treatment of hepatocellular carcinoma (HCC). METHODS: Thirty-three patients with HCC were synthetically treated by systematic measures. Among them, percutaneous port-catheter system (PCS) implantation via the femoral artery was performed in 21 cases. Patients with haemorrhage were treated with prothrombin complex concentrate and fibroraas, and patients with hepatic encephalopathy by branched-chain amino acids and arginine. RESULTS: All indwelling catheters of PCS were patent and no catheter tip dislocations were observed. Of 33 patients with advanced HCC, the mean survival rate was 20.1 months and 12 (36%) patients survived more than 2 years. CONCLUSION: Patients with advanced HCC were treated by synthetic measures. Survival was prolonged, quality of life was improved significantly, and the effectiveness of interventional therapy was further improved.展开更多
基金funded by the Chongqing medical scientific research project(No.2020FYYX059).
文摘Objective:To study the factors influencing secondary indwelling catheterisation after cervical cancer surgery and to develop a predictive risk model.Methods:A total of 260 patients in a tertiary hospital in Chongqing were selected from January 2020 to December 2021 via convenience sampling.Relevant information of patients was recorded,including age;body mass index;history of hypertension and diabetes,bladder dysfunction,postoperative urinary retention,and postoperative urinary tract infection;Histology;staging;surgical approach;Operation time;Time of first remove of catheter;indwelling catheter days;Hospitalization days.Least absolute shrinkage and selection operator was used to reduce dimensionality and select patient characteristics,and multivariate analysis was performed based on the selected variables.Based on the outcome of analysis,a line chart model was developed for predicting the risk of secondary catheterization in patients with indwelling catheterization after radical cervical cancer surgery.The coefficient of conformity index(C-index)and calibration curves were used to evaluate the accuracy and fit.The model was internally validated via bootstrapping(1000 random samples),and the clinical utility of the model was assessed via decision curve analysis(DCA).Results:Four characteristic variables were selected,including preoperative bladder function,postoperative urinary tract infection,surgical approach,and Time of first remove of catheter.They are independent risk factors affecting urinary tract.The risk prediction model exhibited good discrimination performance with a C-index of 0.722(95%CI,0.661-0.783)and was well calibrated.The C-index was 0.708 in internal validation analysis.DCA showed that the risk model was clinically useful for predicting secondary catheterization,and clinical benefits were observed at the decision threshold of≥11%.Conclusion:A novel model was developed to predict the risk of secondary catheterization.The model was based on preoperative bladder dysfunction,postoperative urinary tract infection,surgical approach,and number of days since the removal of the primary catheter.
文摘AIM： To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine （e.g. Dahuang） in treating abdominal compartment syndrome of fulminant acute pancreatitis. METHODS： Patients with fulminant acute pancreatitis were divided randomly into 2 groups of combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring and routine conservative measures group （group 1） and control group （group 2）. Routine non-operative conservative treatments including hemofiltration, respiration support, gastrointestinal TCM ablution were also applied in control group patients. Effectiveness of the two groups was observed, and APACHE Ⅱ scores were applied for analysis. RESULTS： On the second and fifth days after treatment, APACHE Ⅱ scores of group 1 and 2 patients were significantly different. Comparison of effectiveness （abdominalgia and burbulence relief time, hospitalization time） between groups 1 and 2 showed significant difference, as well as incidence rates of cysts formation. Mortality rates of groups 1 and 2 were 10.0% and 20.7%, respectively. For patients in group 1, celiac drainage quantity and intra-abdominal pressure, and hospitalization time were positively correlated （r = 0.552, 0.748, 0.923, P 〈 0.01） with APACHE Ⅱ scores. CONCLUSION： Combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring, short veno-venous hemofiltration （SVVH）, gastrointestinal TCM ablution, respiration support have preventive and treatment effects on abdominal compartment syndrome of fulminant acute pancreatitis.
文摘In this review, we report on the use of indwelling pleural catheters in the treatment of malignant pleural effusions. We describe the most commonly used catheter. Also, treatment with indwelling pleuralcatheters as compared to talc pleurodesis is reviewed. A comparison of efficacy, costs, effects on quality of life, and complications is made. Only one randomized controlled trial comparing the two is available up to date, but several are underway. We conclude that treatment for malignant pleural effusions with indwelling pleural catheters is a save, cost-effective, and patientfriendly method, with low complication rates.
