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Application of ERAS Concept Combined with Psychological Stress Intervention in Laparoscopic Urological Surgery Nursing 认领
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作者 Liumei Luo Xiangling Jiang +3 位作者 Xinli Kang Fanchang Zeng Yuzhu Lin Dingying Wu 《健康(英文)》 2021年第2期134-143,共10页
Enhanced recovery after surgery (ERAS), a series of evidence-based optimization measures during the perioperative period, to reduce patients’ physical and psychological traumatic stress responses, to reduce complicat... Enhanced recovery after surgery (ERAS), a series of evidence-based optimization measures during the perioperative period, to reduce patients’ physical and psychological traumatic stress responses, to reduce complications, to shorten the length of hospital stay, to reduce the risk of readmission and mortality, and ultimately to promote rapid patient resuscitation, is adopted. The negative emotional experience of patients may aggravate the surgical stress response, interfere with the endocrine system and nervous system, cause the imbalance of internal environment, and have a negative impact on the surgical effect. This paper uses the concept of ERAS in combination with psychological stress interventions, perioperative psychological nursing instruction, reduces the laparoscopic surgery in patients with psychological stress reaction on the immune function of cells, improves the body’s immune function, improves the body of bacteria such as vitamin attack resistance, reduces the risk of complications such as infection, and accelerates the process of patient rehabilitation. Here is the report. 展开更多
关键词 Accelerated Rehabilitation Surgery Laparoscopic Urinary Surgery NURSING Stress Response Psychological Intervention
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外科术后肺部感染生理学和手术严重性评分系统风险评估及护理对策 认领
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作者 胡婷 夏慧华 朱先花 《中国当代医药》 CAS 2021年第3期228-231,共4页
目的探讨外科术后肺部感染生理学和手术严重性评分系统(POSSUM)风险评估及其护理对策。方法回顾性分析2019年1月~2020年3月江西省九江市第三人民医院手术治疗的80例中老年患者的临床资料,将2019年1~8月采用普外科常规护理的40例纳入对照... 目的探讨外科术后肺部感染生理学和手术严重性评分系统(POSSUM)风险评估及其护理对策。方法回顾性分析2019年1月~2020年3月江西省九江市第三人民医院手术治疗的80例中老年患者的临床资料,将2019年1~8月采用普外科常规护理的40例纳入对照组,将2019年9月~2020年3月在常规护理基础上采用基于POSSUM评分的肺部感染分级预防护理策略的40例纳入观察组,两组护理时间均为1个月,比较两组的急性生理与慢性健康评分Ⅱ(APACHEⅡ)、护理后肺部感染发生情况和护理总满意度。结果护理1个月后,观察组的APACHEⅡ评分低于对照组,肺部感染总发生率为2.50%(1/40),低于对照组的20.00%(8/40),总满意度为97.50%,高于对照组的77.50%,差异均有统计学意义(P<0.05)。结论外科手术患者采用POSSUM评估术后风险,并根据评估结果制订针对性分级护理方案能显著降低术后肺部感染发生风险,并提升预后效果和患者满意度,有推广价值。 展开更多
关键词 外科手术 肺部感染 生理学和手术严重性评分系统 风险评估 护理对策
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胃肠肿瘤患者的术前预康复 认领
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作者 周岩冰 《中华胃肠外科杂志》 CSCD 北大核心 2021年第2期122-127,共6页
胃肠肿瘤及针对性治疗(放化疗、手术)可以造成患者机体功能状态下降,并对生活质量、临床结局和治疗过程产生负面影响。其中心理困扰会给患者身心状态造成严重的伤害,常会经历焦虑、抑郁、自卑以及对复发和死亡的恐惧。癌症预康复是指肿... 胃肠肿瘤及针对性治疗(放化疗、手术)可以造成患者机体功能状态下降,并对生活质量、临床结局和治疗过程产生负面影响。其中心理困扰会给患者身心状态造成严重的伤害,常会经历焦虑、抑郁、自卑以及对复发和死亡的恐惧。癌症预康复是指肿瘤确诊到实施针对性治疗期间,进行的心理、生理和营养等方面评估、病情判断,并进行针对性的干预,改善患者的健康状况及功能能力,减少肿瘤、化放疗及手术等所带来的危害和严重程度。多模式术前预康复包括术前有计划、结构性、可重复、目标明确的综合体能锻炼、营养支持治疗和减轻焦虑抑郁状态的系列干预措施,已经成为ERAS路径管理最重要的举措之一,能够术前提高患者的功能状态、更好地应对手术应激、改善患者临床结局。但是胃肠道肿瘤术前预康复仍存在一些问题,包括最佳体能训练方案、干预的时机和方式、如何提高依从性、功能能力检测方法以及预康复成本效益等。因此,需要更多高级别循证医学证据来评估术前预康复临床应用的真实价值。 展开更多
关键词 胃肠道肿瘤 手术 术前预康复 加速康复外科 功能状态
Breast Conserving Surgery: Has the Standard of Care Enhanced Outcomes for Patients? 认领
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作者 Rodrigo Arrangoiz Jeronimo Garcialopez De Llano +4 位作者 Maria Fernanda Mijares Gonzalo Fernandez-Christlieb Vanitha Vasudevan Amit Sastry Adrian Legaspi 《乳腺癌(英文)》 2021年第1期1-23,共23页
Breast Conserving Surgery (BCS) is a rapidly emerging field increasingly adopted to facilitate breast conservation and preserve breast aesthetics. Since the publicatio</span><span style="font-family:Verd... Breast Conserving Surgery (BCS) is a rapidly emerging field increasingly adopted to facilitate breast conservation and preserve breast aesthetics. Since the publicatio</span><span style="font-family:Verdana;">n of the Randomized Controlled Trials (RCTs) of Breast Conserving Surgery versus mastectomy in early breast cancer, the adoption of BCS for breast cancer patients’ surgical management has been comprehensive. A computerized