BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing...BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.展开更多
1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,P...1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,Professor Henrik Kehlet,also known as the“father of ERAS”,from the University of Copenhagen in Denmark first proposed the ERAS concept and discovered its clinical feasibility and superiority,achieving remarkable results.ERAS was initially applied in colorectal surgery;subsequently,the concept gradually gained popularity and application worldwide.展开更多
BACKGROUND Data regarding the worldwide gastrointestinal surgery rates in patients with Crohn’s disease(CD)remains limited.AIM To systematically review the global variation in the rates of surgery in CD.METHODS A com...BACKGROUND Data regarding the worldwide gastrointestinal surgery rates in patients with Crohn’s disease(CD)remains limited.AIM To systematically review the global variation in the rates of surgery in CD.METHODS A comprehensive search analysis was performed using multiple electronic databases from inception through July 1,2020,to identify all full text,randomized controlled trials and cohort studies pertaining to gastrointestinal surgery rates in adult patients with CD.Outcomes included continent based demographic data,CD surgery rates over time,as well as the geoepidemiologic variation in CD surgery rates.Statistical analyses were conducted using R.RESULTS Twenty-three studies spanning four continents were included.The median proportion of persons with CD who underwent gastrointestinal surgery in studies from North America,Europe,Asia,and Oceania were 30%(range:1.7%-62.0%),40%(range:0.6%-74.0%),17%(range:16.0%-43.0%),and 38%respectively.No clear association was found regarding the proportion of patients undergoing gastrointestinal surgery over time in North America(R^(2)=0.035)and Europe(R^(2)=0.100).A moderate,negative association was seen regarding the proportion of patients undergoing gastrointestinal surgery over time(R^(2)=0.520)in Asia.CONCLUSION There appears to be significant inter-continental variation regarding surgery rates in CD.Homogenous evidencebased guidelines accounting for the geographic differences in managing patients with CD is prudent.Moreover,as a paucity of data on surgery rates in CD exists outside the North American and European continents,future studies,particularly in less studied locales,are warranted.展开更多
Objective:To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.Methods:Relevant randomized controlled trials that compared the combin...Objective:To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.Methods:Relevant randomized controlled trials that compared the combined effect of music therapy for patients undergoing ophthalmic surgery were included.Four English databases and three Chinese databases were searched from inception to Jan.2022.Two reviewers independently performed data extraction and risk of bias assessments.The Cochrane Collaboration tool was used to assess the risk of bias.Meta-analysis was performed using Review Manager 5.3.The outcomes were overall anxiety,blood pressure,heart rate and pain.Results:A total of 11 trials with 1,469 participants were included in the meta-analysis.Compared to standard care,music therapy had a good effect on reducing the anxiety levels of patients undergoing ophthalmic surgery(P<0.05).The results also suggested that music therapy produced a significant improvement in blood pressure(P<0.05)and heart rate(P<0.05).The visual analogue scale(VAS)showed that music therapy significantly reduced pain compared to standard care(P<0.05).Conclusions:This meta-analysis provided evidence that music therapy has an obvious effect on relieving anxiety levels,while it is also more effective in alleviating pain and improving physiological responses than standard care alone.Our findings may provide accurate evidence-based guidance for the clinical implementation of music therapy.In the future,more high-quality studies are required for verifying these results.展开更多
