BACKGROUND: Fast track strategy in the management of patients undergoing intra-abdominal surgery of various types has emerged as a landmark approach to reduce surgical stress and accelerate recovery. This study was to...BACKGROUND: Fast track strategy in the management of patients undergoing intra-abdominal surgery of various types has emerged as a landmark approach to reduce surgical stress and accelerate recovery. This study was to evaluate the effect of fast track strategy on patients subjected to pancreaticoduo-denectomy (PD) from an individual unit during transit from low to a high volume center. METHODS: A total of 142 PD patients who had been subjected to fast track strategy between June 2008 and September 2012 were compared with 46 patients who had received convention-al surgery between January 2006 and May 2008. Comparative analysis was made of postoperative complications, postopera-tive recovery, length of hospital stay and patient readmission requirement. RESULTS: The patients subjected to fast track strategy had a faster recovery and a shorter hospital stay than those who were treated conventionally (7.8 vs 12.1 days). The intraoperative events like operative blood loss (417.9±83.8 vs 997.4 ±151.8 mL, P<0.001), blood transfused (a median of 0 vs 1 unit,P<0.001) and operative time taken (125 vs 245 minutes,P<0.001) were signiifcantly lower in the fast track group. The frequency of pancreatic ifstula (4.9% vs 13.0%) and delayed gastric empty-ing (7.0% vs 17.4%) was also signiifcantly reduced with fast track treatment. Nevertheless, the readmission rate (11.3% vs 6.5%) was found relatively higher within the fast track group. However, increased readmission rates in this study seem to be independent of fast track protocol. CONCLUSIONS: This preliminary analysis suggests that the fast track approach might be beneifcial to the well-being of the patients after PD, for it accelerates the immediate clinical recovery of patients and signiifcantly shortens their length of hospital stay.展开更多
BACKGROUND Enhanced recovery after surgery strategies are increasingly implemented to improve the management of surgical patients.AIM To evaluate the effects of new perioperative fasting protocols in children≥3 mo of...BACKGROUND Enhanced recovery after surgery strategies are increasingly implemented to improve the management of surgical patients.AIM To evaluate the effects of new perioperative fasting protocols in children≥3 mo of age undergoing non-gastrointestinal surgery.METHODS This prospective pilot study included children≥3 mo of age undergoing nongastrointestinal surgery at the Children’s Hospital(Zhejiang University School of Medicine)from January 2020 to June 2020.The children were divided into either a conventional group or an ERAS group according to whether they had been enrolled before or after the implementation of the new perioperative fasting strategy.The children in the conventional group were fasted using conventional strategies,while those in the ERAS group were given individualized fasting protocols preoperatively(6-h fasting for infant formula/non-human milk/solids,4-h fasting for breast milk,and clear fluids allowed within 2 h of surgery)and postoperatively(food permitted from 1 h after surgery).Pre-operative and postoperative fasting times,pre-operative blood glucose,the incidence of postoperative thirst and hunger,the incidence of perioperative vomiting and aspiration,and the degree of satisfaction were evaluated.RESULTS The study included 303 patients(151 in the conventional group and 152 in the ERAS group).Compared with the conventional group,the ERAS group had a shorter pre-operative food fasting time[11.92(4.00,19.33)vs 13.00(6.00,20.28)h,P<0.001],shorter preoperative liquid fasting time[3.00(2.00,7.50)vs 12.00(3.00,20.28)h,P<0.001],higher preoperative blood glucose level[5.6(4.2,8.2)vs 5.1(4.0,7.4)mmol/L,P<0.001],lower incidence of thirst(74.5%vs 15.3%,P<0.001),shorter time to postoperative feeding[1.17(0.33,6.83)vs 6.00(5.40,9.20),P<0.001],and greater satisfaction[7(0,10)vs 8(5,10),P<0.001].No children experienced perioperative aspiration.The incidences of hunger,perioperative vomiting,and fever were not significantly different between the two groups.CONCLUSION Optimizing fasting and clear fluid drinking before non-gastrointestinal surgery in children≥3 mo of age is possible.It is safe and feasible to start early eating after evaluating the recovery from anesthesia and the swallowing function.展开更多
