Defining the association between the prolonged operative time and 90-day complications in patients undergoing radical cystectomy

Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.Methods:The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution.The OT of 369 min was set as a cutoff value between short and long OT groups.The primary outcome was 90-day postoperative complication rates.Secondary outcomes were gastrointestinal recovery time,length of hospital stay,and 90-day readmission rates.Results:The overall incidence of 90-day postoperative complications was 79.7%where 43.2%representing low-grade complications according to the ClavieneDindo classification(Grade 1 and Grade 2),and 36.5%representing high-grade complications(Grade3).Gastrointestinal tract and infectious complications are the most common complications in our data set(45.9%and 45.6%,respectively).On multivariable analysis,prolonged OT was significantly associated with odds of high-grade complications(odds ratio 2.340,95%confidence interval 1.288e4.250,p=0.005).After propensity score-matched analysis,a higher incidence of major complications was identified in the long OT group 55(51.4%)compared to 35(32.7%)in the short OT group(p=0.006).A shorter gastrointestinal tract recovery time was noticed in the short OT group(p=0.009).Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses(p<0.001,p=0.001,respectively).

Extended radical operation of pancreatic head cancer: Appraisal of its clinical significance

AIM: To evaluate the significance of extended radical operation and its indications.METHODS: Between January 1995 and December 1998, 56inpatients with pancreatic head cancer received operation.Among them 35 patients (group 1) experienced the Whipple operation, and 21 patients (group 2) received the extended radical operation. The 1-, 2-, 3-year cumulative survival rates were used to evaluate the efficacy of the two operative procedures. Clinical stage (CS) was assessed retrospectively with the help of CT. The indications for extended radical operation were discussed.RESULTS: There was no difference in hospital mortality and morbidity rates. Whereas the 1-, 2-, 3-year cumulative survival rates were 84.8%, 62.8%, 39.9% in the extended radical operation group, and were 70.8%, 47.6%, 17.2%in the Whipple operation group, there was a significant difference between the two groups (P＜0.001, P＜0.001,P＜0.001, respectively). Most of the deaths within 3 years after operation were due to recurrence in the two groups.However, the 1-, 2-, 3-year cumulative rates of death due to local recurrence were decreased from 37.4% in patients that received the Whipple procedure to 23.8% in those who received by extended radical operation. Patients who survived for more than 3 years were only noted in those with CS1 in the Whipple procedure group and were founded in cases with CS1, CS2 and part of CS3 in the extended radical operation group.CONCLUSION: The extended radical operation appears to benefit patients with pancreatic head carcinoma which was indicated in CS1, CS2 and part of CS3 without severe invasion.

Efficacy of Bispectral index-monitored closed-loop targeted-controlled infusion of propofol for laparoscopic radical operation for gastric cancer

Objective:To discuss the efficacy of Bispectral index (BIS)-monitored closed-loop targeted-controlled infusion of propofol for laparoscopic radical operation for gastric cancer.Methods:A total of 106 patients with primary gastric cancer who underwent laparoscopic radical operation for gastric cancer in our hospital between August 2015 and February 2018 were chosen as the research subjects and divided into the control group (n=53) and the observation group (n=53) according to the different anesthesia methods. Control group of patients received BIS-monitored manually adjusted targeted-controlled infusion concentration of propofol, and observation group of patients received BIS-monitored closed-loop targeted-controlled infusion of propofol. The differences in hemodynamic index levels as well as serum contents of inflammatory factors and stress hormones were compared between the two groups of patients before anesthesia (T0), 30 min after surgery started (T1) and 30 min before surgery ended (T2).Results:At T0, the differences in hemodynamic index levels as well as serum contents of inflammatory factors and stress hormones were not statistically significant between the two groups. At T1 and T2, hemodynamic indexes MAP and HR levels of observation group were lower than those of control group at the corresponding time points;serum inflammatory factors sICAM-1, IL-1β, IL-8 and TNF-α contents were lower than those of control group at the corresponding time points;serum stress hormones Cor, T4 and glucagon contents were lower than those of control group at the corresponding time points.Conclusion: BIS-monitored closed-loop targeted-controlled infusion of propofol can effectively stabilize the intraoperative hemodynamics and inhibit the systemic inflammatory stress response in patients with laparoscopic radical operation for gastric cancer.