Introduction: Congenital heart disease includes all cardiac and vascular malformations. It accounts for approximately one third of all congenital malformations and is a public health problem, particularly in developin...Introduction: Congenital heart disease includes all cardiac and vascular malformations. It accounts for approximately one third of all congenital malformations and is a public health problem, particularly in developing countries. The aim of this study was to analyze the epidemiological, clinical and paraclinical aspects of congenital heart disease. Methods: This was a retrospective descriptive and analytical study based on the records of 135 patients referred for surgery and followed up in the cardiology department of the Ignace Deen University Hospital, collected in November 2022. Results: Hospital prevalence was 5%. The mean age was 71 months, ranging from 1 month to 19 years. The age group over 24 months was the most represented (62%). The M/F sex ratio was 1.36. Urban origin was predominant (58%). The rate of children not attending school or dropping out was high (16%). Siblings with fewer than 4 children were the most common (88%). A heart murmur was the most frequent sign (78%), followed by cyanosis (36%) and heart failure (29%). The association between heart murmurs and CHD was proven with a p-value Conclusion: CHDs represent the main indication for paediatric cardiac surgery and follow-up (95%). We stress the importance of implementing a screening and management strategy for congenital heart disease.展开更多
Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation sys...Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation systems face challenges such as high equipment costs,complex operation,bulky size,and insufficient anti-interference performance.To address these limitations,our study developed and validated a novel portable electromagnetic neuronavigation system designed to improve the precision,accessibility,and clinical applicability of electromagnetic navigation technology in cranial surgery.Methods The software and hardware architecture of a portable neural magnetic navigation system was designed.The key technologies of the system were analysed,including electromagnetic positioning algorithms,miniaturized sensor design,optimization of electromagnetic positioning and navigation algorithms,anti-interference signal processing methods,and fast three-dimensional reconstruction algorithms.A prototype was developed,and its accuracy was tested.Finally,a preliminary clinical application evaluation was conducted.Results This study successfully developed a comprehensive portable electromagnetic neuronavigation system capable of achieving preoperative planning,intraoperative real-time positioning and navigation,and postoperative evaluation of navigation outcomes.Through rigorous collaborative testing of the system’s software and hardware,the accuracy of electromagnetic neuronavigation has been validated to meet clinical requirements.Conclusions This study developed a portable neuroelectromagnetic navigation system and validated its effectiveness and safety through rigorous model testing and preliminary clinical applications.The system is characterized by its compact size,high precision,excellent portability,and user-friendly operation,making it highly valuable for promoting navigation technology and advancing the precision and minimally invasive nature of neurosurgical procedures.展开更多
Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Desc...Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].展开更多
BACKGROUND Laparoscopic hepatectomy(LH)has been applied in the treatment of hepatolithiasisa in patients with a history of biliary surgery and has already achieved good clinical outcomes.However,reoperative LH(rLH)inc...BACKGROUND Laparoscopic hepatectomy(LH)has been applied in the treatment of hepatolithiasisa in patients with a history of biliary surgery and has already achieved good clinical outcomes.However,reoperative LH(rLH)includes multiple procedures,and the no studies have examined the clinical value of individual laparoscopic procedures.AIM To evaluate the safety and feasibility of each rLH procedure for hepatolithiasisa in patients with a history of biliary surgery.METHODS Patients with previous biliary surgery who underwent reoperative hepatectomy for hepatolithiasis were studied.Liver resection procedures were divided into three categories:(1)Laparoscopic/open left lateral sectionectomy[reoperative laparoscopic left lateral sectionectomy(rLLLS)/reoperative open left lateral sectionectomy(rOLLS)];(2)Laparoscopic/open left hemihepatectomy[reoperative laparoscopic left hemihepatectomy(rLLH)/reoperative open left hemihepatectomy(rOLH)];and(3)Laparoscopic/open complex hepatectomy[reoperative laparoscopic complex hepatectomy(rLCH)/reoperative open complex hepate ctomy(rOCH)].The clinical outcomes were compared between the rLLLS,rLLH,and rLCH groups,and subgroup analyses were performed for the rLLLS/rOLLS,rLLH/rOLH,and rLCH/rOCH subgroups.RESULTS A total of 185 patients were