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Objective:To evaluate the effectiveness and safety of enhanced recovery after surgery(ERAS)in perioperative period of liver transplantation.Methods:The authors searched systematically domestic and foreign databases to collect researches on applying ERAS for liver transplantation. The retrieval period was from database inception to November 2020. Quality assessment and data extraction were performed by two researchers according to the inclusion criteria. Meta-analysis of postoperative indicators(length of ICU stay, total length of hospital stay, postoperative complications, admission rate & mortality rate)was performed by RevMan 5.3.5 software.Results:3 Three randomized controlled studies (RCTs) and 4 cohort studies were selected with a total of 1 016 patients, including 404 in ERAS group and 612 in conventional group(traditional perioperative management). The results of Meta-analysis revealed that, as compared with control group, length of ICU stay was significantly shorter in ERAS group [weighted mean difference(WMD)=-2.20, 95% CI: -2.43~-1.97, P<0.05]; Total length of hospital stay was significantly shorter in ERAS group [WMD=-5.85, 95% CI: -8.20~-3.49, P<0.05]; The incidence of postoperative complications was significantly shorter in ERAS group [OR=0.61, 95% CI: 0.42~0.88, P<0.05]. However, no inter-group statistically significant differences existed between admission rate or mortality rate( P>0.05). Conclusions:In perioperative period of liver transplantation, using ERAS protocol can shorten length of ICU stay and total length of hospital stay, lower the incidence of postoperative complications and accelerate patient recovery.
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This paper introduces the enhanced recovery after surgery (ERAS) of the definition and concept, elaborates the domestic and foreign research results of ERAS in various fields of evidence-based nursing care in perioperative period, and the future development direction of ERAS are discussed.The purpose of this literature is to provide a reference for the individualized,specialized of the ERAS program for different diseases and different operations.
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Objective We observed influence of different handgrip exercise on the changes of blood flow velocity and blood vessel diameter of basilic vein before and after the PICC placement and discuss the best model for handgrip exercise.Methods 60 patients with PICC were chosen and divided into group A,B and C with 20 patients in each groups.Group A received routine guidance on unarmed handgrip exercise,group B used electronic handgrip,the frequency was 25 times/min,the time period was 2 min with 4 times a day,once every 4 hours,group C adopted the same model as that of group B and 6 times a day,once every 3 hours.The venous blood flow velocity and blood vessel diameter was measured by pulsed Doppler ultrasound one hour before the PICC placement and one hour,1 day,3 days,7 days,10 days,14 days,21 days after placement.Results The venous blood flow velocity before and after PICC placement had statistically significant differences at different time points (F=2.934,P ＜ 0.05).The effect of group B and C was better than that of the group A and group C showed the best effect.The blood vessel diameter before and after PICC placement had significant differences at different time points(F=3.940,P ＜ 0.05).There was significant differences in the blood vessel diameter 1h before and 1h after PICC placement.Conclusions Handgrip exercise can effectively promote the upper limb venous blood flow velocity in patients with PICC,but shows little effect on the blood vessel diameter.Using the electronic hand grip in weak tap position,25 times/min,2 min every time,and 6 times a day (once every 3 hours),can obviously promote the upper limb venous blood flow velocity.
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Objective To know the situation of teaching and teacher preparation for nursing under-graduates, and then reference to reasonable clinical teaching mode. Methods Investigated clinical pre-ceptors from 30 hospitals by serf-designed questionnair to know their basic situation, and then investigated nursing undergruaduates who had enter school in 2004 to know their evaluation about their preceptors in the aspect of basic quality. Results In professional tides, most of the teachers are nurse-in-charge, and have been working over 10 years, but qualification certificates levels were low and 50% of them teaching. Experience was short and not qualified to the popurse of bachelors degree, nurse-in-charge and more than five years nursing experience. The ratio in thesis writing, teaching training and awards are rather low. There were teaching assessment from students, mainly in teaching and research initiative. Conclusions The qualities of nursing teachers should be defined and should be established standard teaching training system and qualification organization, the capabilities of teaching and research innovations should be improved.
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Objective To provide a representative,objective and operable evaluation tool for agsessing tlle quality of clinical internship of nursing students,and through fuzzy evaluation and feeding back information scientmcauy to improve clinical teaching quality comprehensively.Methods Employing the method of"sorting of experts contrast"to score assessing indicators according to the importance in the undergraduate nursing internship by 10 experts,using mathematical methods to calculate the index weight,and applying fuzzy mathematics to the quality evaluation of nursing internship. Results The project had appropriate indicators and objective and reasonable weight.By applying this system,the general state of intemship students asessod by the clinical teachers and the head nurses was evaluated fuzzily,which was in accordance with the actual performance of students.Conclusions The index system with the characteristics of modern practice teaching concepts combines comprehensiveness with innovation,importance with completeness,accords with the teaching goals of nursing students,and the fuzzy evaluation of that will be better to evaluate the internship quality of nursing students comprehensively and objectively.
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Objective To investigate the difference of restlessness of patients who was in the stage of recovery from general anesthesia when using urethral catheterization in different time. Methods Divided 80 patients with carcinoma of esophagus into 2 groups randomly.For the cases in the experimental group,using urethral catheterization before the general anesthesia,while for the cases in the control group,using urethral catheterization after the general anesthesia.Compare the condition of restlessness and the ratio of canal emerge of 2 groups. Results The condition of restlessness and the ratio of canal emerge in the experimental group were both better than those of in the control group,P