Clinical application of thoracic small incision in radical operation for lung and esophageal cancer

Objective: The aim of this study was to explore clinical value of thoracic small incision in radical operation for lung and esophageal cancer in assuring same treatment effects with conventional incision. Methods: Collected data of patients was given radical operation for lung and esophageal cancer in our department from January 1, 2006 to January 1, 2007, and performed retrospective analysis, among them, small incision group (improved group) was 143 cases, and conventional group was 167 cases including 6 cases which was changed from small incision to conventional incision in operation. Compared operation time, incision length, intraoperative blood loss, postoperative drainage flow, number of lymph node dissected, recovery time of postoperative upper limb function, postoperative pain, postoperative complications etc. between both groups. Results: Compared with conventional group, intraoperative blood loss, postoperative drainage flow, postoperative pain, recovery time of postoperative upper limb function in improved group was improved significantly, and there was no obvious difference in operation time and number of lymph node dissected between both groups. Conclusion: Small incision in radical operation for lung and esophageal cancer is small trauma, and quick recovery after operation, treatment effects of it is basically similar to that of conventional operation method, however, its application is limited in few cases.

Radical Operation and Everolimus Therapy for Rectal Neuroendocrine Tumor with Liver Metastases: A Case Report with Review of the Literature

Neuroendocrine tumors (NETs) are often misdiagnosed because they can involve any part of the body and have non-specific symptoms. Here, we report a case of a 39-year-old man with rectal neuroendocrine tumor (RNET) and hepatic metastases treated with a combination of radical surgery and Everolimus therapy. The patient complained of abdominal distension, pain, and constipation of one month duration. Enhanced CT scan of the abdomen, colonoscopy and Biopsy findings confirmed the diagnosis of rectal neuroendocrine tumor. As the anatomical structures were clear and the masses seemed to be resectable, we decided to initiate treatment with radical operation and Everolimus therapy. The patient has responded well to the treatment with no evidence of recurrence after 4 years of follow-up. This case is interesting because of the rarity of this neoplasm and its initial misdiagnosis as a giant hepatic carcinoma (hepatoma). It also demonstrates that a combination of curative surgical resection and Everolimus is a good option in a patient with large colorectal neuroendocrine tumors and massive hepatic metastases.

Effect of diazocine combined with sufentanil analgesia after radical operation for esophageal cancer on the release of neurotransmitters and stress mediators

Objective:To study the effect of diazocine combined with sufentanil analgesia after radical operation for esophageal cancer on release of neurotransmitters and stress mediators.Methods:A total of 170 cases of patients with primary esophageal cancer who underwent surgical treatment in this hospital between September 2015 and May 2017 were divided into control group (n=85) and study group (n=85) by random number table method. Control group received postoperative sufentanil analgesia, and study group received postoperative diazocine combined with sufentanil analgesia. The differences in the perioperative contents of monoamine neurotransmitters, amino acid neurotransmitters and stress mediators were compared between the two groups.Results: Before operation, there was no statistically significant difference in the serum contents of monoamine neurotransmitters, amino acid neurotransmitters and stress mediators between the two groups. 12 h after surgery, 24 h after surgery and 36 h after surgery, serum monoamine neurotransmitters DA, NE and 5-HT contents of study group were lower than those of control group;amino acid neurotransmitters Ach, GABA and Glu contents were higher than those of control group;serum stress mediators ACTH, ALD and Cor contents were lower than those of control group.Conclusion: diazocine combined with sufentanil analgesia after radical operation for esophageal cancer can effectively optimize the secretion of neurotransmitters and inhibit the synthesis of stress mediators to alleviate the patients' pain perception.

Effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion

Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric cancer who underwent radical operation for gastric cancer in our hospital were chosen as the research subjects and divided into the control group (n=48) (did not receive preoperative arterial interventional chemotherapy) and the arterial interventional chemotherapy group (n=42) (received preoperative arterial interventional chemotherapy). The differences in tumor markers in serum as well as proliferation and apoptosis gene expression in gastric cancer tissues were compared.Results: Before surgery started, serum CA199, CA153, CA724 and AFP levels of arterial interventional chemotherapy group were significantly lower than those immediately after admission whereas serum CA199, CA153, CA724 and AFP levels of control group were not significantly different from those immediately after admission. After surgery, proliferation genes CUL4A and NTSR1 mRNA expression in gastric cancer tissues of arterial interventional chemotherapy group were lower than those of control group whereas DADS and FAM96B mRNA expression were higher than those of control group;apoptosis genes Livin and Bcl-2 mRNA expression were lower than those of control group whereas p53, p21 and Bax mRNA expression were higher than those of control group.Conclusion:Preoperative arterial interventional chemotherapy combined with radical operation for gastric cancer can more effectively inhibit the malignant degree of tumor and delay the growth of cancer cells.

