Objective:The study aimed to investigate the effect of relaxation techniques in reducing fear and anxiety in patients in need of general surgery.Materials and Methods:This quasi-experimental study with a pre-post cont...Objective:The study aimed to investigate the effect of relaxation techniques in reducing fear and anxiety in patients in need of general surgery.Materials and Methods:This quasi-experimental study with a pre-post control group design was conducted on 120 patients requiring general surgery at Saman Al-Hojjaj Hospital in Sirjan County.Patients were selected using convenience sampling and randomly assigned to the intervention group(n=60)and control group(n=60).The intervention group was taught box breathing and progressive muscle relaxation techniques by a senior psychiatric nursing expert for 15-20 min every 4 h until surgery.The control group received routine care for surgery.Data on fear and anxiety outcomes were collected using the Spielberger State-Trait Anxiety Inventory and the Surgical Fear Questionnaire.Results:The intervention group had a mean total fear score of 29.27±12.69 compared to 37.20±16.39 in the control group(P=0.012),with significant reductions in both short-term(13.57±5.93 vs.15.98±8.90;P=0.209,Cohen’s d=0.32)and long-term(15.70±7.19 vs.21.22±9.11;P=0.001,Cohen’s d=0.66)fear components(total fear:P=0.012,Cohen’s d=0.54).The total anxiety score was 91.88±6.28 in the control group and 93.60±3.62 in the intervention group,with trait anxiety significantly reduced in the intervention group(P=0.039,Cohen’s d=0.41)postintervention,but no significant change in state anxiety(P=0.577,Cohen’s d=0.16).Conclusions:Relaxation techniques significantly alleviate preoperative psychological distress,effectively reducing fear and anxiety in general surgery patients.These cost-effective,non-invasive methods enhance recovery and reduce healthcare costs.We recommend training healthcare providers to implement these techniques for optimal patient outcomes.展开更多
AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality ...AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy. METHODS: Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated. RESULTS: The significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and mortality.CONCLUSION: M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.展开更多
BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical...BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical pathologies. Our study aims to investigate clinical andlaboratory factors, in addition to providers’ interventions, that might have been associated witholigoanalgesia in a group of ED patients with moderate and severe pains due to surgical pathologies.METHODS: We conducted a retrospective study of adult patients who were transferred directlyfrom referring EDs to the emergency general surgery (EGS) service at a quaternary academic centerbetween January 2014 and December 2016. Patients who were intubated, did not have adequaterecords, or had mild pain were excluded. The primary outcome was refractory pain, which wasdefi ned as pain reduction <2 units on the 0–10 pain scale between triage and ED departure.RESULTS: We analyzed 200 patients, and 58 (29%) had refractory pain. Patients with refractory painhad signifi cantly higher disease severity, serum lactate (3.4±2.0 mg/dL vs. 1.4±0.9 mg/dL, P=0.001), and lessfrequent pain medication administration (median [interquartile range], 3 [3–5] vs. 4 [3–7], P=0.001), whencompared to patients with no refractory pain. Multivariable logistic regression showed that the number of painmedication administration (odds ratio [OR] 0.80, 95% confi dence interval [95% CI] 0.68–0.98) and ED serumlactate levels (OR 3.80, 95% CI 2.10–6.80) were signifi cantly associated with the likelihood of refractory pain.CONCLUSIONS: In ED patients transferring to EGS service, elevated serum lactate levelswere associated with a higher likelihood of refractory pain.展开更多
Objective:To analyze and comprehensively study the clinical effects of humanized psychological nursing model in general surgery nursing.Methods:The study period was from January 2018 to December 2020.A sample of 200 p...Objective:To analyze and comprehensively study the clinical effects of humanized psychological nursing model in general surgery nursing.Methods:The study period was from January 2018 to December 2020.A sample of 200 patients who were admitted to The Second People's Hospital of Taizhou City for general surgery were selected.Random lottery grouping was used to divide the subjects into a study group and a control group.The sample within each group was n=100.The patients in the control group were provided with conventional general surgery nursing plan whereas the patients in the study group received the same nursing plan but with addition of the humanized psychological nursing model.The indicators of the two groups were compared and analyzed.Results:Comparing the scores from Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)after nursing intervention,postoperative visual analog scale(VAS),hospital stay,and patient satisfaction with the nursing services between the two groups,the study group was better(P<0.05).Conclusion:The implementation of humanized psychological nursing model in general surgery nursing had a significant effect in which there were improvements in regard to the patientsJ mental state and their satisfaction with the nursing services.Hence,it is worthy of promotion.展开更多
In Mali, few studies have concerned overall mortality in general surgery, but several specific studies have concerned the different affections. Reflection on the causes of death is an inherent part of the activity of ...In Mali, few studies have concerned overall mortality in general surgery, but several specific studies have concerned the different affections. Reflection on the causes of death is an inherent part of the activity of any motivated surgical team. <strong>Objective:</strong> To analyze the rate and the main causes of mortality in the General “A” surgical department of the Point “G” CHU. <strong>Patients Method:</strong> Our study was retrospective, descriptive and covered a period of 5 years from 01/01/2014 to 12/31/2018. We collected 152 deaths for 2011 hospitalized patients. The data were collected from the files of these deaths on pre-established investigation forms. The deceased patients were classified as operative and non-operative death, death from non-cancerous and cancerous diseases, deaths occurring in emergencies and deaths in regulated surgery. <strong>Results:</strong> We recorded 152 cases of death for 2011 hospitalized patients, either an overall mortality rate of 7.55%. The average age of deaths was 44.20 years +- 17.51 years with extremes ranging from 7 years to 85 years. The sex ratio was 1.62 in favor of men. The causes of death were represented by cancerous pathologies (69 deaths or 34.67%), non-cancerous pathologies (83 deaths or 4.58%). <strong>Conclusion:</strong> The mortality rate in general surgery remains high and is mainly linked to cancerous pathologies and the delay in taking care of patients.展开更多
