Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to t...Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.展开更多
Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East res...Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East respiratory syndrome(MERS)in 2012,and coronavirus disease 2019(COVID-19),with the latter being on the rampage since the end of 2019 and bringing the effect of aerosols on health back to the fore(Gralton et al.,2011;Wang et al.,2021).An increasing number of studies have shown that certain highly transmissible pathogens can maintain long-term stability and efficiently spread through aerosols(Leung,2021;Lv et al.,2021).As reported previously,influenza viruses that can spread efficiently through aerosols remain stable for a longer period compared to those that cannot.The World Health Organization(WHO)has stated that aerosol-generating procedures(AGPs)play an important role in aerosol transmission in hospitals(Calderwood et al.,2021).AGPs,referring to medical procedures that produce aerosols,including dental procedures,endotracheal intubation,sputum aspiration,and laparoscopic surgeries,have been reported to be significantly associated with an increased risk of nosocomial infection among medical personnel(Hamilton,2021).展开更多
Objective:To observe and analyze the application of the bedside rhetorical teaching method in teaching nursing interns.Methods:A total of 64 nursing interns in the gastroenterology department of our hospital from July...Objective:To observe and analyze the application of the bedside rhetorical teaching method in teaching nursing interns.Methods:A total of 64 nursing interns in the gastroenterology department of our hospital from July 2022 to May 2023 were randomly divided into two groups,32 cases in the control group and 32 cases in the intervention group.The control group was given conventional teaching methods,and the intervention group was given the bedside rhetorical teaching method on the basis of the conventional teaching.The differences in the methods of teaching between the two groups were compared after the end of the internship,and there was a statistically significant difference with P<0.05.Results:The scores of the interns in the intervention group were significantly better than those of the control group in theoretical knowledge,communication skills,and case analysis items(P<0.05).Conclusion:The bedside rhetorical teaching method transforms classroom education into bedside teaching,which enables the interns to apply the theoretical knowledge to clinical practice,and has a higher improvement in the three aspects of disease knowledge,communication skills,and case analysis,cultivates the interns’comprehensive clinical skills,and lays a good foundation for the future entry into the nursing field.展开更多
Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease in the United States.While the American Association for the Study of Liver Diseases guidelines define NAFLD as hepatic steatosis detected either...Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease in the United States.While the American Association for the Study of Liver Diseases guidelines define NAFLD as hepatic steatosis detected either on histology or imaging without a secondary cause of abnormal hepatic fat accumulation,no imaging modality is recommended as standard of care for screening or diagnosis.Bedside ultrasound has been evaluated as a non-invasive method of diagnosing NAFLD with the presence of characteristic sonographic findings.Prior studies suggest characteristic sonographic findings for NAFLD include bright hepatic echoes,increased hepatorenal echogenicity,vascular blurring of portal or hepatic vein and subcutaneous tissue thickness.These sonographic characteristics have not been shown to aid bedside clinicians easily identify potential cases of NAFLD.While sonographic findings such as attenuation of image,diffuse echogenicity,uniform heterogeneous liver,thick subcutaneous depth,and enlarged liver filling of the entire field could be identifiedby clinicians from bedside ultrasound.The accessibility,ease of use,and low-side effect profile of ultrasound make bedside ultrasound an appealing imaging modality in the detection of hepatic steatosis.When used with appropriate clinical risk factors and steatosis involves greater than 33%of the liver,ultrasound can reliably diagnose NAFLD.Despite the ability of ultrasound in detecting moderate hepatic steatosis,it cannot replace liver biopsy in staging the degree of fibrosis.The purpose of this review is to examine the diagnostic accuracy,utility,and limitations of ultrasound in the diagnosis of NAFLD and its potential use by clinicians in routine practices.展开更多
BACKGROUND: Appendicitis is a common disease requiring surgery. Bedside ultrasound(BUS) is a core technique for emergency medicine(EM). The Alvarado score is a well-studied diagnostic tool for appendicitis. This study...BACKGROUND: Appendicitis is a common disease requiring surgery. Bedside ultrasound(BUS) is a core technique for emergency medicine(EM). The Alvarado score is a well-studied diagnostic tool for appendicitis. This study aimed to investigate the relationship between patients' symptoms, Alvarado score and ultrasound(US) findings, as performed by emergency physicians(EPs) and radiologists, of patients with suspected appendicitis.METHODS: Three EM specialists underwent the BUS course and core course for appendicitis assessment. Patients suspected of having appendicitis were selected and their Alvarado and modif ied(m) Alvarado scores calculated. The specialists performed the BUS. Then, patients were given a formal US and surgery consultation if necessary. Preliminary diagnoses, admission or discharge from the emergency department(ED) and fi nal diagnosis were documented. The patients were also followed up after discharge from the hospital.RESULTS: The determined cut-off value was 2 for Alvarado and 3 for m Alvarado scores. The sensitivities of the two scores were 100%. Each score was used to rule out appendicitis. The results of EP-performed BUS were as follows: accuracy 70%, sensitivity 0.733, specifi city 0.673, + LR 2.24, and – LR 0.40(95%CI). Radiologists were better than EPs at diagnosing appendicitis and radiologists and EPs were equally strong at ruling out appendicitis by US. When US was combined with Alvarado and m Alvarado scores, EP US+Alvarado/m Alvarado scores ≤3 and radiology US+Alvarado/m Alvarado scores ≤4 perfectly ruled out appendicitis.CONCLUSION: BUS performed by EPs is moderately useful in detecting appendicitis. Combined with scoring systems, BUS may be a perfect tool for ruling out decisions in EDs.展开更多
BACKGROUND: Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the popula...BACKGROUND: Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the population is infected with one or more intestinal parasites. If diagnosed early, the consequences of chronic parasitic infection can potentially be avoided.METHODS: Six first-year medical students were recruited to enroll patients in the study. They underwent ten hours of formal, hands-on, ultrasound which included basic cardiac, hepatobiliary, renal, pulmonary and FAST scan ultrasound. A World Health Organization protocol with published grading scales was adapted and used to assess for pathology in each patient's liver, bladder, kidneys, and spleen.RESULTS: A total of 59 patients were enrolled in the study. Students reported a sensitivity of 96% and specificity of 100% for the presence of a dome shaped bladder, a sensitivity and specificity of 100% for bladder thickening, a sensitivity and specificity of 100% for portal hypertension and ascites. The sensitivity was 81% with a specificity of 100% for presence of portal vein distention. The sensitivity was 100% with a specificity of 90% for dilated bowel.CONCLUSIONS: Ultrasound has shown a promise at helping to identify pathology in rural communities with limited resources such as Tanzania. Our data suggest that minimally trained first year medical students are able to perform basic ultrasound scans that can identify ultrasonographic markers of parasitic infections.展开更多