文摘Objective:To explore the effect of modified nasogastric tube placement and Rehabilitation New Liquid Spray in patients with indwelling gastric tube.Methods:Eighty-six cases with indwelling gastric tube in our hospital from January 2020 to May 2021 were randomly selected and divided into the reference group and the research group.The reference group was treated by modified gastric tube placement,and the research group was given the Rehabilitation New Liquid Spray intervention.The effect of the interventions on two groups was observed.Results:The incidence of nasal mucosal injury in the research group was lower than that in the reference group,and the incidence of pharyngeal mucosal injury in the research group was lower than that in the reference group(P<0.05).The pain score of the study group was lower than that of the reference group at 8 h,12 h and 24 h after replacement,and the incidence of hoarseness,swallowing discomfort and dry oropharynx was lower than that of the reference group(P<0.05).Conclusion:The application of modified gastric tube placement and Rehabilitation New Liquid Spray intervention in patients with indwelling gastric tube can effectively reduce the nasopharyngeal injury and improve the pain of catheterization.
基金Planning Project of Guangxi for Educational Science during the 12th Five-Year Plan Period(2015C389)Guangxi Natural Science Foundation(2017GXNSFAA198255).
文摘In this study,an intravenous indwelling needle was placed in the central artery of rabbit ear for collecting blood.The results show that this method greatly improves the success rate of blood sampling and well controls the experimental time.The students'unanimous feedback was that the method is simple and easy to operate,which is of great help to the stability of the experimental results.
文摘Video assisted thoracic surgery in advanced stage postpneumonic empyema aims for thorough debridement and washout of the pleural space followed by an attempt to release the entrapped lung (decortication). When the latter isn’t successful, and the patient is in a poor performance status, applying tube thoracostomy is the usual routine, to avoid conversion to thoracotomy and open decortication. Tube thoracostomy, however, is associated with complications necessitating further surgery, needs long term follow up and also entails quality of life distorting issues. To overcome these disadvantages, we instead inserted a PleurX® indwelling pleural catheter in four patients in the above situation. The method brought success (lung re-expansion and complete or partial pleurodesis) without the need for further surgery or quality of life problems in either patient. Although the use of the indwelling pleural catheter in infected pleural space is not recommended by manufacturers, we noted no complications.
文摘Objective:This paper mainly explores the effect of fine management application in maintenance of deep venous indwelling catheter in hemodialysis patients.Methods:150 hemodialysis patients with deep venous catheter indwelling in our hospital from December 2019 to September 2020 were divided into routine group and study group.The routine group was given routine nursing,and the study group was given fine management nursing.The nursing effect of the two groups was analyzed.Results:After nursing intervention,the incidence of complications in the study group was 14.66%,which was lower than that in the conventional group(53.33%),and the nursing compliance in the study group(98.66%)was higher than that in the conventional group(89.33%),all P<0.05.Conclusion:Fine management plays a significant role in the maintenance of deep venous indwelling catheter in hemodialysis patients,which can reduce the occurrence of complications.
文摘Objective:This paper expounds and analyzes the effect of cluster nursing in preventing urinary tract infection in postoperative patients with indwelling urinary catheter.Methods:A total of 400 postoperative patients with indwelling urinary catheter,treated in Yancheng No.1 People’s Hospital in recent two years,were recruited as research subjects.The patients were equally divided into group A and group B,with 200 patients in each group,and all received routine anti-infectives.The patients in group A(200 cases)received routine nursing.On the basis of group A,cluster nursing was implemented for patients in group B(200 cases).Results:The indwelling time of urinary catheter,the disappearance time of bladder irritation symptoms,and the probability of urinary tract infection were compared between both groups,which showed that the nursing effect of group B was better than that of group A(P<0.05).Conclusion:The implementation of cluster nursing in postoperative patients with indwelling urinary catheter can improve the deficiency of routine nursing,consolidate the treatment effect,and reduce the complication rate of urinary tract infection.
文摘Tracheal intubation by tracheotomy or by placing a tracheal tube through larynx into trachea,is not only one of important measures which are taken to rescue critically ill patients with respiratory failure etc.,but a commonly used method to prevent patients from airway obstruction in the postoperative period and facilitate mechanical ventilation.Meanwhile,the incidence rate of pulmonary infection,a complication caused by indwelling tracheal tubes,especially the incidence rate of hospital acquired pulmonary infection is apparently increasing.Particularly,pulmonary infection of this kind has characteristics of easily recurrent seizures,long treatment period and high drug-resistance.Hence,it is required for medical personnel to summarize,analyze and study not only general nursing,airway nursing and prevention of pulmonary infection,but also antibiotic selection as well as how and when to use those drugs after the incidence of pulmonary infection for the benefit of patients with indwelling tracheal tube.This article is based on a case collected from Comprehensive Surgery Department of the Third Affiliated Hospital of Inner Mongolia Medical University.The patient’s history is as follows:1.Pulmonary infection;2.Indwelling tracheal catheter after tracheotomy;3.Carbon monoxide toxic cerebrosis,mute state.By means of this case analysis,it is expected to make an early detection,and give an early and proper treatment to patients with pulmonary infection caused by indwelling tracheal tubes in clinical practice.