<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Sigmoid colon volvulus is a medico-surgical emergency which represent...<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion,</span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion </span></span></span><span><span><span style="font-family:" color:#c45911;"=""><a href="#ref1" target="_blank"><span style="font-family:Verdana;">[1]</span></a></span><span></span></span></span><span><span></span></span><span></span><span><span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners </span></span></span><span><span><span style="font-family:;" "=""><span style="color:#C45911;"><a href="#ref2" target="_blank"><span style="font-family:Verdana;">[2]</span></a></span></span></span></span><span><span></span></span><span></span><span><span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"></span></b> <span style="font-family:Verdana;">To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus</span><span style="font-family:Verdana;">.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Material and methods:</span></b><span style="font-family:Verdana;"></span></b><span style="font-family:Verdana;"> This was a retrospective and prospective study that took place from January 2008 to December 2020 in the General Surgery Department of Gabriel Touré. The retrospective phase ran from January 2008 to December 2019 and the prospective phase from January 2020 to December 2020.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"></span></b><span style="font-family:Verdana;"> From January 2008 to December 2020, we collected 320 cases of patients operated on for sigmoid colon volvulus out of 7989 surgical emergencies over a 12-year period, or 3.64%. In our study, the most represented age group was between 16 and 60 years old, </span><i></i></span><i><i><span style="font-family:Verdana;">i</span></i></i></span></span><i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">e</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"></span></span></span></i><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> 81.88%. The mean age was 42.6 ± 17.4 years with extremities of 16 and 90 years. The male sex was the most represented, 89% with a sex ratio of 8.41. The surgical history was found in 13.75% of our patients. The clinic was dominated by abdominal pain (100%), meteorism (100%), and gas and matter arrest (91.3%). The most common radiological image found in the ASP was the double jamb, </span><i><span style="font-family:Verdana;">i</span></i></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">e</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 74.69% of cases. We found sigmoid necrosis in 18.13% of cases. We found an absence of necrosis in the majority of cases, </span><i></i></span><i><i><span style="font-family:Verdana;">i</span></i></i></span></span></span><i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">e</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"></span></span></span></i><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 91.56%. The most performed operative procedure in our patients was the RACR, </span><i></i></span><i><i><span style="font-family:Verdana;">i</span></i></i></span></span></span><i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">e</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"></span></span></span></i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 75.63% of cases. The reoperation was performed in only 5.94% of our patients. Complications were grade V in 42.55% according to the Clavin Dindo classification.</span></span></span>展开更多
Objective: to explore the significance and quality of PBL teaching method combined with thinking-guided teaching method in general surgery clinical practice. Methods: 84 general surgery interns were selected as the re...Objective: to explore the significance and quality of PBL teaching method combined with thinking-guided teaching method in general surgery clinical practice. Methods: 84 general surgery interns were selected as the research object and divided into the control group and the observation group according to the drawing of lots, with 42 cases in each group. The control group received traditional teaching;The observation group was taught with PBL teaching method combined with thinking guidance teaching method. The test scores and clinical teaching satisfaction of the two groups were compared. Results: compared with the test results and teaching quality of the control group and the observation group, the observation group was higher than the control group and the total score was better than the control group (P < 0.05). Compared with the clinical teaching satisfaction of the two groups, the observation group was better than the control group (p < 0.05). Conclusion: PBL teaching method combined with thinking-guided teaching method can improve the teaching quality of general surgery interns, effectively improve the interns' active learning, improve the interns' theoretical knowledge and professional skills, and ensure the operation process is accurate. It is worthy of wide application.展开更多
Objective: this article mainly analyzed the choice of general surgery anesthesia and clinical observation and analysis for patients with cardiovascular diseases. Methods: 60 patients with cardiovascular diseases admit...Objective: this article mainly analyzed the choice of general surgery anesthesia and clinical observation and analysis for patients with cardiovascular diseases. Methods: 60 patients with cardiovascular diseases admitted to our hospital from May 2021 to November 2021 were selected as research objects and divided into observation group and control group with 30 cases in each group. The data were compared and analyzed to observe the clinical effect. Results: through the selection of general surgery anesthesia, the treatment of patients with cardiovascular diseases was compared. The difference between the two groups was statistically significant (P < 0.05). Conclusion: in the treatment of patients with cardiovascular diseases, the use of general surgery anesthesia for clinical application is effective and worthy of promotion.展开更多
Objective: to analyze the common causes of postoperative complications and explore effective nursing strategies. Methods: using the method of random number table, 140 cases of patients receiving general surgery in the...Objective: to analyze the common causes of postoperative complications and explore effective nursing strategies. Methods: using the method of random number table, 140 cases of patients receiving general surgery in the hospital were divided into two groups, with 70 cases in each group. One group provided routine nursing and the other group provided high-quality targeted nursing. The nursing effects of the two groups were observed. Results: compared with the control group, the mood of the study group was better (P < 0.05). Conclusion: the causes of complications include age, pain and postoperative malnutrition. Targeted high-quality nursing based on the above reasons can help alleviate patients' unhealthy feelings, which is worthy of publicity and reference.展开更多
General surgery is a key specialty in higher education. It can cultivate high-quality general surgery professionals and provide high-quality personnel resources for the improvement of our medical team system. The trad...General surgery is a key specialty in higher education. It can cultivate high-quality general surgery professionals and provide high-quality personnel resources for the improvement of our medical team system. The traditional teaching mode of general surgery is relatively backward, which only explains the theoretical knowledge related to general surgery to the students. The students' interest in learning is low and they lack learning motivation, which reduces the learning effect and is not conducive to the cultivation of professional medical talents. SPOC is a new teaching model and an important product in the process of educational information reform. It has better application advantages, effectively improves the teaching efficiency of general surgery and provides an important impetus for teaching reform. Based on this, this paper analyzes the application of blend learning based on SPOC in general surgery teaching, in order to provide effective reference for general surgery teaching.展开更多