Objective: to explore the application value of fast recovery surgical nursing for patients with ovarian cancer after surgery. Methods: this study will adopt the method of sampling survey and group study. Firstly, the ...Objective: to explore the application value of fast recovery surgical nursing for patients with ovarian cancer after surgery. Methods: this study will adopt the method of sampling survey and group study. Firstly, the patients participating in the study will be selected by the sampling survey method. The selected objects will be patients undergoing ovarian cancer surgery in our hospital. The sampling time will be from January 2021 to 2022. In January of this year, the number of samples was 300. After sampling, they were divided into groups according to the random number table method. All patients were divided into control group and experimental group. One half of the patients received routine care and was included in the control group. Fast recovery surgical nursing was included in the experimental group, and the first eating time, first defecation time, hospitalization time, nursing satisfaction and complication rate after nursing were compared between the two groups. Results: from the aspect of the first eating time, the first eating time of the experimental group was lower than that of the control group, and the difference between the two groups of data was significant (P<0.05). The first defecation time of the patients was lower than that of the control group, and the difference between the two groups of data was significant (P<0.05). The difference was significant and statistically significant (P<0.05);from the comparison of the nursing satisfaction of the two groups of patients, the nursing satisfaction of the experimental group was higher than that of the control group, and the difference between the two groups of data was significant and statistically significant (P<0.05);from the comparison of the incidence of complications between the two groups, the incidence of complications in the experimental group was lower than that in the control group, and the difference between the two groups was significant (P<0.05). Conclusion: rapid recovery surgical nursing for ovarian cancer patients after surgery can effectively improve their postoperative physical recovery, improve the treatment effect, and shorten the length of hospital stay.展开更多
AIM: To study the implementation of an enhanced recovery after surgery (ERAS) program at a large University Hospital from “pilot study” to “standard of care”.
Enhanced recovery after surgery (ERAS) protocols are now achieving worldwide diffusion in both university and district hospitals with special interest in colorectal surgery. The optimization of the patient’s preopera...Enhanced recovery after surgery (ERAS) protocols are now achieving worldwide diffusion in both university and district hospitals with special interest in colorectal surgery. The optimization of the patient’s preoperative clinical conditions, the careful intraoperative administration of fluids and drugs and the postoperative encouragement to resume the normal physiological functions as early as possible has produced results in a large amounts of studies. These approaches successfully challenged long-standing and well-established perioperative managements and finally achieved the status of gold standard treatments for the perioperative management of uncomplicated colorectal surgery. Even more important, it seems that the clinical improvement of the patient’s clinical management through ERAS protocols is now reaching his best outcomes (length of stay of 4-6 d after the operation) and therefore any further measures add little to the results already established (i.e., the adjunct of laparoscopic surgery to ERAS). Still dedicated meetings and courses around the world are exploring new aspects including the improvement the preoperative nutrition status to provide the energy necessary to face the surgical stress, the preoperative individuation of special requirements that could be properly addressed before the date of surgery and therefore would reduce the number of unnecessary days spent in hospital once fully recovered (i.e., rehabilitation, social discharges), and finally the development of an important web of out-of-hours direct access in order to individuate alarm symptoms in those patients at risk of complications that could prompt an early readmission.展开更多
AIM:To evaluate the fast-track rehabilitation protocol and laparoscopic surgery(LFT)vs conventional care strategies and laparoscopic surgery(LCC).METHODS:Studies and relevant literature comparing the effects of LFT an...AIM:To evaluate the fast-track rehabilitation protocol and laparoscopic surgery(LFT)vs conventional care strategies and laparoscopic surgery(LCC).METHODS:Studies and relevant literature comparing the effects of LFT and LCC for colorectal malignancy were identified in MEDLINE,the Cochrane Central Register of Controlled Trials and EMBASE.The complications and re-admission after approximately 1 mo were assessed.RESULTS:Six recent randomized controlled trials(RCTs)were included in this meta-analysis,which related to 655 enrolled patients.These studies demonstrated that compared with LCC,LFT has fewer complications and a similar incidence of re-admission after approximately 1 mo.LFT had a pooled RR of 0.60(95%CI:0.46-0.79,P<0.001)compared with a pooled RR of 0.69(95%CI:0.34-1.40,P>0.5)for LCC.CONCLUSION:LFT for colorectal malignancy is safe and efficacious.Larger prospective RCTs should be conducted to further compare the efficacy and safety of this approach.展开更多
