ABSTRACT
Objective To evaluate the association between preoperative fasting and postoperative delirium in elderly hip fracture patients. Methods A total of 120 hip fracture patients were divided into the experiment group and the control group with 60 cases each by random digits table method. The experiment group was recommended a 2-3 h preoperative fast for clear fluids and a 6-8 h fast for solids in elective patients. The control group received a 4 h preoperative fast for clear fluids and a 12 h fast for solids in elective patients.Adverse effects of fasting and variation of prevalence of postoperative delirium were compared. Results The incidence rate of hypoglycemi,hunger,anxiety were 18.3%(11/60),63.3% (38/60),16.7%(10/60)in the control group and 3.3%(2/60),36.7%(22/60),5.0%(3/60)in the experiment group, there were significant differences between the two groups(χ2=6.988,8.533, 4.227, P <0.05). There was no significant differences in thirst between the two groups(P>0.05). The incidence rate of postoperative delirium in the experiment group and the control group was 6.7%(4/60)and 21.7%(13/60), there was significant differences between the two groups(χ2=5.551,P<0.05).There was a linear correlation between fasting prohibition and postoperative delirium (r =0.215). Conclusions The new preoperative fasting method is safety and can reduce the incidence of delirium.
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Objective To analyze the risk factors for lower limb venous thromboembolism of patients undergoing hip fractures operation, reduce the incidence of VTE, improve the prognosis of patients. Methods From February 2016 to February 2017, 508 patients with hip fractures were involved in the study from Sino Japanese Union Hospital of Jilin University. The patients were divided into VTE group and VTE-free group. The data were analyzed concerning general clinical information, combined with other systemic diseases, smoking, operation-time, duration from injury to operation, fracture type, anesthetic techniques and so on. The risk factors of VTE were determined using Logistic regression analysis. Results The overall incidence of VTE in this cohort was 25.4％ (129/508). Multi-factor Logistic regression analysis revealed the following risks related to VTE:age 40-59 years(OR 25.986,95％CI 4.552-148.342)and age over 60 years (OR 66.672,95％CI 11.458-387.967 ), concomitant disease (OR 0.228,95％CI 0.105-0.495 ), smoking (OR 3.070, 95％CI 1.647-5.722 ), non-usage of prophylactic anticoagulants(OR 0.069, 95％CI 0.030-0.159), duration from injury to operation≥3 days(OR 9.966,95％CI 4.791-20.733). Conclusions Age, presence of concomitant disease, smoking, non-usage of prophylactic anticoagulants, duration from injury to operation are the risk factors for VTE in patients with hip fracture.
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Objective To observe the effect of team hypnotic counseling for cancer patients on anxiety and depression,and to explore the effective measure to make cancer patients achieve long -term survival and quality of life.Methods The hypnotic treatment technology was carried in the application of team hypnotic counseling,and the emotional status was designed for cancer patients of team hypnotic counseling courses,and the self rating Anxiety Scale(ASA)and self rating Depression Scale(SDS)was contrasted before and after guidance.Results After 20times of team hypnotic counseling,55 cases of cancer patients were taken ASA,SDS measurement,before team hypnot-ic counseling,ASA was (45.5 ±6.2)points,SDS was (47.3 ±9.3)points,and after team hypnotic counseling,ASA was (37.1 ±3.3)points,SDS was (38.2 ±2.4)points,there was a significant difference before and after team hyp-notic counseling(ASA P <0.02,SDS P <0.05).Conclusion The team hypnotic counseling can significantly im-prove cancer patients with anxiety and depression,application of hypnotic technique in cancer team counseling is very practical,feasible and worthy of further exploration.
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Objeetive To observe the curative effect of ultramicro-dosage heparin (UMDH) combining with low-molecule dextran (LMD) on the D-dimer positive infant with severe pneumonia.Methods sixty-eight infant patienls.whose D-dimer in serum were positive,were randomly divided into two gmaps cutaneous injection for 4 times.Arier the D-dimer in serum became negative,the drug was stpped.In the heparin combining with LMD (HCLMD) group,the UMDH (same dosage as above) was used combining with the LMD.The dosage for LMD was 5 ml/kg once with general-speed intravenous drip and 1-2 times a day,which should be continued until the D-dimer in serum became negative.Results After 2-day's trestment,there was no obvious differences in the negative transfer rate of D-dimer between two groups(P＞0.05).However,after 3-4 day's treatment,the negative transfer rate in HCLMD group was absloutely higher than that in heparin group,there were obvious differences in two groups(P＜0.05).As for the death rate of illness,the death rate in HCLMD group was lower than that in hepari.group,being respectively 5.88% and 17.65%.Conclusion The use of UMDH combining with small-dosage LMD dextran can quickly improve the high condemation situation of blood and reverse the condition of infant patients with severe pneumonia.