Objective: to study the influencing factors of nosocomial infection in patients undergoing general surgery. Methods: a total of 60 patients undergoing general surgery in our hospital from January 2019 to December 2020...Objective: to study the influencing factors of nosocomial infection in patients undergoing general surgery. Methods: a total of 60 patients undergoing general surgery in our hospital from January 2019 to December 2020 were selected as the research subjects, among which 39 patients suffered from hospital infection and 21 patients did not. The basic data such as the age of the research subjects, the time of surgery and admission to ICU, and the type of incision were counted by using the method of questionnaire, and the presence of hospital infection was investigated, and the influencing factors were analyzed. Results: the influencing factors of nosocomial infection in patients undergoing general surgery included the time of surgery and admission to ICU, incision type, patients' use of antibiotics before surgery and invasive operation or not (P < 0.05). The age of the patient was not a contributing factor to hospital infection in patients undergoing general surgery (P > 0.05). Analysis of the data revealed that the patient's surgery duration of more than two hours, antibiotics are given before surgery, admission to the ICU of more than four to six days, incidence of sexual invasion and incision type class II and III were all risk factors for nosocomial infection in patients undergoing general surgery. Conclusion: patients' operation time is more than two hours, antibiotics are used before operation, patients stay in ICU for more than four to six days, invasive situation and incision type are the dangerous causes of nosocomial infection in general surgical patients.展开更多
Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare w...Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare workers who were admitted to the general surgery department of the primary hospital between August 2021 and August 2022 were selected as the routine group for routine incision infection management.Forty-nine surgical patients with 11 healthcare workers admitted to the same department between September 2022 and September 2023 were selected as the prevention group for prophylactic management of postoperative incision infections.The incision infection rate,knowledge,attitude,and practice(KAP)scores,and management satisfaction of the patients as well as the management skill scores of healthcare workers were compared between the two groups.Results:The rate of postoperative incision infection in the prevention group was lower than that in the routine group;after implementing management measures,patients in the prevention group had higher KAP scores than those in the routine group;patients in the prevention group were more satisfied with the management than those in the routine group;and healthcare workers in the prevention group had higher scores than those in the routine group,with P<0.05 for the comparison between the groups.Conclusion:The implementation of preventive management for general surgery patients in primary hospitals can reduce the incidence of postoperative incision infection and improve the KAP of patients,with higher management satisfaction.It can also enhance the management skills of healthcare workers,thus improving their overall management level.展开更多
Objective: to analyze the application of fine nursing in general surgery of operating room, and to discuss the effect of preventing infection of surgical incision. Methods: 72 cases of subjects were randomly included ...Objective: to analyze the application of fine nursing in general surgery of operating room, and to discuss the effect of preventing infection of surgical incision. Methods: 72 cases of subjects were randomly included from March 2019.to May 2020.All of them was patients undergoing general surgery. The patients were divided into two groups by the odd-even numbering method. One group received conventional nursing as the control group, and the other group received refined nursing as the intervention group. Results: incidence of surgical incision infection and average hospitalization time in the intervention group were significantly lower than those in the control group (P < 0.05). Conclusion: in the development of general surgery in the operating room, taking fine nursing measures can have a positive effect on the prevention of incision infection;its application value is significant, suitable for popularization and promotion.展开更多
Objective: to analyze the related factors that affect the postoperative pain symptoms of patients undergoing general surgery and explore targeted therapeutic interventions. Methods: 112 surgical patients admitted in o...Objective: to analyze the related factors that affect the postoperative pain symptoms of patients undergoing general surgery and explore targeted therapeutic interventions. Methods: 112 surgical patients admitted in our hospital from August 2020 to September 2021 were selected as the research object, and divided into observation group (targeted treatment intervention) and control group (routine treatment intervention) with 56 cases in each group. The therapeutic effects of the two groups were compared. Results: among 112 patients undergoing general surgery, there was no significant difference in the severity of postoperative pain between male and female patients, patients with or without chronic pain history (p > 0.05). the severity of pain symptoms of patients aged ≥60 years old was higher than that of patients aged < 60 years old (p < 0.05), and the severity of pain symptoms of patients receiving targeted pain intervention was lower than that of patients receiving conventional pain intervention (p < 0.05). The satisfaction degree of the patients in the observation group (96.43% > 82.14%, χ2=5.973) was higher than that of the control group (p < 0.05). the pain VAS score of the patients in the observation group after the intervention was [(1.98±0.43) point < (2.91±0.67) point, t=8.742], and the score of pittsburgh sleep quality index scale (PSQI) [(8.31±1.57) point < (9.44±1.62) point. t = 3.748, SAS score [(36.87±2.97) point < (46.05±3.51) point, t=14.941], SDS score [(37.91±3.98) point < (45.02±4.19) point, t=9.207] was lower than that of the control group (p < 0.05). Conclusion: in the postoperative rehabilitation treatment of general surgery patients, attention should be paid to the postoperative pain symptoms of patients. Considering the related factors that cause the onset of pain symptoms and aggravate the pain, targeted pain intervention should be implemented to effectively reduce the postoperative pain of patients and reduce the adverse effects of pain symptoms on daily life.展开更多
