Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or po...Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.展开更多
BACKGROUND Patients with left ventricular assist devices(LVADs)are at increased risk for recurrent gastrointestinal bleeding(GIB)and repeat endoscopic procedures.We assessed the frequency of endoscopy for GIB in patie...BACKGROUND Patients with left ventricular assist devices(LVADs)are at increased risk for recurrent gastrointestinal bleeding(GIB)and repeat endoscopic procedures.We assessed the frequency of endoscopy for GIB in patients with LVADs and the impact of endoscopic intervention on preventing a subsequent GIB.AIM To evaluate for an association between endoscopic intervention and subsequent GIB.Secondary aims were to assess the frequency of GIB in our cohort,describe GIB presentations and sources identified,and determine risk factors for recurrent GIB.METHODS We conducted a retrospective cohort study of all patients at a large academic institution who underwent LVAD implantation from January 2011–December 2018 and assessed all hospital encounters for GIB through December 2019.We performed a descriptive analysis of the GIB burden and the outcome of endoscopic procedures performed.We performed multivariate logistic regression to evaluate the association between endoscopic intervention and subsequent GIB.RESULTS In the cohort of 295 patients,97(32.9%)had at least one GIB hospital encounter.There were 238 hospital encounters,with 55.4%(132/238)within the first year of LVAD implantation.GIB resolved on its own by discharge in 69.8%(164/235)encounters.Recurrent GIB occurred in 55.5%(54/97)of patients,accounting for 59.2%(141/238)of all encounters.Of the 85.7%(204/238)of encounters that included at least one endoscopic evaluation,an endoscopic intervention was performed in 34.8%(71/204).The adjusted odds ratio for subsequent GIB if an endoscopic intervention was performed during a GIB encounter was not significant(odds ratio 1.18,P=0.58).CONCLUSION Patients implanted with LVADs whom experience recurrent GIB frequently undergo repeat admissions and endoscopic procedures.In this retrospective cohort study,adherence to endoscopic guidelines for performing endoscopic interventions did not significantly decrease the odds of subsequent GIB,thus suggesting the uniqueness of the LVAD population.A prospective study is needed to identify patients with LVAD at risk of recurrent GIB and determine more effective management strategies.展开更多
文摘Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.
基金Supported by National Institute of Diabetes and Digestive and Kidney Diseases,No.T32DK007740 and No.K08DK120902.
文摘BACKGROUND Patients with left ventricular assist devices(LVADs)are at increased risk for recurrent gastrointestinal bleeding(GIB)and repeat endoscopic procedures.We assessed the frequency of endoscopy for GIB in patients with LVADs and the impact of endoscopic intervention on preventing a subsequent GIB.AIM To evaluate for an association between endoscopic intervention and subsequent GIB.Secondary aims were to assess the frequency of GIB in our cohort,describe GIB presentations and sources identified,and determine risk factors for recurrent GIB.METHODS We conducted a retrospective cohort study of all patients at a large academic institution who underwent LVAD implantation from January 2011–December 2018 and assessed all hospital encounters for GIB through December 2019.We performed a descriptive analysis of the GIB burden and the outcome of endoscopic procedures performed.We performed multivariate logistic regression to evaluate the association between endoscopic intervention and subsequent GIB.RESULTS In the cohort of 295 patients,97(32.9%)had at least one GIB hospital encounter.There were 238 hospital encounters,with 55.4%(132/238)within the first year of LVAD implantation.GIB resolved on its own by discharge in 69.8%(164/235)encounters.Recurrent GIB occurred in 55.5%(54/97)of patients,accounting for 59.2%(141/238)of all encounters.Of the 85.7%(204/238)of encounters that included at least one endoscopic evaluation,an endoscopic intervention was performed in 34.8%(71/204).The adjusted odds ratio for subsequent GIB if an endoscopic intervention was performed during a GIB encounter was not significant(odds ratio 1.18,P=0.58).CONCLUSION Patients implanted with LVADs whom experience recurrent GIB frequently undergo repeat admissions and endoscopic procedures.In this retrospective cohort study,adherence to endoscopic guidelines for performing endoscopic interventions did not significantly decrease the odds of subsequent GIB,thus suggesting the uniqueness of the LVAD population.A prospective study is needed to identify patients with LVAD at risk of recurrent GIB and determine more effective management strategies.