<strong>Objective:</strong> This study was designed to investigate risk of ventilator weaning by ultrasound bedside monitoring of the width of inferior vena cava (IVC) and the number of lung B-lines (B-lin...<strong>Objective:</strong> This study was designed to investigate risk of ventilator weaning by ultrasound bedside monitoring of the width of inferior vena cava (IVC) and the number of lung B-lines (B-lines). <strong>Methods:</strong> This study was conducted on 106 patients from January 2019 to January 2020 who had mechanical ventilation for more than 48 hours in an emergency care unit. They were clinically stable and had the criteria for weaning from the ventilator. Before Spontaneous Breathing Test (SBT) and 30 min or 120 min after SBT, the width of IVC and the number of B-lines in patients were monitored via bedside ultrasound. There were 87 cases of successful weaning as a control group and 19 cases of ventilator failure weaning as a study group. Changes of the width of IVC and the number of B-lines were compared in the different stages of SBT. <strong>Results:</strong> A total of 106 patients were included in this study. There were 87 cases of ventilator successful weaning and 19 cases failure weaning. The weaning success rate was 82.08%. The width of IVC and the number of B-lines in the study group were higher than those in the control group in same stage of SBT, the difference was statistically significant (P < 0.05), and which increased significantly with time. There was no significant difference in the width of IVC and the number of B-lines on the different stage of SBT in the control group (P > 0.05), and significant difference in the study group. <strong>Conclusion:</strong> The width of IVC and the number of B-lines monitored by bedside ultrasound can assess the risk of ventilator weaning, it may be caused by cardiopulmonary interaction.展开更多
<strong>Objective: </strong>To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea.<strong> Methods:</strong> Sixty-two patients with acute dyspne...<strong>Objective: </strong>To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea.<strong> Methods:</strong> Sixty-two patients with acute dyspnea who were treated in our hospital from January 2016 to December 2020 were randomly selected and their clinical data were retrospectively analyzed. All patients were randomly divided into a control group for routine examinations (n = 31) and an observation group for real-time beside ultrasonography (n = 31). The costs of medical examinations, examination duration, and diagnostic results of severe pneumonia, acute cardiogenic pulmonary edema, pulmonary embolism, chronic obstructive pulmonary disease, and pneumothorax (including sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy) of the two groups of patients were compared and analyzed. <strong>Results:</strong> Compared with the control group, the observation group had significantly shorter examinations (P < 0.05). Although the cost of medical examinations of the observation group tended to be higher, the difference between groups was not significant (P > 0.05). Moreover, there were no significant differences in left ventricular ejection fraction, left ventricular end-diastolic diameter, or brain natriuretic peptide between the two groups (P > 0.05). Comparison of the etiologic diagnosis results between the two groups showed that the observation group had significantly higher diagnostic sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for various causes compared with the control group (P < 0.05). <strong>Conclusion:</strong> Real-time bedside ultrasonography for the etiologic diagnosis of patients with acute dyspnea was quicker and had higher diagnostic accuracy;thus providing accurate guidance for the disease treatment, and having a higher promotional value in clinical practice compared with routine examinations.展开更多
Objective: to evaluate the directional therapeutic effect of severe ultrasound, PCUM, adjusted pulmonary window, pulmonary ultrasound examination and high-frequency chest wall oscillation sputum discharge system in th...Objective: to evaluate the directional therapeutic effect of severe ultrasound, PCUM, adjusted pulmonary window, pulmonary ultrasound examination and high-frequency chest wall oscillation sputum discharge system in the diagnosis and treatment process of children with severe pneumonia. Method: select from December 2020 to December 2021,256 cases with obvious imaging changes in severe pneumonia, using severe ultrasound PCUM adjust lung window lung ultrasound, combined with its imaging performance, directional implementation of high frequency chest wall oscillation sputum treatment and drainage, treatment before and after the comparison of the oxygenation index, mechanical ventilation mechanical index, imaging changes, evaluate the treatment effect. Results: in 256 children with severe pneumonia, high-frequency chest wall oscillation sputum discharge system significantly improved symptoms, shortened mechanical ventilation time and reduced man-machine confrontation. Conclusion: PCUM adjusted lung window lung ultrasound examination combined with high-frequency chest wall oscillation sputum drainage system treatment can effectively improve the oxygenation, and can also can effectively prevent the occurrence of ventilator-related pneumonia.展开更多
Objective: to explore and analyze the diagnostic effect and application value of bedside lung ultrasound in neonatal lung diseases. Methods: from September 2019 to March 2021, 78 newborn children with lung diseases di...Objective: to explore and analyze the diagnostic effect and application value of bedside lung ultrasound in neonatal lung diseases. Methods: from September 2019 to March 2021, 78 newborn children with lung diseases diagnosed by X-ray examination (set as observation group) and 50 newborns without lung diseases (set as control group) hospitalized in the same period were included in this study. Bedside ultrasound diagnosis of lungs was performed in both groups. According to ultrasound diagnosis images, bilateral lungs of newborns in both groups were analyzed, and their imaging similarities and differences were summarized to find out the diagnostic indicators of newborns suffering from lung diseases. Results: (1) Compared with the accuracy of disease diagnosis, the diagnostic rate of observation group was 93.59% (73/78), that of control group was 2.00% (1/50), and that of control group was 2.00% (1/50), with statistical difference (P 0.05);(2) In the contrast of imaging features of ultrasound diagnosis, the probability of B-line, lung consolidation, abnormal pleural line, lung point, pleural effusion and bronchial inflation sign in the observation group was much higher than that in the control group, and the difference was statistically significant (P 0.05). Conclusion: bedside lung ultrasound is helpful to obtain a good diagnostic effect of neonatal lung diseases, improve the efficiency of diagnosis and treatment of diseases, and increase the security of childrens life safety. It has been identified as a safe and effective diagnostic method for pediatric lung diseases, and is worthy of further popularization and application in clinical practice.展开更多
