BACKGROUND Acute upper gastrointestinal bleeding(AUGIB)is a common emergency critical illness that requires prompt assessment upon admission to prevent disease deterioration.As a resuscitation mode,the fast track for ...BACKGROUND Acute upper gastrointestinal bleeding(AUGIB)is a common emergency critical illness that requires prompt assessment upon admission to prevent disease deterioration.As a resuscitation mode,the fast track for emergency treatment increases the success rate and improves patient outcomes.However,misuse will consume resources.The Glasgow-Blatchford score(GBS)is considered to predict the clinical intervention needs for AUGIB patients,guiding diagnosis and treatment.Therefore,clinical research is needed to identify the recommended GBS thresholds that support effective use in AUGIB patients.AIM To validate the effectiveness of the GBS in establishing a fast track to reduce the time and cost of treatment for patients with AUGIB.METHODS A retrospective analysis was performed using the data of 124 cases of AUGIB patients with GBS≥6 treated at the University-Town Hospital of Chongqing Medical University from August 2020 to April 2023.Based on GBS risk stratification,patients were divided into moderate-risk(12>GBS≥6)and high-risk(GBS≥12)groups.Furthermore,depending on whether a fast track was established after the patients arrived in the emergency department,the patients were categorized into control and fast-track groups.The changes in various indicators,such as length of time in the emergency resuscitation room,door-to-endoscopy time,total blood transfusion volume,hospitalization duration,and hospitalization costs,were compared between the control and fast-track groups under each risk stratification level.RESULTS In the comparison of the aforementioned indicators,the moderate-risk fast-track group did not show any significant differences from the control group(P>0.05).However,in the high-risk fast-track group,the door-toendoscopy time,total blood transfusion volume,and hospitalization costs were significantly lower than those in the control group(P<0.05).CONCLUSION Establishing a fast track for emergency treatment based on GBS risk stratification has assessment value in reducing door-to-endoscopy time,decreasing total blood transfusion volume,and lowering hospitalization costs in patients with AUGIB.GBS≥12 is recommended as the threshold for implementing the fast track for emergency treatment,and its clinical promotion is advised.展开更多
AIM:To compare the fast-track rehabilitation program and conventional care for patients after resection of colorectal cancer.METHODS:One hundred and six consecutive patients who underwent fast-track rehabilitation pro...AIM:To compare the fast-track rehabilitation program and conventional care for patients after resection of colorectal cancer.METHODS:One hundred and six consecutive patients who underwent fast-track rehabilitation program were encouraged to have early oral feeding and movement for early discharge,while 104 consecutive patients underwent conventional care after resection of colorectal cancer.Their gastrointestinal functions,postoperative complications and hospital stay time were recorded.RESULTS:The restoration time of gastrointestinal functions in the patients was significantly faster after fasttrack rehabilitation program than after conventional care(2.1 d vs 3.2 d,P < 0.01).The percentage of patients who developed complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care(13.2% vs 26.9%,P < 0.05).Also,the percentage of patients who had general complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care(6.6% vs 15.4%,P < 0.05).The postoperative hospital stay time of the patients was shorter after fast-track rehabilitation program than after conventional care(5 d vs 7 d,P < 0.01).No significant difference was observed in the readmission rate 30 d after fast-track rehabilitation program and conventional care(3.8% vs 8.7%).CONCLUSION:The fast-track rehabilitation program can significantly decrease the complications and shorten the time of postoperative hospital stay of patients after resection colorectal cancer.展开更多
AIM： To investigate the feasibility of fast track clinica pathway for esophageal tumor resections. METHODS： One hundred and fourteen patients with esophageal carcinoma who underwent esophagogastrectomy from January ...AIM： To investigate the feasibility of fast track clinica pathway for esophageal tumor resections. METHODS： One hundred and fourteen patients with esophageal carcinoma who underwent esophagogastrectomy from January 2006 to October 2007 in our department were studied. Fast track clinical pathway included analgesia control, fluid infusion volume control, early ambulation and enteral nutrition. Nasogastric tube was removed 3 d after operation and chest tube was removed 4 d after operation as a routine, and full liquid diet 5 d after operation. RESULTS： Among 114 patients （84 men and 30 women）, 26 patients underwent fast track surgery, including 17 patients over 65 years old and 9 under 65 （P = 0.014）; 18 patients who had preoperative complications could not bear fast track surgery （P 〈 0.001）. No significant differences in tolerance of fast track surgery were attributed to differences in gender, differentiated degree or stage of tumor, pathological type of tumor, or operative incision. The median length of hospital stay was 7 d （5-28 d）, 4% patients were readmitted to hospital within 30 d of discharge. Three patients died and postoperative mortality was 2.6%. All 3 patients had no determinacy to fast track surgery approach.CONCLUSION： The majority of patients with esophageal carcinoma can tolerate fast track surgery. Patients younger than 65 or who have no preoperative diseases have the best results. Median length of hospital stay has been reduced to 7 d.展开更多