bibliographic search was performed on PubMed/MEDLINE,</span><span style="font-family:Verdana;"> Embase, Google Scholar and Cochrane library databases. This article aims to perform a thorough review of new data regarding invasive cancer and margins while evaluating patient outcomes related to BCS after neoadjuvant chemotherapy focusing on margins, imaging evaluation, the extent of resection, and local regional recurrence outcomes. The growth pattern and biopsy of Ductal Carcinoma </span><i><span style="font-family:Verdana;">In Situ</span></i><span style="font-family:Verdana;"> (DCIS) differ from invasive cancer, impacting margins. It is essential to understand how the Society of Surgical Oncology (SSO) DCIS margin guideline has influenced practice. Early breast cancer surgical management should be unique to each patient, driven by evidence-based medicine, and focused on specific clinical, histological, and molecular characteristics of the tumor. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The current management for early breast cancer should be tailored and evidence-based to each patient based on the clinical, histological and molecular characteristics of the tumor. Presumably, the standard of care in BCS has enhanced the outcomes for this patient population. This review made by peers will help surgeons to stay up to date with the current literature and help them manage breast cancer while improving multiple clinical parameters such as Disease-Free Survival (DFS), Recurrence-Free Survival (RFS) and most importantly Overall Surviva 展开更多
关键词 Breast Conserving Surgery (BCS) Disease-Free Survival (DFS) Recur-rence-Free Survival (RFS) Distant-Disease-Free Survival (DDFS) Overall Sur-vival (OS) Ductal Carcinoma in Situ (DCIS) Neoadjuvant Chemotherapy (NAC)
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Evolution of techniques in robotic kidney transplantation with perspectives on future developments 认领
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作者 Thomas Fonseka 《腔镜、内镜与机器人外科》 2021年第1期3-8,共6页
Robotic kidney transplantation(RKT)has brought the benefits of minimally invasive surgery to the field of renal transplantation.Techniques across the globe have varied and there is a need for standardization within ev... Robotic kidney transplantation(RKT)has brought the benefits of minimally invasive surgery to the field of renal transplantation.Techniques across the globe have varied and there is a need for standardization within evidence-based frameworks in order to justify its widespread utilization and ensure safe and effective innovation.A comprehensive literature review was conducted to identify studies reporting on techniques used in RKT between 2010 and 2020.Conference abstracts,published papers and the latest guidelines were reviewed in this rapidly progressing field.Promising results have been demonstrated so far with unique benefits identified for obese patients who would have otherwise been denied an open kidney transplant.Other developments have been found in gasless surgery,scarless surgery,RKT using grafts with multiple vessels and robotic dual kidney transplantation.In order to continue advancing innovation in kidney transplant surgery,further expansion of RKT is needed to deceased donor programs.Progression in the robotic technology itself will also improve technique,and as the financial costs of the technology decrease the use of RKT is set to grow. 展开更多
关键词 Minimally invasive surgery Transplantation surgery Robotic urology IDEAL framework
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Left Atrium Emboligenic Myxoma: Case Report and Review of the Literature 认领
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作者 Bréhima Coulibaly Abdoulaye Kanté +6 位作者 Mamadou Diakité Samba Sidibé Drissa Traoré Bréhima Bengaly Mariam Daou Demba Yattera Nouhoum Ongoïba 《胸外科期刊(英文)》 2021年第1期18-24,共7页