Introduction: The aim of this study is to provide a comprehensive 5-year audit of patients undergoing laparotomy for suspected or confirmed gynaecological malignancy to document the frequency and incidence of adverse ...Introduction: The aim of this study is to provide a comprehensive 5-year audit of patients undergoing laparotomy for suspected or confirmed gynaecological malignancy to document the frequency and incidence of adverse events and to investigate factors associated with shorter length of stay and readmission to hospital. Methods: A 5-year surgical audit of the period commencing 2008 and concluding 2012. All patients undergoing laparotomy were included in the audit without exclusions. Approval was granted by the local Ethics Review Committee. Results: Four hundred and twenty-seven patients underwent laparotomy for suspected or confirmed gynaecological malignancy and were managed by Fast Track Surgery (FTS) principles. Average age was 54.8 years and average weight and BMI were 73.4 kg and 28.1 respectively. Ultimately 254 (59%) patients had confirmed malignancy. Average surgery duration was 2.36 hours and average estimated blood loss (EBL) at surgery was 262 mL. Median and mean LOS was 3.0 and 3.5 days respectively with 125 (29%) patients discharged on day 2. Overall transfusion rate was 5%. Other adverse events in decreasing frequency were hospital readmission (3.7%), significant wound infection (3%) and unplanned High Dependency Unit (HDU) admission (1.4%). All other adverse events were uncommon with rates <0.5%. Factors associated with a short LOS included year of surgery, age, performance status, malignant vs benign pathology, the use of COX-2 inhibitors, operation time, incision type, transfusion, and radical hysterectomy, at least 1 complication, if patients tolerated early oral feeding (EOF). In multivariable analysis, year, age, performance status, the use of COX-2 inhibitors, operation time and incision type were significant. Factors associated with readmission included the use of COX-2 inhibitors, operation time, performance of a lymph node dissection, return to operating theatre, operation category at least 1 complication, and in multivariable analysis lymph node dissection and the occurrence of at least 1 complication were significant. Conclusions: This 5-year audit is important in establishing a contemporary incidence and the prevalence rate of serious adverse events for patients with suspected or confirmed gynaecological cancer undergoing laparotomy and managed by FTS principles. The community can be reassured that the incidence of serious adverse events is low when managed by FTS principles.展开更多
Objective: to explore the application value and effect of the concept of fast recovery surgery in arthroscopic anterior cruciate ligament reconstruction. Methods: this paper mainly selects patients who received knee a...Objective: to explore the application value and effect of the concept of fast recovery surgery in arthroscopic anterior cruciate ligament reconstruction. Methods: this paper mainly selects patients who received knee arthroscopy anterior cruciate ligament reconstruction in our hospital from January to December 2021 as the research subjects, including 112 cases, divided into control group (56 cases) and experimental group (56 cases). The main method used in the two groups was the conventional treatment concept;the experimental group was mainly treated with the concept of fast recovery surgery. After the clinical treatment, the application value and effect of the concept of fast recovery surgery were evaluated from the Judet and Lysholm scores, postoperative recovery index, satisfaction and infection rate. Results: the Judet and Lysholm scores were compared, and the excellent and good rates were compared between the two groups at 3 months and 6 months after surgery. Among them, the postoperative score of the experimental group was significantly higher than that of the control group, and the difference between the two groups was statistically significant (P<0.05). The recovery from various indicators in the control group and the experimental group, such as: the length of hospital stay in the control group was longer than that in the experimental group;the recovery time of the knee joint range of motion in the control group was relatively longer;the VAS and BI scores in the experimental group were better than those in the control group. Comparing the satisfaction of patients between the two groups, the satisfaction of patients in the experimental group was significantly higher than that in the control group, and the two groups were statistically significant (P<0.05). Comparing the infection rates of the two groups, the infection rate of the control group was 14.29%, and the infection rate of the experimental group was 1.79%, which fully demonstrated that there was a statistically significant difference in the infection rates between the two groups (P<0.05). Conclusion: in the process of patients undergoing knee arthroscopy anterior cruciate ligament reconstruction, the use of fast rehabilitation surgery concept is more effective than traditional treatment, which can effectively speed up the patients rehabilitation process, shorten the patients hospitalization time and recovery time, and improve the patients experience. Satisfactions with clinical treatment improve patients limb function and then obtain higher quality of life.展开更多