Effects of different chemotherapy regimens before radical operation for lung cancer on cancer cell growth and anti-tumor immune response

Objective:To investigate the effects of different chemotherapy regimens before radical operation for lung cancer on cancer cell growth and antitumor immune response.Methods: A total of 180 patients with primary lung cancer who underwent surgery in this hospital between February 2013 and August 2017 were divided into the cisplatin group (n=93) who received cisplatin & paclitaxel chemotherapy and the lobaplatin group (n=87) who received lobaplatin & paclitaxel chemotherapy according to different preoperative neoadjuvant chemotherapy regimens. The differences among the expression of proliferation genes and apoptosis genes in tumor tissues as well as the contents of Th1/Th2 cytokines in serum were compared between the two groups.Results: Proliferation genes DDX17, GPx1, MACC1, RACK1 and SIRT1 mRNA expression levels in tumor tissue of lobaplatin group were lower than those of cisplatin group whereas LRRC3B mRNA expression level was higher than that of cisplatin group;apoptosis gene Fas, FasL and Caspase-3 mRNA expression levels were higher than those of cisplatin group whereas Survivin and Bcl-2 mRNA expression levels were lower than those of cisplatin group;serum Th1 cytokines IFN-γ and IL-12 contents were higher than those of cisplatin group whereas Th2 cytokines IL-5 and IL-10 contents were lower than those of cisplatin group.Conclusion: Lobaplatin chemotherapy before radical operation for lung cancer is more effective than cisplatin chemotherapy to inhibit the proliferation activity and enhance the apoptosis activity of lung cancer cells and optimize the anti-tumor immune response.

Effect of the adaptive intermittent ventilation before radical operation for lung cancer under one-lung ventilation on the non-ventilated lung tissue injury and apoptosis molecule protein expression

Objective: To study the effect of the adaptive intermittent ventilation before radical operation for lung cancer under one-lung ventilation on non-ventilated lung tissue injury and apoptosis molecule protein expression. Methods: A total of 288 patients who received radical operation for lung cancer in the hospital between February 2015 and January 2017 were divided into control group and observation group by random number table method, each with 144 cases. Control group received routine one-lung ventilation, and observation group received preoperative adaptive intermittent ventilation of non-ventilated lung tissue. The differences in the levels of inflammatory factors and oxidative stress indexes in serum as well as the apoptosis molecule protein expression in affected-side normal lung tissue were compared between the two groups of patients immediately after intubation and at two-lung ventilation (T0) as well as 10 min before operation ended and at one-lung ventilation (T1). Results: At T0, the differences in the levels of inflammatory factors and oxidative stress indexes in serum as well as the apoptosis molecule protein expression in affected-side normal lung tissue were not significantly significant between the two groups of patients;at T1, IL-1β, IL-8, TNF-α, MPO and MDA levels in serum as well as Bax, caspase-2 and caspase-3 protein expression in normal lung tissue of observation group were lower than those of control group while SOD level in serum and Bcl-2 protein expression in normal lung tissue were higher than those of control group. Conclusion: Adaptive intermittent ventilation before radical operation for lung cancer under one-lung ventilation can effectively reduce the non-ventilated lung tissue injury and inhibit the apoptosis of normal lung cells.

Effects of enteral nutrition via jejunostomy catheter on immune response and intestinal mucosal barrier function after radical operation for esophageal cancer

Objective: To study the effects of enteral nutrition via jejunostomy catheter on immune response and intestinal mucosal barrier function after radical operation for esophageal cancer. Methods: A total of 90 patients who were diagnosed with esophageal cancer and received radical operation in Xishui People's Hospital between February 2015 and May 2017 were selected and randomly divided into the EN group who accepted enteral nutrition via jejunostomy catheter and the PN group who received parenteral nutrition. 1 week and 2 weeks after surgery, the expression of immune cell transcription factors in peripheral blood as well as the contents of intestinal mucosal injury markers and inflammatory stress markers in serum were measured. Results: 1 week and 2 weeks after surgery, T-bet expression intensity in peripheral blood of EN group was greatly higher than that of PN group while GATA3, RORγt and Foxp3 expression intensity in peripheral blood as well as DAO, Galectin-1, Galectin-3, Claudin, NE, E, Cor, CRP and CER levels were greatly lower than those of PN group. Conclusion: Enteral nutrition via jejunostomy catheter can improve the immune response and intestinal mucosal barrier function after radical operation for esophageal cancer.

