Hemodynamic monitoring and optimization improve postoperative outcome during high-risk surgery.However,hemodynamic management practices among Chinese anesthesiologists are largely unknown.This study sought to evaluate...Hemodynamic monitoring and optimization improve postoperative outcome during high-risk surgery.However,hemodynamic management practices among Chinese anesthesiologists are largely unknown.This study sought to evaluate the current intraoperative hemodynamic management practices for high-risk surgery patients in China.From September 2010 to November 2011,we surveyed anesthesiologists working in the operating rooms of 265 hospitals representing 28 Chinese provinces.All questionnaires were distributed to department chairs of anesthesiology or practicing anesthesiologists.Once completed,the 29-item questionnaires were collected and analyzed.Two hundred and 10 questionnaires from 265 hospitals in China were collected.We found that 91.4%of anesthesiologists monitored invasive arterial pressure,82.9%monitored central venous pressure（CVP）,13.3%monitored cardiac output（CO）,10.5%monitored mixed venous saturation,and less than 2%monitored pulse pressure variation（PPV） or systolic pressure variation（SPV） during high-risk surgery.The majority（88%） of anesthesiologists relied on clinical experience as an indicator for volume expansion and more than 80%relied on blood pressure,CVP and urine output.Anesthesiologists in China do not own enough attention on hemodynamic parameters such as PPV,SPV and CO during fluid management in high-risk surgical patients.The lack of CO monitoring may be attributed largely to the limited access to technologies,the cost of the devices and the lack of education on how to use them.There is a need for improving access to these technologies as well as an opportunity to create guidelines and education for hemodynamic optimization in China.展开更多
The use of two urethral stents woven from titanium nickel alloy (TiNi) in the form of a tubular mesh or a spiral stent (both made in China) is described. They were implanted in 62 patients,vith prostatic outflow obstr...The use of two urethral stents woven from titanium nickel alloy (TiNi) in the form of a tubular mesh or a spiral stent (both made in China) is described. They were implanted in 62 patients,vith prostatic outflow obstruction. till patients were considered contraindicated for surgery. They were divided into a spiral stent group (group I) treated between March 1992 and May 1993, comprising 35 cases, and a tubular mesh group (group 2) treated between October 1993 and December 1994, comprising 31 cases, including four failures in group 1. Thirty-three out of the 35 patients in group 1 were treated successfully. Good results were achieved in eight cases (22.8%) and significant improvements occurred in 24 (68.5%), giving a total effective rate of 91.3%, with a follow-up of 11 to 27 months. Fourteen stents were removed within 6 months after the insertion and six more were removed within 12 months. The mean effective time of the stent in situ was 10.8 months. All 31 cases in the mesh group were treated successfully. Dramatically good effects were obtained in 28 cases (over 90%) and distinct improvements were achieved in two, giving a total effective rate of over 96.5%, with a follow-up of 6 to 14 months (mean 10.5 months). Cystoscopy was carried out in 12 patients after 6 months following the insertion. The major part of the meshes became covered by urothelium. Compared with the spiral, the mesh makes it possible to insert a prosthesis with a larger diameter and anti-pressure. The spiral, however, can be used as a temporary alternative for the relief of prostatic obstruction. A tubular mesh can work well for the relief of prostatic obstruction and remain in situ without causing major problems for at least I year.展开更多
文摘Hemodynamic monitoring and optimization improve postoperative outcome during high-risk surgery.However,hemodynamic management practices among Chinese anesthesiologists are largely unknown.This study sought to evaluate the current intraoperative hemodynamic management practices for high-risk surgery patients in China.From September 2010 to November 2011,we surveyed anesthesiologists working in the operating rooms of 265 hospitals representing 28 Chinese provinces.All questionnaires were distributed to department chairs of anesthesiology or practicing anesthesiologists.Once completed,the 29-item questionnaires were collected and analyzed.Two hundred and 10 questionnaires from 265 hospitals in China were collected.We found that 91.4%of anesthesiologists monitored invasive arterial pressure,82.9%monitored central venous pressure（CVP）,13.3%monitored cardiac output（CO）,10.5%monitored mixed venous saturation,and less than 2%monitored pulse pressure variation（PPV） or systolic pressure variation（SPV） during high-risk surgery.The majority（88%） of anesthesiologists relied on clinical experience as an indicator for volume expansion and more than 80%relied on blood pressure,CVP and urine output.Anesthesiologists in China do not own enough attention on hemodynamic parameters such as PPV,SPV and CO during fluid management in high-risk surgical patients.The lack of CO monitoring may be attributed largely to the limited access to technologies,the cost of the devices and the lack of education on how to use them.There is a need for improving access to these technologies as well as an opportunity to create guidelines and education for hemodynamic optimization in China.
文摘The use of two urethral stents woven from titanium nickel alloy (TiNi) in the form of a tubular mesh or a spiral stent (both made in China) is described. They were implanted in 62 patients,vith prostatic outflow obstruction. till patients were considered contraindicated for surgery. They were divided into a spiral stent group (group I) treated between March 1992 and May 1993, comprising 35 cases, and a tubular mesh group (group 2) treated between October 1993 and December 1994, comprising 31 cases, including four failures in group 1. Thirty-three out of the 35 patients in group 1 were treated successfully. Good results were achieved in eight cases (22.8%) and significant improvements occurred in 24 (68.5%), giving a total effective rate of 91.3%, with a follow-up of 11 to 27 months. Fourteen stents were removed within 6 months after the insertion and six more were removed within 12 months. The mean effective time of the stent in situ was 10.8 months. All 31 cases in the mesh group were treated successfully. Dramatically good effects were obtained in 28 cases (over 90%) and distinct improvements were achieved in two, giving a total effective rate of over 96.5%, with a follow-up of 6 to 14 months (mean 10.5 months). Cystoscopy was carried out in 12 patients after 6 months following the insertion. The major part of the meshes became covered by urothelium. Compared with the spiral, the mesh makes it possible to insert a prosthesis with a larger diameter and anti-pressure. The spiral, however, can be used as a temporary alternative for the relief of prostatic obstruction. A tubular mesh can work well for the relief of prostatic obstruction and remain in situ without causing major problems for at least I year.
