目的构建并评价以导航护士为主导的医护患加速康复临床护理路径在肺癌胸腔镜切除患者围手术期管理中的作用。方法采用方便抽样法选取2022年7月—2023年7月在某三级甲等医院行胸腔镜切除术的肺癌患者128例为研究对象,按照患者入院的先后...目的构建并评价以导航护士为主导的医护患加速康复临床护理路径在肺癌胸腔镜切除患者围手术期管理中的作用。方法采用方便抽样法选取2022年7月—2023年7月在某三级甲等医院行胸腔镜切除术的肺癌患者128例为研究对象,按照患者入院的先后顺序,其中2022年7月—2023年1月入院的患者为对照组,2023年2-7月入院的患者为观察组,每组64例。对照组根据科室制定的常规护理措施实施护理,观察组梳理“医-护-患”三个角色需要完成的内容,构建导航护士主导实施的加速康复临床护理路径并开展培训与实施,比较2组的干预效果。结果2组患者术后首次下床时间、尿管拔除时间、胸管留置时间、术后中度及以上疼痛发生率、住院费用、住院时间、加速康复外科(enhanced recovery after surgery,ERAS)满意度比较均有统计学意义(P<0.05)。结论实施医护患加速康复临床护理路径保障了患者围手术期加速康复护理措施的有效实施,有利于患者的康复进程,缩短住院时间,减少住院费用,提高患者满意度。展开更多
<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Gabapentin is routinely prescribed preoperatively to decrease...<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Gabapentin is routinely prescribed preoperatively to decrease postoperative pain intensity. It is included in the enhanced recovery after surgery (ERAS) recommendations. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To analyze correlation of gabapentin dosage and post anesthesia care unit (PACU) length of stay (LOS) and cost. </span><b><span style="font-family:Verdana;">Study Design:</span></b><span style="font-family:Verdana;"> A retrospective chart review of patients who underwent general anesthesia and received preoperative oral gabapentin from June 2017 </span></span><span style="font-family:Verdana;">to</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> August 2017 for pelvic and breast procedures. The main outcome was correlation between PACU LOS and gabapentin dosage in the outpatients. Financial analysis was performed to assess the cost to the hospital associated with increased LOS. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Of the 636 patients, 405 patients received 300 </span><span style="font-family:Verdana;">mg and 231 patients received 100 mg gabapentin. Mean dosage per kg (mg/k</span><span style="font-family:Verdana;">g ±</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">SD) was 3.12</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">1.51 (range: </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.86 to 6.12). PACU LOS was 96</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">77 (minutes ±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">SD) in patients receiving 100 mg and 120</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">96 in patients receiving 300 mg capsule (p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.001). Linear regression analysis, failed to show a </span><span style="font-family:Verdana;">statistically significant correlation between per kg dosage and PACU LOS (</span><span style="font-family:Verdana;">p</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> 0</span><span style="font-family:Verdana;">.13). Using multiple regression analysis, we calculated the correlation coefficient to be +1.71 minutes per 1mg/kg gabapentin (95% CI: -</span><span style="font-family:Verdana;">3.75 to +7.10, p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> 0</span><span style="font-family:Verdana;">.54) after adjusting for confounders. Adding 3</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">mg/kg to pre-op g</span><span style="font-family:Verdana;">abapentin dosage of all outpatients cost on average</span></span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> an extra $9794 per mo</span><span style="font-family:;" "=""><span style="font-family:Verdana;">nth in this cohort. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Every 1mg/kg increase in gabapentin dosage adds an estimated 7.1 minutes to PACU LOS. A 3</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">mg/kg increase in gabapentin adds estimated 22 additional minutes in PACU LOS. Unfortunately, increase LOS is associated with increased hospital costs.</span>展开更多
The purpose of this study was to investigate the efficacy of post-exercise treatment with “Cool Veil Serum (CVS)” developed by Madre:X Co. Ltd. (Shibuya, Tokyo) to prevent exercise-induced muscle swelling. Calf circ...The purpose of this study was to investigate the efficacy of post-exercise treatment with “Cool Veil Serum (CVS)” developed by Madre:X Co. Ltd. (Shibuya, Tokyo) to prevent exercise-induced muscle swelling. Calf circumferences and mus-cle stiffness of both legs were measured in 10 healthy female. The measurements were made on before 5-minute exercise, after the exercise, and after 10-minute recovery care with CVS and 5-minute rest. The recovery care was applied only on right leg of the subjects. Then, multiple comparisons of calf circumference and muscle stiffness on each leg among pre-exer-cise, post-exercise, and final measurements were carried out. Exercise caused a significant increase in calf circumference and muscle stiff-ness. The recovery care with CVS rapidly re-duced postexercise calf circumference to pre-exercise level. Relationship between reduc-ing muscle swelling after exercise and prevent-ing sport injury should be explored in further studies.展开更多