Objective: to explore and study the effect of bedside comprehensive ability assessment combined with mini CEX feedback to improve core competence in nursing students. Methods: 40 nursing students practicing in our hos...Objective: to explore and study the effect of bedside comprehensive ability assessment combined with mini CEX feedback to improve core competence in nursing students. Methods: 40 nursing students practicing in our hospital from July 2020 to may 2021 were selected as the teaching reform experimental group. The training, guidance, assessment, evaluation and feedback were carried out with the teaching reform practice manual, and the improvement effect, excellence rate and satisfaction of the core competence of the teaching reform experimental group were counted. Results: the core competence of the experimental intervention group was significantly improved (P < 0.01), and the excellent rate was significantly higher than that of the traditional teaching control group. Conclusion: the combination of bedside comprehensive ability assessment and mini CEX feedback in nursing students can improve the core ability of nursing, which is conducive to the cultivation of nursing students ability, and provide more and better teaching ideas and methods for medical colleges.展开更多
Objective: to explore the effect of co-participation in nursing + mother-infant bedside nursing mode applied to postpartum rehabilitation in obstetrics and its impact on the incidence of postpartum complications. Meth...Objective: to explore the effect of co-participation in nursing + mother-infant bedside nursing mode applied to postpartum rehabilitation in obstetrics and its impact on the incidence of postpartum complications. Methods: the period from January 2020 to January 2022 was selected as the study period, and a total of 98 puerperae admitted to the obstetrics and gynecology department of our hospital during this period were selected as the observation objects, and they were randomly divided into the routine group (n49) and the observation group (n49). The puerperium in the routine group carried out routine postpartum care, and the puerperium in the observation group applied the mode of joint nursing care + bedside nursing for mothers and infants, and the recovery conditions of the two groups were compared. Results: after receiving relevant nursing care, compared with the routine group, the puerperae in the observation group had shorter lactation initiation time, lower uterine fundus height, less lochia, and the overall recovery efficiency and prognosis SF-36 quality of life score were significantly higher;anxiety SAS, depression SDS were significantly lower and lower than those of the routine group, and the incidence of postpartum complications and neonatal complications were significantly lower, with statistically significant differences (p < 0.05). Conclusion: the effect of actively carrying out joint nursing care + mother-infant bedside nursing mode in the postpartum rehabilitation process of obstetrics is definite. It can promote the recovery of mothers, optimize the situation of newborns, and reduce the incidence of various postpartum complications, which has high clinical value, worth promoting.展开更多
Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure ...Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure of patients with acute chest pain.Methods and Results 502 consecutive patients with chest pain for less than 24 hours were determined by troponin T test at bedside and quantitative troponin I test in lab. For bedside troponin T tests, there were 160 patients in positive and 323 in negative. During 30 days of followed-up. Myocardial infarction evolved in 139 patients among 160 patients in positive troponin T test, only 7 patients in negative one. Acute heart failure occurred in 51 patients among the positive group, but 37 occurred it at negative group. The odds ratio of acute heart failure of positive group vs. negative group was 3.6. Patients died 39 in positive group, 15 in negative group, the all-cause death odds ratio of positive group vs. negative group was 6.7; 31 patients died with cardiac event in positive group, 5 in negative group only. Conclusions Bedside Troponin T test is a powerful and independent predictor of death and acute heart failure for patients with acute chest pain.展开更多
Objective: this paper aims to explore the clinical effect of bedside arterial blood gas analysis in intensive care unit, so as to have a more comprehensive grasp of the application of arterial blood gas analysis. Meth...Objective: this paper aims to explore the clinical effect of bedside arterial blood gas analysis in intensive care unit, so as to have a more comprehensive grasp of the application of arterial blood gas analysis. Methods: a total of 89 patients who came to our hospital for arterial blood gas analysis from January 2020 to January 2021 were selected and randomly divided into the reference group and the experimental group. The reference group was analyzed by laboratory examination, and the experimental group was monitored by bedside blood gas analysis. Analyze the differences in the results of different test methods. Results: analysis results showed that there was no significant difference in pH, PO2 and PCO2, P > 0.05. There were significant differences in the analysis time of potassium, serum calcium and blood gas (P < 0.05). Conclusion: the application of bedside arterial blood gas analysis in intensive care unit can shorten the time of blood gas analysis, quickly adjust the treatment plan and medication of patients, improve the overall rehabilitation effect and shorten the length of hospital stay, which is worthy of clinical application.展开更多
Objective: to investigate the effect of bedside blind intestinal implantation on enteral nutrition feeding and complications in severe patients. Methods: 72 patients with severe enteral nutrition feeding were randomly...Objective: to investigate the effect of bedside blind intestinal implantation on enteral nutrition feeding and complications in severe patients. Methods: 72 patients with severe enteral nutrition feeding were randomly selected from April 2019 to October 2020. With 36 cases in each group, the control group and the observation group were respectively. Results: in terms of the total incidence of complications, the observed group (8%) was lower than the control group (33.33%) (P <0.05), and prealbumin and total serum protein showed no significant difference between the two groups before treatment (P> 0.05). The observation group was higher after treatment than in the control group, with significant differences (P <0.05). In terms of ICU stay, mechanical ventilation and total hospital stay, the control groups were (18.65 ± 2.83) d, (13.95 ± 2.01) d, (22.82 ± 3) d, (14.21 ± 2.43) d, (10.21 ± 1.24) d, (17.96 ± 2.64) d, respectively, with significant differences (P <0.05). In terms of catheterization success rate and 7d feeding compliance rate, 91.67% and 58.33% in the control group, 100.00% and 94.44% in the observation group, respectively, which were higher than the control group, with significant difference (P <0.05). The QoL score of the observation group was higher than the control group, with significant differences (P <0.05). Conclusion: the method is helpful to reduce the incidence of complications and improve the nutritional status of severe patients, which is worth clinical adoption and promotion.展开更多
