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Objective@#To confirm early (6 hours) exercise in patients with partial hepatectomy is safe and feasible.@*Methods@#The control group included 211 patients who qualified for partial liver resection before the accelerated rehabilitation surgery (ERAS), 218 patients with partial hepatectomy who met the entry criteria after the implementation of ERAS were taken as test group, get out of bed 24 hours after routine mission in control group, activity of 6 hours after operation in ERAS group. To observe the time of getting out of bed and the incidence of postoperative complications in 2 groups.@*Results@#Comparison with control group, early exercise time of patients in ERAS group after surgery. The incidence of postoperative complications decreased was 14.3% (31/218) while 34.6%(73/211) of the control group. The difference was statistically significant (χ2=299.3, 18.270, P < 0.01). And did not increase the risk of falls, incision pain, postoperative bleeding.@*Conclusion@#Liver partial resection is safe and effective for patients with 6 hours post-operative exercise, worth clinical application.
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Objective@#To assess the differences between ultrasound cardiac output monitor (USCOM) and thermodilution (TD) systematically in cardiac function monitoring of critically ill patients.@*Methods@#The Chinese and English literatures about the clinical trials which using USCOM and TD to monitor cardiac function published in CNKI, Wanfang database, China biomedical literature database, VIP database, China Clinical Trial Registration Center, PubMed, Embase and Cochrane Library were searched by computer from the establishment to December 2018. Some indicators, like cardiac output (CO), cardiac index (CI), stroke volume (SV) and other parameters were used to evaluate cardiac function. Literature search, quality evaluation and data extraction were conducted independently by two authors. The tailored Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used for literature quality evaluation. EndNote X6 was used for literature screening and management. RevMan 5.3 was used for Meta-analysis. Funnel chart analysis was used for publication bias.@*Results@#A total of 26 studies involving 772 patients were included. Among them, there were 5 literatures found that the agreements of cardiac function between the USCOM and TD methods were poor. Meta-analysis showed that there was no significant difference between the two methods in CO and CI monitoring [CO: mean difference (MD) = -0.06, 95% confidence interval (95%CI) was -0.17 to 0.05, P = 0.31; CI: MD = -0.04, 95%CI was -0.13 to 0.05, P = 0.38]. Subgroup analysis of different TD methods [pulmonary artery catheter (PAC), pulse indicator continuous cardiac output (PiCCO)] and different windows of USCOM ultrasonic probe [aorta (AA), pulmonary artery (PA)] in CO monitoring was not shown significant difference yet (PAC: MD = -0.07, 95%CI was -0.18 to 0.04, P = 0.23; PiCCO: MD = 0.09, 95%CI was -0.31 to 0.50, P = 0.65; AA windows: MD = -0.14, 95%CI was -0.31 to 0.02, P = 0.09; PA windows: MD = -0.00, 95%CI was -0.15 to 0.14, P = 0.95; AA/PA windows: MD = 0.23, 95%CI was -0.40 to 0.86, P = 0.47). However, the difference in SV was statistically significant between the USCOM and TD method (MD = 1.48, 95%CI was 0.04 to 2.92, P = 0.04). Funnel chart showed that the literature distribution of CO and CI monitoring were basically symmetrical, indicating that the bias of literature publication is small.@*Conclusion@#USCOM has good consistency with TD method in monitoring the cardiac function parameters of CO and CI, and different windows of ultrasonic probe of USCOM have no significant influence on the monitoring results, but there is significant difference in the consistency of the two methods in SV monitoring.
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Objective To assess the differences between ultrasound cardiac output monitor (USCOM) and thermodilution (TD) systematically in cardiac function monitoring of critically ill patients. Methods The Chinese and English literatures about the clinical trials which using USCOM and TD to monitor cardiac function published in CNKI, Wanfang database, China biomedical literature database, VIP database, China Clinical Trial Registration Center, PubMed, Embase and Cochrane Library were searched by computer from the establishment to December 2018. Some indicators, like cardiac output (CO), cardiac index (CI), stroke volume (SV) and other parameters were used to evaluate cardiac function. Literature search, quality evaluation and data extraction were conducted independently by two authors. The tailored Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used for literature quality evaluation. EndNote X6 was used for literature screening and management. RevMan 5.3 was used for Meta-analysis. Funnel chart analysis was used for publication bias. Results A total of 26 studies involving 772 patients were included. Among them, there were 5 literatures found that the agreements of cardiac function between the USCOM and TD methods were poor. Meta-analysis showed that there was no significant difference between the two methods in CO and CI monitoring [CO: mean difference (MD) =-0.06, 95％ confidence interval (95％CI) was -0.17 to 0.05, P = 0.31; CI: MD =-0.04, 95％CI was -0.13 to 0.05, P = 0.38]. Subgroup analysis of different TD methods [pulmonary artery catheter (PAC), pulse indicator continuous cardiac output (PiCCO)] and different windows of USCOM ultrasonic probe [aorta (AA), pulmonary artery (PA)] in CO monitoring was not shown significant difference yet (PAC: MD =-0.07, 95％CI was -0.18 to 0.04, P = 0.23; PiCCO: MD = 0.09, 95％CI was -0.31 to 0.50, P = 0.65; AA windows: MD =-0.14, 95％CI was -0.31 to 0.02, P = 0.09; PA windows: MD =-0.00, 95％CI was -0.15 to 0.14, P = 0.95; AA/PA windows: MD = 0.23, 95％CI was-0.40 to 0.86, P = 0.47). However, the difference in SV was statistically significant between the USCOM and TD method (MD = 1.48, 95％CI was 0.04 to 2.92, P = 0.04). Funnel chart showed that the literature distribution of CO and CI monitoring were basically symmetrical, indicating that the bias of literature publication is small. Conclusion USCOM has good consistency with TD method in monitoring the cardiac function parameters of CO and CI, and different windows of ultrasonic probe of USCOM have no significant influence on the monitoring results, but there is significant difference in the consistency of the two methods in SV monitoring.