Objective: to investigate the clinical application value of nursing risk management, and to observe and analyze the feasibility and application value of this management measure for general surgery. Methods: 50 patient...Objective: to investigate the clinical application value of nursing risk management, and to observe and analyze the feasibility and application value of this management measure for general surgery. Methods: 50 patients who met the research criteria and received general surgery in our hospital from January 2019 to January 2021 were selected and divided into two groups. The study focused on the nursing quality score, the incidence of complications, the incidence of risk events and patient satisfaction of the two groups of nursing risk management (research group) and routine nursing management (reference group). Then the data were compared by using statistical methods to analyze the effectiveness and value of nursing management measures. Results: the research results of each research data in the research group show obvious advantages when compared with the reference group. Therefore, the management measures in the research group have higher clinical feasibility. Meanwhile, the statistical method is significant after processing the comparative data in the two groups (P < 0.05). Conclusion: the application of nursing risk management measures in general surgery department can comprehensively improve the quality of nursing and play a key role in reducing the occurrence of complications and risk events. It can promote patients to give satisfactory evaluation on nursing risk management, with significant effect and wide application value.展开更多
Institute of Otolaryngology of Chinese PLA ( Key Laboratory for the Prevention of Acoustic Trauma,PLA)Key Laboratory of Hearing Impairment Science(Chinese PLA Medical School)Ministry of Education Led by four generatio...Institute of Otolaryngology of Chinese PLA ( Key Laboratory for the Prevention of Acoustic Trauma,PLA)Key Laboratory of Hearing Impairment Science(Chinese PLA Medical School)Ministry of Education Led by four generations of leadership from late Prof. JIANG Sichang (academician, Chinese Academy of Engineering), Prof.YANG Weiyan (Honorary President, Division of Otolaryngology展开更多
Led by four generations of leadership from late Prof.JIANG Sichang(academician,Chinese Academy of Engineering),Prof.YANG Weiyan(Honorary President,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Assoc...Led by four generations of leadership from late Prof.JIANG Sichang(academician,Chinese Academy of Engineering),Prof.YANG Weiyan(Honorary President,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association),Prof.HAN Dongyi(President Elected,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association)to now Prof.YANG Shiming(President,Division of Otolaryngologists,展开更多
AIM To examine the evidence about psychiatric morbidity after inflammatory bowel disease(IBD)-related surgery. METHODS PRISMA guidelines were followed and a protocol was published at PROSPERO(CRD42016037600). Inclusio...AIM To examine the evidence about psychiatric morbidity after inflammatory bowel disease(IBD)-related surgery. METHODS PRISMA guidelines were followed and a protocol was published at PROSPERO(CRD42016037600). Inclusion criteria were studies describing patients with inflammatory bowel disease undergoing surgery and their risk of developing psychiatric disorder. RESULTS Twelve studies(including 4340 patients) were eligible. All studies were non-randomized and most had high risk of bias. Patients operated for inflammatory bowel disease had an increased risk of developing depression,compared with surgical patients with diverticulitis or inguinal hernia,but not cancer. In addition,patients with Crohn's disease had higher risk of depression after surgery compared with non-surgical patients. Patients with ulcerative colitis had higher risk of anxiety after surgery compared with surgical colorectal cancer patients. Charlson comorbidity score more than three and female gender were independent predictors for depression and anxiety following surgery. CONCLUSION The review cannot give any clear answer to the risks of psychiatric morbidity after surgery for IBD studies with the lowest risk of bias indicated an increased risk of depression among surgical patients with Crohn's disease and increased risk of anxiety among patients with ulcerative colitis.展开更多
BACKGROUND Trocar site hernia(TSH)is a rare but potentially dangerous complication of laparoscopic surgery,and the drain-site TSH is an even rarer type.Due to the difficulty to diagnose at early stages,TSH often leads...BACKGROUND Trocar site hernia(TSH)is a rare but potentially dangerous complication of laparoscopic surgery,and the drain-site TSH is an even rarer type.Due to the difficulty to diagnose at early stages,TSH often leads to a delay in surgical intervention and eventually results in life-threatening consequences.Herein,we report an unusual case of drain-site TSH,followed by a brief literature review.Finally,we provide a novel,simple,and practical method of prevention.CASE SUMMARY A 54-year-old female patient underwent laparoscopic subtotal hysterectomy and bilateral adnexectomy for uterine fibroids 8 d ago in another hospital.She was admitted to our hospital with a 2-d history of intermittent abdominal pain,nausea,vomiting,and abdominal enlargement with an inability to pass stool and flatus.The emergency computed tomography scan revealed the small bowel herniated through a 10 mm trocar incision,which was used as a drainage port,with diffuse bowel distension and multiple air-fluid levels with gas in the small intestines.She was diagnosed with drain-site strangulated TSH.The emergency exploratory laparotomy confirmed the diagnosis.A herniorrhaphy followed by standard intestinal resection and anastomosis were performed.The patient recovered well after the operation and was discharged on postoperative day 8 and had no postoperative complications at her 2-wk follow-up visit.CONCLUSION TSH must be kept in mind during the differential diagnosis of post-laparoscopic obstruction,especially after the removal of the drainage tube,to avoid the serious consequences caused by delayed diagnosis.Furthermore,all abdomen layers should be carefully closed under direct vision at the trocar port site,especially where the drainage tube was placed.Our simple and practical method of prevention may be a novel strategy worthy of clinical promotion.展开更多
BACKGROUND The causes of peroneal neuropathy are various,but are rarely due to weight loss.Bilateral peroneal neuropathy caused by weight loss after surgery has been reported only after bariatric surgery and there wer...BACKGROUND The causes of peroneal neuropathy are various,but are rarely due to weight loss.Bilateral peroneal neuropathy caused by weight loss after surgery has been reported only after bariatric surgery and there were no reports associated with other abdominal surgery.In this report,we describe a case of the bilateral peroneal neuropathy that occurred due to marked weight loss after biliary surgery.CASE SUMMARY A 58-year-old male did not receive adequate nutritional support after biliary surgery,and showed a massive weight loss over a short period of time(body mass index;24.1 kg/m2 to 20.5 kg/m2 for 24 d).Then,foot drop occurred on both sides.Physical examination,electromyography(EMG)and magnetic resonance imaging studies were conducted and he was diagnosed as bilateral common peroneal neuropathy around the fibular head level.The patient was treated electrical stimulation therapy on both lower legs along with exercise therapy,and received sufficient oral nutritional support.The patient gradually recovered to his original weight,and the power of the dorsiflexor of bilateral ankles improved after conservative treatment.In addition,the follow-up EMG showed signs of improvement.CONCLUSION Any abdominal surgery that may have rapid and marked weight loss can lead to peroneal neuropathy as a complication.展开更多
基金funded by Sirjan Medical Sciences Faculty,Sirjan,Iran.(Project code:402000018).
