BACKGROUND In the field of anesthesia for procedure for prolapse and hemorrhoids(PPH)surgery,combined spinal-epidural(CSE)anesthesia has been a common approach.However,exploring new combinations to optimize patient ou...BACKGROUND In the field of anesthesia for procedure for prolapse and hemorrhoids(PPH)surgery,combined spinal-epidural(CSE)anesthesia has been a common approach.However,exploring new combinations to optimize patient outcomes remains crucial.Remimazolam,a short-acting benzodiazepine,shows potential for improving sedation and reducing patient anxiety.The effects of combining remimazolam with CSE anesthesia,compared to traditional CSE anesthesia alone,on patient anxiety,sedation depth,and hemodynamics during PPH surgery have not been fully elucidated.AIM To compare remimazolam-CSE vs CSE alone on State-Trait Anxiety Inventory-State scale(STAI-S)scores,sedation,and hemodynamics in PPH surgery.METHODS This study is a single-center,prospective,randomized controlled trial.Between November 23,2022,and August 6,2024,60 eligible patients were randomly assigned to the CSE anesthesia group or the remimazolam-combined CSE anesthesia group(30 patients each).STAI-S scores,Ramsay sedation scores,and hemodynamic parameters(systolic blood pressure,diastolic blood pressure,heart rate)were measured at multiple time points.Two-way mixed-effects ANOVA and posthoc analyses were performed.RESULTS The Combined group demonstrated significantly lower STAI-S scores before leaving the operating room[mean:28.80 vs 54.03,mean difference(95%CI):25.23(21.24-29.23),P<0.001]and 24 hours post-operation[mean:45.07 vs 54.53,mean difference(95%CI):9.47(6.29-12.64),P<0.001]than the CSE group.Moreover,the Combined group achieved a deeper sedation level during intraoperative maintenance[median:5.00(IQR:5.00-5.00)vs 2.00(IQR:2.00-2.00);median difference(95%CI):3.00(3.00-3.00),P<0.001].Regarding hemodynamics,a significant intergroup difference in systolic blood pressure was observed at the start of the surgery[mean:128.8 vs 114.7 for the Combined and CSE groups,mean difference(95%CI):14.17(0.77-27.57),adjusted P=0.033].CONCLUSION Remimazolam-combined anesthesia outperformed CSE anesthesia in reducing STAI-S scores,enhancing intraoperative sedation,and stabilizing systolic blood pressure at a critical stage,indicating its superiority in perioperative management.展开更多
Objective The lack of clarity regarding the application performance of a hybrid operating room(HOR)and the uncertainty of surgical scheduling often lead to its inefficient application.This study aimed to review the cl...Objective The lack of clarity regarding the application performance of a hybrid operating room(HOR)and the uncertainty of surgical scheduling often lead to its inefficient application.This study aimed to review the clinical application of our neurosurgical HOR and propose a scale to score cases clearly.Methods We reviewed the operating procedures and duration of stay in 1865 HOR cases.The actual procedures of each case were summarized into 5 application types,and numerical assignment was used to distinguish the dependence of each type on our HOR:surgical procedures combined with interventional procedures(4 points,the highest dependence),surgical procedures combined with imaging procedures(3 points),interventional procedures(2 points),imaging procedures(1 point),and surgical procedures(0 points,the lowest dependence).Results A novel scale that could score 1865 cases into those 5 grades was developed.The percentages by grade were as follows:4 points,4.24%;3 points,4.88%;2 points,20.75%;1 point,69.38%;and 0 points,0.75%.The cumulative usage time was 4241.9 h,the duration of which was as follows:4 points,16.17%;3 points,15.50%;2 points,31.32%;1 point,35.62%;and 0 points,1.39%.Conclusions The HOR serves as a multifunctional room to treat neurosurgical diseases.The scale helps to quickly prioritize cases that rely more on HOR,providing guidelines for surgical scheduling.Although our HOR is unsuitable for emergency cases,it clearly shows the application performance of our HOR to provide a reference for promoting its efficient application.展开更多
