Aim: To study the clinical value of accelerated recovery care in pulmonary rehabilitation of perioperative lung cancer patients. Methods: 98 lung cancer patients undergoing surgery were admitted to our hospital from M...Aim: To study the clinical value of accelerated recovery care in pulmonary rehabilitation of perioperative lung cancer patients. Methods: 98 lung cancer patients undergoing surgery were admitted to our hospital from March 2020 to November 2021 and randomly divided into an observation group and an ACBT (Active Cycle of Breathing Technique) training group. Accelerated recovery care and routine care were respectively used in the perioperative period to compare the nursing effects of the two groups. Results: All perioperative indicators in the observation group were shorter than those in the ACBT training group. The pain scores at different time periods after surgery were lower in the observation group than in the ACBT training group (P 0.05). The improvement in the above indicators was higher in the observation group than in the ACBT training group after nursing care (P Conclusion: Accelerated recovery care during the perioperative period for lung cancer surgery patients showed significant effectiveness.展开更多
Objective:To analyze the application value of hierarchical quantitative man-agement combined with sensitive indicators of accelerated recovery nursing in patients undergoing liver cancer surgery.Methods:A total of 66 ...Objective:To analyze the application value of hierarchical quantitative man-agement combined with sensitive indicators of accelerated recovery nursing in patients undergoing liver cancer surgery.Methods:A total of 66 patients with liver cancer admitted from 2022 to 2023 were included in the study and the digital lottery group was divided into control group(n=33)and study group(n=33),and the perioperative indicators,complication rate,and liver function level[glutamyl transferase(GGT),aspartate aminotransferase(AST),alanine aminotransferase(ALT)]were compared between the groups.Results:The first exhaust,first ambulation and hospital stay in the study group were shorter than those in the control group,and the complication rate was lower than that in the control group(P<0.05),the liver function(AST,ALT,GGT)was meaningless in the two groups before and after operation(P>0.05),and the postoperative 3dGGT,AST and ALT in the study group were lower than those in the control group(P<0.05).Conclusion:Hierarchical quantitative management+sensitive indicators of accelerated rehabilitation nursing have high application value.展开更多
Summary of the Experience in Perioperative Accelerated Recovery Care of a Patient with Severe Mitral Valve Regurgitation,Mitral Valve Prolapse,Coronary Heart Disease,and Hypertension Undergoing Transesophageal Echocar...Summary of the Experience in Perioperative Accelerated Recovery Care of a Patient with Severe Mitral Valve Regurgitation,Mitral Valve Prolapse,Coronary Heart Disease,and Hypertension Undergoing Transesophageal Echocardiography-Guided Mitral Valve Chord Repair System and Artificial Chord Implantation through the Apex of the Heart The patient had a history of coronary heart disease and hypertension,and was diagnosed with mitral valve prolapse and severe mitral regurgitation at admission.According to the comprehensive evaluation of the patient's condition by the cardiac surgery and MDT(Multidisciplinary Team)team of our hospital before operation,the patient had severe degenerative mitral regurgitation.Considering the high risk of surgical valvuloplasty,the treatment plan of transapical mitral valve artificial chordae implantation with mitral chordae repair system under the guidance of esophageal ultrasound was formulated.Following the guidelines for accelerated recovery,a multidisciplinary approach was taken during the surgery to monitor the patient's condition.Preoperative waiting periods,the postoperative critical period,and the stabilization period were considered,and a rehabilitation program that included exercise,nutritional support,health education,and psychological care was developed for the entire perioperative accelerated recovery process.Nutritional support,health education and psychological nursing were throughout the whole process of perioperative enhanced recovery.The patient was implanted with 4 artificial chordae tendineae.Transesophageal echocardiography monitoring showed that the surgical treatment effect was satisfactory,and no complications occurred during the perioperative period.展开更多
[Objectives]To observe the application effect of the concept of accelerated recovery after surgery(ERAS)on patients undergoing trans-urethral holmium laser enucleation of prostate(HoLEP)during perioperative period.[Me...[Objectives]To observe the application effect of the concept of accelerated recovery after surgery(ERAS)on patients undergoing trans-urethral holmium laser enucleation of prostate(HoLEP)during perioperative period.[Methods]HoLEP patients with benign prostatic hyperplasia admitted to the Department of Urology,Affiliated Hospital of Jinggangshan University from June to December in 2022 were divided into the observation and control group.40 patients in the control group were given perioperative routine nursing,while 40 patients in the observation group were given perioperative systematic nursing under the concept of ERAS.The nursing effect of different measures were evaluated.[Results]The perioperative related indexes of patients in the observation group were lower than those in the control group(P<0.05).The postoperative feeding,exhaust,spontaneous urination,getting out of bed and hematuria stop time of patients in the observation group were all shorter than those in the control group(P<0.05).The IPSS score and RUV of patients in the observation group were significantly lower than those in the control group,while their Qmax was higher than that in the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).[Conclusions]The application of perioperative systematic nursing under ERAS concept in HoLEP patients can promote patients rapid recovery and reduce their complications.展开更多