目的通过Meta分析评价主动呼吸循环技术(ACBT)改善肺癌患者术后的临床效果。方法检索从建库至2024年2月在中国知网、万方、维普、PubMed、Embase、the Cochrane Library、Web of Science等数据库中发表的有关ACBT改善肺癌患者术后情况...目的通过Meta分析评价主动呼吸循环技术(ACBT)改善肺癌患者术后的临床效果。方法检索从建库至2024年2月在中国知网、万方、维普、PubMed、Embase、the Cochrane Library、Web of Science等数据库中发表的有关ACBT改善肺癌患者术后情况的随机对照试验(RCT)。采用RevMan5.3软件进行Meta分析。结果共纳入10篇文献,1044例患者。Meta分析结果显示,试验组的第1秒用力呼气容积(FEV1)高于对照组,差异具有统计学意义(P<0.05)。试验组的6 min步行距离(6MWT)长于对照组,差异具有统计学意义(P<0.05)。试验组的术后住院时间短于对照组,差异具有统计学意义(P<0.05)。试验组的肺不张发生率低于对照组,差异具有统计学意义(P<0.05)。结论ACBT可以改善肺癌患者术后肺功能,增强运动能力,减少肺部并发症的发生,缩短术后住院时间。展开更多
文摘BACKGROUND: Fast track strategy in the management of patients undergoing intra-abdominal surgery of various types has emerged as a landmark approach to reduce surgical stress and accelerate recovery. This study was to evaluate the effect of fast track strategy on patients subjected to pancreaticoduo-denectomy (PD) from an individual unit during transit from low to a high volume center. METHODS: A total of 142 PD patients who had been subjected to fast track strategy between June 2008 and September 2012 were compared with 46 patients who had received convention-al surgery between January 2006 and May 2008. Comparative analysis was made of postoperative complications, postopera-tive recovery, length of hospital stay and patient readmission requirement. RESULTS: The patients subjected to fast track strategy had a faster recovery and a shorter hospital stay than those who were treated conventionally (7.8 vs 12.1 days). The intraoperative events like operative blood loss (417.9±83.8 vs 997.4 ±151.8 mL, P<0.001), blood transfused (a median of 0 vs 1 unit,P<0.001) and operative time taken (125 vs 245 minutes,P<0.001) were signiifcantly lower in the fast track group. The frequency of pancreatic ifstula (4.9% vs 13.0%) and delayed gastric empty-ing (7.0% vs 17.4%) was also signiifcantly reduced with fast track treatment. Nevertheless, the readmission rate (11.3% vs 6.5%) was found relatively higher within the fast track group. However, increased readmission rates in this study seem to be independent of fast track protocol. CONCLUSIONS: This preliminary analysis suggests that the fast track approach might be beneifcial to the well-being of the patients after PD, for it accelerates the immediate clinical recovery of patients and signiifcantly shortens their length of hospital stay.
基金Supported by the Health Science and Technology Plan of Zhejiang Province in 2022,No.2022KY867.
文摘BACKGROUND Enhanced recovery after surgery strategies are increasingly implemented to improve the management of surgical patients.AIM To evaluate the effects of new perioperative fasting protocols in children≥3 mo of age undergoing non-gastrointestinal surgery.METHODS This prospective pilot study included children≥3 mo of age undergoing nongastrointestinal surgery at the Children’s Hospital(Zhejiang University School of Medicine)from January 2020 to June 2020.The children were divided into either a conventional group or an ERAS group according to whether they had been enrolled before or after the implementation of the new perioperative fasting strategy.The children in the conventional group were fasted using conventional strategies,while those in the ERAS group were given individualized fasting protocols preoperatively(6-h fasting for infant formula/non-human milk/solids,4-h fasting for breast milk,and clear fluids allowed within 2 h of surgery)and postoperatively(food permitted from 1 h after surgery).Pre-operative and postoperative fasting times,pre-operative blood glucose,the incidence of postoperative thirst and hunger,the incidence of perioperative vomiting and aspiration,and the degree of satisfaction were evaluated.RESULTS The study included 303 patients(151 in the conventional group and 152 in the ERAS group).Compared with the conventional group,the ERAS group had a shorter pre-operative food fasting time[11.92(4.00,19.33)vs 13.00(6.00,20.28)h,P<0.001],shorter preoperative liquid fasting time[3.00(2.00,7.50)vs 12.00(3.00,20.28)h,P<0.001],higher preoperative blood glucose level[5.6(4.2,8.2)vs 5.1(4.0,7.4)mmol/L,P<0.001],lower incidence of thirst(74.5%vs 15.3%,P<0.001),shorter time to postoperative feeding[1.17(0.33,6.83)vs 6.00(5.40,9.20),P<0.001],and greater satisfaction[7(0,10)vs 8(5,10),P<0.001].No children experienced perioperative aspiration.The incidences of hunger,perioperative vomiting,and fever were not significantly different between the two groups.CONCLUSION Optimizing fasting and clear fluid drinking before non-gastrointestinal surgery in children≥3 mo of age is possible.It is safe and feasible to start early eating after evaluating the recovery from anesthesia and the swallowing function.
