BACKGROUND Venous thromboembolism(VTE)is a major cause of unexpected and perioperative in-hospital deaths.It is characterized by high morbidity,high mortality,high misdiagnosis rate,and high missed diagnosis rates.VTE...BACKGROUND Venous thromboembolism(VTE)is a major cause of unexpected and perioperative in-hospital deaths.It is characterized by high morbidity,high mortality,high misdiagnosis rate,and high missed diagnosis rates.VTE is a common postoperative complication in cancer patients.VTE is preventable,and early identification of risk factors leading to VTE and appropriate early preventive actions can reduce its occurrence and mortality.Presently,there is no uniform standard for the prevention and control of VTE in clinical practice,and hospitals in China lack mature and effective protocols for the assessment,prevention,and treatment of VTE.AIM To explore whether an early warning program could influence the occurrence of deep vein thrombosis(DVT)postoperatively.METHODS This is a comparative retrospective cohort study,which enrolled patients who underwent laparotomic or laparoscopic gastrointestinal tumor resection for gastrointestinal cancer between January 2016 and December 2019.Patients were divided into a control group and an early warning group depending on whether or not the early warning program was implemented.A venous thromboembolism prevention and control team was established.The outcomes included the occurrence of DVT,the correct rate of VTE assessment,the coagulation indicators,and the mastery of VTE knowledge by the nurses.RESULTS A total of 264 patients were included in this study,with 128 patients in the control group and 136 patients in the early warning group.The occurrence rate of DVT in the early warning group was 6.6%(9/136),compared with 14.1%(18/128)in the control group(P<0.05).The correct rates of VTE risk assessment by the nurses and standard implementation rate of VTE preventive measures were 86.8%vs 65.6%and 80.2%vs 57.8%in early warning and control groups,respectively(all P<0.001).The independent factors associated with postoperative DVT occurrence were age(OR=1.083,95%CI:1.070-3.265,P=0.032),Hyperlipidemia(OR=1.127,95%CI:1.139-2.564,P=0.042),preoperative high VTE risk(OR=2.131,95%CI:1.085-5.178,P=0.001),time of operation(OR=2.268,95%CI:2.005-5.546,P=0.026)and not adoption of early warning prevention(OR=3.747,95%CI:1.523-6.956,P=0.017).CONCLUSION The early warning strategy was independently associated with the decreasing occurrence of VTE,and it might be suitable for protection from VTE in patients undergoing gastrointestinal cancer surgery.展开更多
Since the implementation of the Action Plan for Air Pollution Prevention and Control , all regions of China have steadily promoted the prevention and control of air pollution and achieved results continuously. However...Since the implementation of the Action Plan for Air Pollution Prevention and Control , all regions of China have steadily promoted the prevention and control of air pollution and achieved results continuously. However, the atmospheric environment in key areas such as Beijing-Tianjin-Hebei region, the Yangtze River Delta region, and Fenwei Plain is still severe, and especially during the heating period heavy pollution occurs frequently, which has become the focus and difficulty of improving the quality of the atmospheric environment and is also the weakest link of China s air pollution control at present. How to alleviate air pollution, how to win the battle of pollution prevention and control, how to hold the fruits of the blue sky defense war, energy consumption is key.展开更多
Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews th...Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews the definition,incidence,risk factors,preventive measures,and management of perioperative patients of perioperative stroke,to provide a theoretical basis for clinical work,to reduce the incidence of perioperative stroke.展开更多
文摘BACKGROUND Venous thromboembolism(VTE)is a major cause of unexpected and perioperative in-hospital deaths.It is characterized by high morbidity,high mortality,high misdiagnosis rate,and high missed diagnosis rates.VTE is a common postoperative complication in cancer patients.VTE is preventable,and early identification of risk factors leading to VTE and appropriate early preventive actions can reduce its occurrence and mortality.Presently,there is no uniform standard for the prevention and control of VTE in clinical practice,and hospitals in China lack mature and effective protocols for the assessment,prevention,and treatment of VTE.AIM To explore whether an early warning program could influence the occurrence of deep vein thrombosis(DVT)postoperatively.METHODS This is a comparative retrospective cohort study,which enrolled patients who underwent laparotomic or laparoscopic gastrointestinal tumor resection for gastrointestinal cancer between January 2016 and December 2019.Patients were divided into a control group and an early warning group depending on whether or not the early warning program was implemented.A venous thromboembolism prevention and control team was established.The outcomes included the occurrence of DVT,the correct rate of VTE assessment,the coagulation indicators,and the mastery of VTE knowledge by the nurses.RESULTS A total of 264 patients were included in this study,with 128 patients in the control group and 136 patients in the early warning group.The occurrence rate of DVT in the early warning group was 6.6%(9/136),compared with 14.1%(18/128)in the control group(P<0.05).The correct rates of VTE risk assessment by the nurses and standard implementation rate of VTE preventive measures were 86.8%vs 65.6%and 80.2%vs 57.8%in early warning and control groups,respectively(all P<0.001).The independent factors associated with postoperative DVT occurrence were age(OR=1.083,95%CI:1.070-3.265,P=0.032),Hyperlipidemia(OR=1.127,95%CI:1.139-2.564,P=0.042),preoperative high VTE risk(OR=2.131,95%CI:1.085-5.178,P=0.001),time of operation(OR=2.268,95%CI:2.005-5.546,P=0.026)and not adoption of early warning prevention(OR=3.747,95%CI:1.523-6.956,P=0.017).CONCLUSION The early warning strategy was independently associated with the decreasing occurrence of VTE,and it might be suitable for protection from VTE in patients undergoing gastrointestinal cancer surgery.
基金Supported by Special Project for Research on Prevention and Control of Air Pollution from Fire Coal in 2018 of Ministry of Ecology and Environment of the People’s Republic of China(2018A030)National Natural Science Foundation of China(41771498)
文摘Since the implementation of the Action Plan for Air Pollution Prevention and Control , all regions of China have steadily promoted the prevention and control of air pollution and achieved results continuously. However, the atmospheric environment in key areas such as Beijing-Tianjin-Hebei region, the Yangtze River Delta region, and Fenwei Plain is still severe, and especially during the heating period heavy pollution occurs frequently, which has become the focus and difficulty of improving the quality of the atmospheric environment and is also the weakest link of China s air pollution control at present. How to alleviate air pollution, how to win the battle of pollution prevention and control, how to hold the fruits of the blue sky defense war, energy consumption is key.
文摘Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews the definition,incidence,risk factors,preventive measures,and management of perioperative patients of perioperative stroke,to provide a theoretical basis for clinical work,to reduce the incidence of perioperative stroke.