Ectopic pregnancy refers to the implantation and development of pregnant eggs outside the uterine cavity of pregnant women, which is called "ectopic pregnancy". The most common is tubal pregnancy. The diseas...Ectopic pregnancy refers to the implantation and development of pregnant eggs outside the uterine cavity of pregnant women, which is called "ectopic pregnancy". The most common is tubal pregnancy. The disease is mainly caused by inflammation or other pathological changes in the tubal lumen of pregnant women due to various reasons, which will significantly increase the degree of lumen stenosis. Therefore, the process of pregnant eggs entering the uterus is limited and cannot enter the uterus smoothly. It is implanted and developed into fallopian tubes, and finally ectopic pregnancy is formed. Foreign pregnancy usually has no obvious symptoms before abortion or rupture. Some pregnant women will have symptoms such as menopause, abdominal pain and a small amount of vaginal bleeding. After tearing, severe and very intense repeated pain will occur. Vaginal bleeding is increasing. If not treated in time, pregnant women will be shocked and even endanger their lives. At present, the clinical treatment of abnormal pregnancy mainly includes surgical treatment and non-surgical treatment. Surgical treatment can be divided into traditional open surgery and laparoscopic surgery according to the patients requirements (such as still needing pregnancy), which can focus on the incision and connection of the affected fallopian tubes. The ultimate goal is to end the current in situ pregnancy and then continue to prevent in situ pregnancy. Objective: to investigate the effect of laparoscopic surgery for ectopic pregnancy. Methods: 38 patients with ectopic pregnancy from October 2019 to October 2021 were randomly divided into two groups. The results of the two groups were analyzed. Results: the quality of life of the two groups before treatment was similar, but after treatment, the quality of life of the laparoscopic operation group was higher than that of the conventional open operation group (p.0.05). The average operation time of the laparoscopic operation group was shorter than that of the conventional open operation group, the blood loss was lower than that of the conventional open operation group, the time of underground movement was earlier than that of the conventional open operation group, the time of first defecation after operation was earlier than that of the conventional open operation group, and the time from admission to discharge was shorter than that of the conventional open operation group (P.0.05). Complications such as abdominal infection in the laparoscopic operation group were significantly lower than those in the conventional open operation group (p. Conclusion: laparoscopic surgery can achieve good results in minimally invasive pregnancy patients, reduce the injury of minimally invasive pregnancy patients, improve the quality of life of minimally invasive pregnancy patients, reduce the incidence of related complications, and accelerate the recovery of patients.展开更多
Background and aims:Drug-induced liver injury(DILI)is one of the most serious adverse drug reactions and its incidence has been increasing rapidly.Accumulating evidence suggests that immune activation and systemic inf...Background and aims:Drug-induced liver injury(DILI)is one of the most serious adverse drug reactions and its incidence has been increasing rapidly.Accumulating evidence suggests that immune activation and systemic inflammatory responses are very important in the progression of DILI.Corticosteroids are often used in DILI,but their clinical usefulness remains controversial.We therefore conducted a prospective,randomized controlled study to investigate whether corticosteroid therapy can accelerate recovery and reduce mortality in severe DILI(SDILI).Methods:SDILI patients with total bilirubin?171μmol/L who presented to the Fifth Medical Center of Chinese PLA General Hospital,Beijing from 2016 to 2019 were randomly allocated to prednisolone and control groups.The endpoints were resolution of SDILI,defined as a decrease in total bilirubin of at least 35μmol/L to<171μmol/L,and overall survival at 6 months.Patients in the prednisolone group received prednisolone 60 mg/day therapy for the first 7 days.Patients with a decrease in total bilirubin of more than 35μmol/L on day 8 continued on tapering doses of prednisolone;otherwise,prednisolone was discontinued.Results:On day 8,50.75%(34/67)and 26.47%(18/68)of the participants in the prednisolone and control groups,respectively,achieved the primary endpoint(p¼0.002).However,there was no significant difference in overall survival at 6 months:95.52%(64/67)vs.91.18%(62/68)in the prednisolone and control groups,respectively(p¼0.3).All deaths in both groups occurred in patients who failed to achieve SDILI resolution on day 8.Conclusion:Prednisolone therapy may accelerate the recovery of SDILI.展开更多