文摘Objective:The study aimed to investigate the effect of relaxation techniques in reducing fear and anxiety in patients in need of general surgery.Materials and Methods:This quasi-experimental study with a pre-post control group design was conducted on 120 patients requiring general surgery at Saman Al-Hojjaj Hospital in Sirjan County.Patients were selected using convenience sampling and randomly assigned to the intervention group(n=60)and control group(n=60).The intervention group was taught box breathing and progressive muscle relaxation techniques by a senior psychiatric nursing expert for 15-20 min every 4 h until surgery.The control group received routine care for surgery.Data on fear and anxiety outcomes were collected using the Spielberger State-Trait Anxiety Inventory and the Surgical Fear Questionnaire.Results:The intervention group had a mean total fear score of 29.27±12.69 compared to 37.20±16.39 in the control group(P=0.012),with significant reductions in both short-term(13.57±5.93 vs.15.98±8.90;P=0.209,Cohen’s d=0.32)and long-term(15.70±7.19 vs.21.22±9.11;P=0.001,Cohen’s d=0.66)fear components(total fear:P=0.012,Cohen’s d=0.54).The total anxiety score was 91.88±6.28 in the control group and 93.60±3.62 in the intervention group,with trait anxiety significantly reduced in the intervention group(P=0.039,Cohen’s d=0.41)postintervention,but no significant change in state anxiety(P=0.577,Cohen’s d=0.16).Conclusions:Relaxation techniques significantly alleviate preoperative psychological distress,effectively reducing fear and anxiety in general surgery patients.These cost-effective,non-invasive methods enhance recovery and reduce healthcare costs.We recommend training healthcare providers to implement these techniques for optimal patient outcomes.
文摘AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy. METHODS: Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated. RESULTS: The significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and mortality.CONCLUSION: M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.
文摘BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical pathologies. Our study aims to investigate clinical andlaboratory factors, in addition to providers’ interventions, that might have been associated witholigoanalgesia in a group of ED patients with moderate and severe pains due to surgical pathologies.METHODS: We conducted a retrospective study of adult patients who were transferred directlyfrom referring EDs to the emergency general surgery (EGS) service at a quaternary academic centerbetween January 2014 and December 2016. Patients who were intubated, did not have adequaterecords, or had mild pain were excluded. The primary outcome was refractory pain, which wasdefi ned as pain reduction <2 units on the 0–10 pain scale between triage and ED departure.RESULTS: We analyzed 200 patients, and 58 (29%) had refractory pain. Patients with refractory painhad signifi cantly higher disease severity, serum lactate (3.4±2.0 mg/dL vs. 1.4±0.9 mg/dL, P=0.001), and lessfrequent pain medication administration (median [interquartile range], 3 [3–5] vs. 4 [3–7], P=0.001), whencompared to patients with no refractory pain. Multivariable logistic regression showed that the number of painmedication administration (odds ratio [OR] 0.80, 95% confi dence interval [95% CI] 0.68–0.98) and ED serumlactate levels (OR 3.80, 95% CI 2.10–6.80) were signifi cantly associated with the likelihood of refractory pain.CONCLUSIONS: In ED patients transferring to EGS service, elevated serum lactate levelswere associated with a higher likelihood of refractory pain.
文摘Objective:To analyze and comprehensively study the clinical effects of humanized psychological nursing model in general surgery nursing.Methods:The study period was from January 2018 to December 2020.A sample of 200 patients who were admitted to The Second People's Hospital of Taizhou City for general surgery were selected.Random lottery grouping was used to divide the subjects into a study group and a control group.The sample within each group was n=100.The patients in the control group were provided with conventional general surgery nursing plan whereas the patients in the study group received the same nursing plan but with addition of the humanized psychological nursing model.The indicators of the two groups were compared and analyzed.Results:Comparing the scores from Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)after nursing intervention,postoperative visual analog scale(VAS),hospital stay,and patient satisfaction with the nursing services between the two groups,the study group was better(P<0.05).Conclusion:The implementation of humanized psychological nursing model in general surgery nursing had a significant effect in which there were improvements in regard to the patientsJ mental state and their satisfaction with the nursing services.Hence,it is worthy of promotion.