Objective: to study the effect of maternal and infant bedside care model in obstetric care. Methods: a total of 200 parturients admitted to our hospital in recent years were randomly divided into two groups: the contr...Objective: to study the effect of maternal and infant bedside care model in obstetric care. Methods: a total of 200 parturients admitted to our hospital in recent years were randomly divided into two groups: the control group and the experimental group. The control group mainly adopted the conventional nursing method and separated the mother from the baby, while the experimental group adopted the bedside nursing mode of the mother and the baby. The control of the nursing skills of the newborn and the satisfaction degree of the two groups of parturients were observed and compared. The results showed that through the comparative study, the separation time between the parturient and the baby was longer, the knowledge about the baby's nursing was less, and the experimental group had more knowledge about the postpartum nursing, which improved the parenting knowledge and effectively improved the overall nursing skill level of the parturient. This model can be worthy of promotion in clinical aspects, and can help the parturient to quickly master the skills of nursing the baby. The total satisfaction of parturients was higher (P < 0.05). Conclusion: the application of maternal and infant bedside nursing model can enable the puerpera to fully understand the nursing knowledge, improve the puerpera's nursing skills, and effectively improve the nursing satisfaction, which is worthy of promotion.展开更多
Objective: to understand the role of bedside rounds in improving nursing quality of otorhinolaryngology head and neck surgery. Methods: a total of 100 nursing staff of otorhinolaryngology head and neck surgery in Jing...Objective: to understand the role of bedside rounds in improving nursing quality of otorhinolaryngology head and neck surgery. Methods: a total of 100 nursing staff of otorhinolaryngology head and neck surgery in Jingzhou area were selected to carry out relevant research, and the theoretical scores, clinical comprehensive ability and self-evaluation results of nursing staff before and after the implementation of bedside ward rounds were compared. Results: after the implementation of nursing staff's theoretical performance, clinical comprehensive ability and self-evaluation results were better than before (P < 0.05). Conclusion: in the otorhinolaryngology head and neck surgery nursing staff, the implementation of bedside small round system is conducive to the improvement of nursing quality, and plays an important role in promoting the theoretical performance of nurses and the improvement of clinical comprehensive ability. It is suggested to implement the training system in clinical practice.展开更多
Objective: study and compare the role of bedside ultrasound in the examination of deep vein thrombosis of lower extremity in patients with femoral neck fracture during perioperative period. Methods: a total of 100 pat...Objective: study and compare the role of bedside ultrasound in the examination of deep vein thrombosis of lower extremity in patients with femoral neck fracture during perioperative period. Methods: a total of 100 patients with femoral neck fracture admitted to our hospital from February 2018 to November 2018 were divided into two groups for a comparative study. Deep venous thrombosis of lower extremity was examined before operation. In experimental group, deep venous thrombosis of lower extremity was examined by bedside ultrasonography and color Doppler ultrasonography. Patients in control group were examined by deep vein thrombophenography of the lower limbs. The results of deep venous thrombosis in the lower extremities were compared between the two groups. Results: the results of deep vein thrombosis in lower extremity were similar between the experimental group and the control group. Conclusion: the bedside ultrasound can provide accurate and reliable diagnostic results for patients with femoral neck fracture, and it is the first choice for the examination and monitoring of deep vein thrombosis of lower extremity. It is suitable for the examination and monitoring of deep vein thrombosis of lower extremity during perioperative period, and has good clinical application value.展开更多
Objective To analyze the diagnostic value of bedside capsule endoscopy in patients with acute or severeggastrointestinal bleeding.Methods Clinical data from patients who underwent bedside capsule endoscopy due to acut...Objective To analyze the diagnostic value of bedside capsule endoscopy in patients with acute or severeggastrointestinal bleeding.Methods Clinical data from patients who underwent bedside capsule endoscopy due to acute or severe suspected gastrointestinal bleeding in Nanfang Hospital,Southern Medical University from June 2018 to September 2021 were analyzed retrospectively.The efficacy of capsule endoscopy in detecting upper gastrointestinal tract and small intestinal bleeding was evaluated.Results A total of 74 patients underwent bedside capsule endoscopy for suspected acute or severe gastrointestinal bleeding.Five patients were excluded due to failure of examination due to retention of capsule endoscope in the gastric lumen,and 69 were included in the study,of whom 54 patients with a definitive diagnosis of gastrointestinal hemorrhage.The positive detection rate of the capsule endoscopy was 83.33%(45/54),including 17 cases of ulcer,5 cases of erosion,5 cases of vascular malformation,4 protrusion mass,4 diverticulum,5 obscure gastrointestinal bleeding,1 stenosis,1 active mucosal blood exudation,1 gastric retention,1 mucosal swelling,and 1 mucosal wrinkle change.The sensitivity and specificity of capsule endoscopy in the diagnosis of upper gastrointestinal bleeding were 92.31%(12/13)and 75.00%(3/4)respectively.The sensitivity and specificity of capsule endoscopy for diagnosing small intestinal bleeding were 80.49%(33/41)and 90.91%(10/11)respectively.Conclusion Bedside capsule endoscopy demonstrates high sensitivity and specificity in the diagnosis of gastrointestinal bleeding,showing potential advantages in bedside applications for acute and severe gastrointestinal bleeding.展开更多
Objective To access the therapeutic efficacy of newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage for severe acute cholangitis caused by choledocholithiasis.Methods Data o...Objective To access the therapeutic efficacy of newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage for severe acute cholangitis caused by choledocholithiasis.Methods Data of 26 patients were retrospectively analyzed,who were admitted into the intensive care unit(ICU),Zhongda Hospital,Southeast University,due to choledocholithiasis induced by severe acute cholangitis and underwent cholangioscope-assisted bedside one-stage lithotomy and biliary drainage from June 2020 to February 2022.Clinical outcomes were analyzed.Results The time interval from disease onset to endoscopic intervention was 36.2±15.5 hours,with 7.2±4.9 hours from ICU admission to endoscopic intervention.Technical success rate was 100.0%in one-stage stone removal and biliary drainage.Except for one mild pancreatitis,no other complications occurred.Acute physiology and chronic health evaluation(APACHE)II and sequential organ failure assessment(SOFAs)cores prior to endoscopic intervention were 25.2±6.6 and 11.9±3.5,respectively.APACHE II scores at day 1,3,and 7 after endoscopic intervention were 21.7±6.5,17.2±6.8 and 12.7±7.7,respectively,and SOFA scores were 10.6±2.9,8.4±3.0 and 5.4±3.7,respectively,all of which were lower than those before operation(P<0.001).The length of ICU stay and total hospitalization was 9.7±5.0 days and 12.8±4.5 days,respectively.In-hospital mortality occurred in 3(11.5%)patients.According to a 6-month follow-up,one patient died of pneumonia,and another died of acute myocardial infarction.No acute cholangitis re-occurred in those survivors.Conclusion Newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage demonstrate significant improvements in prognosis,highlighting its safety in managingsevere acute cholangitis.展开更多
文摘Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.