Objective: to explore the effect of continuous nursing intervention on wound stomy and the improvement of ECSA scale score. Methods: 100 cases of rectal cancer patients in our hospital from January 2020 to January 202...Objective: to explore the effect of continuous nursing intervention on wound stomy and the improvement of ECSA scale score. Methods: 100 cases of rectal cancer patients in our hospital from January 2020 to January 2021 were collected and randomly divided into two groups. The control group received routine nursing, and the observation group received continuous nursing intervention. The score of ECSA scale and the complication rate of wound stomy were compared between the two groups. Results: the score of ECSA scale in observation group was higher than that in control group, and the incidence of complications in wound stomy was lower than that in control group, with significant difference (P < 0.05). Conclusion: the effect of continuous nursing intervention on wound ostomy and the improvement of ECSA scale score are accurate. It can improve patients' self-management ability and reduce complications of wound ostomy. It is a continuous nursing mode worthy of promotion and application.展开更多
目的:探讨传统开颅手术与神经内镜微创手术对脑出血患者美国国立卫生研究院卒中量表评分(National Institute of Health Stroke Scale Score,NIHSS)及巴塞尔指数评分(Barthel Index Score,BI)的影响。方法:回顾性收集2022年1月至2023年...目的:探讨传统开颅手术与神经内镜微创手术对脑出血患者美国国立卫生研究院卒中量表评分(National Institute of Health Stroke Scale Score,NIHSS)及巴塞尔指数评分(Barthel Index Score,BI)的影响。方法:回顾性收集2022年1月至2023年1月期间本院收治的200例脑出血患者的临床资料。根据治疗方式不同将患者分为对照组(实施传统开颅手术,150例)和观察组(实施神经内镜微创手术,50例)。收集并比较两组术后神经功能恢复情况、术后日常生活活动能力、手术相关指标、术后并发症发生情况。结果:随着术后时间增长,两组NIHSS评分均降低;术后2、3、6、12 m,观察组NIHSS评分均低于对照组(P<0.05)。随着术后时间增长,两组BI评分均提高;术后2、3、6、12 m,观察组BI评分均高于对照组(P<0.05)。观察组手术时间、术后住院时间均短于对照组,术中出血量少于对照组(P<0.05)。观察组术后并发症发生率低于对照组(P<0.05)。结论:与传统开颅手术比较,神经内镜微创手术更有利于促进脑出血患者神经功能恢复、提升日常生活活动能力,且兼具操作时间短、出血量少、住院时间短、并发症发生率低等优势,预后情况良好,值得临床推广应用。展开更多
Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the p...Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days （National Institutes of Health Stroke Scale） and 90 days （modified Rankin Scale） to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.展开更多
基金Supported by the Health Commission of Hunan Province,No.202204115263the Fundamental Research Funds for the Central Universities of Central South University,No.2024XQLH027.
文摘BACKGROUND In the field of anesthesia for procedure for prolapse and hemorrhoids(PPH)surgery,combined spinal-epidural(CSE)anesthesia has been a common approach.However,exploring new combinations to optimize patient outcomes remains crucial.Remimazolam,a short-acting benzodiazepine,shows potential for improving sedation and reducing patient anxiety.The effects of combining remimazolam with CSE anesthesia,compared to traditional CSE anesthesia alone,on patient anxiety,sedation depth,and hemodynamics during PPH surgery have not been fully elucidated.AIM To compare remimazolam-CSE vs CSE alone on State-Trait Anxiety Inventory-State scale(STAI-S)scores,sedation,and hemodynamics in PPH surgery.METHODS This study is a single-center,prospective,randomized controlled trial.Between November 23,2022,and August 6,2024,60 eligible patients were randomly assigned to the CSE anesthesia group or the remimazolam-combined CSE anesthesia group(30 patients each).STAI-S scores,Ramsay sedation scores,and hemodynamic parameters(systolic blood pressure,diastolic blood pressure,heart rate)were measured at multiple time points.Two-way mixed-effects ANOVA and posthoc analyses were performed.RESULTS The Combined group demonstrated significantly lower STAI-S scores before leaving the operating room[mean:28.80 vs 54.03,mean difference(95%CI):25.23(21.24-29.23),P<0.001]and 24 hours post-operation[mean:45.07 vs 54.53,mean difference(95%CI):9.47(6.29-12.64),P<0.001]than the CSE group.Moreover,the Combined group achieved a deeper sedation level during intraoperative maintenance[median:5.00(IQR:5.00-5.00)vs 2.00(IQR:2.00-2.00);median difference(95%CI):3.00(3.00-3.00),P<0.001].Regarding hemodynamics,a significant intergroup difference in systolic blood pressure was observed at the start of the surgery[mean:128.8 vs 114.7 for the Combined and CSE groups,mean difference(95%CI):14.17(0.77-27.57),adjusted P=0.033].CONCLUSION Remimazolam-combined anesthesia outperformed CSE anesthesia in reducing STAI-S scores,enhancing intraoperative sedation,and stabilizing systolic blood pressure at a critical stage,indicating its superiority in perioperative management.