<strong>Introduction</strong>: Cardiac myxomas represent the most frequent forms of primary tumors of the heart. The most frequent location is the interatrial septum. We report the clinical case of a myxom... <strong>Introduction</strong>: Cardiac myxomas represent the most frequent forms of primary tumors of the heart. The most frequent location is the interatrial septum. We report the clinical case of a myxoma of the left atrium and discuss its epidemiological and therapeutic aspects through a review of the literature. <strong>Observation</strong>: This was a 41-year-old female patient who presented with sudden rotational dizziness associated with vomiting. MRI revealed multiple punctiform bilateral supra and subtentorial strokes of different ages, recent and semi-recent, suggesting an embologenic etiology. Transesophageal echocardiography found a large pedunculated, homogeneous, avascular tumor hanging from the interatrial septum. The patient is operated on urgently under cardiopulmonary bypass for resection of a large tumor located in the left atrium. The pathological examination concluded with the diagnosis of myxoma of the left atrium. The postoperative follow-up was straightforward and the patient was discharged from the hospital via home hospitalization. <strong>Conclusion</strong>: The diagnosis of cardiac myxomas is suspected in the presence of symptoms associated with echocardiographic images of intracardiac masses and confirmed by histological study. Embolic accidents are one of the formidable complications of myxomas. Surgical management is urgent, especially in the presence of predictive morphological features of embolism on echocardiography. 展开更多
关键词 Myxoma of the Left Atrium Cerebral Embolism Interest of Trans-Esophageal Ultrasound SURGERY
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Video-Assisted Thoracic Surgery for Residual Aneurysm after Total Arch Replacement 认领
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作者 Kayo Sugiyama Hirotaka Watanuki +5 位作者 Yasuhiro Futamura Masaho Okada Hiroki Numanami Masayuki Yamaji Satoshi Makino Katsuhiko Matsuyama 《胸外科期刊(英文)》 2021年第1期25-30,共6页
<strong>Background</strong>: Residual aneurysms after graft replacement are rare, but they can be detrimental if they are saccular and large. The etiology of residual aneurysms remains unknown, and their m... <strong>Background</strong>: Residual aneurysms after graft replacement are rare, but they can be detrimental if they are saccular and large. The etiology of residual aneurysms remains unknown, and their management is controversial. One treatment option is late open surgical conversion;however, postoperative respiratory complications resulting from the dissection of pleural adhesions, which is frequently necessary with this approach, are often unavoidable. <strong>Case presentation</strong>: Herein, we report a case of open surgical repair of a residual distal aortic arch aneurysm that occurred after total arch replacement and thoracic endovascular aortic repair. Contrast-enhanced magnetic resonance imaging was not possible in this case due to the patient’s severe renal dysfunction;however, contrast-enhanced computed tomography using minimal contrast did not detect remarkable leakage through the graft or stent graft into the aneurysm. Late open surgical conversion using video-assisted thoracic surgery was performed by thoracic surgeons, and the adhesion between the aortic wall and the lung was safely and effectively dissected. Because there was no significant pulsation or evidence of feeding arteries in the aortic wall, the aortic wall was opened carefully. No bleeding or backflow from any branch arteries into the aneurysm was noted, so the aortic wall was ligated with continuous sutures. The patient recovered without experiencing any major complications. <strong>Conclusions</strong>: This case report demonstrates that video-assisted thoracic surgery is safe and effective for late open conversion in cases of residual aneurysm;furthermore, this case suggests that video-assisted thoracic surgery may be particularly beneficial for the dissection of adhesions between the aortic wall and lung in these cases. 展开更多
关键词 Late Open Surgical Conversion Total Arch Replacement Video-Assisted Thoracic Surgery
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Breast Asymmetry Evaluation Using Objective Measures after Breast Cancer Surgery 认领
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作者 Jaejong Park Fariha M. Haque +2 位作者 Achille Louodom Chedjou Michael J. Miller Alok Sutradhar 《生物医学工程(英文)》 2021年第1期1-10,共10页
