Methods The patients were divided into A,Band C groups:3155 patients (group A)were treated surgically in the first 14 years ,5952 patients (group B)in the next 10 years ,and 3863 patients (group C)in the last 10 years...Methods The patients were divided into A,Band C groups:3155 patients (group A)were treated surgically in the first 14 years ,5952 patients (group B)in the next 10 years ,and 3863 patients (group C)in the last 10 years .The early stage lesions (Tis ,Ti)were as-signed as a separate group.The results of these groups were compared. Results The respectability for esophageal and gastric cardiac carcinoma wsa 94.0% and 84.4% respectively ,and the overall respectability .The overall operative mortality was 1.8%,it was 4.4% for group A, 1.6% for group B,and 0.5% for group C.The overall 5-year sur-vival was 31.6%.The 5-year survival for groups A, B,C and the early stage group was 27.0% ,29.1%,32.0% and 92.6%,respect-tively.Among the 3 temporal groups,differences were observed in tems of lesion stage,location and size,surgery with or without com-bined therapy and postoperative complications. Conclusion Best results were achieved in the early cases,with a respectability of 100% and a 5-year survival of 92.6%.The indications for surgical treatment were extended with increased respectability and decreased mortality.Subtotal esophagectomy combined with cervical esophagogastrostomy was advocated as the procedure of first choice for esophageal carcinoma in attempt to diminish the chance of recur-rence,and to achieve better outcomes by using combined therapy for patients with≥stage Ⅲ lesion.展开更多
Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic ...Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic pain patients, paediatric patients, emergency surgeries were excluded. A predesigned proforma was prepared according to American Pain Society recommendations and distributed among Cardiac ICU patients after 24 hours of extubation. This proforma was explained to the patients and collected later. The questionnaire was related to pain severity, aggravating and relieving factors, side effects of analgesics, affective experience and satisfaction with pain management. Results: Total 308 patients participated in one year period. 243 (78.9%) were male and 65 (21.1%) were female. Multimodal analgesia was used in most of the patients. Severity of pain was described as mild 70% and moderate 28.6%. Most of the patients complained of sharp pain 100 (37.5%), mainly at the site of incision 129 (41.9%). The main aggravating factor associated with increased pain was deep breathing 118 (39.8%) while pain was minimized by taking pain medications 40.6%. A significant association was found between preoperative counseling about pain options and satisfaction. 96.8% reported satisfaction with pain management. Conclusion: Although overall pain control was reported as adequate and patients were highly satisfied, there were areas which need further improvement. These include strategies to provide preoperative information about postoperative pain management and better training of medical staff to assess and manage pain. Additionally, the concerns and fears of patients about pain treatment need to be addressed.展开更多
目的对心脏术后重返重症监护室(ICU)预测模型的研究进行范围综述,为今后预测模型的优化或开发提供参考。方法检索中国知网、万方数据服务平台、维普中文科技期刊数据库、中国生物医学文献数据库、Web of Science、PubMed、MEDLINE、Coch...目的对心脏术后重返重症监护室(ICU)预测模型的研究进行范围综述,为今后预测模型的优化或开发提供参考。方法检索中国知网、万方数据服务平台、维普中文科技期刊数据库、中国生物医学文献数据库、Web of Science、PubMed、MEDLINE、Cochrane Library和EMBASE有关心脏术后重返ICU预测模型的研究,检索时限为建库至2023年3月3日。由2名研究者根据CHARMS清单独立筛选、提取数据并以PROBAST工具评估模型偏倚和适用性。结果共纳入6篇文献,涉及6个模型,包括5项开发研究、1项外部验证及更新研究。研究对象集中于冠状动脉旁路移植术和心脏瓣膜术。模型均采用logistic回归分析构建,涉及的预测因子主要包括年龄、慢性肺疾病、射血分数等。模型的受试者工作特征曲线下面积(AUC)为0.74~0.89,偏倚评价结果显示纳入模型多存在较高的偏移风险。结论现有心脏外科术后重返ICU预测模型均未完全满足模型质量和适用性的要求。规范模型的方法学细节和验证情况,如采用TRIPOD报告规范和CHARM清单等,可提高模型的质量和透明度。展开更多