Background:Lung cancer is currently the most prevalent malignancy and the leading cause of cancer deaths worldwide.Although the early stage non-small cell lung cancer(NSCLC)presents a relatively good prognosis,a consi...Background:Lung cancer is currently the most prevalent malignancy and the leading cause of cancer deaths worldwide.Although the early stage non-small cell lung cancer(NSCLC)presents a relatively good prognosis,a considerable number of lung cancer cases are still detected and diagnosed at locally advanced or late stages.Surgical treatment combined with perioperative multimodality treatment is the mainstay of treatment for locally advanced NSCLC and has been shown to improve patient survival.Following the standard methods of neoadjuvant therapy,perioperative management,postoperative adjuvant therapy,and other therapeutic strategies are important for improving patients’prognosis and quality of life.However,controversies remain over the perioperative management of NSCLC and presently consensus and standardized guidelines are lacking for addressing critical clinical issues in multimodality treatment.Methods:The working group consisted of 125 multidisciplinary experts from thoracic surgery,medical oncology,radiotherapy,epidemiology,and psychology.This guideline was developed using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system.The clinical questions were collected and selected based on preliminary open-ended questionnaires and subsequent discussions during the Guideline Working Group meetings.PubMed,Web of Science,Cochrane Library,Scopus,and China National Knowledge Infrastructure(CNKI)were searched for available evidence.The GRADE system was used to evaluate the quality of evidence and grade the strengths of recommendations.Finally,the recommendations were developed through a structured consensus-building process.Results:The Guideline Development Group initially collected a total of 62 important clinical questions.After a series of consensus-building conferences,24 clinical questions were identified and corresponding recommendations were ultimately developed,focusing on neoadjuvant therapy,perioperative management,adjuvant therapy,postoperative psychological rehabilitation,prognosis assement,and follow-up protocols for NSCLC.Conclusions:This guideline puts forward reasonable recommendations focusing on neoadjuvant therapy,perioperative management,adjuvant therapy,postoperative psychological rehabilitation,prognosis assessment,and follow-up protocol of NSCLC.It standardizes perioperative multimodality treatment and provides guidance for clinical practice among thoracic surgeons,medical oncologists,and radiotherapists,aiming to reduce postoperative recurrence,improve patient survival,accelerate recovery,and minimize postoperative complications such as atelectasis.展开更多
文摘Aim: To study the clinical value of accelerated recovery care in pulmonary rehabilitation of perioperative lung cancer patients. Methods: 98 lung cancer patients undergoing surgery were admitted to our hospital from March 2020 to November 2021 and randomly divided into an observation group and an ACBT (Active Cycle of Breathing Technique) training group. Accelerated recovery care and routine care were respectively used in the perioperative period to compare the nursing effects of the two groups. Results: All perioperative indicators in the observation group were shorter than those in the ACBT training group. The pain scores at different time periods after surgery were lower in the observation group than in the ACBT training group (P 0.05). The improvement in the above indicators was higher in the observation group than in the ACBT training group after nursing care (P Conclusion: Accelerated recovery care during the perioperative period for lung cancer surgery patients showed significant effectiveness.
文摘Objective:To analyze the application value of hierarchical quantitative man-agement combined with sensitive indicators of accelerated recovery nursing in patients undergoing liver cancer surgery.Methods:A total of 66 patients with liver cancer admitted from 2022 to 2023 were included in the study and the digital lottery group was divided into control group(n=33)and study group(n=33),and the perioperative indicators,complication rate,and liver function level[glutamyl transferase(GGT),aspartate aminotransferase(AST),alanine aminotransferase(ALT)]were compared between the groups.Results:The first exhaust,first ambulation and hospital stay in the study group were shorter than those in the control group,and the complication rate was lower than that in the control group(P<0.05),the liver function(AST,ALT,GGT)was meaningless in the two groups before and after operation(P>0.05),and the postoperative 3dGGT,AST and ALT in the study group were lower than those in the control group(P<0.05).Conclusion:Hierarchical quantitative management+sensitive indicators of accelerated rehabilitation nursing have high application value.