Although a positive cosmetic outcome is an important goal of breast cancer reconstruction, the objective analysis of breast aesthetics has yet to reach a gold standard or unified method to quantify breast symmetry. Se... Although a positive cosmetic outcome is an important goal of breast cancer reconstruction, the objective analysis of breast aesthetics has yet to reach a gold standard or unified method to quantify breast symmetry. Several scoring systems, both subjective and objective, have been developed over the years to ensure the desirable outcome in breast symmetry, but these methods have yet to reach the unanimous acceptance in terms of accuracy, value and ease of use to be implemented in the clinical setting. By assessing several existing symmetry scores, most of which are based on 2D imaging, along with our own set of symmetry parameters applied to 3D patient images, the goal of this study is to determine if there is an advantage of 3D imaging in formulating an accurate objective breast aesthetic score over the existing objective scores. A reliable breast aesthetic score would improve the decision-making in surgery as well as improve patient satisfaction. Additionally, knowing the quantity and degree of breast asymmetry objectively will improve outcome and reduce revision rates, minimizing patient suffering and improving the overall quality of patient life and body image. 展开更多
关键词 Asymmetry Breast Surgery Outcome Research Surface Imaging 3D Scan
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Role of artificial intelligence in hepatobiliary and pancreatic surgery 认领
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作者 Hassaan Bari Sharan Wadhwani Bobby V M Dasari 《世界胃肠外科杂志:英文版(电子版)》 SCIE 2021年第1期7-18,共12页
Over the past decade,enhanced preoperative imaging and visualization,improved delineation of the complex anatomical structures of the liver and pancreas,and intra-operative technological advances have helped deliver t... Over the past decade,enhanced preoperative imaging and visualization,improved delineation of the complex anatomical structures of the liver and pancreas,and intra-operative technological advances have helped deliver the liver and pancreatic surgery with increased safety and better postoperative outcomes.Artificial intelligence(AI)has a major role to play in 3D visualization,virtual simulation,augmented reality that helps in the training of surgeons and the future delivery of conventional,laparoscopic,and robotic hepatobiliary and pancreatic(HPB)surgery;artificial neural networks and machine learning has the potential to revolutionize individualized patient care during the preoperative imaging,and postoperative surveillance.In this paper,we reviewed the existing evidence and outlined the potential for applying AI in the perioperative care of patients undergoing HPB surgery. 展开更多
关键词 Artificial intelligence Liver surgery Pancreatic surgery Augmented reality Virtual reality INTRA-OPERATIVE
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Risk Factors for Urinary Incontinence after Obstetric Vesicovaginal Fistula Closure in Guinea 认领
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作者 Fatoumata Binta Balde Abdoulaye Bobo Diallo +5 位作者 Abdoulaye Toure Daouda Kante Thierno Mamadou Oury Diallo Alhafiz Lamadine Diao Cisse Olivier Kouadio 《外科学(英文)》 2021年第1期1-8,共8页
<strong>Introduction:</strong> Urinary incontinence after closure of vesicovaginal fistula is any involuntary loss of urine that a patient complains of. We aim to study the risk factors for urinary inconti... <strong>Introduction:</strong> Urinary incontinence after closure of vesicovaginal fistula is any involuntary loss of urine that a patient complains of. We aim to study the risk factors for urinary incontinence after closure of obstetric vesicovaginal fistula in Guinea in order to develop preventive measures to reduce its incidence. <strong>Materials and Methods:</strong> This was a retrospective, multiple center cohort of women operated on for obstetric vesicovaginal fistula during a 10-year period. <strong>Results:</strong> In 1770 vesicovaginal fistulas operated, 1347 were closed. 180 women (13.36%) developed urinary incontinence. After multivariate analysis, the risk factors of urinary incontinence after closure of vesicovaginal fistula were: the patient’s age, the anatomical type III, iterative surgical intervention, the brevity of the urethra and decrease in bladder capacity. <strong>Conclusion:</strong> Urinary incontinence after closure of vesicovaginal fistula is a frequent problem in Guinea, the prevention of which should be integrated into the management of fistulas. 展开更多