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 Fast-track surgery(FTS)is a modern nursing approach that has gained popularity in the perioperative phase of surgery.AIM To investigate the impact of FTS on perioperative care for hepatobiliary surgery.METH...BACKGROUND Fast-track surgery(FTS)is a modern nursing approach that has gained popularity in the perioperative phase of surgery.AIM To investigate the impact of FTS on perioperative care for hepatobiliary surgery.METHODS A retrospective analysis was performed on 98 patients who underwent hepato-biliary surgery and were admitted to our hospital from August 2021 to October 2023.They were divided into an observation group and a control group with 49 patients in each group according to different nursing directions.The control group was treated with standard nursing and the observation group was treated with FTS concept nursing.The length of hospital stay,visual analog scale(VAS)score,wound complications,nursing satisfaction,self-rating scale(SAS)score,and SF-36 quality of life(QoL)score were compared between the two groups before and after care.RESULTS The duration of hospitalization,hospitalization cost,operation time,first im-plantation time,exhaust time,and first defecation time were shorter than the observation group(P<0.05).Additionally,the observation group showed a sig-nificant difference between the VAS and SAS scores on days 1,3,and 7(P<0.05).The complication rate in the observation group was 4.05%was significantly lower than the 18.36%in the control group,and the comparison groups were statistically significant(χ2=5.018,P=0.025).The observation group had a significantly higher level of nurse satisfaction(94.92%)than the control group(79.59%;χ2=6.078,P=0.014).Both groups showed higher QoL scores after nursing care,with higher scores in the observation group than in the control group(P=0.032).CONCLUSION FTS in patients undergoing hepatobiliary surgery can effectively improve negative mood,QoL,and nursing sa-tisfaction;reduce wound complications;and accelerate patient rehabilitation.展开更多
Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing o...Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing on evaluation of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Two people independently screened literatures and extracted data according to the inclusion criteria. Then the available data were analyzed with RevMan software (version 5.3.0). Descriptive techniques were performed when no available data could be used. Results: A total of 8 studies were included, for a total sample of 635 patients. The results showed that fast track surgery care can improve Hospital for Special Surgery Knee score at 2 months, 3 months, 6 months, and 1 years after operation [after 2 months (weighted mean difference (WMD), 15.2;95%CI, 13.58 to 16.82;P < 0.01);after 3 months (WMD, 9.42;95%CI, 7.80 to 11.04;P < 0.01);after 6 months,(WMD, 11.01;95%CI, 9.73 to 12.28;P < 0.01);after 1 years (WMD, 10.78;95%CI, 9.33 to 12.24;P < 0.01)]. Fast track surgery care can improve the knee score of American Knee Society Knee Score(WMD, 9.23;95%CI,0.86 - 17.6;P < 0.05), and reduce the incidence of postoperative deep vein thrombosis, constipation, pulmonary infection, urinary tract infection and other complications. Conclusion: Fast track surgery care can promote knee joint function recovery, reduce postoperative deep venous thrombosis, constipation, pulmonary infection and urinary tract infection. However, rigorous large sample and multicenter randomized controlled trials are needed for further validation.展开更多
The 1993 Seattle First Informal Leaders Meeting elevated it from a ministerialmeeting to a cooperative mechanism at the summit level.The 1994 Bogor Dec-laration then ushered it into a de facto regular mechanism.The 19...The 1993 Seattle First Informal Leaders Meeting elevated it from a ministerialmeeting to a cooperative mechanism at the summit level.The 1994 Bogor Dec-laration then ushered it into a de facto regular mechanism.The 1995 Osaka ActionPlan went a step further to initiate the transition of its function from working outprograms of intent into their enforcement.The forthcoming 1996 Subic Bay Meet-ing will eventually launch it out on fast track.展开更多
Background: Fast track surgery is an evidence-based multidisciplinary approach. The underlying principle is to enable patients to recover from surgery and leave the hospital sooner by minimizing the stress responses o...Background: Fast track surgery is an evidence-based multidisciplinary approach. The underlying principle is to enable patients to recover from surgery and leave the hospital sooner by minimizing the stress responses on the body during surgery. Our aim was to compare the outcome of fast-track protocol and conventional methods in colorectal surgery. Method: It was an observational cross-sectional study carried out at the Department of Surgery in different tertiary level hospitals, Dhaka Bangladesh during the period January 2014 to December 2017. Among this population, 50 patients were placed in the fast-track program (Group A) from January 2014 to December 2015 and 50 patients were in the conventional method (Group B), from January 2016 to December 2017. The fast-track patients were selected after receiving ethical approval from the Bangladesh College of Physician & Surgeons. Data analysis was done using the statistical package for social science (SPSS) for windows version 20. Results: The average age of the patients was 45.24 ± 16.65 years (range: 11 - 70 years) in the fast track group (Group A) and 43.24 ± 17.76 years in the conventional method (Group B). The majority were female between two groups, with 56% in group A and 52% in group B. General and surgical complications occurred in 9 (18%) patients and 11 (22%) patients respectively in group A. On the other hand in group B general and surgical complications occurred in 10 (20%) patients and 13 (26%) patients respectively. The average hospital stay was 9.24 ± 5.99 days in group A and the average hospital stay was 10.10 ± 6.04 days in group B. Conclusion: Making the decision to adopt fast-track surgery will challenge current traditional practice for all members of the multidisciplinary team across the whole local health community.展开更多
