目的分析机器人辅助非气管插管纵隔肿瘤切除术后住院时间(postoperative length of stay,PLOS)延长的危险因素,优化围手术期流程。方法回顾性分析2016—2019年北部战区总医院胸外科机器人辅助非气管插管即喉罩麻醉下纵隔肿瘤切除术患者...目的分析机器人辅助非气管插管纵隔肿瘤切除术后住院时间(postoperative length of stay,PLOS)延长的危险因素,优化围手术期流程。方法回顾性分析2016—2019年北部战区总医院胸外科机器人辅助非气管插管即喉罩麻醉下纵隔肿瘤切除术患者的临床资料,以中位PLOS为界将患者分为两组。通过单因素分析和多因素logistic回归分析明确PLOS延长(长于中位PLOS)的危险因素。结果共纳入190例患者,其中男92例、女98例,中位年龄51.5(41.0,59.0)岁。全组患者的中位PLOS为3.0(2.0,4.0)d,PLOS>3 d组71例,PLOS≤3 d组119例。多因素logistic回归分析显示,留置胸腔引流管[OR=11.852,95%CI(2.384,58.912),P=0.003]、术前合并肌无力症状[OR=4.814,95%CI(1.337,17.337),P=0.016]、术后疼痛视觉模拟评分>5分[OR=6.696,95%CI(3.033,14.783),P<0.001]是PLOS延长的独立危险因素。完全无管化(totally no tube,TNT)有助于患者实现术后第1 d出院。结论机器人辅助非气管插管纵隔肿瘤切除术可促进患者快速康复,TNT、控制患者肌无力症状、减轻患者术后疼痛可优化围手术期流程。展开更多
In the present study, pool boiling heat transfer performance and bubble behaviors of hybrid structures with metal foam and square column are investigated by lattice Boltzmann method. By using the vapor-liquid phase ch...In the present study, pool boiling heat transfer performance and bubble behaviors of hybrid structures with metal foam and square column are investigated by lattice Boltzmann method. By using the vapor-liquid phase change model of Gong-Cheng and Peng-Robinson equation of state, the effects of structural parameters, including metal foam thickness, porosity, column height and ratio of column width(W) to gap spacing(D) are investigated in details. The results show that hybrid structure performs better than pure columnar structure in pool boiling heat transfer. The hybrid structure accelerates bubble growth by fluid disturbance while metal skeletons prevent the bubble escaping. The optimum ratio of column width to gap spacing decreases with the increase of heat flux and HTC(heat transfer coefficient) can achieve an increase up to 25% when W/D change from 5/3 to 1/3. The increase of column height enhances heat transfer by expanding surface area and providing space for bubble motion. The metal foam thickness and porosity have a little influence on pool boiling heat transfer performance, but they have an important effect on bubble motion in the regime.展开更多
文摘目的分析机器人辅助非气管插管纵隔肿瘤切除术后住院时间(postoperative length of stay,PLOS)延长的危险因素,优化围手术期流程。方法回顾性分析2016—2019年北部战区总医院胸外科机器人辅助非气管插管即喉罩麻醉下纵隔肿瘤切除术患者的临床资料,以中位PLOS为界将患者分为两组。通过单因素分析和多因素logistic回归分析明确PLOS延长(长于中位PLOS)的危险因素。结果共纳入190例患者,其中男92例、女98例,中位年龄51.5(41.0,59.0)岁。全组患者的中位PLOS为3.0(2.0,4.0)d,PLOS>3 d组71例,PLOS≤3 d组119例。多因素logistic回归分析显示,留置胸腔引流管[OR=11.852,95%CI(2.384,58.912),P=0.003]、术前合并肌无力症状[OR=4.814,95%CI(1.337,17.337),P=0.016]、术后疼痛视觉模拟评分>5分[OR=6.696,95%CI(3.033,14.783),P<0.001]是PLOS延长的独立危险因素。完全无管化(totally no tube,TNT)有助于患者实现术后第1 d出院。结论机器人辅助非气管插管纵隔肿瘤切除术可促进患者快速康复,TNT、控制患者肌无力症状、减轻患者术后疼痛可优化围手术期流程。
基金supported by the National Natural Science Foundation of China(Grant No.52276075)。
文摘In the present study, pool boiling heat transfer performance and bubble behaviors of hybrid structures with metal foam and square column are investigated by lattice Boltzmann method. By using the vapor-liquid phase change model of Gong-Cheng and Peng-Robinson equation of state, the effects of structural parameters, including metal foam thickness, porosity, column height and ratio of column width(W) to gap spacing(D) are investigated in details. The results show that hybrid structure performs better than pure columnar structure in pool boiling heat transfer. The hybrid structure accelerates bubble growth by fluid disturbance while metal skeletons prevent the bubble escaping. The optimum ratio of column width to gap spacing decreases with the increase of heat flux and HTC(heat transfer coefficient) can achieve an increase up to 25% when W/D change from 5/3 to 1/3. The increase of column height enhances heat transfer by expanding surface area and providing space for bubble motion. The metal foam thickness and porosity have a little influence on pool boiling heat transfer performance, but they have an important effect on bubble motion in the regime.