关键词 Vesicovaginal Fistula SURGERY Urinary Incontinence
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Treatment Options for Pin Site Infection during Kirschner Wires in Elective Forefoot Surgery 认领
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作者 Ismail Mohamed Hussein Lei Wang Bin Yu 《矫形学期刊(英文)》 2021年第2期47-66,共20页
The Kirschner wires (K-wires) are stiff and straight wires made of smooth stainless steel. These are used in surgery to aid in repairing the process of a fractured bone. In forefoot elective surgeries, these pins are ... The Kirschner wires (K-wires) are stiff and straight wires made of smooth stainless steel. These are used in surgery to aid in repairing the process of a fractured bone. In forefoot elective surgeries, these pins are mostly used for fixation of the phalangeal or metatarsal area. These wires are usually either buried or exposed, The exposed wires do not require another operation to remove them and are generally preferred. In using the forefoot surgery history of a single surgeon which was taken for 3 years<span>.</span><span> The purpose of this study is to evaluate the occurrence of infections following elective surgeries of the forefoot that were fixed using k-pins and to indicate an effective treatment option for resolving the infection. The inclusion criteria set for this study was to remove any patient having any disease except for diabetes. Moreover, the age limit was set to be 18</span><span> </span><span>-</span><span> </span><span>44, making a final sample of 50 people, prescribed prophylactic antibiotics or early removal of k-pins, where necessary. The researcher recorded demographic and biological data from the patients such as age, BMI, and smoking status were recorded. The researcher conducted a Univariate analysis via a Chi-square test. 50</span><b><span> </span></b><span>Patients (82 K-wires) were analyzed. Results showed that surgery type, BMI, and smoking were three variables that affect the infection growth significantly while diabetes and type of cleaning disinfectant had marginal effects. Further study is required to clarify the best treatments in this area, as the treatment option antibiotics have nearly similar results.</span> 展开更多
关键词 Kirschner Wires COMPLICATIONS Risk Factors DISINFECTANT Forefoot Surgery Infection Risk Treatment Options
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A Study on the Psychological Status of the Caregivers to Patients Out of ICU after Craniocerebral Tumor Surgery and Their Factors 认领
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作者 Ying Li Daili Zou +3 位作者 Yu Yang Yunjia Li Qinqin Zhao Zhihuan Zhou 《神经系统科学与医药(英文)》 2021年第1期1-11,共11页
<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Objective:</strong> So as to provide a theoretical basis for the future development of intervent... <div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Objective:</strong> So as to provide a theoretical basis for the future development of intervention measures to reduce the negative psychological mood of caregivers. To investigate the psychological status of the main caregivers for patients who were transferred out of ICU after craniocerebral tumor surgery and analyze their factors. <strong>Methods:</strong> 112 patients with cerebral tumor surgery were reviewed from sun yat-sen university cancer hospital. The research object is caregivers. The general data questionnaire, hospital anxiety depression scale and migration of ICU patients’ family members stress questionnaire scale investigation are collected. Multiple linear regression analysis in cerebral tumor patients with postoperative ICU transition out main factors influencing the psychological condition of the caregivers. <strong>Results:</strong> The anxiety and depression scores were (15.60 ± 5.83) and (38.73 ± 3.23) respectively. The results of multiple regression analysis showed that the gender, education level, relationship with the patient and family monthly income of the primary caregivers of the patients were the influencing factors of anxiety, depression and migration stress psychological state (P < 0.05). <strong>Conclusion:</strong> The main caregivers of patients who were transferred out of ICU after craniocerebral tumor surgery had relatively severe anxiety, depression and migration stress. Medical staff should pay attention to the psychological status of caregivers and take effective measures to promote their physical and mental health.</span> </div> 展开更多
