Enhanced recovery nursing and mental health education on postoperative recovery and mental health of laparoscopic liver resection

BACKGROUND Patients undergoing laparoscopic resection of liver metastases of colorectal cancer are prone to negative emotions and decrease of digestive function.Early nursing and psychological intervention are necessary.AIM To observe the effect of enhanced recovery nursing combined with mental health education on postoperative recovery and mental health of patients undergoing laparoscopic resection of liver metastases of colorectal cancer.METHODS One hundred and twenty patients who underwent laparoscopic resection of liver metastases of colorectal cancer at our hospital between March 2021 and March 2023,were selected as participants.The patients admitted from March 1,2021 to February 28,2022 were set as the control group,and they were given routine nursing combined with mental health education intervention.While the patients admitted from March 1,2022 to March 31,2023 were set as the observation group,they were given accelerated rehabilitation surgical nursing combined with mental health education intervention.The differences in postoperative recovery-related indices,complications and pain degrees,and mental health-related scores were compared between groups.The T lymphocyte subset levels of the two groups were also compared.RESULTS The postoperative exhaust,defecation,eating and drainage time of the observation group were shorter than those of the control group.The pain scores of the observation group were lower than those of the control group at 6,12,24,48,and 72 h after surgery.The cumulative complication rate of the observation group was lower than that of the control group(P<0.05).The CD4+/CD8+in the observation group was higher than that in the control group 3 d after surgery(P<0.05).After intervention,the self-rating depression scale,self-rating anxiety scale,avoidance dimension,and yielding dimension in Medical coping style(MCMQ)scores of the two groups were lower than those prior to intervention,and the scores in the observation group were lower than those in the control group(P<0.05).The face dimension score in the MCMQ score was higher than that before intervention,and that of the observation group was higher than that of the control group(P<0.05).After intervention,the total scores of the life function index scale(FLIC)and psychological well-being scores of cancer patients in the two groups,and the physical and social well-being scores in the observation group,were higher than those before intervention.The nursing satisfaction of the observation group was higher than that of the control group(P<0.05).The physical,psychological,and social well-being,and the total FLIC scores of the observation group were higher than those in the control group after surgery(P<0.05).CONCLUSION Enhanced recovery nursing combined with mental health education can promote the recovery of gastrointestinal function,improve the mental health and quality of life of patients after laparoscopic resection of colorectal cancer liver metastases,and reduce the incidence of complications.

Effect of ivabradine in the treatment of acute exacerbation of chronic obstructive pulmonary disease with heart failure

Objective: To observe the effectiveness and safety of ivabradine in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and heart failure. Methods:Patients who were admitted to hospital with AECOPD during the period from August 2017 to July 2018. Then those both had heart failure with reduced ejection fraction(HFrEF) and a resting heart rate>70 beats/min were enrolled. A total of 86 cases were screened and completed, which were randomly divided into two groups for treatment. The control group(41 cases) received standard treatments, such as oxygen, anti-infection, anti-spasmodic, hormone, diuretic, ACEI/ARB, recombinant human brain natriuretic peptide (rhBNP), etc. The bisoprolol was given 2.5~5 mg orally once a day to control heart rate, and the test group(45 cases) was further treated with ivabradine 2.5~5 mg orally twice a day on the basis of the control group. The average heart rate, cardiac function, lung function, and 6-minute walking test were compared between the two groups. Results: After treatment, the average heart rate of the test group was lower than the control group, and the heart rate control rate(<70 beats/min%) of the test group was superior to the control group. The level of N-terminal B-type natriuretic peptide(NT-proBNP) in test group was significantly lower than that in control group. The distance of the 6-minute walking test in e test group was significantly longer than that in control group. Conclusion: Ivabradine combined with bisoprolol could help patients with AECOPD and heart failure to further reduce the heart rates, improve heart function and exercise tolerance. Moreover, the therapeutic safety was acceptable during the short term.

A Clinical Retrospective Analysis of 340 Inpatients With Malignant Skin Tumors in Western Inner Mongolia

Objective:This study was performed to evaluate the clinical and epidemiological characteristics of inpatients with malignant skin tumors in western Inner Mongolia during the past 10 years.Methods:We collected the clinical data of inpatients with histopathologically diagnosed malignant skin tumors admitted to the Affiliated Hospital of Inner Mongolia Medical University from June 2008 to December 2018.Morbidity was compared using the Chi-square test.Results:In total,340 inpatients with malignant skin tumors were evaluated,including 163(47.94%)patients with basal cell carcinoma,134(39.41%)with squamous cell carcinoma,5(1.47%)with malignant melanoma,21(6.18%)with Bowen disease,and 6(1.76%)with Paget’s disease.Four(1.18%)patients had metastatic skin cancer and seven(2.06%)had other malignant skin tumors.The patients comprised 132(38.8%)men and 208(61.1%)women,and there were no statistically significant sex-related differences among the skin malignancies(χ^(2)=5.006,P>0.05).Among the 340 patients,314(92.4%)were of Han nationality and 26(7.6%)were of ethnic minorities.Statistically significant differences were found in the various types of malignant skin tumors between the Han and minority groups(χ^(2)=19.446,P<0.05).Among the selected patients,61.76%were farmers and herdsmen,and the sites mainly affected were the head,face,neck,trunk,limbs,and vulva.Conclusion:The incidence of malignant skin tumors in western Inner Mongolia has substantially increased during the past decade,especially in the past 2 years.Therefore,we should increase the awareness of prevention and treatment of malignant skin tumors to achieve early diagnosis and treatment effects.