Objective: to explore the effect of emergency nursing fast track on the treatment time and effect of acute stroke. Conclusion: emergency nursing fast track has a good effect in the treatment of acute cerebral infarcti...Objective: to explore the effect of emergency nursing fast track on the treatment time and effect of acute stroke. Conclusion: emergency nursing fast track has a good effect in the treatment of acute cerebral infarction, which can effectively shorten the time of receiving and treatment, reduce the disability rate of patients and improve the treatment and prognosis of patients. It has high application value and is worthy of active promotion in clinical treatment.展开更多
Objective: to evaluate the application effect of fast track surgery in perioperative nursing of patients with spontaneous pneumothorax. Methods: 78 patients with spontaneous pneumothorax who completed surgical treatme...Objective: to evaluate the application effect of fast track surgery in perioperative nursing of patients with spontaneous pneumothorax. Methods: 78 patients with spontaneous pneumothorax who completed surgical treatment in our hospital from March 2019 to June 2020 were selected and divided into groups according to different nursing measures. 39 patients in the reference group received conventional nursing, and 39 patients in the experimental group received perioperative nursing with fast track surgery. Perioperative correlation indexes were recorded between the two groups. Results: the initial postoperative exhaust time, drainage tube storage period and discharge time in the experimental group were shorter than those in the reference group, with statistical significance (P < 0.05). Conclusion: fast track surgery in the perioperative nursing of patients with spontaneous pneumothorax is beneficial to accelerate the recovery of patients and shorten the postoperative recovery time of patients, which is worthy of further promotion.展开更多
The traditional oriented FAST and rotated BRIEF（ORB） algorithm has problems of instability and repetition of keypoints and it does not possess scale invariance. In order to deal with these drawbacks, a modified ORB...The traditional oriented FAST and rotated BRIEF（ORB） algorithm has problems of instability and repetition of keypoints and it does not possess scale invariance. In order to deal with these drawbacks, a modified ORB（MORB） algorithm is proposed. In order to improve the precision of matching and tracking, this paper puts forward an MOK algorithm that fuses MORB and Kanade-Lucas-Tomasi（KLT）. By using Kalman, the object＇s state in the next frame is predicted in order to reduce the size of search window and improve the real-time performance of object tracking. The experimental results show that the MOK algorithm can accurately track objects with deformation or with background clutters, exhibiting higher robustness and accuracy on diverse datasets. Also, the MOK algorithm has a good real-time performance with the average frame rate reaching 90.8 fps.展开更多
In order to meet the precision requirements and tracking performance of the continuous rotary motor electro-hydraulic servo system under unknown strong non-linear and uncertain strong disturbance factors,such as dynam...In order to meet the precision requirements and tracking performance of the continuous rotary motor electro-hydraulic servo system under unknown strong non-linear and uncertain strong disturbance factors,such as dynamic uncertainty and parameter perturbation,an improved active disturbance rejection control(ADRC)strategy was proposed.The state space model of the fifth order closed-loop system was established based on the principle of valve-controlled hydraulic motor.Then the three parts of ADRC were improved by parameter perturbation and external disturbance;the fast tracking differentiator was introduced into linear and non-linear combinations;the nonlinear state error feedback was proposed using synovial control;the extended state observer was determined by nonlinear compensation.In addition,the grey wolf algorithm was used to set the parameters of the three parts.The simulation and experimental results show that the improved ADRC can realize the system frequency 12 Hz when the tracking accuracy and response speed meet the requirements of double ten indexes,which lay foundation for the motor application.展开更多
Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery(ERAS), has been generally...Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery(ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioperative management, the implementation of this complex protocol has been slow. Barriers to implementation involve both patient- and staff-related factors as well as practice-related issues and resources. To support efficient and successful implementation, further educational and structural measures have to be made on a national or regional level to improve the standard of general health care. Besides postoperative morbidity, biological and physiological variables have been quite commonly reported in previous ERAS studies. Little information, however, has been obtained on cost-effectiveness, long-term outcomes, quality of life and patient-related outcomes, and these issues remain important areas of research for future studies.展开更多
Background:The purpose of this study is to summarize the application of day surgery combined with fast track program in strabismus operation under general anesthesia.Methods:The clinical data of 2,000 cases of strabis...Background:The purpose of this study is to summarize the application of day surgery combined with fast track program in strabismus operation under general anesthesia.Methods:The clinical data of 2,000 cases of strabismus patients who had underwent surgery in day surgery or traditional hospitalization in the duration from 2015 to 2016 was retrospectively analyzed.The safety and efficacy were assessed by comparing the average length of stay in hospitals,anesthesia recovery time,patient satisfaction and number of adverse events.Results:Compared with the traditional group,the average length of stay in hospital and recovery time in day surgery group were significantly lower(P<0.001)and the satisfaction of patient was improved(P<0.05),which were statistically significant difference.Moreover,no adverse events occurred among these patients.Conclusions:The application of day surgery in strabismus operation under general anesthesia is feasible,which can reduce the recovery time and shorten the hospital stay of patients safely and effectively,and their satisfaction was improved at the same time.展开更多