肝移植作为终末期肝病唯一有效的治疗手段,具有手术复杂、时间长、创伤大等特点,患者术后恢复面临感染、腹腔出血、排斥反应等诸多挑战,直接影响康复质量。加速术后康复(enhanced recovery after surgery,ERAS)作为一种新型围术期管理策...肝移植作为终末期肝病唯一有效的治疗手段,具有手术复杂、时间长、创伤大等特点,患者术后恢复面临感染、腹腔出血、排斥反应等诸多挑战,直接影响康复质量。加速术后康复(enhanced recovery after surgery,ERAS)作为一种新型围术期管理策略,可有效促进患者术后康复,目前已广泛应用于外科各领域,但目前我国肝移植领域尚缺乏全面、科学的ERAS共识方案。2022年12月,国际肝移植学会发布了首个《肝移植手术加速康复共识建议》,对接受死亡后器官捐献和活体器官捐献的肝移植受者、活体肝移植供者ERAS策略提出建议。本文对该共识要点进行详细解读,以期为我国肝移植患者围术期ERAS实践提供参考。展开更多
文摘目的构建并评价以导航护士为主导的医护患加速康复临床护理路径在肺癌胸腔镜切除患者围手术期管理中的作用。方法采用方便抽样法选取2022年7月—2023年7月在某三级甲等医院行胸腔镜切除术的肺癌患者128例为研究对象,按照患者入院的先后顺序,其中2022年7月—2023年1月入院的患者为对照组,2023年2-7月入院的患者为观察组,每组64例。对照组根据科室制定的常规护理措施实施护理,观察组梳理“医-护-患”三个角色需要完成的内容,构建导航护士主导实施的加速康复临床护理路径并开展培训与实施,比较2组的干预效果。结果2组患者术后首次下床时间、尿管拔除时间、胸管留置时间、术后中度及以上疼痛发生率、住院费用、住院时间、加速康复外科(enhanced recovery after surgery,ERAS)满意度比较均有统计学意义(P<0.05)。结论实施医护患加速康复临床护理路径保障了患者围手术期加速康复护理措施的有效实施,有利于患者的康复进程,缩短住院时间,减少住院费用,提高患者满意度。
文摘<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Gabapentin is routinely prescribed preoperatively to decrease postoperative pain intensity. It is included in the enhanced recovery after surgery (ERAS) recommendations. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To analyze correlation of gabapentin dosage and post anesthesia care unit (PACU) length of stay (LOS) and cost. </span><b><span style="font-family:Verdana;">Study Design:</span></b><span style="font-family:Verdana;"> A retrospective chart review of patients who underwent general anesthesia and received preoperative oral gabapentin from June 2017 </span></span><span style="font-family:Verdana;">to</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> August 2017 for pelvic and breast procedures. The main outcome was correlation between PACU LOS and gabapentin dosage in the outpatients. Financial analysis was performed to assess the cost to the hospital associated with increased LOS. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Of the 636 patients, 405 patients received 300 </span><span style="font-family:Verdana;">mg and 231 patients received 100 mg gabapentin. Mean dosage per kg (mg/k</span><span style="font-family:Verdana;">g ±</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">SD) was 3.12</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">1.51 (range: </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.86 to 6.12). PACU LOS was 96</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">77 (minutes ±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">SD) in patients receiving 100 mg and 120</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">96 in patients receiving 300 mg capsule (p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.001). Linear regression analysis, failed to show a </span><span style="font-family:Verdana;">statistically significant correlation between per kg dosage and PACU LOS (</span><span style="font-family:Verdana;">p</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> 0</span><span style="font-family:Verdana;">.13). Using multiple regression analysis, we calculated the correlation coefficient to be +1.71 minutes per 1mg/kg gabapentin (95% CI: -</span><span style="font-family:Verdana;">3.75 to +7.10, p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> 0</span><span style="font-family:Verdana;">.54) after adjusting for confounders. Adding 3</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">mg/kg to pre-op g</span><span style="font-family:Verdana;">abapentin dosage of all outpatients cost on average</span></span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> an extra $9794 per mo</span><span style="font-family:;" "=""><span style="font-family:Verdana;">nth in this cohort. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Every 1mg/kg increase in gabapentin dosage adds an estimated 7.1 minutes to PACU LOS. A 3</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">mg/kg increase in gabapentin adds estimated 22 additional minutes in PACU LOS. Unfortunately, increase LOS is associated with increased hospital costs.</span>
文摘The purpose of this study was to investigate the efficacy of post-exercise treatment with “Cool Veil Serum (CVS)” developed by Madre:X Co. Ltd. (Shibuya, Tokyo) to prevent exercise-induced muscle swelling. Calf circumferences and mus-cle stiffness of both legs were measured in 10 healthy female. The measurements were made on before 5-minute exercise, after the exercise, and after 10-minute recovery care with CVS and 5-minute rest. The recovery care was applied only on right leg of the subjects. Then, multiple comparisons of calf circumference and muscle stiffness on each leg among pre-exer-cise, post-exercise, and final measurements were carried out. Exercise caused a significant increase in calf circumference and muscle stiff-ness. The recovery care with CVS rapidly re-duced postexercise calf circumference to pre-exercise level. Relationship between reduc-ing muscle swelling after exercise and prevent-ing sport injury should be explored in further studies.
文摘肝移植作为终末期肝病唯一有效的治疗手段,具有手术复杂、时间长、创伤大等特点,患者术后恢复面临感染、腹腔出血、排斥反应等诸多挑战,直接影响康复质量。加速术后康复(enhanced recovery after surgery,ERAS)作为一种新型围术期管理策略,可有效促进患者术后康复,目前已广泛应用于外科各领域,但目前我国肝移植领域尚缺乏全面、科学的ERAS共识方案。2022年12月,国际肝移植学会发布了首个《肝移植手术加速康复共识建议》,对接受死亡后器官捐献和活体器官捐献的肝移植受者、活体肝移植供者ERAS策略提出建议。本文对该共识要点进行详细解读,以期为我国肝移植患者围术期ERAS实践提供参考。