基金supported by the Medicine and Health Care in Zhejiang Province Science and Technology Plan Projects(Nos.2020KY552 and 2021PY006)the Commonweal Project of Science and Technology Department of Zhejiang Province(No.LGF21H030007),China.
文摘Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East respiratory syndrome(MERS)in 2012,and coronavirus disease 2019(COVID-19),with the latter being on the rampage since the end of 2019 and bringing the effect of aerosols on health back to the fore(Gralton et al.,2011;Wang et al.,2021).An increasing number of studies have shown that certain highly transmissible pathogens can maintain long-term stability and efficiently spread through aerosols(Leung,2021;Lv et al.,2021).As reported previously,influenza viruses that can spread efficiently through aerosols remain stable for a longer period compared to those that cannot.The World Health Organization(WHO)has stated that aerosol-generating procedures(AGPs)play an important role in aerosol transmission in hospitals(Calderwood et al.,2021).AGPs,referring to medical procedures that produce aerosols,including dental procedures,endotracheal intubation,sputum aspiration,and laparoscopic surgeries,have been reported to be significantly associated with an increased risk of nosocomial infection among medical personnel(Hamilton,2021).
文摘Objective:To observe and analyze the application of the bedside rhetorical teaching method in teaching nursing interns.Methods:A total of 64 nursing interns in the gastroenterology department of our hospital from July 2022 to May 2023 were randomly divided into two groups,32 cases in the control group and 32 cases in the intervention group.The control group was given conventional teaching methods,and the intervention group was given the bedside rhetorical teaching method on the basis of the conventional teaching.The differences in the methods of teaching between the two groups were compared after the end of the internship,and there was a statistically significant difference with P<0.05.Results:The scores of the interns in the intervention group were significantly better than those of the control group in theoretical knowledge,communication skills,and case analysis items(P<0.05).Conclusion:The bedside rhetorical teaching method transforms classroom education into bedside teaching,which enables the interns to apply the theoretical knowledge to clinical practice,and has a higher improvement in the three aspects of disease knowledge,communication skills,and case analysis,cultivates the interns’comprehensive clinical skills,and lays a good foundation for the future entry into the nursing field.
文摘Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease in the United States.While the American Association for the Study of Liver Diseases guidelines define NAFLD as hepatic steatosis detected either on histology or imaging without a secondary cause of abnormal hepatic fat accumulation,no imaging modality is recommended as standard of care for screening or diagnosis.Bedside ultrasound has been evaluated as a non-invasive method of diagnosing NAFLD with the presence of characteristic sonographic findings.Prior studies suggest characteristic sonographic findings for NAFLD include bright hepatic echoes,increased hepatorenal echogenicity,vascular blurring of portal or hepatic vein and subcutaneous tissue thickness.These sonographic characteristics have not been shown to aid bedside clinicians easily identify potential cases of NAFLD.While sonographic findings such as attenuation of image,diffuse echogenicity,uniform heterogeneous liver,thick subcutaneous depth,and enlarged liver filling of the entire field could be identifiedby clinicians from bedside ultrasound.The accessibility,ease of use,and low-side effect profile of ultrasound make bedside ultrasound an appealing imaging modality in the detection of hepatic steatosis.When used with appropriate clinical risk factors and steatosis involves greater than 33%of the liver,ultrasound can reliably diagnose NAFLD.Despite the ability of ultrasound in detecting moderate hepatic steatosis,it cannot replace liver biopsy in staging the degree of fibrosis.The purpose of this review is to examine the diagnostic accuracy,utility,and limitations of ultrasound in the diagnosis of NAFLD and its potential use by clinicians in routine practices.
文摘BACKGROUND: Appendicitis is a common disease requiring surgery. Bedside ultrasound(BUS) is a core technique for emergency medicine(EM). The Alvarado score is a well-studied diagnostic tool for appendicitis. This study aimed to investigate the relationship between patients' symptoms, Alvarado score and ultrasound(US) findings, as performed by emergency physicians(EPs) and radiologists, of patients with suspected appendicitis.METHODS: Three EM specialists underwent the BUS course and core course for appendicitis assessment. Patients suspected of having appendicitis were selected and their Alvarado and modif ied(m) Alvarado scores calculated. The specialists performed the BUS. Then, patients were given a formal US and surgery consultation if necessary. Preliminary diagnoses, admission or discharge from the emergency department(ED) and fi nal diagnosis were documented. The patients were also followed up after discharge from the hospital.RESULTS: The determined cut-off value was 2 for Alvarado and 3 for m Alvarado scores. The sensitivities of the two scores were 100%. Each score was used to rule out appendicitis. The results of EP-performed BUS were as follows: accuracy 70%, sensitivity 0.733, specifi city 0.673, + LR 2.24, and – LR 0.40(95%CI). Radiologists were better than EPs at diagnosing appendicitis and radiologists and EPs were equally strong at ruling out appendicitis by US. When US was combined with Alvarado and m Alvarado scores, EP US+Alvarado/m Alvarado scores ≤3 and radiology US+Alvarado/m Alvarado scores ≤4 perfectly ruled out appendicitis.CONCLUSION: BUS performed by EPs is moderately useful in detecting appendicitis. Combined with scoring systems, BUS may be a perfect tool for ruling out decisions in EDs.