The Application of Forward Control Nursing in Anesthesia, Recovery, and Rehabilitation of Thoracoscopic Lung Cancer Radical Surgery

Objective: To explore the clinical application effect of formulating the operating room nursing work procedure sheet for elderly lung cancer patients in thoracoscopic radical surgery. Methods: A total of 85 elderly patients with lung cancer treated in our hospital from May 2022 to May 2023 were included as the study population for this research. They were divided into a study group of 42 cases and a regular group of 43 cases. The regular group of elderly patients received routine nursing care, while the study group of elderly patients was provided with the operating room nursing care work procedure sheet. The surgical duration, intraoperative blood loss, time to mobilization, and postoperative complication rate were compared and analyzed between the two groups. Results: Compared to the regular group, the study group had significantly shorter surgical duration and time to mobilization, as well as less intraoperative blood loss (P < 0.05). The overall incidence of postoperative complications in the study group (4.76%) was significantly lower than that in the regular group (19.05%) (P Conclusion: Formulating the operating room nursing work procedure sheet for elderly lung cancer patients can effectively improve surgical efficiency, reduce the incidence of postoperative complications, and promote patient prognosis in thoracoscopic radical surgery. Therefore, this model is worth promoting and adopting in clinical practice.

腹腔镜下D2根治术联合CME对局部进展期胃癌术后腹腔游离癌细胞检出率及预后的影响

目的:探讨腹腔镜下D2根治术联合完整系膜切除术(complete mesocolic excision,CME)对局部进展期胃癌腹腔游离癌细胞及预后的影响。方法:回顾性分析2021年06月至2022年06月于医院住院治疗的128例局部进展期胃癌患者临床资料,将64例实施腹腔镜下D2根治术的患者纳入对照组,64例实施腹腔镜下D2根治术联合CME的患者纳入研究组。记录两组手术、住院及并发症情况,采用生活质量综合评定问卷-74(GQOLI-74)评定生活质量。分别于腹腔镜探查后和肿瘤切除后收集腹腔冲洗液,应用细胞学检查检测腹腔游离癌细胞。术后随访1年,记录总生存期(OS)及无进展生存期(PFS)情况。结果:研究组淋巴结清扫总数及阳性淋巴结数量显著大于对照组(P<0.05)。与术前比较,研究组术后腹腔游离癌细胞阳性率显著降低(P<0.05)。与术前比较,两组术后GQOLI-74评分均显著增加,且研究组高于对照组(P<0.05)。两组腹腔感染/积液、胃排空障碍、肠梗阻、吻合口瘘、胰瘘、淋巴漏发生率及不良反应总发生率比较,差异均无统计学意义(P>0.05)。研究组术后1年PFS率和OS率均显著高于对照组(P<0.05)。结论:腹腔镜下D2根治术联合CME有利于彻底清除局部进展期胃癌淋巴结,减少术后复发,促进术后康复,且不增加腹腔游离癌细胞脱落和手术并发症风险,具有临床推广价值。