文摘Objective: to explore the application value of fast recovery surgical nursing for patients with ovarian cancer after surgery. Methods: this study will adopt the method of sampling survey and group study. Firstly, the patients participating in the study will be selected by the sampling survey method. The selected objects will be patients undergoing ovarian cancer surgery in our hospital. The sampling time will be from January 2021 to 2022. In January of this year, the number of samples was 300. After sampling, they were divided into groups according to the random number table method. All patients were divided into control group and experimental group. One half of the patients received routine care and was included in the control group. Fast recovery surgical nursing was included in the experimental group, and the first eating time, first defecation time, hospitalization time, nursing satisfaction and complication rate after nursing were compared between the two groups. Results: from the aspect of the first eating time, the first eating time of the experimental group was lower than that of the control group, and the difference between the two groups of data was significant (P<0.05). The first defecation time of the patients was lower than that of the control group, and the difference between the two groups of data was significant (P<0.05). The difference was significant and statistically significant (P<0.05);from the comparison of the nursing satisfaction of the two groups of patients, the nursing satisfaction of the experimental group was higher than that of the control group, and the difference between the two groups of data was significant and statistically significant (P<0.05);from the comparison of the incidence of complications between the two groups, the incidence of complications in the experimental group was lower than that in the control group, and the difference between the two groups was significant (P<0.05). Conclusion: rapid recovery surgical nursing for ovarian cancer patients after surgery can effectively improve their postoperative physical recovery, improve the treatment effect, and shorten the length of hospital stay.
文摘AIM: To study the implementation of an enhanced recovery after surgery (ERAS) program at a large University Hospital from “pilot study” to “standard of care”.
文摘Enhanced recovery after surgery (ERAS) protocols are now achieving worldwide diffusion in both university and district hospitals with special interest in colorectal surgery. The optimization of the patient’s preoperative clinical conditions, the careful intraoperative administration of fluids and drugs and the postoperative encouragement to resume the normal physiological functions as early as possible has produced results in a large amounts of studies. These approaches successfully challenged long-standing and well-established perioperative managements and finally achieved the status of gold standard treatments for the perioperative management of uncomplicated colorectal surgery. Even more important, it seems that the clinical improvement of the patient’s clinical management through ERAS protocols is now reaching his best outcomes (length of stay of 4-6 d after the operation) and therefore any further measures add little to the results already established (i.e., the adjunct of laparoscopic surgery to ERAS). Still dedicated meetings and courses around the world are exploring new aspects including the improvement the preoperative nutrition status to provide the energy necessary to face the surgical stress, the preoperative individuation of special requirements that could be properly addressed before the date of surgery and therefore would reduce the number of unnecessary days spent in hospital once fully recovered (i.e., rehabilitation, social discharges), and finally the development of an important web of out-of-hours direct access in order to individuate alarm symptoms in those patients at risk of complications that could prompt an early readmission.
基金Supported by The National Natural Science Foundation of China,No.81201885 and No.81172279
文摘AIM:To evaluate the fast-track rehabilitation protocol and laparoscopic surgery(LFT)vs conventional care strategies and laparoscopic surgery(LCC).METHODS:Studies and relevant literature comparing the effects of LFT and LCC for colorectal malignancy were identified in MEDLINE,the Cochrane Central Register of Controlled Trials and EMBASE.The complications and re-admission after approximately 1 mo were assessed.RESULTS:Six recent randomized controlled trials(RCTs)were included in this meta-analysis,which related to 655 enrolled patients.These studies demonstrated that compared with LCC,LFT has fewer complications and a similar incidence of re-admission after approximately 1 mo.LFT had a pooled RR of 0.60(95%CI:0.46-0.79,P<0.001)compared with a pooled RR of 0.69(95%CI:0.34-1.40,P>0.5)for LCC.CONCLUSION:LFT for colorectal malignancy is safe and efficacious.Larger prospective RCTs should be conducted to further compare the efficacy and safety of this approach.