studied,including 101 rLH patients(40 rLLLS,50 rLLH,and 11 rLCH)and 84 reoperative open hepatectomy(40 rOLLS,33 rOLH,and 11 rOCH).Among the three types of rLH procedure,rLLLS required the shortest operation time(240.0 minutes vs 325.0 minutes vs 350.0 minutes,P=0.001)and the lowest blood transfusion rate(10.0%vs 22.0%vs 54.5%,P=0.005),followed by rLLH.The rLCH had the highest conversion rate(P<0.05)and postoperative intensive care unit stay rate(P=0.001).Most clinical outcomes in rLLLS and rLLH were superior or similar to those in the corresponding open surgery,while there were no differences in all outcomes between the rLCH and rOCH subgroups.CONCLUSION The rLH is safe for hepatolithiasis patients with a history of biliary surgery.The rLLLS and rLLH can be recommended for these patients,whereas rLCH should be applied with caution.展开更多
BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice be...BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice between intraperitoneal anastomosis(IA)and extraperitoneal anastomosis(EA)remains a subject of considerable debate.This study uses intraperitoneal isoperistaltic side-to-side anastomosis(IISSA)with hand-sewn closure of the common opening to evaluate its safety and short-term outcomes.It is hypothesized that this technique may offer better short-term outcomes than EA.AIM To investigate the safety and short-term outcomes of IISSA with hand-sewn closure of the common opening compared to EA.METHODS Patients who underwent laparoscopic radical colon cancer surgery between January 2018 and June 2022 at the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Surgical,postoperative,and pathological features of the IA and EA groups were observed before and after propensity score matching.Patients with right-sided and left-sided colon cancer were separated,each further divided into IA and EA groups(R-IA vs R-EA for right-sided,L-IA vs L-EA for left-sided),for stratified analysis of the aforementioned indicators.RESULTS After propensity score matching,63 pairs were matched in each group.In surgical characteristics,the IA group exhibited less blood loss and shorter incisions than the EA group.Regarding postoperative recovery,the IA group showed earlier recovery of gastrointestinal function.Pathologically,the IA group had greater lymph node clearance.Relative to the R-EA group,the R-IA group experienced reduced blood loss,shorter assisted incisions,earlier recovery of gastrointestinal functions and greater lymph node dissection.When compared to the L-EA group,the L-IA group demonstrated earlier postoperative anal exhaust and defecation,along with a reduced length of hospitalization.Regarding postoperative complications,no statistically significant differences were found between the groups either after matching or in the stratified analyses.CONCLUSION Compared to EA,IISSA with hand-sewn closure of the common opening is a safe and feasible option for laparoscopic radical colon cancer surgery.展开更多
BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for ...BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.展开更多
BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic...BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.展开更多
目的:探究白内障患者人工晶状体(IOL)植入后Kappa角变化趋势及与IOL稳定性的关系。方法:选择2023-02/2024-01于我院接受IOL植入的白内障患者120例120眼为研究对象,其中左眼56眼,右眼64眼。比较手术前后眼科检查结果、Kappa角的分布,以...目的:探究白内障患者人工晶状体(IOL)植入后Kappa角变化趋势及与IOL稳定性的关系。方法:选择2023-02/2024-01于我院接受IOL植入的白内障患者120例120眼为研究对象,其中左眼56眼,右眼64眼。比较手术前后眼科检查结果、Kappa角的分布,以及术后不同时点Kappa角变化和IOL稳定性。Pearson相关及多重线性回归分析IOL旋转稳定性与各眼科检查指标的相关性。多元线性回归分析Kappa角与IOL稳定性的相关性并绘制变化趋势图。结果:术后Kappa角逐渐减小且减小程度逐渐降低(均P<0.05),IOL旋转度数也逐渐减小(P<0.05)。术后2 mo IOL旋转度数与术后1 d AL、LT、K1、K2、PD、Kappa角呈正相关(均P<0.05),与术后1 d ACD呈负相关(均P<0.05)。术后1 d AL、ACD、PD、Kappa角对IOL旋转度数产生显著影响(均P<0.05)。随着Kappa角增大,IOL旋转度数逐渐增大,即IOL稳定性逐渐降低(P<0.05)。结论:白内障患者IOL植入后Kappa角显著减小,前期减小幅度较大,而后趋于稳定,IOL稳定性随Kappa角的增大而降低。展开更多
Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperativ...Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.展开更多
AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-a...AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-assisted cataract surgery(FLACS).METHODS:A total of 36 patients(72 eyes)with age-related cataracts who underwent FLACS and ZCB00 aspherical IOL implantation at Aier Eye Hospital Medical Center,Anhui Medical University between January and December 2023 were included in this prospective study.Patients were divided into three groups based on the central positioning mode for anterior capsulotomy:pupil center,limbus center,and lens apex center groups.IOL alignment and displacement were evaluated using the Casia2 device,and the postoperative visual quality was assessed.RESULTS:At 1 d postoperatively,the IOL tilt for the pupil,limbus,and apex groups were 3.96°±1.51°,4.63°±1.87°,and 3.90°±2.24°,respectively(F=1.07,P=0.35);IOL decentration values were 0.21±0.10 mm,0.23±0.16 mm,and 0.21±0.12 mm,respectively(F=0.14,P=0.87);total higher-order aberrations were 0.32±0.40μm,0.56±0.61μm,and 0.53±0.60μm,respectively(F=1.38,P=0.26);and coma aberrations values were 0.13±0.10μm,0.16±0.15μm,and 0.14±0.15μm,respectively(F=0.3,P=0.74).All results obtained postoperative day 1 did not differ significantly.At 3 mo postoperatively,IOL tilt values were 5.42°±2.00°,3.96°±1.44°,and 3.20°±1.19°,respectively(F=12.40,P<0.001);IOL decentration values were 0.33±0.07 mm,0.23±0.11 mm,and 0.21±0.11 mm,respectively(F=4.99,P=0.008);total higher-order aberrations were 0.67±0.29μm,0.44±0.37μm,and 0.42±0.19μm,respectively(F=5.50,P=0.006);and coma aberrations values were 0.21±0.12μm,0.19±0.12μm,and 0.12±0.11μm,respectively(F=3.87,P=0.03).All results obtained 3 mo postoperatively were statistically significant.CONCLUSION:Using the lens apex as the central positioning mode for anterior capsulotomy in FLACS improves postoperative IOL stability and reduces postoperative IOL tilt and decentration.If the lens apex cannot be determined intraoperatively,the limbus center-positioning mode is recommended.展开更多
This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be consid...This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be considered in patients presenting with abnormal genital bleeding after hysteroscopy and offers valuable insights and lessons for gynecologists in hysteroscopic procedures.The patient underwent timely relevant examinations to confirm the diagnosis,allowing for crucial time required for her treatment.In this study,the primary cause of UAP formation in the patient was attributed to a prior hysteroscopic surgical procedure conducted at another medical facility,suggesting that the selection and imple-mentation of dilatation catheters are some of the predisposing factors for UAP.In conclusion,this case study offers a comprehensive analysis of the etiology of UAP and effectively provides timely diagnosis and treatment,offering valuable in-sights for the clinical diagnosis and management of UAP.展开更多
Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent compl...Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.展开更多
文摘BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.
文摘1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,Professor Henrik Kehlet,also known as the“father of ERAS”,from the University of Copenhagen in Denmark first proposed the ERAS concept and discovered its clinical feasibility and superiority,achieving remarkable results.ERAS was initially applied in colorectal surgery;subsequently,the concept gradually gained popularity and application worldwide.
文摘BACKGROUND Data regarding the worldwide gastrointestinal surgery rates in patients with Crohn’s disease(CD)remains limited.AIM To systematically review the global variation in the rates of surgery in CD.METHODS A comprehensive search analysis was performed using multiple electronic databases from inception through July 1,2020,to identify all full text,randomized controlled trials and cohort studies pertaining to gastrointestinal surgery rates in adult patients with CD.Outcomes included continent based demographic data,CD surgery rates over time,as well as the geoepidemiologic variation in CD surgery rates.Statistical analyses were conducted using R.RESULTS Twenty-three studies spanning four continents were included.The median proportion of persons with CD who underwent gastrointestinal surgery in studies from North America,Europe,Asia,and Oceania were 30%(range:1.7%-62.0%),40%(range:0.6%-74.0%),17%(range:16.0%-43.0%),and 38%respectively.No clear association was found regarding the proportion of patients undergoing gastrointestinal surgery over time in North America(R^(2)=0.035)and Europe(R^(2)=0.100).A moderate,negative association was seen regarding the proportion of patients undergoing gastrointestinal surgery over time(R^(2)=0.520)in Asia.CONCLUSION There appears to be significant inter-continental variation regarding surgery rates in CD.Homogenous evidencebased guidelines accounting for the geographic differences in managing patients with CD is prudent.Moreover,as a paucity of data on surgery rates in CD exists outside the North American and European continents,future studies,particularly in less studied locales,are warranted.