Objective: to explore the application value of fast track surgical nursing measures in patients with colorectal cancer during perioperative period. Methods: 68 patients with colorectal cancer from July 2018 to January...Objective: to explore the application value of fast track surgical nursing measures in patients with colorectal cancer during perioperative period. Methods: 68 patients with colorectal cancer from July 2018 to January 2019 in our hospital were randomly divided into observation group and control group. The observation group was given rapid rehabilitation surgery nursing, while the control group was given routine nursing. The nursing satisfaction, postoperative rehabilitation level and hospital stay time of the two groups were analyzed. Results: there were significant differences in postoperative exhaust time and hospitalization days between the observation group and the control group and the differences were statistically significant (P < 0.05). Conclusion: the application of fast track surgical nursing in the diagnosis of colorectal cancer can effectively improve the nursing satisfaction of patients which is worthy of promotion.展开更多
Background Few clinical studies or randomized clinical trial results have reported the impact of fast track surgery on postoperative insulin sensitivity. This study aimed to investigate the effects of fast track surge...Background Few clinical studies or randomized clinical trial results have reported the impact of fast track surgery on postoperative insulin sensitivity. This study aimed to investigate the effects of fast track surgery on postoperative insulin sensitivity in patients undergoing elective open colorectal resection. Methods Controlled, randomized clinical trial was conducted from November 2008 to January 2009 with one-month post-discharge follow-up. Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups： a fast track group （35 cases） and a conventional care group （35 cases）. All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters （complication rates, return of gastrointestinal function and postoperative length of stay）, stress index and insulin sensitivity were evaluated in both groups perioperatively. Results Sixty-two patients finally completed the study, 32 cases in the fast-track group and 30 cases in the conventional care group. Our findings revealed a significantly faster recovery of postoperative insulin sensitivity on postoperative day 7 in the fast-track group than that in the conventional care group. We also found a significantly shorter length of postoperative stay and a significantly faster return of gastrointestinal function in patients undergoing fast-track rehabilitation. Conclusion Fast track surgery accelerates the recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.展开更多
This study evaluates the application of fast track(FT)nasogastric decompression in patients who underwent anterior resection of rectal cancer.A randomized control trial was performed comparing the group with the fast ...This study evaluates the application of fast track(FT)nasogastric decompression in patients who underwent anterior resection of rectal cancer.A randomized control trial was performed comparing the group with the fast track treatment(n=57)and the group with traditional nasogastric decompression(n=84).Preoperative characteristics and postoperative recovery indices were recorded and analyzed.The results indicate no significant differences in gender(P=0.614),age(P=0.653),tumor location(P=0.113),and TNM stages(P=0.054)were observed between the 2 groups.The differences in the type of resection,anastomosis,and adoption of protective colostomy were all not significant between the FT and the traditional group.During the first 24 hours after surgery,the volume of nasogastric drainage averaged 197 ml in the FT group and 155 ml in the traditional group(P=0.197).The initiation of test-meal(P=0.000),semiliquid diet(P=0.002),and ordinary diet(P=0.008)were all significantly shorter in the FT group.Furthermore,compared with the other group,the patients in the FT group enjoyed earlier removal of the abdominal drainage,urinary catheter,and shorter hospital stays(P=0.000).Based on a correlation test,the duration of nasogastric decompression is related to the time of test-meal and semiliquid diet.The routine usage of nasogastric decompression in rectal surgery is unnecessary.The fast track procedure might help in facilitating postoperative functional and diet recovery,reducing the time of catheterization,and shortening hospital stay.展开更多
Healthcare systems engineering in emergency departments(EDs)are developing rapidly in the world nowadays.Fast track(FT)as a rapid treatment system is considered to facilitate ED patient flow.To know how FT can improve...Healthcare systems engineering in emergency departments(EDs)are developing rapidly in the world nowadays.Fast track(FT)as a rapid treatment system is considered to facilitate ED patient flow.To know how FT can improve the performance of ED,one should study the best configuration of resources for implementation of FT.This research presents a pattern for implementation of FT systems in hospital EDs using healthcare simulation paradigms.Simulation-based optimization model uses modeling and simulation capabilities to generate configurations of FT resources and its patient prioritization pattern with Arena rsimulation software.A decision making method is used to select the optimal configuration based on pre-specified performance indicators.The results imply that the proposed FT implementation pattern is efficient and capable of improving patient flow.展开更多
基金Supported by the Key Discipline of Pathology at Chongqing Medical and Pharmaceutical College,No.ygz2021303.