文摘Introduction: The aim of this study is to provide a comprehensive 5-year audit of patients undergoing laparotomy for suspected or confirmed gynaecological malignancy to document the frequency and incidence of adverse events and to investigate factors associated with shorter length of stay and readmission to hospital. Methods: A 5-year surgical audit of the period commencing 2008 and concluding 2012. All patients undergoing laparotomy were included in the audit without exclusions. Approval was granted by the local Ethics Review Committee. Results: Four hundred and twenty-seven patients underwent laparotomy for suspected or confirmed gynaecological malignancy and were managed by Fast Track Surgery (FTS) principles. Average age was 54.8 years and average weight and BMI were 73.4 kg and 28.1 respectively. Ultimately 254 (59%) patients had confirmed malignancy. Average surgery duration was 2.36 hours and average estimated blood loss (EBL) at surgery was 262 mL. Median and mean LOS was 3.0 and 3.5 days respectively with 125 (29%) patients discharged on day 2. Overall transfusion rate was 5%. Other adverse events in decreasing frequency were hospital readmission (3.7%), significant wound infection (3%) and unplanned High Dependency Unit (HDU) admission (1.4%). All other adverse events were uncommon with rates <0.5%. Factors associated with a short LOS included year of surgery, age, performance status, malignant vs benign pathology, the use of COX-2 inhibitors, operation time, incision type, transfusion, and radical hysterectomy, at least 1 complication, if patients tolerated early oral feeding (EOF). In multivariable analysis, year, age, performance status, the use of COX-2 inhibitors, operation time and incision type were significant. Factors associated with readmission included the use of COX-2 inhibitors, operation time, performance of a lymph node dissection, return to operating theatre, operation category at least 1 complication, and in multivariable analysis lymph node dissection and the occurrence of at least 1 complication were significant. Conclusions: This 5-year audit is important in establishing a contemporary incidence and the prevalence rate of serious adverse events for patients with suspected or confirmed gynaecological cancer undergoing laparotomy and managed by FTS principles. The community can be reassured that the incidence of serious adverse events is low when managed by FTS principles.
文摘Objective: to explore the application value and effect of the concept of fast recovery surgery in arthroscopic anterior cruciate ligament reconstruction. Methods: this paper mainly selects patients who received knee arthroscopy anterior cruciate ligament reconstruction in our hospital from January to December 2021 as the research subjects, including 112 cases, divided into control group (56 cases) and experimental group (56 cases). The main method used in the two groups was the conventional treatment concept;the experimental group was mainly treated with the concept of fast recovery surgery. After the clinical treatment, the application value and effect of the concept of fast recovery surgery were evaluated from the Judet and Lysholm scores, postoperative recovery index, satisfaction and infection rate. Results: the Judet and Lysholm scores were compared, and the excellent and good rates were compared between the two groups at 3 months and 6 months after surgery. Among them, the postoperative score of the experimental group was significantly higher than that of the control group, and the difference between the two groups was statistically significant (P<0.05). The recovery from various indicators in the control group and the experimental group, such as: the length of hospital stay in the control group was longer than that in the experimental group;the recovery time of the knee joint range of motion in the control group was relatively longer;the VAS and BI scores in the experimental group were better than those in the control group. Comparing the satisfaction of patients between the two groups, the satisfaction of patients in the experimental group was significantly higher than that in the control group, and the two groups were statistically significant (P<0.05). Comparing the infection rates of the two groups, the infection rate of the control group was 14.29%, and the infection rate of the experimental group was 1.79%, which fully demonstrated that there was a statistically significant difference in the infection rates between the two groups (P<0.05). Conclusion: in the process of patients undergoing knee arthroscopy anterior cruciate ligament reconstruction, the use of fast rehabilitation surgery concept is more effective than traditional treatment, which can effectively speed up the patients rehabilitation process, shorten the patients hospitalization time and recovery time, and improve the patients experience. Satisfactions with clinical treatment improve patients limb function and then obtain higher quality of life.