基金supported by the Technology Innovation Special Major Project of Hubei Province(grant number 2022BCA003).
文摘Objective The lack of clarity regarding the application performance of a hybrid operating room(HOR)and the uncertainty of surgical scheduling often lead to its inefficient application.This study aimed to review the clinical application of our neurosurgical HOR and propose a scale to score cases clearly.Methods We reviewed the operating procedures and duration of stay in 1865 HOR cases.The actual procedures of each case were summarized into 5 application types,and numerical assignment was used to distinguish the dependence of each type on our HOR:surgical procedures combined with interventional procedures(4 points,the highest dependence),surgical procedures combined with imaging procedures(3 points),interventional procedures(2 points),imaging procedures(1 point),and surgical procedures(0 points,the lowest dependence).Results A novel scale that could score 1865 cases into those 5 grades was developed.The percentages by grade were as follows:4 points,4.24%;3 points,4.88%;2 points,20.75%;1 point,69.38%;and 0 points,0.75%.The cumulative usage time was 4241.9 h,the duration of which was as follows:4 points,16.17%;3 points,15.50%;2 points,31.32%;1 point,35.62%;and 0 points,1.39%.Conclusions The HOR serves as a multifunctional room to treat neurosurgical diseases.The scale helps to quickly prioritize cases that rely more on HOR,providing guidelines for surgical scheduling.Although our HOR is unsuitable for emergency cases,it clearly shows the application performance of our HOR to provide a reference for promoting its efficient application.
文摘Objective: to explore the effect of continuous nursing intervention on wound stomy and the improvement of ECSA scale score. Methods: 100 cases of rectal cancer patients in our hospital from January 2020 to January 2021 were collected and randomly divided into two groups. The control group received routine nursing, and the observation group received continuous nursing intervention. The score of ECSA scale and the complication rate of wound stomy were compared between the two groups. Results: the score of ECSA scale in observation group was higher than that in control group, and the incidence of complications in wound stomy was lower than that in control group, with significant difference (P < 0.05). Conclusion: the effect of continuous nursing intervention on wound ostomy and the improvement of ECSA scale score are accurate. It can improve patients' self-management ability and reduce complications of wound ostomy. It is a continuous nursing mode worthy of promotion and application.
文摘目的:探讨传统开颅手术与神经内镜微创手术对脑出血患者美国国立卫生研究院卒中量表评分(National Institute of Health Stroke Scale Score,NIHSS)及巴塞尔指数评分(Barthel Index Score,BI)的影响。方法:回顾性收集2022年1月至2023年1月期间本院收治的200例脑出血患者的临床资料。根据治疗方式不同将患者分为对照组(实施传统开颅手术,150例)和观察组(实施神经内镜微创手术,50例)。收集并比较两组术后神经功能恢复情况、术后日常生活活动能力、手术相关指标、术后并发症发生情况。结果:随着术后时间增长,两组NIHSS评分均降低;术后2、3、6、12 m,观察组NIHSS评分均低于对照组(P<0.05)。随着术后时间增长,两组BI评分均提高;术后2、3、6、12 m,观察组BI评分均高于对照组(P<0.05)。观察组手术时间、术后住院时间均短于对照组,术中出血量少于对照组(P<0.05)。观察组术后并发症发生率低于对照组(P<0.05)。结论:与传统开颅手术比较,神经内镜微创手术更有利于促进脑出血患者神经功能恢复、提升日常生活活动能力,且兼具操作时间短、出血量少、住院时间短、并发症发生率低等优势,预后情况良好,值得临床推广应用。
基金supported by the National Natural Science Foundation of China,No.81371521
文摘Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days （National Institutes of Health Stroke Scale） and 90 days （modified Rankin Scale） to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.
