ABSTRACT
Objective:To study the effect of heated carbon dioxide pneumoperitoneum on the prognosis of patients undergoing pancreaticoduodenectomy by Da Vinci robot.Methods:A total of 307 patients who underwent pancreaticoduodenectomy by Da Vinci robot from January 2016 to December 2018 were selected as subjects. 140 patients who underwent pancreaticoduodenectomy from January 2016 to April 2017 were selected as the control group, and room temperature carbon dioxide pneumoperitoneum was used. From May 2017 to December 2018, 167 patients were set as the intervention group, and heated carbon dioxide pneumoperitoneum was used. Body temperature, heart rate and blood oxygen saturation of the two groups were compared after entering the operating room, before anesthesia, before the establishment of carbon dioxide pneumoperitoneum and after the closure of carbon dioxide pneumoperitoneum, and the duration of operation, intraoperative blood loss, postoperative anesthesia recovery time, hospitalization time and postoperative complication rate were recorded.Results:There was no significant difference in body temperature after entering the operating room, before the establishment of carbon dioxide pneumoperitoneum between the two groups ( P>0.05). After the closure of carbon dioxide pneumoperitoneum, the decline range of the body temperature of the control group was(1.24±2.36) ℃, which was significantly higher than that of the intervention group (0.60±0.25) ℃, and the difference was statistically significant ( t value was 6.892, P<0.05). There were no statistically significant differences between the two groups in terms of operation duration, number of cases with blood oxygen saturation < 0.90, incidence of gastrointestinal fistula and incision infection ( P>0.05). The intraoperative blood loss, resuscitation time, drainage time was (291.08±265.42) ml, (27.04±10.89) min, (8.69±6.64) d in the intervention group and (364.29±309.28) ml, (32.60±12.17) min, (10.76±6.25) d in the control group, and the difference was statistically significant ( t value was 2.232, 7.294, 2.789, P<0.05 or 0.01). There was statistically significant difference in The incidence of pancreatic fistula and biliary fistula, and length of hospital stay was 20 cases, 7 cases, (27.62±17.30) d in the intervention group, and 31 cases, 15 cases, (32.38±12.22) d in the control group, and the difference was statistically significant ( χ2 value was 4.653, 4.870, t value was 6.284, P<0.05). Conclusions:Warming carbon dioxide pneumoperitoneum can reduce the incidence of perioperative hypothermia and improve the prognosis of patients undergoing pancreaticoduodenectomy by Da Vinci robot.
ABSTRACT
According to the information of the supervision and inspection of in vitro diagnostic reagents for clinical use, this article analyzed the compliance issues and discussed the methods to solve the problems, to urge medical institutions to reduce the regulatory risk of in vitro diagnostic reagents in use.
Subject(s)
Government Regulation , Indicators and Reagents , RiskABSTRACT
Objective To use the liquid phase coprecipitation method for preparing gemcitabine magnetic nanoparticles to the pouch,and explore the preparation process in a number of conditions. Methods The effect of different stirring speeds,Fe3+/Fe2+ratio,pH,temperature of Fe3O4 powder and emulsification condition,ultrasonic time,curing temperature on the preparation of target?ed magnetic nanoparticles were observed. Results The preparation of Fe3O4 nanoparticles was as follows:800 r/ min of stirring speed,1.7∶1 Fe3+/Fe2+ratio,pH=9,the reaction temperature of 60℃,and the 5∶40 water/oil compared,ultrasonic time of 10 min, 100℃curing temperature. Conclusion Fe3O4 powder with small particle size,high purity,and no agglomeration are prepared,the stability of the gemcitabine magnetic nanoparticles capsule is good.