ABSTRACT
Objective:To investigate the effect of modified cervicothoracic compression band on successful hemostasis and postoperative complications of patients with endoscopic radical thyroidectomy via breast areola approach and to provide reference for postoperative nursing of thyroid cancer.Methods:A total of 128 patients with endoscopic radical thyroidectomy via breast areola approach from October 2018 to October 2019 in the Second Affiliated Hospital of Zhejiang University School of Medicine were selected and divided into experimental group(64 cases) and control group (64 cases) by random digits table method. Patients in the control group were fixed with wide adhesive tape for hemostasis, while patients in the experimental group wore modified cervicothoracic compression band. The postoperative complications between two groups were recorded, in addition, the physical condition and comfort of patients was assessed by Edmonton Symptom Assessment System (ESAS) and Kolcaba General Comfort Questionnaire (GCQ), respectively.Results:There was no sigrificance in the score of ESAS, GCQ on the 1st day before the operation between the two groups ( P>0.05). The median score of happiness in ESAS was 6.0 points in the experimental group on the 3rd day after the operation, significantly higher than 4.0 points in the control gorup, the difference was statistically significant ( Z value was 2.919, P<0.01). The physiological, psychological, social, cultural and environmental comfort, total GCQ scores were (10.73±2.35), (24.41±4.99), (23.09±2.11), (20.17±2.32), (78.41±6.49) points in the experimental group and (8.41±2.23), (22.42±4.79), (21.22±2.73), (19.20±2.97), (71.25±6.92) points in the control group, the differences were statistically significant ( t values were 2.058-6.031, P<0.05 or 0.01). The incidence of contact dermatitis, pressure purpura and tension blister were 0, 3.1% (2/64), 0 in the experimental group and 6.3% (4/64), 12.5% (8/64), 7.8% (5/64) in the control group, the differences were statistically significant ( χ2 values were 4.129, 3.095, 5.203, P<0.05). Conclusions:Modified cervicothoracic compression band can significantly alleviate the symptoms of postoperative patients with endoscopic radical thyroidectomy, reduce postoperative complications and improve patient comfort.
ABSTRACT
Objective To investigate the clinical features,diagnostic modalities and treatment of duodenal Brunner′gland adenoma(BGA).Methods Fifteen patients with duodenal BGA were evaluated base on clinical presentations,the results of serologic test,barium meal examination,gastroscopy and endoscopic ultrasonography(EUS)as well as treatment.The post-operative histological results were compared with pre-operation EUS findings.Results Eight out of 15 patients with duodenal BGA had presentations,including duodenal ulcer(4 patients),upper gastrointestinal hemorrhage (4 patients). The serologic tests of all patients were within the normal limits.Six patients underwent barium meal examination and 13 patients received gastroscopy.Seven patients underwent surgical treatment and 8 patients received endoscopic resection.The post-operative histological results were compatible with the pre-operative EUS findings.Conclusions Duodenal BGA is a benign tumor.EUS was helpful in making the diagnosis and determination of treatment methods(surgical operation or endoscopic resection).