关键词 Craniocerebral Tumor Surgery ICU Transition Period CAREGIVERS Psychological Status Factors Affecting
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The Endonasal Endoscopic Management of Paranasal Sinuses Mucoceles 认领
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作者 Sarah A. AlMansour Ali A. AlMomen 《耳鼻喉(英文)》 2021年第1期20-29,共10页
<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacen... <strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacent structures, serious morbidities and mortalities may occur. <strong>Objective:</strong> To emphasize on the efficacy of endonasal endoscopic marsupialization in the treatment of paranasal sinus mucoceles. <strong>Method:</strong> Retrospective descriptive study on paranasal sinus mucocele cases operated on endoscopically by the author (AAM), in the 10-year-period from to 2009-2019. <strong>Result:</strong> Total of 23 cases were included, 16 were males and 7 females, age ranging between 14 - 76 years, with a mean age of 45 years Location of mucoceles varied between: Frontal 7 cases (30%), Fronto-ethmoidal 6 cases (26%), Isolated Ethmoidal accounted for 3 cases (13%), sphenoidal 4 cases (17%), maxillary were 3 cases (13%) all of the 23 cases underwent endonasal endoscopic complete marsupialization, none of them required combination with external approach in-spite of different locations and complications, with no recurrence in a mean follow up period of 2.4 years. <strong>Conclusion:</strong> Endonasal endoscopic approach is a safe, efficient approach in the treatment of most paranasal sinus mucocele case in their different presentations and locations. 展开更多
关键词 MUCOCELE Paranasal Sinus Chronic Rhinosinusitis Endoscopic Sinus Surgery MARSUPIALIZATION
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Observation on the Efficacy of Autologous Blood Transfusion Combined with Controlled Hypotension in Patients with Spinal Internal Fixation during the Outbreak of New Coronavirus Pneumonia in Western Guangxi (in Guixi) 认领
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作者 Chengkua Huang Guosheng Su +3 位作者 Yong Zhao Chunxian Lu Sheng Nong Xiaohua Huang 《血液病期刊(英文)》 2021年第1期15-23,共9页
<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>... <strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant. 展开更多
关键词 New Coronavirus Pneumonia Spinal Internal Fixation Surgery Autologous Blood Reinfusion Controlled Hypotension Curative Effect
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Trends in the management of anorectal melanoma:A multiinstitutional retrospective study and review of the world literature 认领
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作者 Josh Bleicher Jessica N Cohan +6 位作者 Lyen C Huang William Peche T Bartley Pickron Courtney L Scaife Tawnya L Bowles John R Hyngstrom Elliot A Asare 《世界胃肠病学杂志:英文版》 SCIE CAS 2021年第3期267-280,共14页
BACKGROUND Anorectal melanoma(ARM)is a rare disease with a poor prognosis.Evidence on optimal treatment is limited and surgical management varies widely.We hypothesized that the frequency of abdominoperineal resection... BACKGROUND Anorectal melanoma(ARM)is a rare disease with a poor prognosis.Evidence on optimal treatment is limited and surgical management varies widely.We hypothesized that the frequency of abdominoperineal resection used as primary treatment of ARM has decreased over the past several decades.AIM To update our understanding of outcomes for patients with ARM and analyze management trends around the world.METHODS This is a multi-institutional,retrospective study of patients treated for ARM at 7 hospitals.Hospitals included both large,academic,tertiary care centers and smaller,general community hospitals.Using prospectively maintained