BACKGROUND A hybrid operating room(hybrid-OR)is a surgical space that combines a conventional operating room with advanced medical imaging devices.AIM To explore and summarize the technical features and effectiveness ...BACKGROUND A hybrid operating room(hybrid-OR)is a surgical space that combines a conventional operating room with advanced medical imaging devices.AIM To explore and summarize the technical features and effectiveness of the application of a hybrid-OR in dealing with spinal dural arteriovenous fistulas(SDAVFs).METHODS Eleven patients with SDAVFs were treated with the use of a hybrid-OR at the Department of Neurosurgery of our hospital between January 2015 and December 2018.The dual-marker localization technique was used in the hybrid-OR to locate the SDAVFs and skin incision,and the interoperative digital subtraction angiography(DSA)technique was used before and after microsurgical ligation of the fistulae in the hybrid-OR to verify the accuracy of obliteration.The patients were followed for an average of 2 years after the operation,and the preoperative American Spinal Cord Injury Association(ASIA)score and postoperative ASIA score at 6 mo after the operation were compared.RESULTS The location and skin incision of the SDAVFs were accurately obtained by using the dual-marker localization technique in the hybrid-OR in all patients,and there were no cases that required expansion of the range of the bone window in order to expose the lesions.Intraoperative error obliteration occurred and was identified in two patients by using the intraoperative DSA technique;therefore,the findings provided by the intraoperative DSA system significantly changed the surgical procedure in these two patients.With the assistance of the hybrid-OR,the feeding artery was correctly ligated in all cases,and the intraoperative error obliteration rate decreased from 18.2%(2/11)to 0%.All 11 patients were followed for an average of 2 years.The ASIA score at 6 mo after the operation was significantly improved compared with the preoperative ASIA score,and there were no patients with late recurrence during the follow-up.CONCLUSION Compared with intra-arterial embolization for the treatment of SDAVFs,hybrid-ORs can solve the problem of a higher incidence of initial failure and late recurrence.Compared with direct occlusion of SDAVFs in microsurgery,hybrid-ORs can take advantage of the intraoperative DSA system for locating the shunt and verifying the obliteration of fistulae in order to reduce the error obliteration rate.At this point,our experience suggests that the safety and ease of use make hybrid-ORs combined with microsurgery and intraoperative DSA systems an attractive modality for dealing with SDAVFs.展开更多
Objective:To develop and apply a novel surgical aseptic technique curriculum in specialty training for operating room(OR)nurses.Methods:As surgical environments were improved,related specifications were revised.The pr...Objective:To develop and apply a novel surgical aseptic technique curriculum in specialty training for operating room(OR)nurses.Methods:As surgical environments were improved,related specifications were revised.The proposed surgical aseptic procedure was discussed,improved,and recorded as procedure videos.In the new training program,traditional theoretical lecture training was replaced with sequential theoretical lessons and video demonstration,operation presentation,and skill competition.At the end of the training,the trainees were given questionnaires to assess training outcomes.Differences in student satisfaction regarding the proposed training program and conventional training programs were then compared.Results:A GPA of 3.61±0.58 was recorded after the new training program was implemented.The minimum and maximum average scores of each item were 3.05±0.43 and 4.61±0.33,respectively The satisfaction rate of the trainees in 2013 was significantly higher than that in 2011(t=2.14,P=0.039).Conclusion:Novel surgical aseptic technique and application in the curriculum design of training for OR nurses should be developed to enhance their mastery of theoretical and practical skills and to modify their behaviors.展开更多
目的探讨丙泊酚复合瑞芬太尼无痛技术在手术室外麻醉应用的效果及安全性。方法将本院2015年全年行无痛诊疗的患者随机分为两组,观察组以丙泊酚复合瑞芬太尼(异丙酚9 m L(90 mg)复合瑞芬太尼1m L(10μg))镇痛,对照组以丙泊酚镇痛,术中记...目的探讨丙泊酚复合瑞芬太尼无痛技术在手术室外麻醉应用的效果及安全性。方法将本院2015年全年行无痛诊疗的患者随机分为两组,观察组以丙泊酚复合瑞芬太尼(异丙酚9 m L(90 mg)复合瑞芬太尼1m L(10μg))镇痛,对照组以丙泊酚镇痛,术中记录患者呼吸、脉搏、氧饱和度、加药次数,并对镇痛及苏醒程度进行分级。结果观察组患者呼吸循环抑制发生率及加药次数均明显低于对照组,镇痛完全程度观察组高于对照组,苏醒分级观察组优于对照组。结论无痛诊疗中使用丙泊酚复合瑞芬太尼"9+1"模式操作简便,不良反应少,苏醒快,安全可行。展开更多
基金the Tianjin Science and Technology Projects in Key Areas of Traditional Chinese Medicine,No.2018001.
