ABSTRACT
Objective To discuss the clinical effect of early bladder instillation of pirarubicin after transurethral resection of bladder tumor and the psychological intervention measures. Methods 86 patients from August 2015 to December 2016 for transurethral resection of bladder tumor treated with pirarubicin(PHT) early intravesical therapy were divided randomly into experimental group 43 cases and control group 43 cases, control group in transurethral resection of bladder tumor after transurethral resection take the routine drug regimen, early implementation of pirarubicin therapy after surgery in the experimental group, to compare and analyze the recurrence of bladder cancer after operation in the two groups, and two groups of patients were given psychological nursing, to explore the implementation and effect of psychological nursing measures. Results The patients in the experimental group the recurrence rate was 9.3%, significantly higher than the control group 18.6%, the differences between groups was statistically significant (P<0.05); two groups of patients were given psychological nursing was found to improve patient psychological treatment, increase treatment compliance. Conclusion THP in transurethral resection of bladder tumor after star early bladder irrigation can effectively reduce the recurrence rate of bladder cancer after operation, psychological nursing in the treatment process, can enhance the tolerance in the treatment of patients, improve the treatment compliance, is worthy of clinical popularization and application.
ABSTRACT
Objective To discuss the clinical effect of early bladder instillation of pirarubicin after transurethral resection of bladder tumor and the psychological intervention measures. Methods 86 patients from August 2015 to December 2016 for transurethral resection of bladder tumor treated with pirarubicin(PHT) early intravesical therapy were divided randomly into experimental group 43 cases and control group 43 cases, control group in transurethral resection of bladder tumor after transurethral resection take the routine drug regimen, early implementation of pirarubicin therapy after surgery in the experimental group, to compare and analyze the recurrence of bladder cancer after operation in the two groups, and two groups of patients were given psychological nursing, to explore the implementation and effect of psychological nursing measures. Results The patients in the experimental group the recurrence rate was 9.3%, significantly higher than the control group 18.6%, the differences between groups was statistically significant (P<0.05); two groups of patients were given psychological nursing was found to improve patient psychological treatment, increase treatment compliance. Conclusion THP in transurethral resection of bladder tumor after star early bladder irrigation can effectively reduce the recurrence rate of bladder cancer after operation, psychological nursing in the treatment process, can enhance the tolerance in the treatment of patients, improve the treatment compliance, is worthy of clinical popularization and application.
ABSTRACT
Background: Bloodstream infections (BSIs) due to Enterococcus faecium (E. faecium), particularly those due to vancomycin-resistant enterococcus (VRE), are still a therapeutic challenge. Aim: To evaluate mortality from BSI due to E. faecium and VRE in central Taiwan. Materials and Methods: We retrospectively analyzed cases of significant E. faecium BSI in the Changhua Christian Hospital System between January 1, 2010 and December 31, 2013. Results: Of the 76 cases, 28 patients (36.8%) were admitted to intensive care units (ICUs) at the onset of BSI, 10 (13.2%) cases were associated with polymicrobial bacteremia, and 29 (38.2%) cases were associated with entry via the biliary tract. VRE was observed in 18 (23.7%) cases. The 30-day mortality rate was 13.1% (10/76). Multivariate logistic regression analysis showed that bacteremia of non-biliary tract origin (OR = 8.43, 95% confidence interval (95% CI) = 1.32-54.00, p = 0.002) and ICU admission (OR = 4.2, 95% CI = 1.7-10.0, p = 0.002) were significant risk factors for 30-day mortality, whereas appropriate antimicrobial therapy was a protective factor for 30-day mortality (OR = 0.33, 95% CI = 0.14-0.79, p = 0.013). Conclusions: Our results underscore the need to assist patients admitted to ICUs with E. faecium BSIs with a non-biliary tract origin. We emphasize the use of appropriate antimicrobial therapy for E. faecium BSI with the aim to rescue more patients with these infections.
Antecedentes: Las infecciones del torrente sanguíneo por Enterococcus faecium, particularmente aquellas causadas por enterococos resistentes a vancomicina (ERV), representan aún un desafío para los tratamientos. Este estudio está orientado a la evaluación de la mortalidad debido a la infección del torrente sanguíneo (ITS) por E. faecium y por enterococos resistentes a vancomicina (ERV) en Taiwán central. Materiales y Métodos: Analizamos de forma retrospectiva casos de ITS causadas por E. faecium genuinas en el Sistema del Hospital Changhua Christian, entre los días 1 de enero de 2010 y 31 de diciembre de 2013. Resultados: De los 76 casos analizados, 28 pacientes fueron ingresados a las Unidades de Cuidados Intensivos (UCI) al comienzo de una ITS (36,8%), 10 casos fueron asociados a bacteriemia polimicrobiana (13,2%), y 29 casos tuvieron como puerta de entrada la vía biliar. En 18 casos se pudieron observar ERV (23,7%). La mortalidad a 30 días fue de 13,1% (10/76). El análisis multivariado mediante regresión logística mostró que la bacteriemia de origen no biliar (OR = 8,43, 95% intervalo de confianza (95% CI) = 1,32-54,00; p = 0,002), y el ingreso a la UCI (OR = 4,2; 95% CI = 1,7-10,0; p = 0,002), fueron factores de riesgo significativos para el rango de mortalidad de 30 días, así como un tratamiento de antimicrobiano apropiado constituye un factor protector en contra la mortalidad (OR = 0,33; 95% CI = 0,14-0,79; p = 0,013). Conclusiones: Nuestros resultados destacan la necesidad de asistir a los pacientes ingresados a la UCI con ITS por E. faecium con origen no biliar. Hacemos énfasis a la aplicación de una antibioterapia adecuada para sacar adelante a un mayor número de pacientes con este tipo de infecciones.