institutional tumor registries,we identified 24 patients diagnosed with ARM between January 2000 and May 2019.We analyzed factors prognostic for recurrence and survival.We then used Cox regression to measure overall survival(OS)and melanoma-specific survival.We also performed a literature review to assess trends in surgical management and outcomes.RESULTS Of the 24 patients diagnosed with ARM,12(50.0%)had local,8(33.3%)regional,and 4(16.7%)distant disease at diagnosis.Median time to recurrence was 10.4 mo[interquartile range(IQR)7.5-17.2]with only 2 patients(9.3%)not developing recurrence following surgical resection.Median OS was 18.8 mo(IQR 13.5-33.9).One patient is still alive without recurrence at 21.4 mo from diagnosis;no other patient survived 5 years.Primary surgical management with abdominoperineal resection(APR)vs wide excision(WE)did not lead to differences in OS[hazard ratio=1.4(95%CI:0.3-6.8)].Review of the literature revealed geographic differences in surgical management of ARM,with increased use of WE in the United States and Europe over time and more frequent use of APR in Asia and India.There was no significant improvement in survival over time.CONCLUSION There is wide variation in the management of ARM and survival outcomes remain poor regardless of approach.Surgical management should aim to minimize morbidity. 展开更多
关键词 MELANOMA Anorectal melanoma Literature review Melanoma surgery Surgical oncology Colorectal surgery
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Ultrasound-Guided Erector Spinae Plane Block for Lumbar Spinal Stenosis Surgery 认领
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作者 Ayhan Şahin Onur Baran +2 位作者 Ahmet Gültekin Gülcan Gücer Şahin Cavidan Arar 《麻醉学期刊(英文)》 2021年第3期72-84,共13页
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">In... <b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">In this retrospective observational study, we evaluated patients who underwent elective lumbar stenosis surgery between February 1, 2019, and April 1, 2019. Patients who underwent surgery for lumbar spinal stenosis under general anesthesia alone were compared with those who underwent general anesthesia combined with erector spinae plane block.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Aims:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We aimed to retrospectively evaluate whether erector spinae plane block reduced opioid consumption following surgery for spinal stenosis.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Study Design:</span></b><span style="font-family:Verdana;"> A retrospective observational study</span><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We collected data on the pain scores, time for the first requirement for patient-controlled analgesia with tramadol, the cumulative patient-controlled analgesia dose, requirement for rescue analgesia, time to first stand up postoperatively and the incidence of postoperative nausea and vomiting.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Sixty patients were included in the study. The numerical rating scale</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s pain scores were significantly lower in the erector spinae plane group at 1, 2, 4, 6, 12 and 24 hours than in the general anesthesia group. The cumulative dose of patient-controlled analgesia with tramadol was higher in the general 展开更多
关键词 Erector Spinae Plane Block Ultrasound Guidance Lumbar Surgery Regional Anesthesia
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早期护理干预在行日间手术的老年白内障病人中的应用 认领
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作者 李慧姣 史静华 +2 位作者 郭丽霞 刘璐 唐昕宇 《护理研究》 北大核心 2021年第5期928-930,共3页
目的:探讨早期护理干预对行日间手术的老年白内障病人术前焦虑、健康知识掌握度和护理满意度的影响。方法:选取行日间手术的200例老年白内障病人随机分为干预组100例和对照组100例,对照组实施日间常规护理措施,干预组在此基础上给予早... 目的:探讨早期护理干预对行日间手术的老年白内障病人术前焦虑、健康知识掌握度和护理满意度的影响。方法:选取行日间手术的200例老年白内障病人随机分为干预组100例和对照组100例,对照组实施日间常规护理措施,干预组在此基础上给予早期护理干预措施,比较两组病人干预前后焦虑评分、术后护理满意度和健康知识知晓度。结果:干预后干预组病人焦虑评分低于对照组,术后护理满意度和健康知识知晓度高于对照组,差异均有统计学意义(P<0.05)。结论:对行日间手术的老年白内障病人给予早期护理干预措施,有助于有效缓解病人的术前焦虑情绪,提高病人的健康知识知晓度和护理满意度。 展开更多
关键词 老年病人 护理干预 手术 焦虑 满意度 日间手术
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Analysis of 154 T4 Colorectal Cancer Patients with Peritoneal Carcinomatosis Treated by Surgery 认领