文摘Methods The patients were divided into A,Band C groups:3155 patients (group A)were treated surgically in the first 14 years ,5952 patients (group B)in the next 10 years ,and 3863 patients (group C)in the last 10 years .The early stage lesions (Tis ,Ti)were as-signed as a separate group.The results of these groups were compared. Results The respectability for esophageal and gastric cardiac carcinoma wsa 94.0% and 84.4% respectively ,and the overall respectability .The overall operative mortality was 1.8%,it was 4.4% for group A, 1.6% for group B,and 0.5% for group C.The overall 5-year sur-vival was 31.6%.The 5-year survival for groups A, B,C and the early stage group was 27.0% ,29.1%,32.0% and 92.6%,respect-tively.Among the 3 temporal groups,differences were observed in tems of lesion stage,location and size,surgery with or without com-bined therapy and postoperative complications. Conclusion Best results were achieved in the early cases,with a respectability of 100% and a 5-year survival of 92.6%.The indications for surgical treatment were extended with increased respectability and decreased mortality.Subtotal esophagectomy combined with cervical esophagogastrostomy was advocated as the procedure of first choice for esophageal carcinoma in attempt to diminish the chance of recur-rence,and to achieve better outcomes by using combined therapy for patients with≥stage Ⅲ lesion.
文摘Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic pain patients, paediatric patients, emergency surgeries were excluded. A predesigned proforma was prepared according to American Pain Society recommendations and distributed among Cardiac ICU patients after 24 hours of extubation. This proforma was explained to the patients and collected later. The questionnaire was related to pain severity, aggravating and relieving factors, side effects of analgesics, affective experience and satisfaction with pain management. Results: Total 308 patients participated in one year period. 243 (78.9%) were male and 65 (21.1%) were female. Multimodal analgesia was used in most of the patients. Severity of pain was described as mild 70% and moderate 28.6%. Most of the patients complained of sharp pain 100 (37.5%), mainly at the site of incision 129 (41.9%). The main aggravating factor associated with increased pain was deep breathing 118 (39.8%) while pain was minimized by taking pain medications 40.6%. A significant association was found between preoperative counseling about pain options and satisfaction. 96.8% reported satisfaction with pain management. Conclusion: Although overall pain control was reported as adequate and patients were highly satisfied, there were areas which need further improvement. These include strategies to provide preoperative information about postoperative pain management and better training of medical staff to assess and manage pain. Additionally, the concerns and fears of patients about pain treatment need to be addressed.
文摘目的对心脏术后重返重症监护室(ICU)预测模型的研究进行范围综述,为今后预测模型的优化或开发提供参考。方法检索中国知网、万方数据服务平台、维普中文科技期刊数据库、中国生物医学文献数据库、Web of Science、PubMed、MEDLINE、Cochrane Library和EMBASE有关心脏术后重返ICU预测模型的研究,检索时限为建库至2023年3月3日。由2名研究者根据CHARMS清单独立筛选、提取数据并以PROBAST工具评估模型偏倚和适用性。结果共纳入6篇文献,涉及6个模型,包括5项开发研究、1项外部验证及更新研究。研究对象集中于冠状动脉旁路移植术和心脏瓣膜术。模型均采用logistic回归分析构建,涉及的预测因子主要包括年龄、慢性肺疾病、射血分数等。模型的受试者工作特征曲线下面积(AUC)为0.74~0.89,偏倚评价结果显示纳入模型多存在较高的偏移风险。结论现有心脏外科术后重返ICU预测模型均未完全满足模型质量和适用性的要求。规范模型的方法学细节和验证情况,如采用TRIPOD报告规范和CHARM清单等,可提高模型的质量和透明度。
