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Objective:To investigate the effect of upper limb pillow position on hemodynamic and safety of patients undergoing cerebellopontine angle tumor resection.Methods:Eighty-four patients receiving cerebellopontine angle tumor resection in our hospital from January 2016 to December 2019 were randomly divided into the experimental group (42 cases) and the control group (42 cases). Patients in the control group were placed in routine upper limb position, while patients in the experimental group were placed in upper limb pillow position. The data including systolic pressure, diastolic pressure, heart rate, saturation of blood oxygen were recorded on admission of operation room, completing placing body position, 30 minutes and 60 minutes after operation and after finishing the operation. The numbness/soreness of upper limbs and pressure injury rate was compared between the experimental group and the control group.Results:The rate of numbness/soreness of upper limbs were 2.4% (1/42) in the experimental group, 19.1%(8/42) in the control group, the differences were statistically significant ( χ2 value was 6.098, P<0.05). The stage 1 pressure injury were 2 cases in the experimental group, stage 1 and 2 pressure injury were 6 cases and 2 cases, respectively in the control group, the differences were statically significant ( Z value was 2.039, P<0.05). Conclusion:Upper limb pillow position of the operation side can reduce postoperative complication of patients undergoing cerebellopontine angle tumor resection, but will not increase the risk of abnormal hemodynamic fluctuation.
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Objective:To observe the effect of feedback pulmonary rehabilitation guidance on self-management of elderly patients with stable chronic obstructive pulmonary disease (COPD).Methods:Ninety-four elderly patients with stable COPD that visited the outpatient department between January 2018 and January 2019 were selected. Block randomization methods were used to divide the patients into two groups: routine lung rehabilitation instruction group (referred to as the “routine group”) and feedback lung rehabilitation group (referred to as the “feedback group”). The feedback group received the instruction of feedback pulmonary rehabilitation guidance, while the routine group received the instruction of routine pulmonary rehabilitation guidance. The quality of life and the self-management ability of the two groups before and after the intervention were compared.Results:There was no statistically significant difference between the scores of the feedback and routine groups before the intervention of the COPD-specific self-management scale ( P>0.05). In the feedback group, the scores of emotional management, daily life management, symptom management, self-efficacy management, and information management on the COPD-specific self-management scale after the intervention were 45.01±5.31, 53.10±6.60, 25.88±3.03, 35.01±5.31, and 24.32±4.20, respectively, whereas those for the routine group were 40.23±5.19, 48.02±6.58, 22.88±3.01, 31.01±4.80, and 20.30±2.88, respectively. The scores of the feedback group were higher than the routine group and the difference was significant ( P<0.001). There was no significant difference between the feedback group and the routine group before the intervention of the respiratory disease questionnaire, i.e., the airways questionnaire 20-revised (AQ20-R) score ( P>0.05). The AQ20-R score of the feedback group after the intervention was 7.22±1.08, which was lower than that of the routine group (9.01±2.01); the difference was significant ( P<0.001). Conclusion:The application of feedback pulmonary rehabilitation guidance in the self-management of elderly patients with stable COPD can improve both their self-management ability and quality of life.
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Objective To observe the clinical effect of replantation and non-finger replantation in the treatment of complete distal segment finger amputations,and to analyze the related factors affecting the survival rate of replantation of amputated finger,so as to provide an objective reference for clinical treatment. Methods From March 2015 to June 2016,sixty-two patients with complete distal segment finger amputations treated in the Third People's Hospital of Huizhou were randomly divided into two groups: the observation group and the control group according to the random number table method. The observation group was treated with finger replantation (Pancreatic repair,orthotopic suture and stump remodeling); the two groups of patients with early finger survival rate,replanting fingernail growth,two points discrimination,distal fingertips The clinical data of 288 patients with replantation of single finger rupture were analyzed retrospectively. The clinical data were divided into two groups:the survivors group,the survivors group 74 cases,compared the clinical data of the two groups of patients,analysis of the impact of replantation of the survival rate of the relevant factors. Results The survival rate of early finger was 8. 57% ( 3/ 35) in the observation group and 15. 15% ( 5/ 33) in the control group, the difference was not statistically significant (χ2 = 0. 216,P>0. 05). At 6 months after operation,the length of nail growth,the two-point discrimination and the distal interphalangeal mobility were significantly better than those in the control group((13. 5±2. 9)mmvs. (11. 8±2. 2)mm);(4. 6±0. 3)mmvs. (7. 5±0. 6)mm;(62. 5±4. 4)°vs. (45. 3±3. 6)°) (P<0. 05) . After 6 months,the observation group The excellent and good rate of finger joint activity was 93. 55% (29/ 31). The excellent rate of joint activity was 70. 97% (22/ 31) in the control group,the difference was statistically significant (χ2 = 3. 979,P<0. 05) 288 cases of replantation of clinical data found that smoking history,type of injury,warm ischemic time,degree of disruption,cross-section thrombosis,postoperative skin temperature,pulp elasticity and postoperative psychological status can affect the replantation ( P< 0. 05) . Multivariate logistic regression analysis showed that the factors affecting the survival rate of replantation of finger injury were significantly higher than those of severe depression(OR5. 698,95%CI:2. 892- 8. 738,P< 0. 001)>complete disconnection(OR5. 389,95%CI:2. 672-7. 964,P<0. 001) >warm ischemic time more than 6 hour (OR4. 515,95%CI:1. 366-8. 847,P<0. 001)>postoperative section Thrombosis 成(OR3. 287,95%CI:2. 543~9. 678,P< 0. 001) > low postoperative skin temperature ( OR2. 142,95% CI:1. 243 - 5. 212,P < 0. 001) > poor postoperative knee elasticity(OR2. 008,95% CI:1. 117- 5.449,P< 0. 001) . Conclusion In the treatment of patients with complete injury from the end of the finger,the effect of replantation of the finger is significantly improved,which can improve the postoperative joint activity and improve the appearance and function of the finger. The period of severe depression,complete disconnection and warm ischemia is long Affect the survival rate of finger replantation of the main risk factors for the above factors targeted measures can improve the survival rate of finger replantation.