ABSTRACT
Objective To investigate the risk factors and preventive measures of liver transplantation in patients with liver cirrhosis complicated with portal hypertension. Methods About 63 patients with cirrhosis and portal hypertension were treated with liver transplantation in our hospital from June 2014 to June 2016. The risk factors were investigated and the corresponding care measures were taken. Results All the 63 patients underwent the operation successfully. The total operation time ranged from 276 to 750 min, averaged (450.52 ± 25.43) minutes. The intraoperative blood loss was 300~5,600 mL, averaged (1693.06 ± 193.24) mL. Intraoperative blood transfusion ranged from 0 to 3,000mL, with an average (1400.50 ± 400.61) mL. Three patients contracted gastrointestinal bleeding after liver implants, which was cured after timely treatment and 5 patients with sacral pressure red tail, improved after treatment. Conclusion Due to the long operation time, bleeding, low temperature, risks of infection and other factors, pre-assessment of the intraoperative risks and relative coping measures are of great significance for the complete of operations.
ABSTRACT
Objective To explore the application effect of postural animation video instruction mode in elderly patients undergoing epidural anesthesia. Methods A total of 300 patients with epidural anesthesia were registered from January 2015 to February 2016. The patients were divided into trial group and control group with 150 cases each. The trial group was preoperatively interviewed by the postural anatomy video instruction mode, and the control group was only preoperatively interviewed by oral interpretation. The epidural anesthesia effect and anxiety between the two groups were compared. Results The difference of anesthesia posture and anatomical position, the average time of epidural puncture, the success rate of one puncture and the degree of anxiety before and after mission were 90.67% (136/150), (14.50 ± 10.20) s, (425.60 ± 78.30) s, 97.33% (146/150) and (21.65 ± 6.62) points respectively. The control group was 22.00%(33/150), (112.60 ± 60.80) s, (589.40 ± 90.70)s, 82.67%(124/150) and (6.65 ± 5.40) points respectively. There were significant differences between the two groups (χ2=8.79, t=13.54-19.88, all P < 0.01). Conclusions The postural anatomical video teaching mode can relieve anxiety, improve the degree of fit of epidural anesthesia and the success rate of puncture, shorten the time of posture, thus shorten the average time of epidural puncture, improve the quality of nursing in the operating room, work efficiency.
ABSTRACT
Objective To investigate the nursing risks in the patients undergoing radio-frequency ablation surgery during cardiac valve replacement.Methods The nursing risks in 110 patients undergoing radio-frequency ablation surgery during cardiac valve replacement were summarized to include disorder of water electrolyte and acid-base balance, arrhythmia,hypothermia,skin ulcer,reduction of effective circulating blood volume,infection and so on, so as to carry out the corresponding nursing measures. Results Ventricular fibrillation occurred in 11 patients,hypothermia after rewarming on cardiopulmonary bypass in 31 patients,left atrial bleeding after aortic de-clamping in 1 patient.All the complications were successfully controlled by corresponding management. The operation time ranged from 178 mins to 310 mins and average time was(245.32±34.40)mins.Conclusion The full-scale assessments and effective nursing interventions are the key points to improve the efficiency and success of cardiac valve replacement combined with radio-frequency ablation.