基金supported by National Key Research and Development Program of China (No.2022YFC2407406)2022 Stability Support for Innovative Capacity Building of Guangdong Provincial Scientific Research Institutions (No.KD022022015)Science and Technology Program of Guangzhou,China (No.202206010049)。
文摘Summary of the Experience in Perioperative Accelerated Recovery Care of a Patient with Severe Mitral Valve Regurgitation,Mitral Valve Prolapse,Coronary Heart Disease,and Hypertension Undergoing Transesophageal Echocardiography-Guided Mitral Valve Chord Repair System and Artificial Chord Implantation through the Apex of the Heart The patient had a history of coronary heart disease and hypertension,and was diagnosed with mitral valve prolapse and severe mitral regurgitation at admission.According to the comprehensive evaluation of the patient's condition by the cardiac surgery and MDT(Multidisciplinary Team)team of our hospital before operation,the patient had severe degenerative mitral regurgitation.Considering the high risk of surgical valvuloplasty,the treatment plan of transapical mitral valve artificial chordae implantation with mitral chordae repair system under the guidance of esophageal ultrasound was formulated.Following the guidelines for accelerated recovery,a multidisciplinary approach was taken during the surgery to monitor the patient's condition.Preoperative waiting periods,the postoperative critical period,and the stabilization period were considered,and a rehabilitation program that included exercise,nutritional support,health education,and psychological care was developed for the entire perioperative accelerated recovery process.Nutritional support,health education and psychological nursing were throughout the whole process of perioperative enhanced recovery.The patient was implanted with 4 artificial chordae tendineae.Transesophageal echocardiography monitoring showed that the surgical treatment effect was satisfactory,and no complications occurred during the perioperative period.
基金Supported by the Guiding Science and Technology Planning Project of Ji an City.
文摘[Objectives]To observe the application effect of the concept of accelerated recovery after surgery(ERAS)on patients undergoing trans-urethral holmium laser enucleation of prostate(HoLEP)during perioperative period.[Methods]HoLEP patients with benign prostatic hyperplasia admitted to the Department of Urology,Affiliated Hospital of Jinggangshan University from June to December in 2022 were divided into the observation and control group.40 patients in the control group were given perioperative routine nursing,while 40 patients in the observation group were given perioperative systematic nursing under the concept of ERAS.The nursing effect of different measures were evaluated.[Results]The perioperative related indexes of patients in the observation group were lower than those in the control group(P<0.05).The postoperative feeding,exhaust,spontaneous urination,getting out of bed and hematuria stop time of patients in the observation group were all shorter than those in the control group(P<0.05).The IPSS score and RUV of patients in the observation group were significantly lower than those in the control group,while their Qmax was higher than that in the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).[Conclusions]The application of perioperative systematic nursing under ERAS concept in HoLEP patients can promote patients rapid recovery and reduce their complications.
文摘Ectopic pregnancy refers to the implantation and development of pregnant eggs outside the uterine cavity of pregnant women, which is called "ectopic pregnancy". The most common is tubal pregnancy. The disease is mainly caused by inflammation or other pathological changes in the tubal lumen of pregnant women due to various reasons, which will significantly increase the degree of lumen stenosis. Therefore, the process of pregnant eggs entering the uterus is limited and cannot enter the uterus smoothly. It is implanted and developed into fallopian tubes, and finally ectopic pregnancy is formed. Foreign pregnancy usually has no obvious symptoms before abortion or rupture. Some pregnant women will have symptoms such as menopause, abdominal pain and a small amount of vaginal bleeding. After tearing, severe and very intense repeated pain will occur. Vaginal bleeding is increasing. If not treated in time, pregnant women will be shocked and even endanger their lives. At present, the clinical treatment of abnormal pregnancy mainly includes surgical treatment and non-surgical treatment. Surgical treatment can be divided into traditional open surgery and laparoscopic surgery according to the patients requirements (such as still needing pregnancy), which can focus on the incision and connection of the affected fallopian tubes. The ultimate goal is to end the current in situ pregnancy and then continue to prevent in situ pregnancy. Objective: to investigate the effect of laparoscopic surgery for ectopic pregnancy. Methods: 38 patients with ectopic pregnancy from October 2019 to October 2021 were randomly divided into two groups. The results of the two groups were analyzed. Results: the quality of life of the two groups before treatment was similar, but after treatment, the quality of life of the laparoscopic operation group was higher than that of the conventional open operation group (p.0.05). The average operation time of the laparoscopic operation group was shorter than that of the conventional open operation group, the blood loss was lower than that of the conventional open operation group, the time of underground movement was earlier than that of the conventional open operation group, the time of first defecation after operation was earlier than that of the conventional open operation group, and the time from admission to discharge was shorter than that of the conventional open operation group (P.0.05). Complications such as abdominal infection in the laparoscopic operation group were significantly lower than those in the conventional open operation group (p. Conclusion: laparoscopic surgery can achieve good results in minimally invasive pregnancy patients, reduce the injury of minimally invasive pregnancy patients, improve the quality of life of minimally invasive pregnancy patients, reduce the incidence of related complications, and accelerate the recovery of patients.
