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
Background:Postoperative care has been evolving since the concept of enhanced recovery after surgery(ERAS)was introduced in China.This study aimed to evaluate the effects of early ambulation within 24h after unilatera...Background:Postoperative care has been evolving since the concept of enhanced recovery after surgery(ERAS)was introduced in China.This study aimed to evaluate the effects of early ambulation within 24h after unilateral total knee arthroplasty(TKA)on postoperative rehabilitation and costs in a Chinese population.Methods:This cohort study of patients with knee osteoarthritis who had undergone TKA at 24 large teaching hospitals between January 2014 and November 2016 involved 2687 patients who began ambulating within 24h(Group A)and 3761 patients who began ambulating later than 24h(Group B).The outcome measurements,such as length of stay(LOS),total hospitalization costs,dynamic pain level,knee flexion range of motion(ROM),results of the 12-Item Short Form Survey(SF-12),incidence of thromboembolic events and other complications,were recorded and compared.Results:The early ambulation group(Group A)had a shorter LOS and lower hospitalization costs and pain levels than the late ambulation group(Group B).There was a favorable effect in enhancing ROM for patients in Group A compared with patients in Group B.In Group A,patients had significantly higher postoperative SF-12 scores than those in Group B.The incidence of deep venous thrombosis(DVT)and pulmonary infection was significantly lower in Group A than in Group B.The incidence of pulmonary embolism(PE)and other complications did not differ between the two groups.Conclusions:Early ambulation within 24h after TKA was associated with reduced LOS,improved knee function,lower hospitalization costs and lower incidence of DVT and pulmonary infection in the Chinese population.展开更多
BACKGROUND The effect of posterior spinal fusion(PSF)incorporating the pelvis on an ambulatory patient’s ability to mobilize after the fusion is not well understood.AIM To see whether a posterior spinal fusion with p...BACKGROUND The effect of posterior spinal fusion(PSF)incorporating the pelvis on an ambulatory patient’s ability to mobilize after the fusion is not well understood.AIM To see whether a posterior spinal fusion with pelvic fixation using iliac or sacral alar iliac screws in ambulatory neuromuscular scoliosis(NMS)patients influences postoperative ambulatory ability.METHODS A retrospective review of all patients with NMS that underwent PSF with fixation incorporating the pelvis between January 1,2012 and February 29,2019.A total of 118 patients were eligible,including 11 ambulatory patients.The primary outcome was the maintenance of ambulatory status postoperatively.Secondary outcomes included postoperative curve magnitude,pelvic obliquity,and complications,comprising infections,instrumentation failure,and any unplanned returns to the operative room.RESULTS The ambulatory function was maintained in all 11 ambulatory NMS patients.One patient had an improvement in functional status with equipment-free ambulation postoperatively.An average postoperative follow-up was 19 mo.The overall complication rate was 19.4%(n=23)with no significant differences between the groups in infection(P=0.365),hardware failure(P=0.505),and reoperation rate(P=1.0).Ambulatory status did not affect complication rate(P=0.967).CONCLUSION Spinal fusion to the pelvis in ambulatory patients with NMS provides effective deformity correction without the reduction in ambulatory capabilities.展开更多
Background and Purpose: Walking difficulties are defined as any reduction in speed, balance, or change of gait, causing limited ambulation. These difficulties are a common problem in older adults and may greatly affec...Background and Purpose: Walking difficulties are defined as any reduction in speed, balance, or change of gait, causing limited ambulation. These difficulties are a common problem in older adults and may greatly affect their quality of life (QOL) and restrict their personal independence and participation. This study aimed to determine the effect of intermittent pneumatic compression (IPC) on lower leg pain, walking capacity, functional mobility, ankle range of motion (AROM), and QOL of community-dwelling older people with walking difficulties. Methods: In this randomized controlled trial, 34 eligible participants with self-reported lower limb pain and limited ambulation were randomized either to the intermittent pneumatic compression intervention group (IPCIG) or static compression control group (SCCG). The IPCIG and SCCG were trained to receive IPC