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Objective To confirm early (6 hours) exercise in patients with partial hepatectomy is safe and feasible. Methods The control group included 211 patients who qualified for partial liver resection before the accelerated rehabilitation surgery (ERAS), 218 patients with partial hepatectomy who met the entry criteria after the implementation of ERAS were taken as test group, get out of bed 24 hours after routine mission in control group, activity of 6 hours after operation in ERAS group. To observe the time of getting out of bed and the incidence of postoperative complications in 2 groups. Results Comparison with control group, early exercise time of patients in ERAS group after surgery. The incidence of postoperative complications decreased was 14.3% (31/218) while 34.6%(73/211) of the control group. The difference was statistically significant ( χ2=299.3, 18.270, P<0.01). And did not increase the risk of falls, incision pain, postoperative bleeding. Conclusion Liver partial resection is safe and effective for patients with 6 hours post-operative exercise, worth clinical application.
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Objective To assess the clinical application values of HC visual laryngoscope in emergency tracheal intubation for severe craniocerebral trauma patients with basilar fracture.Methods Retrospective analysis was used to review 60 patients of severe traumatic brain injury with basilar fracture in emergency resuscitation room who needed the hospital emergency tracheal intubation.There were 30 patients operated with visual HC laryngoscope (the observation group), and the other 30 patients underwent common direct laryngoscope (the control group).The index of the degree of exposure,intubation time,success rate of intubation were compared between the two groups.ResultsThere were 28 cases (93.33%) of Cormark-Lehane grading Ⅰ to Ⅱ in observation group,which was significantly higher than 20 cases (66.67%) in the control group(P< 0.05).The average intubation time in observation group was (34.3±6.7) seconds,and it was shorter than (44.5±5.7) seconds in the control group (P<0.05).In observation group,26 cases (86.67%) were of one-time successful intubation,which was higher than 19 cases (63.33%) in the control group,and the difference was statistically significant(P<0.05).ConclusionHC visual laryngoscope in emergency tracheal intubation for severe craniocerebral trauma patients with basilar fracture can improve the success rate of intubation,shorten the intubation time,reduce adverse reactions,and it is worthy of clinical application.
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Objective To observe the characteristics of the two-dimensional global strain index in patients with different degrees heart failure with speckle tracking echocardiography. Methods Totally 35 myocardial infarction patients with heart failure and 28 healthy subjects (control group) were enrolled in the study. The patients were divided into mild (n=14), moderate (n=13), and severe heart failure subgroup (n=8) according to left ventricular ejection fraction (LVEF). The systolic longitudinal strain (LS), radial strain (RS) and circumferential strain (CS) were measured of left ventricular with two-dimensional speckle tracking technique. The average value of left ventricular 18 segmental LS, RS and CS was calculated as the global longitudinal strain (GLS), the global radial strain (GRS) and the global circumference strain (GCS), respectively. LVEF and left ventricular end diastolic volume (LVEDV) were also measured with conventional two-dimensional echocardiography. The global two-dimensional strain and heart function between two groups were compared. The change of GLS, GRS and GCS of different heart failure and the relationship between them and LVEF were analyzed. Results Compared with control group, GLS, GRS and GCS reduced in heart failure groups (P0.05). There was no significant difference in GRS among heart failure subgroups (P>0.05). GLS was closely correlated to LVEF (r=-0.65, P<0.01), GCS was also correlated to LVEF (r=-0.55, P<0.01). Conclusion The changes of GLS, GRS and GCS is different in different degrees of heart failure. GLS is closely correlated to the change of LVEF. The change of GLS, GRS and GCS may reflect degrees of myocardial injury.