文摘BACKGROUND: Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the population is infected with one or more intestinal parasites. If diagnosed early, the consequences of chronic parasitic infection can potentially be avoided.METHODS: Six first-year medical students were recruited to enroll patients in the study. They underwent ten hours of formal, hands-on, ultrasound which included basic cardiac, hepatobiliary, renal, pulmonary and FAST scan ultrasound. A World Health Organization protocol with published grading scales was adapted and used to assess for pathology in each patient's liver, bladder, kidneys, and spleen.RESULTS: A total of 59 patients were enrolled in the study. Students reported a sensitivity of 96% and specificity of 100% for the presence of a dome shaped bladder, a sensitivity and specificity of 100% for bladder thickening, a sensitivity and specificity of 100% for portal hypertension and ascites. The sensitivity was 81% with a specificity of 100% for presence of portal vein distention. The sensitivity was 100% with a specificity of 90% for dilated bowel.CONCLUSIONS: Ultrasound has shown a promise at helping to identify pathology in rural communities with limited resources such as Tanzania. Our data suggest that minimally trained first year medical students are able to perform basic ultrasound scans that can identify ultrasonographic markers of parasitic infections.
文摘<strong>Objective:</strong> This study was designed to investigate risk of ventilator weaning by ultrasound bedside monitoring of the width of inferior vena cava (IVC) and the number of lung B-lines (B-lines). <strong>Methods:</strong> This study was conducted on 106 patients from January 2019 to January 2020 who had mechanical ventilation for more than 48 hours in an emergency care unit. They were clinically stable and had the criteria for weaning from the ventilator. Before Spontaneous Breathing Test (SBT) and 30 min or 120 min after SBT, the width of IVC and the number of B-lines in patients were monitored via bedside ultrasound. There were 87 cases of successful weaning as a control group and 19 cases of ventilator failure weaning as a study group. Changes of the width of IVC and the number of B-lines were compared in the different stages of SBT. <strong>Results:</strong> A total of 106 patients were included in this study. There were 87 cases of ventilator successful weaning and 19 cases failure weaning. The weaning success rate was 82.08%. The width of IVC and the number of B-lines in the study group were higher than those in the control group in same stage of SBT, the difference was statistically significant (P < 0.05), and which increased significantly with time. There was no significant difference in the width of IVC and the number of B-lines on the different stage of SBT in the control group (P > 0.05), and significant difference in the study group. <strong>Conclusion:</strong> The width of IVC and the number of B-lines monitored by bedside ultrasound can assess the risk of ventilator weaning, it may be caused by cardiopulmonary interaction.
文摘<strong>Objective: </strong>To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea.<strong> Methods:</strong> Sixty-two patients with acute dyspnea who were treated in our hospital from January 2016 to December 2020 were randomly selected and their clinical data were retrospectively analyzed. All patients were randomly divided into a control group for routine examinations (n = 31) and an observation group for real-time beside ultrasonography (n = 31). The costs of medical examinations, examination duration, and diagnostic results of severe pneumonia, acute cardiogenic pulmonary edema, pulmonary embolism, chronic obstructive pulmonary disease, and pneumothorax (including sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy) of the two groups of patients were compared and analyzed. <strong>Results:</strong> Compared with the control group, the observation group had significantly shorter examinations (P < 0.05). Although the cost of medical examinations of the observation group tended to be higher, the difference between groups was not significant (P > 0.05). Moreover, there were no significant differences in left ventricular ejection fraction, left ventricular end-diastolic diameter, or brain natriuretic peptide between the two groups (P > 0.05). Comparison of the etiologic diagnosis results between the two groups showed that the observation group had significantly higher diagnostic sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for various causes compared with the control group (P < 0.05). <strong>Conclusion:</strong> Real-time bedside ultrasonography for the etiologic diagnosis of patients with acute dyspnea was quicker and had higher diagnostic accuracy;thus providing accurate guidance for the disease treatment, and having a higher promotional value in clinical practice compared with routine examinations.
文摘Objective: to evaluate the directional therapeutic effect of severe ultrasound, PCUM, adjusted pulmonary window, pulmonary ultrasound examination and high-frequency chest wall oscillation sputum discharge system in the diagnosis and treatment process of children with severe pneumonia. Method: select from December 2020 to December 2021,256 cases with obvious imaging changes in severe pneumonia, using severe ultrasound PCUM adjust lung window lung ultrasound, combined with its imaging performance, directional implementation of high frequency chest wall oscillation sputum treatment and drainage, treatment before and after the comparison of the oxygenation index, mechanical ventilation mechanical index, imaging changes, evaluate the treatment effect. Results: in 256 children with severe pneumonia, high-frequency chest wall oscillation sputum discharge system significantly improved symptoms, shortened mechanical ventilation time and reduced man-machine confrontation. Conclusion: PCUM adjusted lung window lung ultrasound examination combined with high-frequency chest wall oscillation sputum drainage system treatment can effectively improve the oxygenation, and can also can effectively prevent the occurrence of ventilator-related pneumonia.
