ABSTRACT
Objective To investigate the clinical effect of epidural anesthesia combined with general anesthesia on the expression of serum interleukin 6(IL-6),interleukin 8(IL-8) and C-reactive protein (CRP) in patients undergoing hip replacement.Methods From February 2017 to February 2018,82 patients who underwent hip replacement in Zhuji People's Hospital were selected in the research.According to the random table method ,the patients were divided into two groups , with 41 patients in each group.The observation group was given epidural anesthesia combined with general anesthesia ,while the control group was given general anesthesia.The extubation time and recovery time,the scores of MMSE and the changes of inflammatory factors at preoperation ,postoperative 3h and postoperative 24h were compared between the two groups.Results The extubation time and recovery time of the observation group [( 10.93 ±2.41) min and (17.85 ±3.24) min] were shorter than those of the control group [(16.29 ±2.73)min and (23.94 ±2.46)min] (t＝9.425,9.586,all P＜0.05).The scores of MMSE in the obser-vation group at postoperative 3h[(25.48 ±1.43)points] and postoperative 24h [(26.83 ±1.09)points] were higher than those in the control group [(23.09 ±1.60) poinrts and (25.32 ±1.42) points] ( t＝7.132,5.401,all P＜0.05).The serum levels of IL-6,IL-8 and CRP in the observation group at postoperative 3h [(28.93 ±3.54)ng／L, (37.92 ±6.73)ng／L,(18.93 ±3.25)mg／L] and postoperative 24h [(21.09 ±1.76)ng／L,(28.76 ±3.25)ng／L, (10.39 ±2.67) mg／L] were lower than those in the control group [3h after operation:( 49.97 ±5.46) ng／L, (64.32 ±8.98)ng／L,(29.90 ±4.36) mg／L;24h after operation:(34.52 ±3.49) ng／L,(43.65 ±5.61) ng／L, (18.89 ±2.34)mg／L] (3h after operation:t＝20.704,15.064,12.917;24h after operation:t＝22.001,14.706, 15.330,all P＜0.05).Conclusion Epidural anesthesia combined with general anesthesia has better clinical effect than general anesthesia alone in patients with hip replacement ,and can reduce the occurrence of cognitive dysfunction and inhibit the release of inflammatory reaction after operation ,which is worthy of clinical reference.
ABSTRACT
Objective@#To investigate the clinical effect of epidural anesthesia combined with general anesthesia on the expression of serum interleukin 6(IL-6), interleukin 8(IL-8) and C-reactive protein (CRP) in patients undergoing hip replacement.@*Methods@#From February 2017 to February 2018, 82 patients who underwent hip replacement in Zhuji People's Hospital were selected in the research.According to the random table method, the patients were divided into two groups, with 41 patients in each group.The observation group was given epidural anesthesia combined with general anesthesia, while the control group was given general anesthesia.The extubation time and recovery time, the scores of MMSE and the changes of inflammatory factors at preoperation, postoperative 3h and postoperative 24h were compared between the two groups.@*Results@#The extubation time and recovery time of the observation group [(10.93±2.41)min and (17.85±3.24)min] were shorter than those of the control group [(16.29±2.73)min and (23.94±2.46)min] (t=9.425, 9.586, all P<0.05). The scores of MMSE in the observation group at postoperative 3h[(25.48±1.43)points] and postoperative 24h [(26.83±1.09)points] were higher than those in the control group [(23.09±1.60)poinrts and (25.32±1.42)points] (t=7.132, 5.401, all P<0.05). The serum levels of IL-6, IL-8 and CRP in the observation group at postoperative 3h [(28.93±3.54)ng/L, (37.92±6.73)ng/L, (18.93±3.25)mg/L] and postoperative 24h [(21.09±1.76)ng/L, (28.76±3.25)ng/L, (10.39±2.67)mg/L] were lower than those in the control group [3h after operation: (49.97±5.46)ng/L, (64.32±8.98)ng/L, (29.90±4.36)mg/L; 24h after operation: (34.52±3.49)ng/L, (43.65±5.61)ng/L, (18.89±2.34)mg/L] (3h after operation: t=20.704, 15.064, 12.917; 24h after operation: t=22.001, 14.706, 15.330, all P<0.05).@*Conclusion@#Epidural anesthesia combined with general anesthesia has better clinical effect than general anesthesia alone in patients with hip replacement, and can reduce the occurrence of cognitive dysfunction and inhibit the release of inflammatory reaction after operation, which is worthy of clinical reference.
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As one of the important factors that impact the life of quality to the elderly,visual impairment has become a research highlight in developed countries.And some related results have been found out.It is in the primary stage of establishing the elderly community extending service system in China.Based on this background,literature about the impact of visual impairment on quality of life of the residential setting elderly and related interventions were reviewed.By drawing the experience from developed countries,we aim to innovate perfect interventions,improve the quality of life,avoid unexpected events such as fall and medication mistakes.
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A comprehensive analysis was carried out about the influencing factors of medication safety in the elderly with multiple chronic diseases,who lived in the community and stayed at their own homes.Applicable and simple preventive countermeasures should be established to ensure the medication safety outside medical agency.We should promote extending service of hospitals,cooperate with community and nursing facility in order to increase life quality of the elderly,and supply reference for professional continuous service model including rapid aging,empty nest with advanced age,disability and dementia and elderly people with chronic diseases.
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In the treatment of 32 cases of bile reflux gastritis by embedding catgut in the acupoints of Danshu (BL 19), Weishu (BL 21), Liangmen (ST 21), Zhongwan (CV 12),Shangwan (CV 13), Zusanli (ST 36), Neiguan (PC 6), Taichong (LR 3) and Yanglingquan (GB34), taken off one day later, embedded once every 15-20 days, the results showed cure in 20cases and improvement in 12 cases after four treatments.