文摘Objective:To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.Methods:Relevant randomized controlled trials that compared the combined effect of music therapy for patients undergoing ophthalmic surgery were included.Four English databases and three Chinese databases were searched from inception to Jan.2022.Two reviewers independently performed data extraction and risk of bias assessments.The Cochrane Collaboration tool was used to assess the risk of bias.Meta-analysis was performed using Review Manager 5.3.The outcomes were overall anxiety,blood pressure,heart rate and pain.Results:A total of 11 trials with 1,469 participants were included in the meta-analysis.Compared to standard care,music therapy had a good effect on reducing the anxiety levels of patients undergoing ophthalmic surgery(P<0.05).The results also suggested that music therapy produced a significant improvement in blood pressure(P<0.05)and heart rate(P<0.05).The visual analogue scale(VAS)showed that music therapy significantly reduced pain compared to standard care(P<0.05).Conclusions:This meta-analysis provided evidence that music therapy has an obvious effect on relieving anxiety levels,while it is also more effective in alleviating pain and improving physiological responses than standard care alone.Our findings may provide accurate evidence-based guidance for the clinical implementation of music therapy.In the future,more high-quality studies are required for verifying these results.
文摘Introduction: Congenital heart disease includes all cardiac and vascular malformations. It accounts for approximately one third of all congenital malformations and is a public health problem, particularly in developing countries. The aim of this study was to analyze the epidemiological, clinical and paraclinical aspects of congenital heart disease. Methods: This was a retrospective descriptive and analytical study based on the records of 135 patients referred for surgery and followed up in the cardiology department of the Ignace Deen University Hospital, collected in November 2022. Results: Hospital prevalence was 5%. The mean age was 71 months, ranging from 1 month to 19 years. The age group over 24 months was the most represented (62%). The M/F sex ratio was 1.36. Urban origin was predominant (58%). The rate of children not attending school or dropping out was high (16%). Siblings with fewer than 4 children were the most common (88%). A heart murmur was the most frequent sign (78%), followed by cyanosis (36%) and heart failure (29%). The association between heart murmurs and CHD was proven with a p-value Conclusion: CHDs represent the main indication for paediatric cardiac surgery and follow-up (95%). We stress the importance of implementing a screening and management strategy for congenital heart disease.
基金funded by National Natural Science Foundation of China(No.82272134)Innovative Research Group Project of the National Natural Science Foundation of China(No.82272134,Xiao-lei Chen).
文摘Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation systems face challenges such as high equipment costs,complex operation,bulky size,and insufficient anti-interference performance.To address these limitations,our study developed and validated a novel portable electromagnetic neuronavigation system designed to improve the precision,accessibility,and clinical applicability of electromagnetic navigation technology in cranial surgery.Methods The software and hardware architecture of a portable neural magnetic navigation system was designed.The key technologies of the system were analysed,including electromagnetic positioning algorithms,miniaturized sensor design,optimization of electromagnetic positioning and navigation algorithms,anti-interference signal processing methods,and fast three-dimensional reconstruction algorithms.A prototype was developed,and its accuracy was tested.Finally,a preliminary clinical application evaluation was conducted.Results This study successfully developed a comprehensive portable electromagnetic neuronavigation system capable of achieving preoperative planning,intraoperative real-time positioning and navigation,and postoperative evaluation of navigation outcomes.Through rigorous collaborative testing of the system’s software and hardware,the accuracy of electromagnetic neuronavigation has been validated to meet clinical requirements.Conclusions This study developed a portable neuroelectromagnetic navigation system and validated its effectiveness and safety through rigorous model testing and preliminary clinical applications.The system is characterized by its compact size,high precision,excellent portability,and user-friendly operation,making it highly valuable for promoting navigation technology and advancing the precision and minimally invasive nature of neurosurgical procedures.
基金Supported by the Natural Science Foundation of Fujian Province(No.2024J011318No.2024J011321)Fuzhou Science and Technology Program(No.2023-S-005).
文摘Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].
基金Supported by The Key Research and Development Program of Anhui Province of China,No.1804h08020273The Key Research Project of Health Commission of Anhui Province of China,No.AHWJ2022a016.
