ABSTRACT
Objective:To investigate the effects on perceived quality of a management assessment system for orthopedic surgery in elderly patients.Methods:Based on the concept of lean management and process nodes in systems, an information management system was established to evaluate the perceived quality of surgical service for elderly orthopedic patients.Four hundred and two elderly orthopedic patients receiving orthopedic surgery after the implementation of the management system were included in the observation group, while 402 elderly patients undergoing orthopedic surgery before the implementation of management system formed the control group.Results:The incidence of hypothermia in patients admitted to the resuscitation room after surgery was lower in the observation group than in the control group(1.7% vs.4.5%, χ2=5.136、 P=0.023). The incidence of shivering during resuscitation was lower and the satisfaction rate of surgical services was higher in the observation group than in the control group(0.7% vs.3.2%) χ2=5.279、 P=0.022, 96.55(95.58, 97.28)分, vs.87.9(83.2, 89.95)分, Z=-4.16, P=0.00). Conclusions:A perceived quality assessment system composed of lean management and information technology for surgical services can reduce complications and improve satisfaction for patients receiving surgery.
ABSTRACT
Objective To explore the effect of dexmedetomidine combined with sufentanil on postoperative analgesia , early postoperative cognitive function and serum inflammatory factors in patients with laparoscopic gastrectomy of gastric cancer.Methods 80 cases of laparoscopic resection of gastric cancer were randomly assigned to treatment group and control group.The control group were treated by sufentanil 1.6μg/kg.The treatment group were given sufentanil 1.6μg/kg combined with dexmedetomidine 2 μg/kg.The analgesic effect, early cognitive function and serum levels of inflammatory factors were tested and compared after surgery.Results Compared with the control group, the VAS score in 4 h,8 h,24 h and 48 h after surgery were lower in the treatment group (P<0.05), the POCD(P<0.05), the IL-6,IL-10 and TNF-αlevel were lower in the treatment group(P<0.05). Conclusion Dexmedetomidine combined with sufentanil showes better postoperative analgesic effect and fast recovery of cognitive function, regulate the levels of serum inflammatory cytokines after laparoscopic resection of gastric cancer .