基金This work was supported by the Capital Clinical Characteristic Application Research on Funded Projects(No:Z161100000516172)the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine(No:ZYYCXTD-C-202005).
文摘Background and aims:Drug-induced liver injury(DILI)is one of the most serious adverse drug reactions and its incidence has been increasing rapidly.Accumulating evidence suggests that immune activation and systemic inflammatory responses are very important in the progression of DILI.Corticosteroids are often used in DILI,but their clinical usefulness remains controversial.We therefore conducted a prospective,randomized controlled study to investigate whether corticosteroid therapy can accelerate recovery and reduce mortality in severe DILI(SDILI).Methods:SDILI patients with total bilirubin?171μmol/L who presented to the Fifth Medical Center of Chinese PLA General Hospital,Beijing from 2016 to 2019 were randomly allocated to prednisolone and control groups.The endpoints were resolution of SDILI,defined as a decrease in total bilirubin of at least 35μmol/L to<171μmol/L,and overall survival at 6 months.Patients in the prednisolone group received prednisolone 60 mg/day therapy for the first 7 days.Patients with a decrease in total bilirubin of more than 35μmol/L on day 8 continued on tapering doses of prednisolone;otherwise,prednisolone was discontinued.Results:On day 8,50.75%(34/67)and 26.47%(18/68)of the participants in the prednisolone and control groups,respectively,achieved the primary endpoint(p¼0.002).However,there was no significant difference in overall survival at 6 months:95.52%(64/67)vs.91.18%(62/68)in the prednisolone and control groups,respectively(p¼0.3).All deaths in both groups occurred in patients who failed to achieve SDILI resolution on day 8.Conclusion:Prednisolone therapy may accelerate the recovery of SDILI.
文摘Background:Lung cancer is currently the most prevalent malignancy and the leading cause of cancer deaths worldwide.Although the early stage non-small cell lung cancer(NSCLC)presents a relatively good prognosis,a considerable number of lung cancer cases are still detected and diagnosed at locally advanced or late stages.Surgical treatment combined with perioperative multimodality treatment is the mainstay of treatment for locally advanced NSCLC and has been shown to improve patient survival.Following the standard methods of neoadjuvant therapy,perioperative management,postoperative adjuvant therapy,and other therapeutic strategies are important for improving patients’prognosis and quality of life.However,controversies remain over the perioperative management of NSCLC and presently consensus and standardized guidelines are lacking for addressing critical clinical issues in multimodality treatment.Methods:The working group consisted of 125 multidisciplinary experts from thoracic surgery,medical oncology,radiotherapy,epidemiology,and psychology.This guideline was developed using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system.The clinical questions were collected and selected based on preliminary open-ended questionnaires and subsequent discussions during the Guideline Working Group meetings.PubMed,Web of Science,Cochrane Library,Scopus,and China National Knowledge Infrastructure(CNKI)were searched for available evidence.The GRADE system was used to evaluate the quality of evidence and grade the strengths of recommendations.Finally,the recommendations were developed through a structured consensus-building process.Results:The Guideline Development Group initially collected a total of 62 important clinical questions.After a series of consensus-building conferences,24 clinical questions were identified and corresponding recommendations were ultimately developed,focusing on neoadjuvant therapy,perioperative management,adjuvant therapy,postoperative psychological rehabilitation,prognosis assement,and follow-up protocols for NSCLC.Conclusions:This guideline puts forward reasonable recommendations focusing on neoadjuvant therapy,perioperative management,adjuvant therapy,postoperative psychological rehabilitation,prognosis assessment,and follow-up protocol of NSCLC.It standardizes perioperative multimodality treatment and provides guidance for clinical practice among thoracic surgeons,medical oncologists,and radiotherapists,aiming to reduce postoperative recurrence,improve patient survival,accelerate recovery,and minimize postoperative complications such as atelectasis.