文摘BACKGROUND Acute upper gastrointestinal bleeding(AUGIB)is a common emergency critical illness that requires prompt assessment upon admission to prevent disease deterioration.As a resuscitation mode,the fast track for emergency treatment increases the success rate and improves patient outcomes.However,misuse will consume resources.The Glasgow-Blatchford score(GBS)is considered to predict the clinical intervention needs for AUGIB patients,guiding diagnosis and treatment.Therefore,clinical research is needed to identify the recommended GBS thresholds that support effective use in AUGIB patients.AIM To validate the effectiveness of the GBS in establishing a fast track to reduce the time and cost of treatment for patients with AUGIB.METHODS A retrospective analysis was performed using the data of 124 cases of AUGIB patients with GBS≥6 treated at the University-Town Hospital of Chongqing Medical University from August 2020 to April 2023.Based on GBS risk stratification,patients were divided into moderate-risk(12>GBS≥6)and high-risk(GBS≥12)groups.Furthermore,depending on whether a fast track was established after the patients arrived in the emergency department,the patients were categorized into control and fast-track groups.The changes in various indicators,such as length of time in the emergency resuscitation room,door-to-endoscopy time,total blood transfusion volume,hospitalization duration,and hospitalization costs,were compared between the control and fast-track groups under each risk stratification level.RESULTS In the comparison of the aforementioned indicators,the moderate-risk fast-track group did not show any significant differences from the control group(P>0.05).However,in the high-risk fast-track group,the door-toendoscopy time,total blood transfusion volume,and hospitalization costs were significantly lower than those in the control group(P<0.05).CONCLUSION Establishing a fast track for emergency treatment based on GBS risk stratification has assessment value in reducing door-to-endoscopy time,decreasing total blood transfusion volume,and lowering hospitalization costs in patients with AUGIB.GBS≥12 is recommended as the threshold for implementing the fast track for emergency treatment,and its clinical promotion is advised.
基金Supported by Social Development Fund of Jiangsu Province,No. BS2007054
文摘AIM:To compare the fast-track rehabilitation program and conventional care for patients after resection of colorectal cancer.METHODS:One hundred and six consecutive patients who underwent fast-track rehabilitation program were encouraged to have early oral feeding and movement for early discharge,while 104 consecutive patients underwent conventional care after resection of colorectal cancer.Their gastrointestinal functions,postoperative complications and hospital stay time were recorded.RESULTS:The restoration time of gastrointestinal functions in the patients was significantly faster after fasttrack rehabilitation program than after conventional care(2.1 d vs 3.2 d,P < 0.01).The percentage of patients who developed complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care(13.2% vs 26.9%,P < 0.05).Also,the percentage of patients who had general complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care(6.6% vs 15.4%,P < 0.05).The postoperative hospital stay time of the patients was shorter after fast-track rehabilitation program than after conventional care(5 d vs 7 d,P < 0.01).No significant difference was observed in the readmission rate 30 d after fast-track rehabilitation program and conventional care(3.8% vs 8.7%).CONCLUSION:The fast-track rehabilitation program can significantly decrease the complications and shorten the time of postoperative hospital stay of patients after resection colorectal cancer.
文摘AIM： To investigate the feasibility of fast track clinica pathway for esophageal tumor resections. METHODS： One hundred and fourteen patients with esophageal carcinoma who underwent esophagogastrectomy from January 2006 to October 2007 in our department were studied. Fast track clinical pathway included analgesia control, fluid infusion volume control, early ambulation and enteral nutrition. Nasogastric tube was removed 3 d after operation and chest tube was removed 4 d after operation as a routine, and full liquid diet 5 d after operation. RESULTS： Among 114 patients （84 men and 30 women）, 26 patients underwent fast track surgery, including 17 patients over 65 years old and 9 under 65 （P = 0.014）; 18 patients who had preoperative complications could not bear fast track surgery （P 〈 0.001）. No significant differences in tolerance of fast track surgery were attributed to differences in gender, differentiated degree or stage of tumor, pathological type of tumor, or operative incision. The median length of hospital stay was 7 d （5-28 d）, 4% patients were readmitted to hospital within 30 d of discharge. Three patients died and postoperative mortality was 2.6%. All 3 patients had no determinacy to fast track surgery approach.CONCLUSION： The majority of patients with esophageal carcinoma can tolerate fast track surgery. Patients younger than 65 or who have no preoperative diseases have the best results. Median length of hospital stay has been reduced to 7 d.