文摘BACKGROUND Laparoscopic hepatectomy(LH)has been applied in the treatment of hepatolithiasisa in patients with a history of biliary surgery and has already achieved good clinical outcomes.However,reoperative LH(rLH)includes multiple procedures,and the no studies have examined the clinical value of individual laparoscopic procedures.AIM To evaluate the safety and feasibility of each rLH procedure for hepatolithiasisa in patients with a history of biliary surgery.METHODS Patients with previous biliary surgery who underwent reoperative hepatectomy for hepatolithiasis were studied.Liver resection procedures were divided into three categories:(1)Laparoscopic/open left lateral sectionectomy[reoperative laparoscopic left lateral sectionectomy(rLLLS)/reoperative open left lateral sectionectomy(rOLLS)];(2)Laparoscopic/open left hemihepatectomy[reoperative laparoscopic left hemihepatectomy(rLLH)/reoperative open left hemihepatectomy(rOLH)];and(3)Laparoscopic/open complex hepatectomy[reoperative laparoscopic complex hepatectomy(rLCH)/reoperative open complex hepate ctomy(rOCH)].The clinical outcomes were compared between the rLLLS,rLLH,and rLCH groups,and subgroup analyses were performed for the rLLLS/rOLLS,rLLH/rOLH,and rLCH/rOCH subgroups.RESULTS A total of 185 patients were studied,including 101 rLH patients(40 rLLLS,50 rLLH,and 11 rLCH)and 84 reoperative open hepatectomy(40 rOLLS,33 rOLH,and 11 rOCH).Among the three types of rLH procedure,rLLLS required the shortest operation time(240.0 minutes vs 325.0 minutes vs 350.0 minutes,P=0.001)and the lowest blood transfusion rate(10.0%vs 22.0%vs 54.5%,P=0.005),followed by rLLH.The rLCH had the highest conversion rate(P<0.05)and postoperative intensive care unit stay rate(P=0.001).Most clinical outcomes in rLLLS and rLLH were superior or similar to those in the corresponding open surgery,while there were no differences in all outcomes between the rLCH and rOCH subgroups.CONCLUSION The rLH is safe for hepatolithiasis patients with a history of biliary surgery.The rLLLS and rLLH can be recommended for these patients,whereas rLCH should be applied with caution.
基金Bethune Charitable Foundation Project,No.HZB-20190528-10Natural Science Foundation of Fujian Province,No.2020J011230.
文摘BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice between intraperitoneal anastomosis(IA)and extraperitoneal anastomosis(EA)remains a subject of considerable debate.This study uses intraperitoneal isoperistaltic side-to-side anastomosis(IISSA)with hand-sewn closure of the common opening to evaluate its safety and short-term outcomes.It is hypothesized that this technique may offer better short-term outcomes than EA.AIM To investigate the safety and short-term outcomes of IISSA with hand-sewn closure of the common opening compared to EA.METHODS Patients who underwent laparoscopic radical colon cancer surgery between January 2018 and June 2022 at the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Surgical,postoperative,and pathological features of the IA and EA groups were observed before and after propensity score matching.Patients with right-sided and left-sided colon cancer were separated,each further divided into IA and EA groups(R-IA vs R-EA for right-sided,L-IA vs L-EA for left-sided),for stratified analysis of the aforementioned indicators.RESULTS After propensity score matching,63 pairs were matched in each group.In surgical characteristics,the IA group exhibited less blood loss and shorter incisions than the EA group.Regarding postoperative recovery,the IA group showed earlier recovery of gastrointestinal function.Pathologically,the IA group had greater lymph node clearance.Relative to the R-EA group,the R-IA group experienced reduced blood loss,shorter assisted incisions,earlier recovery of gastrointestinal functions and greater lymph node dissection.When compared to the L-EA group,the L-IA group demonstrated earlier postoperative anal exhaust and defecation,along with a reduced length of hospitalization.Regarding postoperative complications,no statistically significant differences were found between the groups either after matching or in the stratified analyses.CONCLUSION Compared to EA,IISSA with hand-sewn closure of the common opening is a safe and feasible option for laparoscopic radical colon cancer surgery.
文摘BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.
