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Objective:To explore the application value of ultrasound-guided stellate ganglion block in perioperative period of thyroid cancer patients.Methods:From March 2018 to November 2019, in the Second People′s Hospital of Lu′an, Anhui Province, the clinical data of 80 thyroid cancer patients who had underwent open radical operation were retrospectively analyzed. Among them, ultrasound-guided stellate ganglion block was performed in 40 cases (observation group), while ultrasound-guided stellate ganglion block was not performed in 40 cases (control group). The pain digital score (NRS) 6, 12 and 24 h after operation was evaluated. The levels of inflammatory factors, including tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) 24 h after operation were detected. The indexes of cellular immune function (CD 4+, CD 8+ and CD 4+/CD 8+) 24 h after operation, serum parathyroid hormone (PTH) before operation and 48 h after operation were detected. The postoperative complication was observed. Results:The NRS 6, 12 and 24 h after operation in observation group were significantly lower than that in control group: (3.6 ± 0.3) scores vs. (4.3 ± 0.4) scores, (2.1 ± 0.2) scores vs. (3.5 ± 0.3) scores and (2.6 ± 0.2) scores vs. (3.6 ± 0.3) scores, and there was statistical difference ( P<0.01). The TNF-α, hs-CRP and IL-6 24 h after operation in observation group were significantly lower than those in control group: (85.9 ± 6.8) μg/L vs. (263.5 ± 13.7) μg/L, (6.1 ± 1.6) mg/L vs. (12.3 ± 2.5) mg/L and (236.9 ± 8.6) μg/L vs. (388.9 ± 15.5) μg/L, the CD 4+, CD 8+ and CD 4+/CD 8+ were significantly higher than those in control group: 0.036 ± 0.013 vs. 0.024 ± 0.010, 0.034 ± 0.013 vs. 0.026 ± 0.009 and 1.9 ± 0.1 vs. 1.4 ± 0.1, and there were statistical differences ( P<0.01). There was no statistical difference in PTH before operation between 2 groups ( P>0.05); the PTH 48 h after operation in observation group was significantly higher than that in control group: (29.8 ± 3.9) μg/L vs. (18.7 ± 2.0) μg/L, and there was statistical difference ( P<0.01). The incidence of postoperative complication in observation group was significantly lower than those in control group: 5.0% (2/40) vs. 25.0% (10/40), and there was statistical difference ( χ2 = 4.804, P<0.05). Conclusions:Ultrasound-guided right stellate ganglion block can effectively relieve postoperative pain, reduce inflammatory reaction, improve immunity, promote the recovery of parathyroid function, and reduce the incidence of postoperative complication in patients with thyroid cancer.
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Objective@#To investigate the situation and influencing factors of bowel cleansing in patients before colonoscopy, and to provide reference for guiding patients′ bowel preparation.@*Methods@#The clinical data of 421 patients undergoing electronic colonoscopy in the endoscopy center of the second people′s hospital of Lu′an city in Anhui Province from April to September 2018, Prospective collection by systematic sampling, including general data of patients, clinical data of bowel preparation and score of Boston bowel preparation scale. Univariate analysis and logistic regression analysis were performed on the relevant factors of bowel preparation.@*Results@#Among the 421 patients, 52 cases were not eligible for intestinal cleaning, and the unqualified rate was 12.35%(52/421). Logistic regression analysis showed that: Total amount of drinking water prepared for intestinal tract before colonoscopy (OR=1.674, P=0.018),The total times of defecations after taking the drug (OR=1.270, P=0.014), the characteristics of last stool before colonoscopy (OR=2.211, P=0.042), the diet the day before colonoscopy (OR=0.553, P=0.006) , body mass index (OR=1.111, P=0.042), and intestinal diseases (P=0.022), were all intestinal clearance independent influencing factors of cleaning effect; While took laxative type (mannitol/PEG), drunk water speed (within 3 hours), first defecation time, the site of drinking bowel-clearing drugs, daily activity, none of the above factors affected the bowel preparation effect (P>0.05) .@*Conclusion@#Before colonoscopy, there were many factors affecting the cleaning effect of the intestine. The total water intake of intestinal preparation was less than 2 000 ml, the total number of defecation after taking medicine was less than 5 times, the last defecation contained residue, the day before the examination was strictly fasting, the body mass index was less than 18.5 kg/m2, and colitis, enterelcosis and occupying lesion are independent risk factors for intestinal cleaning. Attention should be paid to the comfort care and guidance of intestinal preparation, and prospective intervention can effectively improve the cleaning effect of intestinal tract.
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Objective To investigate the effects of laparoscopic and open resection with pelvic autonomic nerve preservation (PANP) on sexual function of male patients with lower rectal cancer. Methods Total 177 male patients with lower rectal cancer received surgery from September 2008 to December 2013 were enrolled into two groups: the laparoscopic PANP group (n = 105) and the open PANP group (n = 72). The classifications of erectile and ejaculatory functions were used to evaluate the sexual functions of patients at 6 months and 12 months post-operation, respectively. The effect of different operation on the sexual function of the male patients was compared between the two groups. Results The incidence rates of erectile dysfunction at 6 months and 12 months post-operation in the laparoscopic group were lower than those in the laparotomy group (P < 0.05). The incidence rates of ejaculatory dysfunction at 6 months and 12 months post-operation in the laparoscopic group were also lower than those in the laparotomy group (P < 0.05). Conclusion The laparoscopic resection with PANP in patients with lower rectal cancer can not only clearly reveal pelvic autonomic nerve and effectively protect them, but also reduce the incidence of postoperative sexual dysfunction.