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.
文摘BACKGROUND Fast-track surgery(FTS)is a modern nursing approach that has gained popularity in the perioperative phase of surgery.AIM To investigate the impact of FTS on perioperative care for hepatobiliary surgery.METHODS A retrospective analysis was performed on 98 patients who underwent hepato-biliary surgery and were admitted to our hospital from August 2021 to October 2023.They were divided into an observation group and a control group with 49 patients in each group according to different nursing directions.The control group was treated with standard nursing and the observation group was treated with FTS concept nursing.The length of hospital stay,visual analog scale(VAS)score,wound complications,nursing satisfaction,self-rating scale(SAS)score,and SF-36 quality of life(QoL)score were compared between the two groups before and after care.RESULTS The duration of hospitalization,hospitalization cost,operation time,first im-plantation time,exhaust time,and first defecation time were shorter than the observation group(P<0.05).Additionally,the observation group showed a sig-nificant difference between the VAS and SAS scores on days 1,3,and 7(P<0.05).The complication rate in the observation group was 4.05%was significantly lower than the 18.36%in the control group,and the comparison groups were statistically significant(χ2=5.018,P=0.025).The observation group had a significantly higher level of nurse satisfaction(94.92%)than the control group(79.59%;χ2=6.078,P=0.014).Both groups showed higher QoL scores after nursing care,with higher scores in the observation group than in the control group(P=0.032).CONCLUSION FTS in patients undergoing hepatobiliary surgery can effectively improve negative mood,QoL,and nursing sa-tisfaction;reduce wound complications;and accelerate patient rehabilitation.
文摘Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing on evaluation of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Two people independently screened literatures and extracted data according to the inclusion criteria. Then the available data were analyzed with RevMan software (version 5.3.0). Descriptive techniques were performed when no available data could be used. Results: A total of 8 studies were included, for a total sample of 635 patients. The results showed that fast track surgery care can improve Hospital for Special Surgery Knee score at 2 months, 3 months, 6 months, and 1 years after operation [after 2 months (weighted mean difference (WMD), 15.2;95%CI, 13.58 to 16.82;P < 0.01);after 3 months (WMD, 9.42;95%CI, 7.80 to 11.04;P < 0.01);after 6 months,(WMD, 11.01;95%CI, 9.73 to 12.28;P < 0.01);after 1 years (WMD, 10.78;95%CI, 9.33 to 12.24;P < 0.01)]. Fast track surgery care can improve the knee score of American Knee Society Knee Score(WMD, 9.23;95%CI,0.86 - 17.6;P < 0.05), and reduce the incidence of postoperative deep vein thrombosis, constipation, pulmonary infection, urinary tract infection and other complications. Conclusion: Fast track surgery care can promote knee joint function recovery, reduce postoperative deep venous thrombosis, constipation, pulmonary infection and urinary tract infection. However, rigorous large sample and multicenter randomized controlled trials are needed for further validation.
文摘The 1993 Seattle First Informal Leaders Meeting elevated it from a ministerialmeeting to a cooperative mechanism at the summit level.The 1994 Bogor Dec-laration then ushered it into a de facto regular mechanism.The 1995 Osaka ActionPlan went a step further to initiate the transition of its function from working outprograms of intent into their enforcement.The forthcoming 1996 Subic Bay Meet-ing will eventually launch it out on fast track.
文摘Background: Fast track surgery is an evidence-based multidisciplinary approach. The underlying principle is to enable patients to recover from surgery and leave the hospital sooner by minimizing the stress responses on the body during surgery. Our aim was to compare the outcome of fast-track protocol and conventional methods in colorectal surgery. Method: It was an observational cross-sectional study carried out at the Department of Surgery in different tertiary level hospitals, Dhaka Bangladesh during the period January 2014 to December 2017. Among this population, 50 patients were placed in the fast-track program (Group A) from January 2014 to December 2015 and 50 patients were in the conventional method (Group B), from January 2016 to December 2017. The fast-track patients were selected after receiving ethical approval from the Bangladesh College of Physician & Surgeons. Data analysis was done using the statistical package for social science (SPSS) for windows version 20. Results: The average age of the patients was 45.24 ± 16.65 years (range: 11 - 70 years) in the fast track group (Group A) and 43.24 ± 17.76 years in the conventional method (Group B). The majority were female between two groups, with 56% in group A and 52% in group B. General and surgical complications occurred in 9 (18%) patients and 11 (22%) patients respectively in group A. On the other hand in group B general and surgical complications occurred in 10 (20%) patients and 13 (26%) patients respectively. The average hospital stay was 9.24 ± 5.99 days in group A and the average hospital stay was 10.10 ± 6.04 days in group B. Conclusion: Making the decision to adopt fast-track surgery will challenge current traditional practice for all members of the multidisciplinary team across the whole local health community.