文摘Objective:To analyze the effect of enteral nutrition and nursing intervention in patients with indwelling nasojejunal tube in acute severe pancreatitis.Methods:Sixty cases of patients with indwelt nasojejunal tubes treated in our hospital from August 2019 to August 2020 were divided into routine group and observation group as research subjects.Patients in both groups received enteral nutrition,patients in the routine group received routine care,and patients in the observation group received quality care.The recovery time of gastrointestinal function,length of hospital stay,hospitalization cost,nutritional indicators and incidence of complications in the two groups were compared.Results:The recovery time of gastrointestinal function in observation group was lower than that in routine group,P<0.05;The length and cost of hospitalization in observation group were lower than those in routine group,P<0.05;The nutritional indexes in observation group were higher than those in routine group,P<0.05;The incidence of complications in observation group was lower than that in routine group,P<0.05.Conclusion:Quality nursing service improve the effect of enteral nutrition,so as to ensure that patients get sufficient nutritional support.Its effect is remarkable and it is worthy of widespread clinical application.
文摘BACKGROUND Long-term abdominal drains(LTAD)are a cost-effective palliative measure to manage malignant ascites in the community,but their use in patients with end-stage chronic liver disease and refractory ascites is not routine practice.The safety and cost-effectiveness of LTAD are currently being studied in this setting,with preliminary positive results.We hypothesised that palliative LTAD are as effective and safe as repeat palliative large volume paracentesis(LVP)in patients with cirrhosis and refractory ascites and may offer advantages in patients’quality of life.AIM To compare the effectiveness and safety of palliative LTAD and LVP in refractory ascites secondary to end-stage chronic liver disease.METHODS A retrospective,observational cohort study comparing the effectiveness and safety outcomes of palliative LTAD and regular palliative LVP as a treatment for refractory ascites in consecutive patients with end-stage chronic liver disease followed-up at our United Kingdom tertiary centre between 2018 and 2022 was conducted.Fisher’s exact tests and the Mann-Whitney U test were used to compare qualitative and quantitative variables,respectively.Kaplan-Meier survival estimates were generated to stratify time-related outcomes according to the type of drain.RESULTS Thirty patients had a total of 35 indwelling abdominal drains and nineteen patients underwent regular LVP.The baseline characteristics were similar between the groups.Prophylactic antibiotics were more frequently prescribed in patients with LTAD(P=0.012),while the incidence of peritonitis did not differ between the two groups(P=0.46).The incidence of acute kidney injury(P=0.014)and ascites/drain-related hospital admissions(P=0.004)were significantly higher in the LVP group.The overall survival was similar in the two groups(log-rank P=0.26),but the endpoint-free survival was significantly shorter in the LVP group(P=0.003,P<0.001,P=0.018 for first ascites/drain-related admission,acute kidney injury and drain-related complications,respectively).CONCLUSION The use of LTAD in the management of refractory ascites in palliated end-stage liver disease is effective,safe,and may reduce hospital admissions and utilisation of healthcare resources compared to LVP.
文摘BACKGROUND Chronic obstructive pulmonary disease(COPD)combined with spontaneous pneumothorax,is characterized by significant decline in lung function,and even cause cardiopulmonary failure and hypoxia.AIM To evaluate the clinical effectiveness of central venous catheters and indwelling pleural catheters(IPC)in managing closed thoracic drainage in patients diagnosed with COPD with concomitant by spontaneous pneumothorax.METHODS Retrospective analysis was conducted on the clinical information of 60 elderly patients with COPD complicated by spontaneous pneumothorax admitted to the Shexian Branch of the second affiliated hospital of Zhejiang university school of medicine between March 2020 and March 2023.The clinical efficacy,complications,hospitalization duration,and costs were compared between patients with an indwelling thoracic catheter and those with a central venous catheter.Univariate logistic regression was used to analyze the causes of catheter displacement.RESULTS According to our findings,there were significant differences in the IPC group’s clinical efficacy,catheter operation time,and lung recruitment time(P<0.05).Comparing the complications after catheter treatment between the two groups revealed statistically significant variations in the incidence of postoperative analgesics,catheter abscission,catheter blockage,and subcutaneous emphysema in the IPC group(P<0.05).Univariate analysis demonstrated significant differences between patients with and without catheter dislodgement regarding duty nurse’s working years(less than three),Acute Physiology and Chronic Health Evaluation II(APACHE II)scores(less than 15),lack of catheter suture fixation,and the proportion of catheters not fixed twice(P<0.05).CONCLUSION Our results demonstrated that when treating elderly COPD patients with spontaneous pneumothorax,indwelling thoracic catheters are more effective than the central venous catheter group.Patients’catheter shedding is influenced by the primary nurse’s working years,APACHE II scores,and catheter fixation technique.
