Nursing practices for accelerated perioperative recovery of patients undergoing esophageal ultrasound-guided mitral valve chordae tendineae repair at the cardiac apex

Summary of the Experience in Perioperative Accelerated Recovery Care of a Patient with Severe Mitral Valve Regurgitation,Mitral Valve Prolapse,Coronary Heart Disease,and Hypertension Undergoing Transesophageal Echocardiography-Guided Mitral Valve Chord Repair System and Artificial Chord Implantation through the Apex of the Heart The patient had a history of coronary heart disease and hypertension,and was diagnosed with mitral valve prolapse and severe mitral regurgitation at admission.According to the comprehensive evaluation of the patient's condition by the cardiac surgery and MDT(Multidisciplinary Team)team of our hospital before operation,the patient had severe degenerative mitral regurgitation.Considering the high risk of surgical valvuloplasty,the treatment plan of transapical mitral valve artificial chordae implantation with mitral chordae repair system under the guidance of esophageal ultrasound was formulated.Following the guidelines for accelerated recovery,a multidisciplinary approach was taken during the surgery to monitor the patient's condition.Preoperative waiting periods,the postoperative critical period,and the stabilization period were considered,and a rehabilitation program that included exercise,nutritional support,health education,and psychological care was developed for the entire perioperative accelerated recovery process.Nutritional support,health education and psychological nursing were throughout the whole process of perioperative enhanced recovery.The patient was implanted with 4 artificial chordae tendineae.Transesophageal echocardiography monitoring showed that the surgical treatment effect was satisfactory,and no complications occurred during the perioperative period.

Prednisolone therapy accelerates recovery of severe drug-induced liver injury: A prospective, randomized controlled study

Background and aims:Drug-induced liver injury(DILI)is one of the most serious adverse drug reactions and its incidence has been increasing rapidly.Accumulating evidence suggests that immune activation and systemic inflammatory responses are very important in the progression of DILI.Corticosteroids are often used in DILI,but their clinical usefulness remains controversial.We therefore conducted a prospective,randomized controlled study to investigate whether corticosteroid therapy can accelerate recovery and reduce mortality in severe DILI(SDILI).Methods:SDILI patients with total bilirubin?171μmol/L who presented to the Fifth Medical Center of Chinese PLA General Hospital,Beijing from 2016 to 2019 were randomly allocated to prednisolone and control groups.The endpoints were resolution of SDILI,defined as a decrease in total bilirubin of at least 35μmol/L to<171μmol/L,and overall survival at 6 months.Patients in the prednisolone group received prednisolone 60 mg/day therapy for the first 7 days.Patients with a decrease in total bilirubin of more than 35μmol/L on day 8 continued on tapering doses of prednisolone;otherwise,prednisolone was discontinued.Results:On day 8,50.75%(34/67)and 26.47%(18/68)of the participants in the prednisolone and control groups,respectively,achieved the primary endpoint(p¼0.002).However,there was no significant difference in overall survival at 6 months:95.52%(64/67)vs.91.18%(62/68)in the prednisolone and control groups,respectively(p¼0.3).All deaths in both groups occurred in patients who failed to achieve SDILI resolution on day 8.Conclusion:Prednisolone therapy may accelerate the recovery of SDILI.

Evaluation of Clinical Application of ERAS Concept in Perioperative Nursing of HoLEP Patients

[Objectives]To observe the application effect of the concept of accelerated recovery after surgery(ERAS)on patients undergoing trans-urethral holmium laser enucleation of prostate(HoLEP)during perioperative period.[Methods]HoLEP patients with benign prostatic hyperplasia admitted to the Department of Urology,Affiliated Hospital of Jinggangshan University from June to December in 2022 were divided into the observation and control group.40 patients in the control group were given perioperative routine nursing,while 40 patients in the observation group were given perioperative systematic nursing under the concept of ERAS.The nursing effect of different measures were evaluated.[Results]The perioperative related indexes of patients in the observation group were lower than those in the control group(P<0.05).The postoperative feeding,exhaust,spontaneous urination,getting out of bed and hematuria stop time of patients in the observation group were all shorter than those in the control group(P<0.05).The IPSS score and RUV of patients in the observation group were significantly lower than those in the control group,while their Qmax was higher than that in the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).[Conclusions]The application of perioperative systematic nursing under ERAS concept in HoLEP patients can promote patients rapid recovery and reduce their complications.