文摘目的:探究白内障患者人工晶状体(IOL)植入后Kappa角变化趋势及与IOL稳定性的关系。方法:选择2023-02/2024-01于我院接受IOL植入的白内障患者120例120眼为研究对象,其中左眼56眼,右眼64眼。比较手术前后眼科检查结果、Kappa角的分布,以及术后不同时点Kappa角变化和IOL稳定性。Pearson相关及多重线性回归分析IOL旋转稳定性与各眼科检查指标的相关性。多元线性回归分析Kappa角与IOL稳定性的相关性并绘制变化趋势图。结果:术后Kappa角逐渐减小且减小程度逐渐降低(均P<0.05),IOL旋转度数也逐渐减小(P<0.05)。术后2 mo IOL旋转度数与术后1 d AL、LT、K1、K2、PD、Kappa角呈正相关(均P<0.05),与术后1 d ACD呈负相关(均P<0.05)。术后1 d AL、ACD、PD、Kappa角对IOL旋转度数产生显著影响(均P<0.05)。随着Kappa角增大,IOL旋转度数逐渐增大,即IOL稳定性逐渐降低(P<0.05)。结论:白内障患者IOL植入后Kappa角显著减小,前期减小幅度较大,而后趋于稳定,IOL稳定性随Kappa角的增大而降低。
文摘Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.
文摘AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-assisted cataract surgery(FLACS).METHODS:A total of 36 patients(72 eyes)with age-related cataracts who underwent FLACS and ZCB00 aspherical IOL implantation at Aier Eye Hospital Medical Center,Anhui Medical University between January and December 2023 were included in this prospective study.Patients were divided into three groups based on the central positioning mode for anterior capsulotomy:pupil center,limbus center,and lens apex center groups.IOL alignment and displacement were evaluated using the Casia2 device,and the postoperative visual quality was assessed.RESULTS:At 1 d postoperatively,the IOL tilt for the pupil,limbus,and apex groups were 3.96°±1.51°,4.63°±1.87°,and 3.90°±2.24°,respectively(F=1.07,P=0.35);IOL decentration values were 0.21±0.10 mm,0.23±0.16 mm,and 0.21±0.12 mm,respectively(F=0.14,P=0.87);total higher-order aberrations were 0.32±0.40μm,0.56±0.61μm,and 0.53±0.60μm,respectively(F=1.38,P=0.26);and coma aberrations values were 0.13±0.10μm,0.16±0.15μm,and 0.14±0.15μm,respectively(F=0.3,P=0.74).All results obtained postoperative day 1 did not differ significantly.At 3 mo postoperatively,IOL tilt values were 5.42°±2.00°,3.96°±1.44°,and 3.20°±1.19°,respectively(F=12.40,P<0.001);IOL decentration values were 0.33±0.07 mm,0.23±0.11 mm,and 0.21±0.11 mm,respectively(F=4.99,P=0.008);total higher-order aberrations were 0.67±0.29μm,0.44±0.37μm,and 0.42±0.19μm,respectively(F=5.50,P=0.006);and coma aberrations values were 0.21±0.12μm,0.19±0.12μm,and 0.12±0.11μm,respectively(F=3.87,P=0.03).All results obtained 3 mo postoperatively were statistically significant.CONCLUSION:Using the lens apex as the central positioning mode for anterior capsulotomy in FLACS improves postoperative IOL stability and reduces postoperative IOL tilt and decentration.If the lens apex cannot be determined intraoperatively,the limbus center-positioning mode is recommended.
文摘This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be considered in patients presenting with abnormal genital bleeding after hysteroscopy and offers valuable insights and lessons for gynecologists in hysteroscopic procedures.The patient underwent timely relevant examinations to confirm the diagnosis,allowing for crucial time required for her treatment.In this study,the primary cause of UAP formation in the patient was attributed to a prior hysteroscopic surgical procedure conducted at another medical facility,suggesting that the selection and imple-mentation of dilatation catheters are some of the predisposing factors for UAP.In conclusion,this case study offers a comprehensive analysis of the etiology of UAP and effectively provides timely diagnosis and treatment,offering valuable in-sights for the clinical diagnosis and management of UAP.
文摘Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.