and SC respectively for both lower legs and instructed to continue the application independently at home for 15 minutes per session, 2 sessions a day, 7 days per week for 4 weeks independently at the home. Outcome measures of lower leg pain, AROM, walking capacity, and functional mobility were assessed at baseline and at the first, second, third, and fourth weeks after randomization. Quality of life was assessed at baseline and immediately after the intervention. Results and Discussion: IPCIG showed a more significant improvement compared to the SCCG at the post-interventional stage for QOL and all the subscales. The findings show that “80% improved QOL” is 53% higher with the application of IPC than with SC for 4 weeks. The IPCIG showed a more significant improvement in the 6-minute walk test (6 MWT) at the third and fourth weeks compared to the SCCG. A pairwise comparison of mean values of 6 MWT over 4 weeks within the IPCIG showed a significant difference between all the weeks. Pairwise comparisons between groups at each time point showed that the IPCIG showed a more significant improvement in the timed up and go (TUG) test at the third and fourth weeks compared to the SCCG. Pairwise comparison of mean values of TUG test within the IPCIG showed a significant difference over 4 weeks, except between the second and third weeks, fourth week, and third and fourth weeks. The IPCIG showed a more significant improvement in lower leg pain between all weeks except the first week compared to the SCCG. Pairwise comparison of mean values of lower leg pain over 4 weeks within the IPCIG showed a significant difference among all weekly outcomes except between 1 and 2 weeks. The IPCIG showed a more significant improvement in left and right ankle dorsiflexion ROM at the third and fourth weeks compared to the SCCG. Conclusions: The IPC was effective in reducing lower leg pain and increasing the AROM and improving the walking capacity, functional mobility level, and QOL of community-dwelling older people with walking disabilities. Walking disability in old age is a common condition requiring physical therapy. Intermittent pneumatic compression can be used as a physical therapy modality for this patient group.展开更多
为系统分析和总结急救车资源布局与运营调度的研究现状与发展趋势,基于Web of Science数据库收录的1 502篇文献,从战略层、战术层、操作层3个层次梳理急救车资源布局与运营调度的研究脉络。研究结果表明,在战略层,急救车定位问题的研究...为系统分析和总结急救车资源布局与运营调度的研究现状与发展趋势,基于Web of Science数据库收录的1 502篇文献,从战略层、战术层、操作层3个层次梳理急救车资源布局与运营调度的研究脉络。研究结果表明,在战略层,急救车定位问题的研究重点在于持续改善覆盖定义、准确刻画系统内在的不确定性,主要研究方法包括随机规划、鲁棒优化等不确定性建模和求解方法。在战术层,急救车重定位问题按照触发重定位决策的方式分为多阶段重定位和动态重定位,由于重定位较定位更为复杂,研究重点在于应用启发式、强化学习等算法求解现实中的大规模问题。操作层关键的决策问题包括急救车指派、目的地选择和路径规划:急救车指派相关研究呈现从基于规则到基于模型,从独立优化到和重定位联合优化的发展历程;目的地选择涉及与医院工作负载的协同优化,路径规划则主要针对灾难响应等特殊场景。在未来的研究中,需要紧扣动态性和随机性2条研究主线,在准确刻画院前医疗急救系统不确定性来源的同时,充分利用更细粒度的数据辅助实时决策。在建模和求解的具体技术上,应考虑打通不同层次的多个决策问题开展联合优化,实现急救车定位与调度方案从局部最优到系统最优的迭代,并持续开发能处理现实大规模场景的高效求解算法以支撑联合优化的求解。展开更多
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.
基金the National Health and Family Planning Commission of the People’s Republic of China(CN)program(201302007).
文摘Background:Postoperative care has been evolving since the concept of enhanced recovery after surgery(ERAS)was introduced in China.This study aimed to evaluate the effects of early ambulation within 24h after unilateral total knee arthroplasty(TKA)on postoperative rehabilitation and costs in a Chinese population.Methods:This cohort study of patients with knee osteoarthritis who had undergone TKA at 24 large teaching hospitals between January 2014 and November 2016 involved 2687 patients who began ambulating within 24h(Group A)and 3761 patients who began ambulating later than 24h(Group B).The outcome measurements,such as length of stay(LOS),total hospitalization costs,dynamic pain level,knee flexion range of motion(ROM),results of the 12-Item Short Form Survey(SF-12),incidence of thromboembolic events and other complications,were recorded and compared.Results:The early ambulation group(Group A)had a shorter LOS and lower hospitalization costs and pain levels than the late ambulation group(Group B).There was a favorable effect in enhancing ROM for patients in Group A compared with patients in Group B.In Group A,patients had significantly higher postoperative SF-12 scores than those in Group B.The incidence of deep venous thrombosis(DVT)and pulmonary infection was significantly lower in Group A than in Group B.The incidence of pulmonary embolism(PE)and other complications did not differ between the two groups.Conclusions:Early ambulation within 24h after TKA was associated with reduced LOS,improved knee function,lower hospitalization costs and lower incidence of DVT and pulmonary infection in the Chinese population.
