BACKGROUND Peroral endoscopic esophageal myotomy(POEM)is an innovative,minimally invasive endoscopic technique that has been widely adopted and recognized for the clinical management of achalasia because of its advant...BACKGROUND Peroral endoscopic esophageal myotomy(POEM)is an innovative,minimally invasive endoscopic technique that has been widely adopted and recognized for the clinical management of achalasia because of its advantages of minimal trauma and rapid recovery.Nevertheless,clinical data have indicated that approximately 67%of patients experience esophageal pain after POEM.This high prevalence of pain not only affects patients’post-POEM recovery experience and quality of life but also presents challenges to its clinical implementation.Therefore,it is urgently necessary to explore effective intervention strategies.AIM To accurately determine the incidence of post-POEM pain and to comprehensively investigate the potential risk factors for the development of post-POEM pain.METHODS In this study,123 patients who were clinically diagnosed with achalasia and who underwent POEM were included.Baseline demographic characteristics,post-POEM numerical rating scale(NRS)pain scores,and anesthesia/surgery-related parameters were systematically collected.Patients were categorized into a pain group and a non-pain group on the basis of whether the NRS score exceeded 4 at 12 hours post-POEM.Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors associated with post-POEM pain.RESULTS On the basis of the predefined inclusion and exclusion criteria,123 eligible patients were enrolled.After adjusting for confounding factors,stepwise multivariate logistic regression analysis revealed that the preoperative Eckardt score[odds ratio(OR)=1.317,95%confidence interval(95%CI):0.992-1.748,P=0.057]and preoperative anxiety status(OR=5.195,95%CI:1.691-15.959,P=0.004)were independent risk factors for post-POEM pain.Our multifactor model exhibited robust predictive ability for postoperative pain following POEM,with an area under the receiver operating characteristic curve of 0.760(95%CI:0.661–0.859).CONCLUSION Patients with achalasia who underwent POEM presented a high prevalence of post-POEM pain,which was moderate or severe in 26.8%of these patients.After adjusting for confounding factors,multivariate analysis revealed that preoperative anxiety and a higher Eckardt score were independent risk factors for post-POEM pain.展开更多
BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in t...BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in the peri-and postoperative care of patients.However,its effects after laparoscopic hepatectomy remains unclear.AIM To explore the influence of nursing under the ERAS concept on time to first ambulation and complications after laparoscopic hepatectomy.METHODS Data from 119 patients,who underwent laparoscopic hepatectomy for various indications between January 2020 and March 2025,were divided into 2 groups according to nursing mode:Observation[nursing based on the ERAS concept(n=59)],and control[basic nursing(n=60)].Time to first ambulation,complications,length of hospital stay,and numerical rating scale(NRS)scores were compared between the groups.Statistical analysis was performed using SPSS version 26.0(IBM Corp.,Armonk,NY,United States).Differences with P<0.05 were considered statistically significant.RESULTS Findings indicated that after post-nursing intervention,the observation group experienced significantly sooner initial discharge times and shorter hospital stays than the control group(P<0.05).The NRS score of the observation group was lower than that of the control group(P<0.05).The observation group experienced a significantly lower incidence of postoperative complications than the control group(P<0.05).CONCLUSION Operating room nursing based on the ERAS concept significantly shortens the time to first ambulation,reduces the incidence of postoperative complications,and improves patient quality of life after laparoscopic hepatectomy.展开更多
目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病...目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病人66例,根据治疗方法不同分为手术组35例和注射组31例,分别在术前、术后第2周、1个月、3个月、6个月、12个月应用疼痛数字分级评分法(numerical rating scale,NRS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎评分、药物使用率、手术相关并发症、病人的满意度进行随访评估以及统计学分析。结果:与术前相比,手术组疗效优于注射组,在术后2周、1个月、3个月、6个月、12个月手术组NRS评分和WOMAC评分、术后药物使用率均明显下降;两组术后均未观察到下肢麻木、下肢无力、感觉减退、感觉异常、神经痛等严重不良反应。术后12个月,手术组82.9%的病人对术后疗效满意,注射组38.7%的病人对术后疗效感到满意。结论:膝神经射频联合低温等离子射频消融术可以有效缓解膝关节疼痛,改善关节功能,且未发现严重不良反应,可以作为全膝关节置换术以外的顽固性KOA的替代治疗模式。展开更多
Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain manageme...Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain management.Methods:A retrospective study of 489 inpatient cancer patients(1081 visits)was conducted by querying the electronic medical record database to test the reliability and validity of the Edmonton Symptom Assessment System.Data from a pilot prospective randomized controlled study on acupuncture for cancer pain was analyzed to validate the Edmonton Symptom Assessment System(ESAS)as the primary outcome in the integrative oncology research.Results:In the retrospective analysis,scores of the numerical rating scale(NRS)and the ESAS total score were significantly correlated(r=0.15,P=0.02),and the correlation coefficient between NRS and pain sub-scale in ESAS was 0.47(P<0.001).The pilot study showed the proportions of participants experiencing more than a 2-point reduction in NRS at the end of the treatment were 80%(n=12/15)in the acupuncture group and 50%(n=7/14)in the control group,without a significant difference between groups(P=0.13).For the total scores of ESAS,more responders were found in the acupuncture group(n=13/15)compared to that in the control group(n=7/14),with no significant difference between groups(P=0.05).Conclusions:ESAS is suitable for the comprehensive assessment in patients with cancer pain and could be an appropriate outcome measurement in acupuncture research for cancer pain.Trial registration:Registered on 09/07/2018 with ChiCTR1800017023(https://www.chictr/org.cn/edit.aspx?pid=28879&htm=4)展开更多
基金Supported by the Special Research Project on Optimal Management of Acute Pain,Wu Jie-ping Medical Foundation,No.320.6750.2024-15.101.