文摘BACKGROUND A hybrid operating room(hybrid-OR)is a surgical space that combines a conventional operating room with advanced medical imaging devices.AIM To explore and summarize the technical features and effectiveness of the application of a hybrid-OR in dealing with spinal dural arteriovenous fistulas(SDAVFs).METHODS Eleven patients with SDAVFs were treated with the use of a hybrid-OR at the Department of Neurosurgery of our hospital between January 2015 and December 2018.The dual-marker localization technique was used in the hybrid-OR to locate the SDAVFs and skin incision,and the interoperative digital subtraction angiography(DSA)technique was used before and after microsurgical ligation of the fistulae in the hybrid-OR to verify the accuracy of obliteration.The patients were followed for an average of 2 years after the operation,and the preoperative American Spinal Cord Injury Association(ASIA)score and postoperative ASIA score at 6 mo after the operation were compared.RESULTS The location and skin incision of the SDAVFs were accurately obtained by using the dual-marker localization technique in the hybrid-OR in all patients,and there were no cases that required expansion of the range of the bone window in order to expose the lesions.Intraoperative error obliteration occurred and was identified in two patients by using the intraoperative DSA technique;therefore,the findings provided by the intraoperative DSA system significantly changed the surgical procedure in these two patients.With the assistance of the hybrid-OR,the feeding artery was correctly ligated in all cases,and the intraoperative error obliteration rate decreased from 18.2%(2/11)to 0%.All 11 patients were followed for an average of 2 years.The ASIA score at 6 mo after the operation was significantly improved compared with the preoperative ASIA score,and there were no patients with late recurrence during the follow-up.CONCLUSION Compared with intra-arterial embolization for the treatment of SDAVFs,hybrid-ORs can solve the problem of a higher incidence of initial failure and late recurrence.Compared with direct occlusion of SDAVFs in microsurgery,hybrid-ORs can take advantage of the intraoperative DSA system for locating the shunt and verifying the obliteration of fistulae in order to reduce the error obliteration rate.At this point,our experience suggests that the safety and ease of use make hybrid-ORs combined with microsurgery and intraoperative DSA systems an attractive modality for dealing with SDAVFs.
文摘Objective:To develop and apply a novel surgical aseptic technique curriculum in specialty training for operating room(OR)nurses.Methods:As surgical environments were improved,related specifications were revised.The proposed surgical aseptic procedure was discussed,improved,and recorded as procedure videos.In the new training program,traditional theoretical lecture training was replaced with sequential theoretical lessons and video demonstration,operation presentation,and skill competition.At the end of the training,the trainees were given questionnaires to assess training outcomes.Differences in student satisfaction regarding the proposed training program and conventional training programs were then compared.Results:A GPA of 3.61±0.58 was recorded after the new training program was implemented.The minimum and maximum average scores of each item were 3.05±0.43 and 4.61±0.33,respectively The satisfaction rate of the trainees in 2013 was significantly higher than that in 2011(t=2.14,P=0.039).Conclusion:Novel surgical aseptic technique and application in the curriculum design of training for OR nurses should be developed to enhance their mastery of theoretical and practical skills and to modify their behaviors.
文摘目的探讨丙泊酚复合瑞芬太尼无痛技术在手术室外麻醉应用的效果及安全性。方法将本院2015年全年行无痛诊疗的患者随机分为两组,观察组以丙泊酚复合瑞芬太尼(异丙酚9 m L(90 mg)复合瑞芬太尼1m L(10μg))镇痛,对照组以丙泊酚镇痛,术中记录患者呼吸、脉搏、氧饱和度、加药次数,并对镇痛及苏醒程度进行分级。结果观察组患者呼吸循环抑制发生率及加药次数均明显低于对照组,镇痛完全程度观察组高于对照组,苏醒分级观察组优于对照组。结论无痛诊疗中使用丙泊酚复合瑞芬太尼"9+1"模式操作简便,不良反应少,苏醒快,安全可行。