宫颈癌患者自身免疫功能、肿瘤标志物水平对癌肿根治术后复发的影响

目的探讨宫颈癌患者自身免疫功能、肿瘤标志物水平对癌肿根治术后复发的影响。方法选择2021年1月—2022年11月新疆维吾尔自治区人民医院妇科诊治的宫颈癌患者108例作为研究对象。患者均接受宫颈癌根治术,根据治疗后1年内肿瘤复发转移情况分为未复发组(n=86)和复发组(n=22)。比较2组患者临床资料、宫颈癌疾病特征、自身免疫功能及肿瘤标志物的差异;Spearman相关性分析及多因素Logistic回归分析筛选宫颈癌患者肿瘤复发的危险因素;受试者工作特征(ROC)曲线评估各危险因素对宫颈癌患者术后复发的预测价值。结果复发组患者脉管癌栓及深肌层浸润比例高于未复发组(χ^(2)/P=4.923/0.027、4.284/0.038);复发组患者CD4^(+)/CD8^(+)T细胞比值、NK细胞比例均低于未复发组,全身免疫炎性指数(SII)水平高于未复发组(t/P=4.117/<0.001、2.680/0.009、3.709/<0.001);CA125及CA199水平均高于未复发组(t/P=2.040/0.044、2.586/0.011);Spearman相关性分析及多因素Logistic回归分析发现宫颈癌患者CD4^(+)/CD8^(+)比值高、NK细胞比例高是术后复发的保护因素[OR(95%CI)=0.019(0.010~0.048)、0.621(0.453~0.852)],SII、CA125水平高均是术后复发的危险因素[OR(95%CI)=1.080(1.003~1.160)、1.042(1.009~1.076)];CD4^(+)/CD8^(+)比值、NK细胞比例、SII、CA125及四项指标联合预测宫颈癌患者术后复发的曲线下面积分别为0.757、0.682、0.730、0.661、0.914,四项联合优于各自单独预测效能(Z/P=4.234/<0.001、5.113/<0.001、4.512/<0.001、5.452/<0.001)。结论宫颈癌患者根治术后免疫功能较差、肿瘤标志物水平较高均提示患者存在复发风险,持续监测宫颈癌根治术后患者的免疫功能并及时干预可在一定程度上避免术后肿瘤复发,进而改善患者的预后。

急性压力性损伤风险防控护理在行肺癌根治术患者中的应用效果

目的探究急性压力性损伤风险防控护理在行肺癌根治术患者中的应用效果。方法选取2022年1月至2023年1月南京医科大学附属淮安第一医院120例行肺癌根治术患者作为研究对象,按照随机数字表法将其分为对照组和观察组,各60例。对照组采取常规手术护理措施,观察组应用术中急性压力性损伤风险防控护理。比较两组手术相关指标变化及并发症。结果术毕时,两组气道压、平均脉压、心率、体温、乳酸、血氧饱和度高于术前即刻,且观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论在行肺癌根治术患者中采用急性压力性损伤风险防控护理,可有效改善患者手术相关指标,降低并发症发生率,提高预后效果,值得临床推广采纳。

术前血清TG/TSH水平预测甲状腺癌根治术后复发风险的价值

目的探讨术前血清甲状腺球蛋白(TG)/促甲状腺激素(TSH)水平预测甲状腺癌根治术后复发风险的价值。方法回顾性分析2021年3月至2023年3月本院接受甲状腺癌根治术治疗的110例甲状腺癌患者临床资料,根据随访结果分为复发组(n=27)和未复发组(n=83)。比较两组一般资料、血清TG、TSH及TG/TSH水平。采用多因素Logistic回归分析甲状腺癌根治术后复发的影响因素并通过ROC曲线分析血清TG、TG/TSH水平预测甲状腺癌根治术后复发的价值。结果两组临床分期Ⅱ期占比、淋巴转移占比及TG、TG/TSH水平比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示临床分期Ⅱ期占比、淋巴转移占比及TG、TG/TSH水平为甲状腺癌根治术后复发的影响因素(P<0.05);TG、TG/TSH水平预测甲状腺癌根治术后复发情况的曲线下面积分别为0.745、0.892(P<0.05)。结论影响甲状腺癌根治术后复发的因素较多,包括临床分期、淋巴转移占比及TG、TG/TSH水平,患者术前TG、TG/TSH水平越高患者复发风险越高。

肛痈促愈汤联合紫草纱条创面引流对肛周脓肿患者术后创面愈合的影响

目的观察肛痈促愈汤联合紫草纱条创面引流应用于肛周脓肿患者术后创面愈合的效果。方法选取2021年9月至2023年9月成都大学附属医院肛肠科收治的肛周脓肿患者100例,随机数字表法分为对照组与试验组,每组各50例。对照组患者于肛周脓肿根治术后实施常规处理,试验组则在常规处理基础上加用肛痈促愈汤口服结合紫草纱条创面引流,治疗时间为3周。比较2组治疗后创面愈合情况、疼痛程度、创面肉芽生长情况、血清炎症因子[血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)、白细胞计数(WBC)]、血管内皮生长因子(VEGF)及表皮生长因子(EGF)。结果试验组腐肉完全脱落时间、创面愈合时间均短于对照组,治疗7 d后创面愈合率高于对照组,差异均有统计学意义(P均<0.05)。治疗7 d后2组的疼痛视觉模拟法评分(VAS)、创面肉芽生长情况评分均明显低于治疗1 d后,且试验组治疗7 d后疼痛VAS评分、创面肉芽生长情况评分显著低于对照组同期,差异均有统计学意义(P<0.05)。治疗3周后2组的SAA、CRP、WBC水平均显著低于治疗1 d后,VEGF、EGF水平均显著高于治疗1 d后,且试验组治疗3周后SAA、CRP、WBC水平显著低于对照组同期,VEGF、EGF水平显著高于对照组同期,差异均有统计学意义(P<0.05)。结论肛痈促愈汤结合紫草纱条创面引流应用于肛周脓肿患者术后创面愈合效果较好,可缓解创面疼痛,加快创面愈合,减轻炎症反应,促进组织再生修复。