文摘BACKGROUND Peroral endoscopic esophageal myotomy(POEM)is an innovative,minimally invasive endoscopic technique that has been widely adopted and recognized for the clinical management of achalasia because of its advantages of minimal trauma and rapid recovery.Nevertheless,clinical data have indicated that approximately 67%of patients experience esophageal pain after POEM.This high prevalence of pain not only affects patients’post-POEM recovery experience and quality of life but also presents challenges to its clinical implementation.Therefore,it is urgently necessary to explore effective intervention strategies.AIM To accurately determine the incidence of post-POEM pain and to comprehensively investigate the potential risk factors for the development of post-POEM pain.METHODS In this study,123 patients who were clinically diagnosed with achalasia and who underwent POEM were included.Baseline demographic characteristics,post-POEM numerical rating scale(NRS)pain scores,and anesthesia/surgery-related parameters were systematically collected.Patients were categorized into a pain group and a non-pain group on the basis of whether the NRS score exceeded 4 at 12 hours post-POEM.Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors associated with post-POEM pain.RESULTS On the basis of the predefined inclusion and exclusion criteria,123 eligible patients were enrolled.After adjusting for confounding factors,stepwise multivariate logistic regression analysis revealed that the preoperative Eckardt score[odds ratio(OR)=1.317,95%confidence interval(95%CI):0.992-1.748,P=0.057]and preoperative anxiety status(OR=5.195,95%CI:1.691-15.959,P=0.004)were independent risk factors for post-POEM pain.Our multifactor model exhibited robust predictive ability for postoperative pain following POEM,with an area under the receiver operating characteristic curve of 0.760(95%CI:0.661–0.859).CONCLUSION Patients with achalasia who underwent POEM presented a high prevalence of post-POEM pain,which was moderate or severe in 26.8%of these patients.After adjusting for confounding factors,multivariate analysis revealed that preoperative anxiety and a higher Eckardt score were independent risk factors for post-POEM pain.
文摘BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in the peri-and postoperative care of patients.However,its effects after laparoscopic hepatectomy remains unclear.AIM To explore the influence of nursing under the ERAS concept on time to first ambulation and complications after laparoscopic hepatectomy.METHODS Data from 119 patients,who underwent laparoscopic hepatectomy for various indications between January 2020 and March 2025,were divided into 2 groups according to nursing mode:Observation[nursing based on the ERAS concept(n=59)],and control[basic nursing(n=60)].Time to first ambulation,complications,length of hospital stay,and numerical rating scale(NRS)scores were compared between the groups.Statistical analysis was performed using SPSS version 26.0(IBM Corp.,Armonk,NY,United States).Differences with P<0.05 were considered statistically significant.RESULTS Findings indicated that after post-nursing intervention,the observation group experienced significantly sooner initial discharge times and shorter hospital stays than the control group(P<0.05).The NRS score of the observation group was lower than that of the control group(P<0.05).The observation group experienced a significantly lower incidence of postoperative complications than the control group(P<0.05).CONCLUSION Operating room nursing based on the ERAS concept significantly shortens the time to first ambulation,reduces the incidence of postoperative complications,and improves patient quality of life after laparoscopic hepatectomy.
文摘目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病人66例,根据治疗方法不同分为手术组35例和注射组31例,分别在术前、术后第2周、1个月、3个月、6个月、12个月应用疼痛数字分级评分法(numerical rating scale,NRS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎评分、药物使用率、手术相关并发症、病人的满意度进行随访评估以及统计学分析。结果:与术前相比,手术组疗效优于注射组,在术后2周、1个月、3个月、6个月、12个月手术组NRS评分和WOMAC评分、术后药物使用率均明显下降;两组术后均未观察到下肢麻木、下肢无力、感觉减退、感觉异常、神经痛等严重不良反应。术后12个月,手术组82.9%的病人对术后疗效满意,注射组38.7%的病人对术后疗效感到满意。结论:膝神经射频联合低温等离子射频消融术可以有效缓解膝关节疼痛,改善关节功能,且未发现严重不良反应,可以作为全膝关节置换术以外的顽固性KOA的替代治疗模式。
基金Supported by the National Natural Science Foundation of China(no.82004447)Guangdong Basic and Applied Basic Research Foundation(no.2021A1515011597)Discipline-Collaborative Innovation Team for"Double First-Class"and High-Level University in Guangzhou University of Chinese Medicine(no.2021XK08)。
文摘Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain management.Methods:A retrospective study of 489 inpatient cancer patients(1081 visits)was conducted by querying the electronic medical record database to test the reliability and validity of the Edmonton Symptom Assessment System.Data from a pilot prospective randomized controlled study on acupuncture for cancer pain was analyzed to validate the Edmonton Symptom Assessment System(ESAS)as the primary outcome in the integrative oncology research.Results:In the retrospective analysis,scores of the numerical rating scale(NRS)and the ESAS total score were significantly correlated(r=0.15,P=0.02),and the correlation coefficient between NRS and pain sub-scale in ESAS was 0.47(P<0.001).The pilot study showed the proportions of participants experiencing more than a 2-point reduction in NRS at the end of the treatment were 80%(n=12/15)in the acupuncture group and 50%(n=7/14)in the control group,without a significant difference between groups(P=0.13).For the total scores of ESAS,more responders were found in the acupuncture group(n=13/15)compared to that in the control group(n=7/14),with no significant difference between groups(P=0.05).Conclusions:ESAS is suitable for the comprehensive assessment in patients with cancer pain and could be an appropriate outcome measurement in acupuncture research for cancer pain.Trial registration:Registered on 09/07/2018 with ChiCTR1800017023(https://www.chictr/org.cn/edit.aspx?pid=28879&htm=4)