文摘In Mali, few studies have concerned overall mortality in general surgery, but several specific studies have concerned the different affections. Reflection on the causes of death is an inherent part of the activity of any motivated surgical team. <strong>Objective:</strong> To analyze the rate and the main causes of mortality in the General “A” surgical department of the Point “G” CHU. <strong>Patients Method:</strong> Our study was retrospective, descriptive and covered a period of 5 years from 01/01/2014 to 12/31/2018. We collected 152 deaths for 2011 hospitalized patients. The data were collected from the files of these deaths on pre-established investigation forms. The deceased patients were classified as operative and non-operative death, death from non-cancerous and cancerous diseases, deaths occurring in emergencies and deaths in regulated surgery. <strong>Results:</strong> We recorded 152 cases of death for 2011 hospitalized patients, either an overall mortality rate of 7.55%. The average age of deaths was 44.20 years +- 17.51 years with extremes ranging from 7 years to 85 years. The sex ratio was 1.62 in favor of men. The causes of death were represented by cancerous pathologies (69 deaths or 34.67%), non-cancerous pathologies (83 deaths or 4.58%). <strong>Conclusion:</strong> The mortality rate in general surgery remains high and is mainly linked to cancerous pathologies and the delay in taking care of patients.
文摘<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:Verdana;"> Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion,</span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion </span></span></span><span><span><span style="font-family:" color:#c45911;"=""><a href="#ref1" target="_blank"><span style="font-family:Verdana;">[1]</span></a></span><span></span></span></span><span><span></span></span><span></span><span><span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners </span></span></span><span><span><span style="font-family:;" "=""><span style="color:#C45911;"><a href="#ref2" target="_blank"><span style="font-family:Verdana;">[2]</span></a></span></span></span></span><span><span></span></span><span></span><span><span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"></span></b> <span style="font-family:Verdana;">To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus</span><span style="font-family:Verdana;">.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Material and methods:</span></b><span style="font-family:Verdana;"></span></b><span style="font-family:Verdana;"> This was a retrospective and prospective study that took place from January 2008 to December 2020 in the General Surgery Department of Gabriel Touré. The retrospective phase ran from January 2008 to December 2019 and the prospective phase from January 2020 to December 2020.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"></span></b><span style="font-family:Verdana;"> From January 2008 to December 2020, we collected 320 cases of patients operated on for sigmoid colon volvulus out of 7989 surgical emergencies over a 12-year period, or 3.64%. In our study, the most represented age group was between 16 and 60 years old, </span><i></i></span><i><i><span style="font-family:Verdana;">i</span></i></i></span></span><i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">e</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"></span></span></span></i><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> 81.88%. The mean age was 42.6 ± 17.4 years with extremities of 16 and 90 years. The male sex was the most represented, 89% with a sex ratio of 8.41. The surgical history was found in 13.75% of our patients. The clinic was dominated by abdominal pain (100%), meteorism (100%), and gas and matter arrest (91.3%). The most common radiological image found in the ASP was the double jamb, </span><i><span style="font-family:Verdana;">i</span></i></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">e</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 74.69% of cases. We found sigmoid necrosis in 18.13% of cases. We found an absence of necrosis in the majority of cases, </span><i></i></span><i><i><span style="font-family:Verdana;">i</span></i></i></span></span></span><i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">e</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"></span></span></span></i><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 91.56%. The most performed operative procedure in our patients was the RACR, </span><i></i></span><i><i><span style="font-family:Verdana;">i</span></i></i></span></span></span><i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">e</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">.</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"></span></span></span></i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 75.63% of cases. The reoperation was performed in only 5.94% of our patients. Complications were grade V in 42.55% according to the Clavin Dindo classification.</span></span></span>
文摘Objective: to explore the significance and quality of PBL teaching method combined with thinking-guided teaching method in general surgery clinical practice. Methods: 84 general surgery interns were selected as the research object and divided into the control group and the observation group according to the drawing of lots, with 42 cases in each group. The control group received traditional teaching;The observation group was taught with PBL teaching method combined with thinking guidance teaching method. The test scores and clinical teaching satisfaction of the two groups were compared. Results: compared with the test results and teaching quality of the control group and the observation group, the observation group was higher than the control group and the total score was better than the control group (P < 0.05). Compared with the clinical teaching satisfaction of the two groups, the observation group was better than the control group (p < 0.05). Conclusion: PBL teaching method combined with thinking-guided teaching method can improve the teaching quality of general surgery interns, effectively improve the interns' active learning, improve the interns' theoretical knowledge and professional skills, and ensure the operation process is accurate. It is worthy of wide application.
文摘Objective: this article mainly analyzed the choice of general surgery anesthesia and clinical observation and analysis for patients with cardiovascular diseases. Methods: 60 patients with cardiovascular diseases admitted to our hospital from May 2021 to November 2021 were selected as research objects and divided into observation group and control group with 30 cases in each group. The data were compared and analyzed to observe the clinical effect. Results: through the selection of general surgery anesthesia, the treatment of patients with cardiovascular diseases was compared. The difference between the two groups was statistically significant (P < 0.05). Conclusion: in the treatment of patients with cardiovascular diseases, the use of general surgery anesthesia for clinical application is effective and worthy of promotion.
文摘Objective: to analyze the common causes of postoperative complications and explore effective nursing strategies. Methods: using the method of random number table, 140 cases of patients receiving general surgery in the hospital were divided into two groups, with 70 cases in each group. One group provided routine nursing and the other group provided high-quality targeted nursing. The nursing effects of the two groups were observed. Results: compared with the control group, the mood of the study group was better (P < 0.05). Conclusion: the causes of complications include age, pain and postoperative malnutrition. Targeted high-quality nursing based on the above reasons can help alleviate patients' unhealthy feelings, which is worthy of publicity and reference.