文摘BACKGROUND The effect of posterior spinal fusion(PSF)incorporating the pelvis on an ambulatory patient’s ability to mobilize after the fusion is not well understood.AIM To see whether a posterior spinal fusion with pelvic fixation using iliac or sacral alar iliac screws in ambulatory neuromuscular scoliosis(NMS)patients influences postoperative ambulatory ability.METHODS A retrospective review of all patients with NMS that underwent PSF with fixation incorporating the pelvis between January 1,2012 and February 29,2019.A total of 118 patients were eligible,including 11 ambulatory patients.The primary outcome was the maintenance of ambulatory status postoperatively.Secondary outcomes included postoperative curve magnitude,pelvic obliquity,and complications,comprising infections,instrumentation failure,and any unplanned returns to the operative room.RESULTS The ambulatory function was maintained in all 11 ambulatory NMS patients.One patient had an improvement in functional status with equipment-free ambulation postoperatively.An average postoperative follow-up was 19 mo.The overall complication rate was 19.4%(n=23)with no significant differences between the groups in infection(P=0.365),hardware failure(P=0.505),and reoperation rate(P=1.0).Ambulatory status did not affect complication rate(P=0.967).CONCLUSION Spinal fusion to the pelvis in ambulatory patients with NMS provides effective deformity correction without the reduction in ambulatory capabilities.
文摘Background and Purpose: Walking difficulties are defined as any reduction in speed, balance, or change of gait, causing limited ambulation. These difficulties are a common problem in older adults and may greatly affect their quality of life (QOL) and restrict their personal independence and participation. This study aimed to determine the effect of intermittent pneumatic compression (IPC) on lower leg pain, walking capacity, functional mobility, ankle range of motion (AROM), and QOL of community-dwelling older people with walking difficulties. Methods: In this randomized controlled trial, 34 eligible participants with self-reported lower limb pain and limited ambulation were randomized either to the intermittent pneumatic compression intervention group (IPCIG) or static compression control group (SCCG). The IPCIG and SCCG were trained to receive IPC and SC respectively for both lower legs and instructed to continue the application independently at home for 15 minutes per session, 2 sessions a day, 7 days per week for 4 weeks independently at the home. Outcome measures of lower leg pain, AROM, walking capacity, and functional mobility were assessed at baseline and at the first, second, third, and fourth weeks after randomization. Quality of life was assessed at baseline and immediately after the intervention. Results and Discussion: IPCIG showed a more significant improvement compared to the SCCG at the post-interventional stage for QOL and all the subscales. The findings show that “80% improved QOL” is 53% higher with the application of IPC than with SC for 4 weeks. The IPCIG showed a more significant improvement in the 6-minute walk test (6 MWT) at the third and fourth weeks compared to the SCCG. A pairwise comparison of mean values of 6 MWT over 4 weeks within the IPCIG showed a significant difference between all the weeks. Pairwise comparisons between groups at each time point showed that the IPCIG showed a more significant improvement in the timed up and go (TUG) test at the third and fourth weeks compared to the SCCG. Pairwise comparison of mean values of TUG test within the IPCIG showed a significant difference over 4 weeks, except between the second and third weeks, fourth week, and third and fourth weeks. The IPCIG showed a more significant improvement in lower leg pain between all weeks except the first week compared to the SCCG. Pairwise comparison of mean values of lower leg pain over 4 weeks within the IPCIG showed a significant difference among all weekly outcomes except between 1 and 2 weeks. The IPCIG showed a more significant improvement in left and right ankle dorsiflexion ROM at the third and fourth weeks compared to the SCCG. Conclusions: The IPC was effective in reducing lower leg pain and increasing the AROM and improving the walking capacity, functional mobility level, and QOL of community-dwelling older people with walking disabilities. Walking disability in old age is a common condition requiring physical therapy. Intermittent pneumatic compression can be used as a physical therapy modality for this patient group.
文摘为系统分析和总结急救车资源布局与运营调度的研究现状与发展趋势,基于Web of Science数据库收录的1 502篇文献,从战略层、战术层、操作层3个层次梳理急救车资源布局与运营调度的研究脉络。研究结果表明,在战略层,急救车定位问题的研究重点在于持续改善覆盖定义、准确刻画系统内在的不确定性,主要研究方法包括随机规划、鲁棒优化等不确定性建模和求解方法。在战术层,急救车重定位问题按照触发重定位决策的方式分为多阶段重定位和动态重定位,由于重定位较定位更为复杂,研究重点在于应用启发式、强化学习等算法求解现实中的大规模问题。操作层关键的决策问题包括急救车指派、目的地选择和路径规划:急救车指派相关研究呈现从基于规则到基于模型,从独立优化到和重定位联合优化的发展历程;目的地选择涉及与医院工作负载的协同优化,路径规划则主要针对灾难响应等特殊场景。在未来的研究中,需要紧扣动态性和随机性2条研究主线,在准确刻画院前医疗急救系统不确定性来源的同时,充分利用更细粒度的数据辅助实时决策。在建模和求解的具体技术上,应考虑打通不同层次的多个决策问题开展联合优化,实现急救车定位与调度方案从局部最优到系统最优的迭代,并持续开发能处理现实大规模场景的高效求解算法以支撑联合优化的求解。
