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Objective To investigate the application of Vein Infrared Imaging instrument in the treatment of medical patients with difficulty of vein-detaining needle. Methods A total of 116 cases of patients with difficulty of vein-detaining needle were admitted to Peking Union Medical College Hospital International Medical Service Department from June 2015 to May 2016. These participants were divided into vein imaging and conventional puncture group by the punctures method, 58 cases in each group. Vein imaging group applied vein imaging device in the whole process of venous indwelling needle, including vascular assessment before operation, real-time imaging and confirmation, the control group used conventional technology in peripheral venous catheter. The success rate of vein-detaining needle, operation time, puncture tube material cost, the incidence rate of venous indwelling needle complications were compared between two groups of patients. Results One-time success rate of vein imaging group reached 72.4% (42/58), puncture success rate reached 93.1% (54/58), higher than in conventional puncture group, which was 48.3% (28/58), 67.2% (39/58),the difference between the two groups had statistical significance(χ2=7.061, 10.629,P<0.05). Conventional puncture group 's operation time was (8.4±4.2) min,and puncture tube material cost was(123.37±62.20)yuan;vein imaging group respectively were (3.5±1.2) min, (67.50±24.82) yuan, the difference between the two groups had statistical significance (t=5.410, 4.057, P<0.05). Conventional puncture group's rate of complications was 41.4%(24/58), and vein imaging group was 17.2%(10/58), the difference between the two groups had statistical significance (χ2=8.155,P=0.004). Conclusions Application of vein infrared imaging instrument is a practical, safe and rapid method of vein-detaining needle, which can improve the work efficiency of nurses, and have more advantages in the treatment of patients with difficulty of vein-detaining needle.
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Objective To investigate the risk factors for postoperative pulmonary complications (PPCs) in colorectal cancer patients.Methods From January 2014 to June 2016,risk factors for postoperative pulmonary complications in colorectal cancer patients were analyzed retrospectively.The data was analyzed by individual elcment,then the statistically significant factors were analyzed by logistic regression analysis.Results Forty-one out of 352 had PPCs,the incidence rate was 11.6％.The incidence of PPCs was significantly increased in patients with age over 65,a history of smoking,the combined chronic obstructive pulmonary disease (COPD),body mass index (BMI) over 25 kg/m2,operation time (3 h) or longer and preoperative neoadjuvant chemotherapy (P ＜ 0.05) with single factor analysis.In the six kinds of risk factors,age over 65,body mass index (BMI) over 25 kg/m2,COPD and operation time (3 h) or longer wcre the independent risk factors for multiple factors analysis (P ＜ 0.05).Conclusion For elderly patients with colorectal cancer,especially with a history of COPD or obesity,if the operation time was long,more attention should be paid for the happen of PPCs.
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Objective To evaluated the risk factors of urethral recurrence ( UR) following radical cystectomy ( RC) in patients with bladder urothelial carcinoma.Methods The clinical data of 350 male patients who underwent RC between January 2005 and January 2013 were retrospectively analyzed.The mean age was 63 years (rang 46-76) years.176 cases had the history of non-muscle-invasive bladder cancer.15 cases were were found the tumor invasion into the prostatic urethral.The way of urinary diversion after RC included 172 cases were orthotopic neobladder, 90 cases were cutaneous diversion and 88 cases were ileal couduitin.331 cases underwent preoperation intravesical instillation.36 cases underwent systemic chemotherapy after operation.148 cases were found the multiple tumor lesions, which was more than 2 sites. The pathological stage was more than T2 satge in 189 cases.And 177 cases were diagnosed as high-grade urothelial carcinoma.Multivariate Cox regression analyses were used to evaluate the risk factors associated with the UR.Results There were 350 cases in this study, UR was observed in 28 cases ( 8%).On multivariate Cox regression analyses, previous history of NMIBC (HR=15.205,95%CI 3.718-62.180,P<0.001), prostate urethral involvement(HR=5.233,95%CI 1.106-24.754,P=0.037) and Non-orthotopic neobladder(HR=6.656,95%CI 1.840-24.077,P=0.004)which the operation of cutaneous diversion and ileal couduit , were independent risk factors of UR following RC.Intravesical instillation before operation ( HR =0.470, 95%CI 0.010-0.217, P <0.001 ) was the protective factor of the UR.Conclusions Previous history of NMIBC, prostatic urethral involvement and Non-orthotopic neobladder were independent risk factors of UR.Intravesical instillation before operation was protective factor of UR.Urethrectomy for patients with high risk factors and intravesical instillation before operation were important.
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Objective To investigate the effect of autologous serum therapy in the treatment of three cases of exposure keratitis after general anesthesia.Method Autologous serum therapy was used to treat 3 cases of exposure keratitis,the curative effects assessed by the patients’complaints and observation of the ocular symptoms.Result All the patients reported eliminations of exposure keratitis and symptomatic relief.Conclusions The autologous serum therapy is effective for the treatment of exposure keratitis.The nursing strategies of keeping cornea moist,preventing infections,performing mental nursing and storing serum properly are critical for the enhanced curative effect.