文摘General surgery is a key specialty in higher education. It can cultivate high-quality general surgery professionals and provide high-quality personnel resources for the improvement of our medical team system. The traditional teaching mode of general surgery is relatively backward, which only explains the theoretical knowledge related to general surgery to the students. The students' interest in learning is low and they lack learning motivation, which reduces the learning effect and is not conducive to the cultivation of professional medical talents. SPOC is a new teaching model and an important product in the process of educational information reform. It has better application advantages, effectively improves the teaching efficiency of general surgery and provides an important impetus for teaching reform. Based on this, this paper analyzes the application of blend learning based on SPOC in general surgery teaching, in order to provide effective reference for general surgery teaching.
文摘Objective: to study the influencing factors of nosocomial infection in patients undergoing general surgery. Methods: a total of 60 patients undergoing general surgery in our hospital from January 2019 to December 2020 were selected as the research subjects, among which 39 patients suffered from hospital infection and 21 patients did not. The basic data such as the age of the research subjects, the time of surgery and admission to ICU, and the type of incision were counted by using the method of questionnaire, and the presence of hospital infection was investigated, and the influencing factors were analyzed. Results: the influencing factors of nosocomial infection in patients undergoing general surgery included the time of surgery and admission to ICU, incision type, patients' use of antibiotics before surgery and invasive operation or not (P < 0.05). The age of the patient was not a contributing factor to hospital infection in patients undergoing general surgery (P > 0.05). Analysis of the data revealed that the patient's surgery duration of more than two hours, antibiotics are given before surgery, admission to the ICU of more than four to six days, incidence of sexual invasion and incision type class II and III were all risk factors for nosocomial infection in patients undergoing general surgery. Conclusion: patients' operation time is more than two hours, antibiotics are used before operation, patients stay in ICU for more than four to six days, invasive situation and incision type are the dangerous causes of nosocomial infection in general surgical patients.
文摘Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare workers who were admitted to the general surgery department of the primary hospital between August 2021 and August 2022 were selected as the routine group for routine incision infection management.Forty-nine surgical patients with 11 healthcare workers admitted to the same department between September 2022 and September 2023 were selected as the prevention group for prophylactic management of postoperative incision infections.The incision infection rate,knowledge,attitude,and practice(KAP)scores,and management satisfaction of the patients as well as the management skill scores of healthcare workers were compared between the two groups.Results:The rate of postoperative incision infection in the prevention group was lower than that in the routine group;after implementing management measures,patients in the prevention group had higher KAP scores than those in the routine group;patients in the prevention group were more satisfied with the management than those in the routine group;and healthcare workers in the prevention group had higher scores than those in the routine group,with P<0.05 for the comparison between the groups.Conclusion:The implementation of preventive management for general surgery patients in primary hospitals can reduce the incidence of postoperative incision infection and improve the KAP of patients,with higher management satisfaction.It can also enhance the management skills of healthcare workers,thus improving their overall management level.
文摘Objective: to analyze the application of fine nursing in general surgery of operating room, and to discuss the effect of preventing infection of surgical incision. Methods: 72 cases of subjects were randomly included from March 2019.to May 2020.All of them was patients undergoing general surgery. The patients were divided into two groups by the odd-even numbering method. One group received conventional nursing as the control group, and the other group received refined nursing as the intervention group. Results: incidence of surgical incision infection and average hospitalization time in the intervention group were significantly lower than those in the control group (P < 0.05). Conclusion: in the development of general surgery in the operating room, taking fine nursing measures can have a positive effect on the prevention of incision infection;its application value is significant, suitable for popularization and promotion.
文摘Objective: to analyze the related factors that affect the postoperative pain symptoms of patients undergoing general surgery and explore targeted therapeutic interventions. Methods: 112 surgical patients admitted in our hospital from August 2020 to September 2021 were selected as the research object, and divided into observation group (targeted treatment intervention) and control group (routine treatment intervention) with 56 cases in each group. The therapeutic effects of the two groups were compared. Results: among 112 patients undergoing general surgery, there was no significant difference in the severity of postoperative pain between male and female patients, patients with or without chronic pain history (p > 0.05). the severity of pain symptoms of patients aged ≥60 years old was higher than that of patients aged < 60 years old (p < 0.05), and the severity of pain symptoms of patients receiving targeted pain intervention was lower than that of patients receiving conventional pain intervention (p < 0.05). The satisfaction degree of the patients in the observation group (96.43% > 82.14%, χ2=5.973) was higher than that of the control group (p < 0.05). the pain VAS score of the patients in the observation group after the intervention was [(1.98±0.43) point < (2.91±0.67) point, t=8.742], and the score of pittsburgh sleep quality index scale (PSQI) [(8.31±1.57) point < (9.44±1.62) point. t = 3.748, SAS score [(36.87±2.97) point < (46.05±3.51) point, t=14.941], SDS score [(37.91±3.98) point < (45.02±4.19) point, t=9.207] was lower than that of the control group (p < 0.05). Conclusion: in the postoperative rehabilitation treatment of general surgery patients, attention should be paid to the postoperative pain symptoms of patients. Considering the related factors that cause the onset of pain symptoms and aggravate the pain, targeted pain intervention should be implemented to effectively reduce the postoperative pain of patients and reduce the adverse effects of pain symptoms on daily life.