文摘Objective: to explore and analyze the diagnostic effect and application value of bedside lung ultrasound in neonatal lung diseases. Methods: from September 2019 to March 2021, 78 newborn children with lung diseases diagnosed by X-ray examination (set as observation group) and 50 newborns without lung diseases (set as control group) hospitalized in the same period were included in this study. Bedside ultrasound diagnosis of lungs was performed in both groups. According to ultrasound diagnosis images, bilateral lungs of newborns in both groups were analyzed, and their imaging similarities and differences were summarized to find out the diagnostic indicators of newborns suffering from lung diseases. Results: (1) Compared with the accuracy of disease diagnosis, the diagnostic rate of observation group was 93.59% (73/78), that of control group was 2.00% (1/50), and that of control group was 2.00% (1/50), with statistical difference (P 0.05);(2) In the contrast of imaging features of ultrasound diagnosis, the probability of B-line, lung consolidation, abnormal pleural line, lung point, pleural effusion and bronchial inflation sign in the observation group was much higher than that in the control group, and the difference was statistically significant (P 0.05). Conclusion: bedside lung ultrasound is helpful to obtain a good diagnostic effect of neonatal lung diseases, improve the efficiency of diagnosis and treatment of diseases, and increase the security of childrens life safety. It has been identified as a safe and effective diagnostic method for pediatric lung diseases, and is worthy of further popularization and application in clinical practice.
文摘Objective: to explore and study the effect of bedside comprehensive ability assessment combined with mini CEX feedback to improve core competence in nursing students. Methods: 40 nursing students practicing in our hospital from July 2020 to may 2021 were selected as the teaching reform experimental group. The training, guidance, assessment, evaluation and feedback were carried out with the teaching reform practice manual, and the improvement effect, excellence rate and satisfaction of the core competence of the teaching reform experimental group were counted. Results: the core competence of the experimental intervention group was significantly improved (P < 0.01), and the excellent rate was significantly higher than that of the traditional teaching control group. Conclusion: the combination of bedside comprehensive ability assessment and mini CEX feedback in nursing students can improve the core ability of nursing, which is conducive to the cultivation of nursing students ability, and provide more and better teaching ideas and methods for medical colleges.
文摘Objective: to explore the effect of co-participation in nursing + mother-infant bedside nursing mode applied to postpartum rehabilitation in obstetrics and its impact on the incidence of postpartum complications. Methods: the period from January 2020 to January 2022 was selected as the study period, and a total of 98 puerperae admitted to the obstetrics and gynecology department of our hospital during this period were selected as the observation objects, and they were randomly divided into the routine group (n49) and the observation group (n49). The puerperium in the routine group carried out routine postpartum care, and the puerperium in the observation group applied the mode of joint nursing care + bedside nursing for mothers and infants, and the recovery conditions of the two groups were compared. Results: after receiving relevant nursing care, compared with the routine group, the puerperae in the observation group had shorter lactation initiation time, lower uterine fundus height, less lochia, and the overall recovery efficiency and prognosis SF-36 quality of life score were significantly higher;anxiety SAS, depression SDS were significantly lower and lower than those of the routine group, and the incidence of postpartum complications and neonatal complications were significantly lower, with statistically significant differences (p < 0.05). Conclusion: the effect of actively carrying out joint nursing care + mother-infant bedside nursing mode in the postpartum rehabilitation process of obstetrics is definite. It can promote the recovery of mothers, optimize the situation of newborns, and reduce the incidence of various postpartum complications, which has high clinical value, worth promoting.
文摘Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure of patients with acute chest pain.Methods and Results 502 consecutive patients with chest pain for less than 24 hours were determined by troponin T test at bedside and quantitative troponin I test in lab. For bedside troponin T tests, there were 160 patients in positive and 323 in negative. During 30 days of followed-up. Myocardial infarction evolved in 139 patients among 160 patients in positive troponin T test, only 7 patients in negative one. Acute heart failure occurred in 51 patients among the positive group, but 37 occurred it at negative group. The odds ratio of acute heart failure of positive group vs. negative group was 3.6. Patients died 39 in positive group, 15 in negative group, the all-cause death odds ratio of positive group vs. negative group was 6.7; 31 patients died with cardiac event in positive group, 5 in negative group only. Conclusions Bedside Troponin T test is a powerful and independent predictor of death and acute heart failure for patients with acute chest pain.
文摘Objective: this paper aims to explore the clinical effect of bedside arterial blood gas analysis in intensive care unit, so as to have a more comprehensive grasp of the application of arterial blood gas analysis. Methods: a total of 89 patients who came to our hospital for arterial blood gas analysis from January 2020 to January 2021 were selected and randomly divided into the reference group and the experimental group. The reference group was analyzed by laboratory examination, and the experimental group was monitored by bedside blood gas analysis. Analyze the differences in the results of different test methods. Results: analysis results showed that there was no significant difference in pH, PO2 and PCO2, P > 0.05. There were significant differences in the analysis time of potassium, serum calcium and blood gas (P < 0.05). Conclusion: the application of bedside arterial blood gas analysis in intensive care unit can shorten the time of blood gas analysis, quickly adjust the treatment plan and medication of patients, improve the overall rehabilitation effect and shorten the length of hospital stay, which is worthy of clinical application.
文摘Objective: to investigate the effect of bedside blind intestinal implantation on enteral nutrition feeding and complications in severe patients. Methods: 72 patients with severe enteral nutrition feeding were randomly selected from April 2019 to October 2020. With 36 cases in each group, the control group and the observation group were respectively. Results: in terms of the total incidence of complications, the observed group (8%) was lower than the control group (33.33%) (P <0.05), and prealbumin and total serum protein showed no significant difference between the two groups before treatment (P> 0.05). The observation group was higher after treatment than in the control group, with significant differences (P <0.05). In terms of ICU stay, mechanical ventilation and total hospital stay, the control groups were (18.65 ± 2.83) d, (13.95 ± 2.01) d, (22.82 ± 3) d, (14.21 ± 2.43) d, (10.21 ± 1.24) d, (17.96 ± 2.64) d, respectively, with significant differences (P <0.05). In terms of catheterization success rate and 7d feeding compliance rate, 91.67% and 58.33% in the control group, 100.00% and 94.44% in the observation group, respectively, which were higher than the control group, with significant difference (P <0.05). The QoL score of the observation group was higher than the control group, with significant differences (P <0.05). Conclusion: the method is helpful to reduce the incidence of complications and improve the nutritional status of severe patients, which is worth clinical adoption and promotion.
