ABSTRACT
Objective:To investigate the feasibility and effectiveness of incision subcutaneous porous catheter combined with ropivacaine analgesia in enhanced recovery after laparoscopic gastrointestinal surgery.Methods:The clinical data of 140 patients underwent gastrointestinal surgery from August 2021 to April 2022 in Shanghai Fourth People′s Hospital, School of Medicine, Tongji University were retrospectively analyzed. Among them, 70 patients were given routine postoperative analgesia (control group), and 70 patients were given incision subcutaneous porous catheter combined with ropivacaine analgesia on the basis of routine postoperative analgesia (observation group). The visual analogue score (VAS) 4, 24, 32, 48, 56 and 72 h after operation was evaluated; and the complications of subcutaneous catheterization, incision infection, postoperative nausea vomiting, neurological symptoms, time to extubation, patient satisfaction degree, recovery time of intestinal function and hospital stay were recorded.Results:The VAS 4, 24, 32, 48, 56 and 72 h after operation in observation group was significantly lower than that in control group: 1.000 (- 0.250, 2.250) scores vs. 1.000 (- 1.000, 3.000) scores, 2.000 (1.000, 3.000) scores vs. 4.000 (2.000, 6.000) scores, 1.000 (0.000, 2.000) scores vs. 3.000 (1.000, 5.000) scores, 2.000 (1.000, 3.000) scores vs. 3.000 (1.750, 4.250) scores, (1.100 ± 0.934) scores vs. (2.085 ± 0.943) scores and (0.985 ± 0.842) scores vs. (1.814 ± 0.921) scores, and there was statistical difference ( P<0.05 or <0.01). The recovery time of intestinal function and hospital stay in observation group were significantly shorter than that that in control group: (1.743 ± 0.557) d vs. (2.200 ± 0.714) d and (8.043 ± 1.160) d vs. (8.757 ± 1.221) d, and there were statistical difference ( P<0.01); there were no statistical differences in the rate of incision infection, incidence of postoperative nausea vomiting, time to extubation and patient dissatisfaction rate between two groups ( P>0.05); there were no the complications of subcutaneous catheterization and neurological symptoms in two groups. Conclusions:The incision subcutaneous porous catheter combined with ropivacaine analgesia after laparoscopic gastrointestinal surgery is a safe, effective and feasible method. Multimodal analgesia under enhanced recovery after surgery can increase the postoperative recovery after gastrointestinal operations and shorten the postoperative hospital stay.
ABSTRACT
Objective To compare the therapeutic efficacy of laparoscopic common bile duct exploration (LCBDE) plus laparoscopic cholecystectomy (LC),and endoscopic retrograde cholangiopancretography (ERCP) plus endoscopic sphinetemtomy (EST) plus laparoscopic cholecystectomy (LC) in treatment of acute biliary pancreatitis.Method One hundred and six patients with acute biliary pancreatitis and biliary obstruction underwent minimally invasive surgery between January 2012 and February 2016 in our hospital,including 54 cases received LCBDE + LC (LCBDE group) and 52 cases received ERCP + EST + LC (ERCP group).The operation time,intraoperative blood loss,length of hospital stay,medical expenses and postoperative complications were compared between two groups.Results The operating time in LCBDE group was longer than that in ERCP group [(110.2 ± 11.2) min vs.(100.8 ±22.8) min,x2 =-2.11,P ＜ 0.05],the length of hospital stay was shorter [(10.3 ± 3.8) d vs.(12.6 ±3.4) d,x2 =2.32,P ＜ 0.05],the medical expense was less [(31 245.3 ± 1 237.2) Yuan vs.(42 342.2 ±1 354.3)Yuan,x2 =2.82,P ＜ 0.01].There were no significant differences in intraoperative blood loss [(40.2 ± 10.3) ml vs.(39.3 ± 10.4) ml,x2 =0.88,P ＞ 0.05],the rate of postoperative analgesic use [11.11％ (6/54) vs.13.46％ (7/52),x2 =0.102,P ＞0.05] and the incidence of postoperativecomplications [9.26％ (5/54) vs.11.54％ (6/52),x2 =0.080,P ＞0.05] between two groups.Conclusion laparoscopic common bile duct exploration plus laparoscopic cholecystectomy has advantages of shorter hospital stay and lower medical expenses in treatment of acute biliary pancreatitis combined with biliary infection.
ABSTRACT
Objective: To study current prevalence of hypertension in professional drivers and related influencing factors.Methods: A total of 2693 professional drivers, who received physical examination in Shenzhen municipal hospitals from May 2015 to Sep 2015, were enrolled.According to suffering from hypertension or not, they were divided into hypertension group (n=759) and normotensive group (n=1934).General data were compared and analyzed between two groups, then Logistic regression analysis was used to analyze risk factors for hypertension in professional drivers.Results: Among the 2693 professional drivers, there were 759 cases (28.18%) with hypertension.Compared with normotensive group, there were significant rise in percentages of ≥45 years old (3.78% vs.41.37%), male (66.03% vs.81.29%), literacy level of primary school or below (81.75% vs.92.22%), love pickled products (14.48% vs.70.75%), no exercise (24.15% vs.50.33%) and diabetes mellitus (11.17% vs.36.10%) in hypertension group,P<0.01 all.After general data entered Logistic regression equation, it indicated that age, male, literacy level, favor for picked products, daily physical activity time and diabetes mellitus were risk factors for hypertension in professional drivers (OR=1.095~1.393, P<0.01 all).Conclusion: For professional drivers, they should be motivated to perform regular exercise and control diet, receive enhanced health education about hypertension, therefore, it can help to reduce incidence rate of hypertension in these people.
ABSTRACT
Objective To determine the influence of stellate ganglion block on myocardial ischemial reperfusion arrhythmia.Methods Sixteen rabbits were divided randomly into two groups : group A(control group), group B (experimental group) was left lateral stellate ganglion blocks. Myocardial ischemia reperfusion model in vivo was carried out routinely. Blood samplies were taken from coronary sinus for the determination of neuropeptide(NPY) and noradrenaline(NE) at the following time point before LAD crossclamping , 5min, 30min after reperfusion.The occurrence of RA was measured in 1～5min during reperfusion.Results The level of plasma NPY and NE were significantly reduced at 5min, 30min after reperfusion (P