文摘Objective: to investigate the clinical application value of nursing risk management, and to observe and analyze the feasibility and application value of this management measure for general surgery. Methods: 50 patients who met the research criteria and received general surgery in our hospital from January 2019 to January 2021 were selected and divided into two groups. The study focused on the nursing quality score, the incidence of complications, the incidence of risk events and patient satisfaction of the two groups of nursing risk management (research group) and routine nursing management (reference group). Then the data were compared by using statistical methods to analyze the effectiveness and value of nursing management measures. Results: the research results of each research data in the research group show obvious advantages when compared with the reference group. Therefore, the management measures in the research group have higher clinical feasibility. Meanwhile, the statistical method is significant after processing the comparative data in the two groups (P < 0.05). Conclusion: the application of nursing risk management measures in general surgery department can comprehensively improve the quality of nursing and play a key role in reducing the occurrence of complications and risk events. It can promote patients to give satisfactory evaluation on nursing risk management, with significant effect and wide application value.
文摘Institute of Otolaryngology of Chinese PLA ( Key Laboratory for the Prevention of Acoustic Trauma,PLA)Key Laboratory of Hearing Impairment Science(Chinese PLA Medical School)Ministry of Education Led by four generations of leadership from late Prof. JIANG Sichang (academician, Chinese Academy of Engineering), Prof.YANG Weiyan (Honorary President, Division of Otolaryngology
文摘Led by four generations of leadership from late Prof.JIANG Sichang(academician,Chinese Academy of Engineering),Prof.YANG Weiyan(Honorary President,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association),Prof.HAN Dongyi(President Elected,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association)to now Prof.YANG Shiming(President,Division of Otolaryngologists,
文摘AIM To examine the evidence about psychiatric morbidity after inflammatory bowel disease(IBD)-related surgery. METHODS PRISMA guidelines were followed and a protocol was published at PROSPERO(CRD42016037600). Inclusion criteria were studies describing patients with inflammatory bowel disease undergoing surgery and their risk of developing psychiatric disorder. RESULTS Twelve studies(including 4340 patients) were eligible. All studies were non-randomized and most had high risk of bias. Patients operated for inflammatory bowel disease had an increased risk of developing depression,compared with surgical patients with diverticulitis or inguinal hernia,but not cancer. In addition,patients with Crohn's disease had higher risk of depression after surgery compared with non-surgical patients. Patients with ulcerative colitis had higher risk of anxiety after surgery compared with surgical colorectal cancer patients. Charlson comorbidity score more than three and female gender were independent predictors for depression and anxiety following surgery. CONCLUSION The review cannot give any clear answer to the risks of psychiatric morbidity after surgery for IBD studies with the lowest risk of bias indicated an increased risk of depression among surgical patients with Crohn's disease and increased risk of anxiety among patients with ulcerative colitis.
基金Supported by National Key Research and Development Program of China,No.2016YFC0906000.
文摘BACKGROUND Trocar site hernia(TSH)is a rare but potentially dangerous complication of laparoscopic surgery,and the drain-site TSH is an even rarer type.Due to the difficulty to diagnose at early stages,TSH often leads to a delay in surgical intervention and eventually results in life-threatening consequences.Herein,we report an unusual case of drain-site TSH,followed by a brief literature review.Finally,we provide a novel,simple,and practical method of prevention.CASE SUMMARY A 54-year-old female patient underwent laparoscopic subtotal hysterectomy and bilateral adnexectomy for uterine fibroids 8 d ago in another hospital.She was admitted to our hospital with a 2-d history of intermittent abdominal pain,nausea,vomiting,and abdominal enlargement with an inability to pass stool and flatus.The emergency computed tomography scan revealed the small bowel herniated through a 10 mm trocar incision,which was used as a drainage port,with diffuse bowel distension and multiple air-fluid levels with gas in the small intestines.She was diagnosed with drain-site strangulated TSH.The emergency exploratory laparotomy confirmed the diagnosis.A herniorrhaphy followed by standard intestinal resection and anastomosis were performed.The patient recovered well after the operation and was discharged on postoperative day 8 and had no postoperative complications at her 2-wk follow-up visit.CONCLUSION TSH must be kept in mind during the differential diagnosis of post-laparoscopic obstruction,especially after the removal of the drainage tube,to avoid the serious consequences caused by delayed diagnosis.Furthermore,all abdomen layers should be carefully closed under direct vision at the trocar port site,especially where the drainage tube was placed.Our simple and practical method of prevention may be a novel strategy worthy of clinical promotion.
文摘BACKGROUND The causes of peroneal neuropathy are various,but are rarely due to weight loss.Bilateral peroneal neuropathy caused by weight loss after surgery has been reported only after bariatric surgery and there were no reports associated with other abdominal surgery.In this report,we describe a case of the bilateral peroneal neuropathy that occurred due to marked weight loss after biliary surgery.CASE SUMMARY A 58-year-old male did not receive adequate nutritional support after biliary surgery,and showed a massive weight loss over a short period of time(body mass index;24.1 kg/m2 to 20.5 kg/m2 for 24 d).Then,foot drop occurred on both sides.Physical examination,electromyography(EMG)and magnetic resonance imaging studies were conducted and he was diagnosed as bilateral common peroneal neuropathy around the fibular head level.The patient was treated electrical stimulation therapy on both lower legs along with exercise therapy,and received sufficient oral nutritional support.The patient gradually recovered to his original weight,and the power of the dorsiflexor of bilateral ankles improved after conservative treatment.In addition,the follow-up EMG showed signs of improvement.CONCLUSION Any abdominal surgery that may have rapid and marked weight loss can lead to peroneal neuropathy as a complication.