文摘Objective: to explore the effect of emergency nursing fast track on the treatment time and effect of acute stroke. Conclusion: emergency nursing fast track has a good effect in the treatment of acute cerebral infarction, which can effectively shorten the time of receiving and treatment, reduce the disability rate of patients and improve the treatment and prognosis of patients. It has high application value and is worthy of active promotion in clinical treatment.
文摘Objective: to evaluate the application effect of fast track surgery in perioperative nursing of patients with spontaneous pneumothorax. Methods: 78 patients with spontaneous pneumothorax who completed surgical treatment in our hospital from March 2019 to June 2020 were selected and divided into groups according to different nursing measures. 39 patients in the reference group received conventional nursing, and 39 patients in the experimental group received perioperative nursing with fast track surgery. Perioperative correlation indexes were recorded between the two groups. Results: the initial postoperative exhaust time, drainage tube storage period and discharge time in the experimental group were shorter than those in the reference group, with statistical significance (P < 0.05). Conclusion: fast track surgery in the perioperative nursing of patients with spontaneous pneumothorax is beneficial to accelerate the recovery of patients and shorten the postoperative recovery time of patients, which is worthy of further promotion.
基金supported by the National Natural Science Foundation of China(61471194)the Fundamental Research Funds for the Central Universities+2 种基金the Science and Technology on Avionics Integration Laboratory and Aeronautical Science Foundation of China(20155552050)the CASC(China Aerospace Science and Technology Corporation) Aerospace Science and Technology Innovation Foundation Projectthe Nanjing University of Aeronautics And Astronautics Graduate School Innovation Base(Laboratory)Open Foundation Program(kfjj20151505)
文摘The traditional oriented FAST and rotated BRIEF（ORB） algorithm has problems of instability and repetition of keypoints and it does not possess scale invariance. In order to deal with these drawbacks, a modified ORB（MORB） algorithm is proposed. In order to improve the precision of matching and tracking, this paper puts forward an MOK algorithm that fuses MORB and Kanade-Lucas-Tomasi（KLT）. By using Kalman, the object＇s state in the next frame is predicted in order to reduce the size of search window and improve the real-time performance of object tracking. The experimental results show that the MOK algorithm can accurately track objects with deformation or with background clutters, exhibiting higher robustness and accuracy on diverse datasets. Also, the MOK algorithm has a good real-time performance with the average frame rate reaching 90.8 fps.
基金Project(51975164)supported by the National Natural Science Foundation of ChinaProject(2019-KYYWF-0205)supported by the Fundamental Research Foundation for Universities of Heilongjiang Province,China。
文摘In order to meet the precision requirements and tracking performance of the continuous rotary motor electro-hydraulic servo system under unknown strong non-linear and uncertain strong disturbance factors,such as dynamic uncertainty and parameter perturbation,an improved active disturbance rejection control(ADRC)strategy was proposed.The state space model of the fifth order closed-loop system was established based on the principle of valve-controlled hydraulic motor.Then the three parts of ADRC were improved by parameter perturbation and external disturbance;the fast tracking differentiator was introduced into linear and non-linear combinations;the nonlinear state error feedback was proposed using synovial control;the extended state observer was determined by nonlinear compensation.In addition,the grey wolf algorithm was used to set the parameters of the three parts.The simulation and experimental results show that the improved ADRC can realize the system frequency 12 Hz when the tracking accuracy and response speed meet the requirements of double ten indexes,which lay foundation for the motor application.
文摘Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery(ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioperative management, the implementation of this complex protocol has been slow. Barriers to implementation involve both patient- and staff-related factors as well as practice-related issues and resources. To support efficient and successful implementation, further educational and structural measures have to be made on a national or regional level to improve the standard of general health care. Besides postoperative morbidity, biological and physiological variables have been quite commonly reported in previous ERAS studies. Little information, however, has been obtained on cost-effectiveness, long-term outcomes, quality of life and patient-related outcomes, and these issues remain important areas of research for future studies.
基金This study was approved by The Medical Committee of Zhongshan Ophthalmic Center,Sun Yat-sen University(approval number 2018KYPJ127)written informed consent was obtained from all patients.