文摘Objective: To investigate the application value of midline catheters in patients with larynx cancer during the postoperative period. Methods: 150 patients with larynx cancer treated in our hospital from May 2019 to May 2022 were selected as the study objects. According to the random number method, 75 cases were divided into a control group and a study group. The study group used a midline catheter during treatment, and the control group used a Peripheral venous indwelling needle during treatment. The indwelling time, puncture times, complication rate, daily catheter maintenance cost and catheterization satisfaction rate of the two groups were compared. Result: The retention time of the study group (11.53 ± 6.91 days) was significantly higher than that of the control group (2.92 ± 1.41 days) (P . The total puncture times were significantly lower than that of the control group (P cidence of complications such as catheter blockage, catheter detachment, drug extravasation and phlebitis were lower than those of the control group. The difference was statistically significant (P < 0.05), the average daily maintenance cost of the two groups was not statistically significant (P > 0.05), and the satisfaction rate of the study group was significantly higher than that of the control group, the difference was statistically significant (P Conclusion: Compared with the Peripheral venous indwelling needle, postoperative application of a midline catheter in patients with larynx cancer can effectively reduce the number of puncture times and the incidence of catheter-related adverse reactions, and has higher economic benefits and satisfaction rate, which is worthy of clinical application.
文摘BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive care unit(EICU)in order to provide the beneficial reference.METHODS:From January 2008 to December 2010,a total of 1 363 patients were subjected to catheterization.In these patients,the peak CRI rate of the patients was determined by bacterial cultivation and blood bacterial cultivation.RESULTS:CRI happened in 147 of the 1 363 patients using the central venous catheter.The peak rate of CRI was 10.79%,with an incidence of 3.05 episodes per 1 000 catheter days.Of the147 patients,46.94%had gram-negative bacilli,40.14%had gram-positive cocci,and 12.92%had fungi.Unconditional logistic regression analysis suggests that multiple catheterization,femoral vein catheterization,the application of multicavity catheter,and the duration of catheterization were the independent risk factors for CRI.CONCLUSION:The risk factors for catheter-related infections should be controlled to prevent the occurrence of nosocomial infection.
文摘Benign prostatic hyperplasia(BPH)is one of the most common conditions experienced by aging males and a frequent cause of bladder outlet obstruction and macroscopic haematuria.Giant prostatic hyperplasia(GPH)is an extremely rare form of prostatic hyperplasia.We present a case of a patient with GPH of 800 mL.To our knowledge,this is the fourth largest prostatic hyperplasia ever reported in the literature.
文摘We describe three cases of inadvertent placement of the urinary catheter into the ureter.An 85-year-old gentleman on long-term indwelling catheter(IDC)for neurogenic bladder presented with fever and right flank pain.CT of abdomen and pelvis demonstrated the tip of the IDC to be located within the right vesicoureteric junction with acute right hydronephrosis and acute pyelonephritis.A 74-year-old woman,on long-term IDC for neurogenic bladder was found to have hydronephrosis on ultrasound imaging.Contrast-enhanced CT intravenous pyelography done subsequently showed the IDC was in the right distal ureter.A 47-year-old lady,on IDC for urinary retention and voiding dysfunction likely secondary to schizophrenia and anti-psychotic medications,presented with raised creatinine.A non-enhanced CT of her abdomen and pelvis was done and showed that the tip of the urethral IDC was located up to the left vesicoureteric junction.In all patients,the hydronephrosis resolved after changing the catheter and they were well on discharge.We also review the literature to identify the incidence,outcomes and possible risk factors.To our knowledge,only 20 cases have been reported thus far in the English literature.Although serious complications can occur,the incidence is very low.One risk factor that has been identified is long-term catheterization in patients with neurogenic bladder.We do not recommend routine imaging after catheterization in this group of patients.However,we should still be mindful of the possibility of this occurrence and evaluate and treat as necessary when clinical suspicion arises.