文摘Objective: to study the effect of maternal and infant bedside care model in obstetric care. Methods: a total of 200 parturients admitted to our hospital in recent years were randomly divided into two groups: the control group and the experimental group. The control group mainly adopted the conventional nursing method and separated the mother from the baby, while the experimental group adopted the bedside nursing mode of the mother and the baby. The control of the nursing skills of the newborn and the satisfaction degree of the two groups of parturients were observed and compared. The results showed that through the comparative study, the separation time between the parturient and the baby was longer, the knowledge about the baby's nursing was less, and the experimental group had more knowledge about the postpartum nursing, which improved the parenting knowledge and effectively improved the overall nursing skill level of the parturient. This model can be worthy of promotion in clinical aspects, and can help the parturient to quickly master the skills of nursing the baby. The total satisfaction of parturients was higher (P < 0.05). Conclusion: the application of maternal and infant bedside nursing model can enable the puerpera to fully understand the nursing knowledge, improve the puerpera's nursing skills, and effectively improve the nursing satisfaction, which is worthy of promotion.
文摘Objective: to understand the role of bedside rounds in improving nursing quality of otorhinolaryngology head and neck surgery. Methods: a total of 100 nursing staff of otorhinolaryngology head and neck surgery in Jingzhou area were selected to carry out relevant research, and the theoretical scores, clinical comprehensive ability and self-evaluation results of nursing staff before and after the implementation of bedside ward rounds were compared. Results: after the implementation of nursing staff's theoretical performance, clinical comprehensive ability and self-evaluation results were better than before (P < 0.05). Conclusion: in the otorhinolaryngology head and neck surgery nursing staff, the implementation of bedside small round system is conducive to the improvement of nursing quality, and plays an important role in promoting the theoretical performance of nurses and the improvement of clinical comprehensive ability. It is suggested to implement the training system in clinical practice.
文摘Objective: study and compare the role of bedside ultrasound in the examination of deep vein thrombosis of lower extremity in patients with femoral neck fracture during perioperative period. Methods: a total of 100 patients with femoral neck fracture admitted to our hospital from February 2018 to November 2018 were divided into two groups for a comparative study. Deep venous thrombosis of lower extremity was examined before operation. In experimental group, deep venous thrombosis of lower extremity was examined by bedside ultrasonography and color Doppler ultrasonography. Patients in control group were examined by deep vein thrombophenography of the lower limbs. The results of deep venous thrombosis in the lower extremities were compared between the two groups. Results: the results of deep vein thrombosis in lower extremity were similar between the experimental group and the control group. Conclusion: the bedside ultrasound can provide accurate and reliable diagnostic results for patients with femoral neck fracture, and it is the first choice for the examination and monitoring of deep vein thrombosis of lower extremity. It is suitable for the examination and monitoring of deep vein thrombosis of lower extremity during perioperative period, and has good clinical application value.
文摘Objective To analyze the diagnostic value of bedside capsule endoscopy in patients with acute or severeggastrointestinal bleeding.Methods Clinical data from patients who underwent bedside capsule endoscopy due to acute or severe suspected gastrointestinal bleeding in Nanfang Hospital,Southern Medical University from June 2018 to September 2021 were analyzed retrospectively.The efficacy of capsule endoscopy in detecting upper gastrointestinal tract and small intestinal bleeding was evaluated.Results A total of 74 patients underwent bedside capsule endoscopy for suspected acute or severe gastrointestinal bleeding.Five patients were excluded due to failure of examination due to retention of capsule endoscope in the gastric lumen,and 69 were included in the study,of whom 54 patients with a definitive diagnosis of gastrointestinal hemorrhage.The positive detection rate of the capsule endoscopy was 83.33%(45/54),including 17 cases of ulcer,5 cases of erosion,5 cases of vascular malformation,4 protrusion mass,4 diverticulum,5 obscure gastrointestinal bleeding,1 stenosis,1 active mucosal blood exudation,1 gastric retention,1 mucosal swelling,and 1 mucosal wrinkle change.The sensitivity and specificity of capsule endoscopy in the diagnosis of upper gastrointestinal bleeding were 92.31%(12/13)and 75.00%(3/4)respectively.The sensitivity and specificity of capsule endoscopy for diagnosing small intestinal bleeding were 80.49%(33/41)and 90.91%(10/11)respectively.Conclusion Bedside capsule endoscopy demonstrates high sensitivity and specificity in the diagnosis of gastrointestinal bleeding,showing potential advantages in bedside applications for acute and severe gastrointestinal bleeding.
文摘Objective To access the therapeutic efficacy of newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage for severe acute cholangitis caused by choledocholithiasis.Methods Data of 26 patients were retrospectively analyzed,who were admitted into the intensive care unit(ICU),Zhongda Hospital,Southeast University,due to choledocholithiasis induced by severe acute cholangitis and underwent cholangioscope-assisted bedside one-stage lithotomy and biliary drainage from June 2020 to February 2022.Clinical outcomes were analyzed.Results The time interval from disease onset to endoscopic intervention was 36.2±15.5 hours,with 7.2±4.9 hours from ICU admission to endoscopic intervention.Technical success rate was 100.0%in one-stage stone removal and biliary drainage.Except for one mild pancreatitis,no other complications occurred.Acute physiology and chronic health evaluation(APACHE)II and sequential organ failure assessment(SOFAs)cores prior to endoscopic intervention were 25.2±6.6 and 11.9±3.5,respectively.APACHE II scores at day 1,3,and 7 after endoscopic intervention were 21.7±6.5,17.2±6.8 and 12.7±7.7,respectively,and SOFA scores were 10.6±2.9,8.4±3.0 and 5.4±3.7,respectively,all of which were lower than those before operation(P<0.001).The length of ICU stay and total hospitalization was 9.7±5.0 days and 12.8±4.5 days,respectively.In-hospital mortality occurred in 3(11.5%)patients.According to a 6-month follow-up,one patient died of pneumonia,and another died of acute myocardial infarction.No acute cholangitis re-occurred in those survivors.Conclusion Newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage demonstrate significant improvements in prognosis,highlighting its safety in managingsevere acute cholangitis.