文摘Background:The purpose of this study is to summarize the application of day surgery combined with fast track program in strabismus operation under general anesthesia.Methods:The clinical data of 2,000 cases of strabismus patients who had underwent surgery in day surgery or traditional hospitalization in the duration from 2015 to 2016 was retrospectively analyzed.The safety and efficacy were assessed by comparing the average length of stay in hospitals,anesthesia recovery time,patient satisfaction and number of adverse events.Results:Compared with the traditional group,the average length of stay in hospital and recovery time in day surgery group were significantly lower(P<0.001)and the satisfaction of patient was improved(P<0.05),which were statistically significant difference.Moreover,no adverse events occurred among these patients.Conclusions:The application of day surgery in strabismus operation under general anesthesia is feasible,which can reduce the recovery time and shorten the hospital stay of patients safely and effectively,and their satisfaction was improved at the same time.
文摘Objective: to explore the application value of fast track surgical nursing measures in patients with colorectal cancer during perioperative period. Methods: 68 patients with colorectal cancer from July 2018 to January 2019 in our hospital were randomly divided into observation group and control group. The observation group was given rapid rehabilitation surgery nursing, while the control group was given routine nursing. The nursing satisfaction, postoperative rehabilitation level and hospital stay time of the two groups were analyzed. Results: there were significant differences in postoperative exhaust time and hospitalization days between the observation group and the control group and the differences were statistically significant (P < 0.05). Conclusion: the application of fast track surgical nursing in the diagnosis of colorectal cancer can effectively improve the nursing satisfaction of patients which is worthy of promotion.
文摘Background Few clinical studies or randomized clinical trial results have reported the impact of fast track surgery on postoperative insulin sensitivity. This study aimed to investigate the effects of fast track surgery on postoperative insulin sensitivity in patients undergoing elective open colorectal resection. Methods Controlled, randomized clinical trial was conducted from November 2008 to January 2009 with one-month post-discharge follow-up. Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups： a fast track group （35 cases） and a conventional care group （35 cases）. All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters （complication rates, return of gastrointestinal function and postoperative length of stay）, stress index and insulin sensitivity were evaluated in both groups perioperatively. Results Sixty-two patients finally completed the study, 32 cases in the fast-track group and 30 cases in the conventional care group. Our findings revealed a significantly faster recovery of postoperative insulin sensitivity on postoperative day 7 in the fast-track group than that in the conventional care group. We also found a significantly shorter length of postoperative stay and a significantly faster return of gastrointestinal function in patients undergoing fast-track rehabilitation. Conclusion Fast track surgery accelerates the recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.
基金supported by the Foundation for the Author of National Excellent Doctoral Dissertation of China(Grant No.FANEDD 2007B66)by the National Science Foundation of China(Grant No.30801331).
文摘This study evaluates the application of fast track(FT)nasogastric decompression in patients who underwent anterior resection of rectal cancer.A randomized control trial was performed comparing the group with the fast track treatment(n=57)and the group with traditional nasogastric decompression(n=84).Preoperative characteristics and postoperative recovery indices were recorded and analyzed.The results indicate no significant differences in gender(P=0.614),age(P=0.653),tumor location(P=0.113),and TNM stages(P=0.054)were observed between the 2 groups.The differences in the type of resection,anastomosis,and adoption of protective colostomy were all not significant between the FT and the traditional group.During the first 24 hours after surgery,the volume of nasogastric drainage averaged 197 ml in the FT group and 155 ml in the traditional group(P=0.197).The initiation of test-meal(P=0.000),semiliquid diet(P=0.002),and ordinary diet(P=0.008)were all significantly shorter in the FT group.Furthermore,compared with the other group,the patients in the FT group enjoyed earlier removal of the abdominal drainage,urinary catheter,and shorter hospital stays(P=0.000).Based on a correlation test,the duration of nasogastric decompression is related to the time of test-meal and semiliquid diet.The routine usage of nasogastric decompression in rectal surgery is unnecessary.The fast track procedure might help in facilitating postoperative functional and diet recovery,reducing the time of catheterization,and shortening hospital stay.
文摘Healthcare systems engineering in emergency departments(EDs)are developing rapidly in the world nowadays.Fast track(FT)as a rapid treatment system is considered to facilitate ED patient flow.To know how FT can improve the performance of ED,one should study the best configuration of resources for implementation of FT.This research presents a pattern for implementation of FT systems in hospital EDs using healthcare simulation paradigms.Simulation-based optimization model uses modeling and simulation capabilities to generate configurations of FT resources and its patient prioritization pattern with Arena rsimulation software.A decision making method is used to select the optimal configuration based on pre-specified performance indicators.The results imply that the proposed FT implementation pattern is efficient and capable of improving patient flow.