文摘Objective: The study aims to compare the application value of midline catheter and indwelling needle in patients with oral cavity malignancies during perioperative period. Methods: 146 patients with oral cavity malignancies admitted to our hospital from January 2019 to July 2021 were selected as the research subjects. 73 patients treated with midline catheters during the treatment were the experimental group, and another 73 patients were treated with indwelling needles as the control group. The indwelling time, total number of puncturing times, and incidence of adverse reactions of two catheterization methods were compared between the two groups. Meanwhile, each patient was investigated for treatment satisfaction. Result: The indwelling time was significantly longer in the experimental group than in the control group (P < 0.0001), and the total number of puncturing times in the experimental group was significantly lower than that in the control group (P < 0.0001). The incidence of adverse reactions in the experimental group (χ<sup>2</sup> = 4.960, P = 0.0259) was significantly lower than that in the control group in terms of catheter occlusion (χ<sup>2</sup> = 12.56, P = 0.0004), catheter detachment (χ<sup>2</sup> = 8.46, P = 0.0036), drug extravasation (χ<sup>2</sup> = 3.27, P = 0.0011), phlebitis (χ<sup>2</sup> = 3.62, P = 0.0003), and bleeding from the puncture point (χ<sup>2</sup> = 14.98, P = 0.0001). The satisfaction rate (χ<sup>2</sup> = 33.45, P < 0.0001) and fundamental satisfaction rate (χ<sup>2</sup> = 16.57, P < 0.0001) in the experimental group were significantly higher than those in the control group, while the dissatisfaction rate was significantly lower than that in the control group (χ<sup>2</sup> = 11.38, P = 0.0007). The difference is statistically significant. Conclusion: Compared with indwelling needle, the application of midline catheters in patients with oral cavity malignancies during perioperative period can effectively reduce the number of puncturing times and the incidence of catheter-related adverse reactions, with a high satisfaction rate, which is worthy of clinical promotion and application.
文摘Objective: The objective of this study is to assess the outcome of port-a-cath (PAC) maintenance every three months in patients with gynecologic malignancies with the goal of standardizing a safe and appropriate interval that would maintain patency and minimize side effects. Methods: We performed a retrospective medical record review and evaluation of all patients with a Bard? PAC who were noted to have no evidence of disease (NED) during the years 2003 to 2010. The interval between accessions and any complications related to the presence of the PAC were recorded. Relevant complications included skin infections, bacteremia, thrombosis, and occlusions. Statistical analysis was done using the Fisher’s exact test. Results: A total of 201 patients had PAC placed and 43 patients underwent PAC accessions to maintain patency. The total number of accessions was 150 with a median number per patient of 2.0 (range 1 - 10). The mean time between flushes was 112 days (SD = 57). When comparing women in maintenance who had flushes within 90 days versus those who had flushes over 90 days apart, there was no difference in infection or occlusion rates between these groups (p = 0.515). In the Conclusion: Infections and occlusions are rare in women with gynecologic malignancies undergoing maintenance of their PAC. Longer intervals between PAC flushes do not appear to affect the outcome in our patients. Our ongoing data and follow-up confirm that extending the interval of PAC accession to every 3 months, rather than monthly, is safe, effective and convenient in the patient population with gynecologic malignancies.
文摘Objective： The study aimed to explore a lien secure trocar as an effective method to prevent blood spills. Methods： This study included 1200 patients, who had a safety catheter from March to April in 2012, from the emergency department of the Shengjing Hospital of China Medical University. The patients were randomly divided into an experimental group and a control group. Using a conventional method, we compressed the vein at the tip of catheter to prevent blood spillage in the control group. We raised the patient＇s upper limb, while compressing the vein at the tip of catheter in the experimental group. Results： The results showed that the experimental group was better than the control group not only in quantity but also in quality regarding blood pollution. The results reached a level of statistical signifi- cance （P 〈 0.01）. Conclusions： Raising the patient＇s upper limb and occluding the vein distal to the catheter can effectively interrupt blood spillage while withdrawing the steel needle （i.e., pulling out the trocar）.
文摘OBJECTIVE: To evaluate the clinical efficacy of interventional therapy in the treatment of hepatocellular carcinoma (HCC). METHODS: Thirty-three patients with HCC were synthetically treated by systematic measures. Among them, percutaneous port-catheter system (PCS) implantation via the femoral artery was performed in 21 cases. Patients with haemorrhage were treated with prothrombin complex concentrate and fibroraas, and patients with hepatic encephalopathy by branched-chain amino acids and arginine. RESULTS: All indwelling catheters of PCS were patent and no catheter tip dislocations were observed. Of 33 patients with advanced HCC, the mean survival rate was 20.1 months and 12 (36%) patients survived more than 2 years. CONCLUSION: Patients with advanced HCC were treated by synthetic measures. Survival was prolonged, quality of life was improved significantly, and the effectiveness of interventional therapy was further improved.