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作者 Wei Chen Junwen Ye +3 位作者 Xiaoping Tan Yan Zhang Jinglin Liang Meijin Huang 《临床医学国际期刊(英文)》 2021年第2期61-70,共10页
<strong>Objective: </strong>The purpose of this study was to observe the factors related to T4 patients who underwent surgery for colorectal cancer (CRC) with peritoneal carcinomatosis. <strong>Metho... <strong>Objective: </strong>The purpose of this study was to observe the factors related to T4 patients who underwent surgery for colorectal cancer (CRC) with peritoneal carcinomatosis. <strong>Methods: </strong>154 T4 colorectal cancer patients who underwent surgery in the first Affiliated Hospital of Sun Yat-sen University were included in the study between August, 1994 and December, 2005. Some clinical variables were selected and statistically correlated with prognosis. <strong>Results:</strong> The overall survival time was 91.7 months at the end of December of 2010 or death. The complete cytoreduction had significant survival benefit than the palliative surgery group. The age, location, histological grade, complete cytoreduction and liver metastasis were associated with overall survival time (OS) according to the univariate analysis (P < 0.05). In addition, Cox multivariate analysis showed that the complete cytoreduction (CCR) and liver metastasis were independent factor influencing survival. <strong>Conclusion:</strong> Compared with palliative surgery, the incomplete cytoreduction fails to improve patient prognosis. Patients performed completed cytoreduction have a relative good prognosis. 展开更多
关键词 Colorectal Cancer Peritoneal Carcinomatosis SURGERY PROGNOSIS
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Complications of Goitre Surgery in “A” Surgery at the Chu of Point G 认领
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作者 Moussa Sissoko Mahamadou Coulibaly +12 位作者 Oumar Sacko Sekou Koumaré Adaman F. Traoré Soumaîla Keïta Sidiki Keita Siaka Diallo Mossa Camara Lamine Soumaré Adama K. Koïta A. Camara H. Dicko D. Goïta Zimogo Zié Sanogo 《外科学(英文)》 2021年第3期46-52,共7页
Total or partial thyroidectomy has been proposed as the initial treatment for benign euthyroid oiter. The aim of this study is to determine the complications associated with surgical procedures for goiter, based on ou... Total or partial thyroidectomy has been proposed as the initial treatment for benign euthyroid oiter. The aim of this study is to determine the complications associated with surgical procedures for goiter, based on our experience. <span style="text-align:justify;font-family:Verdana;">Material and method: A retrospective study over 10 years concerning 409 patients operated on for goiters in the department with 48 cases of complications. Results: 409 patients operated on for goiter in the department with 48 cases of complications (11.82%). The per- and post-operative complications were: hemorrhage (18: 4.40%), recurrent lesions (1;0.24%), 8 cases of infection (1.96%), 5 cases of transient hypocalcemia (1.22%) and phonation disorders 9 cases (2.20%).</span><span "="" style="text-align:justify;font-family:Verdana;font-size:10pt;"> </span><span style="text-align:justify;font-family:Verdana;">Conclusion: Complications from goiter surgery seem to be more related to thyroid disease and the surgeon’s experience than to the surgical procedure. Better knowledge of the factors leading to complications will improve the outcome of goiter surgery.</span> 展开更多
关键词 GOITER COMPLICATIONS SURGERY BAMAKO
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Prevention of Venous Thromboembolism in General Surgery at Gabriel TouréUniversity Hospital in Mali 认领
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作者 Amadou Traoré Madiassa Konaté +18 位作者 Abdoulaye Diarra Koniba Keïta Kadia Traoré Zakari Saye Youssouf Koné Boubacar Yoro Sidibé Amadou Maïga Amadou Bah Bouréima Kelly Tani Koné Boubacar Karembé Souleymane Thiam Assitan Koné Drissa Bagayogo Bakary Tientigui Dembélé Alhassane Traoré Ibrahim Diakité Lassana Kanté Adégné Togo 《外科学(英文)》 2021年第3期67-75,共9页
Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine t... Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context. 展开更多
关键词 Venous Thromboembolism PREVENTION SURGERY MALI
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