激励式信念干预用于卵巢癌根治术患者手术室护理中的效果观察

目的观察激励式信念干预用于卵巢癌根治术患者手术室护理的效果。方法86例行卵巢癌根治术的患者随机分为两组,常规护理组给予常规护理,研究组在常规护理基础上给予激励式信念干预,比较两组的负面情绪、应激反应以及并发症结果麻醉前,研究组的HADS-A、HADS-D评分均低于常规护理组(P<0.05)。术中,研究组的心率、收缩压均低于常规护理组(P<0.05)。研究组的并发症总发生率为2.33%,低于常规护理组的13.95%(P<0.05)。结论激励式信念干预应用于卵巢癌根治术患者手术室护理中,可减轻其负面情绪,稳定术中生命体征,减少术后并发症。

根治性膀胱癌术后患者延续性护理的研究进展

膀胱癌根治性切除术+尿流改道术是治疗浸润性膀胱癌的金标准。行膀胱癌根治术的患者在出院后的一段时间里仍然存在较高的医疗及护理需求,因此,积极实施延续性护理是解决该问题的一条重要途径。本文从膀胱癌根治术后信息支持、心理支持、社会支持及日常生活及活动支持等4个方面对行膀胱癌根治术患者的护理现状、延续性护理的优势及延续性护理的新进展作一综述,为行该手术患者出院后生活质量的提升而提供相关护理理论和实践基础。通过对患者提供及时、有效的延续性护理、康复措施和社会支持,提高其依从性和自我护理能力,改善其心理状态和家庭及社会适应能力。

健康教育及心理干预在先天性巨结肠根治术患儿中的应用效果

目的探讨健康教育及心理干预在先天性巨结肠根治术患儿中的应用效果。方法选取2020年1月至2023年6月新疆医科大学第一附属医院收治的80例行先天性巨结肠根治术患儿为研究对象,按照随机数字表法分为对照组(n=40,实施常规护理)与观察组(n=40,在对照组的基础上实施健康教育及心理干预)。比较两组治疗依从性、并发症总发生率、住院时间及护理前后焦虑、抑郁评分。结果观察组治疗总依从率高于对照组(P<0.05)。观察组并发症总发生率低于对照组,住院时间短于对照组(P<0.05)。护理前,两组焦虑、抑郁评分比较,差异无统计学意义(P>0.05);护理后,两组焦虑、抑郁评分均低于护理前,且观察组焦虑、抑郁评分低于对照组(P<0.05)。结论健康教育及心理干预用于先天性巨结肠根治术患儿,可有效提升依从性,减少并发症的发生,缩短住院时间,值得推广。

手术室优质干预在腹腔镜结直肠癌根治术患者中的应用效果

目的探讨手术室优质干预在腹腔镜结直肠癌根治术患者中的应用效果。方法根据干预方法的不同将180例腹腔镜结直肠癌根治术患者分为常规组(n=85)和优质组(n=95),常规组患者采取常规手术室干预,优质组患者采取手术室优质干预。比较两组患者的手术相关指标、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]、术后并发症发生情况及满意度。结果优质组患者首次下床活动时间、术后住院时间均明显短于常规组,差异均有统计学意义(P﹤0.01)。干预后,两组患者EORTC QLQ-C30各维度评分均高于本组干预前,优质组患者EORTC QLQ-C30各维度评分均高于常规组,差异均有统计学意义(P﹤0.05)。优质组患者的术后并发症总发生率明显低于常规组,总满意度明显高于常规组,差异均有统计学意义(P﹤0.01)。结论手术室优质干预可促进腹腔镜结直肠癌根治术患者术后恢复,提高患者生活质量及满意度,降低术后并发症发生率。