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Objective:To explore the effects of different initial flow rates of humidified high flow nasal cannula oxygen therapy on weaning outcomes and comfort level among ICU patients with difficult weaning.Methods:A total of 99 ICU patients with difficult weaning received at Guangzhou Red Cross Hospital ICU from June 2019 to June 2021 were enrolled in the present study, they were assigned to 40 L/min group, 50 L/min group and 60 L/min group according to the random number table method, with 33 cases in each group. The weaning outcomes among three groups were compared, the degree of dryness of oral/nasal cavity, throat pain as well as vital signs and blood gas indexes were also compared before extubation and 30 min after the first humidified high flow nasal cannula (HHFNC) oxygen therapy.Results:There was no significant difference in length of stay in ICU and hospital, re-intubation within 7 days, the mortality within 28 days in ICU and the hospital among three groups ( P>0.05). The weaning success rate were 78.8% (24/33) and 77.4% (23/31) in 50 L/min group and 60 L/min, higher than in the 40 L/min group 53.1% (17/32), the difference was statistically significant ( χ2=4.78, 4.09, both P<0.05). After oxygen therapy, the scores of dryness of oral/nasal cavity and throat pain in the 40 L/min group, 50 L/min group and 60 L/min group were (3.16 ± 0.77), (2.94 ± 0.80) and (3.27 ± 0.92), (3.09 ± 0.77), and (4.10 ± 1.01), (3.97 ± 1.40), the differences were statistically significant ( F=5.21, 9.26, both P<0.05), and the differences between 50 L/min group and 40 L/min group and 60 L/min group were statistically significant ( t values were 2.62-3.99, all P<0.05). However, there was no significant difference in vital signs and blood gas indexes among the three groups before extubation and after oxygen therapy ( P>0.05). Conclusions:Humidified high flow nasal cannula oxygen therapy for the ICU patients with difficult weaning, oxygen flow with 50L/min can not only effectively promote weaning success rate but also improve patients′ respiratory comfort level.
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Objective To compare the therapeutic effect of conventional dental prosthesis and implant repair in the treatment of dentition defect.Methods From March 2016 to December 2017,110 patients with dental defects in the First People＇s Hospital of Yongkang were selected and divided into control group and observation group according to different treatment methods,with 55 cases in each group.The control group received oral routine repair,and the observation group was treated with implant repair.The therapeutic effect of the two groups was analyzed.Results The total effective rate of the observation group was 96.36%,which was significantly higher than 81.82% of the control group (χ2＝3.168,P＜0.05).After treatment,the scores of fixation function,chewing function,language function,degree of comfort,degree of aesthetics in the observation group were (18.06 ±1.32)points,(17.97 ±1.12) points,(18.41 ±1.06) points,(18.24 ±1.03) points and (18.37 ±1.21) points,respectively,which in the control group were (12.51 ±2.43) points,(13.19 ±2.55) points,(13.76 ±2.46) points,(11.64 ±2.12) points,(13.16 ± 2.45)points,respectively,the differences between the two groups were statistically significant (t＝8.957,11.235,10.369,11.036,13.554,all P＜0.05).After treatment for 1 week,the denture plaque index,gingival index and gingival bleeding index in the observation group were (0.81 ±0.11) points,(0.92 ±0.14 ) points,(1.33 ± 0.17) points,respectively,which in the control group were (1.58 ±0.49) points,(1.65 ±0.58) points and (2.67 ±0.62) points,respectively,and the differences between the two groups were statistically significant ( t ＝14.512,10.647,11.354,all P＜0.05).Conclusion The effect of implant repair in the treatment of dentition defect better than conventional dental prosthesis,which can improve the repair effect of patients and maintain the healthy periodontal health,it is worthy of clinical application.
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Objective To evaluate the effects of nitrous oxide inhalation on conscious sedation of patients during colonoscopy and analyze its risk factors. Methods From October 2016 to July 2017, a total of 154 patients undergoing colonoscopy were included in the study. The comfort level was rated using Modified Gloucester Comfort Scale ( MGCS). Factors affecting comfort level were analyzed by univariate analysis and multivariate Logistic regression, and then a comfort stratification predicting model was created. Results All 154 patients finished colonoscopy. The mean time of ideal anesthesia state was 195. 15 s. Among the 154 cases, 115 ( 74. 7%) were identified as comfort ( grade of MGCS from 1 to 3) and 39 (25. 3%) were rated as discomfort ( grade of MGCS from 4 to 5). Multivariate regression indicated that age ≥60 years ( P＝0. 000, OR＝1. 074, 95%CI: 1. 036-1. 114) and mild anxiety ( P＝0. 018, OR＝3. 338, 95%CI: 1. 227-9. 079) were associated with comfort level during colonoscopy.The established model with the age (X1) and mild anxiety (X2) was P＝eY/(1+eY), Y＝－3. 812+0. 071X1+1. 205X2(no anxiety was assigned 1, mild anxiety was assigned 2), and the area under the receiver operating characteristics curve was 0. 746 (95%CI: 0. 661-0. 830), which showed moderate predictive power of the final model. The model reached the highest predictive accuracy when the Yoden Index was 0. 838 with sensitivity of 50. 4% and specificity of 89. 7% for predicting comfort level of patients in conscious sedation status induced by nitrous oxide inhalation during colonoscopy. Conclusion Nitrous oxide can ease pain during colonoscopy, especially for patients over 60 years old and with anxiety. We can use it as an option according to actual circumstance in practice.
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Objective To observe the effect of comfort levels in patients during long-term video electroencephalographic(VEEG) monitoring on the monitoring effect. Methods A total of 168 patients with consecutive epilepsy were observed about the Bruggrmann comfort scale(BCS) and artifacts of VEEG during VEEG monitoring. Pearson′s correlation coefficient was used to evaluate a possible correlation between BCS and artifacts. Results The average single score before VEEG, including psychological comfort, social comfort, comfortable environment and overall comfort was (2.87±1.04), (2.63±0.98), (2.40± 1.25), (2.84 ± 0.90), (2.69 ± 1.07) points, which was (2.06 ± 1.38), (1.66 ± 1.40), (1.89 ± 0.57), (1.83 ± 1.24), (1.86 ± 1.19) points after VEEG. There was significant difference between 2 groups (t=4.011-6.353, P0.05) between the average single score of comfort and sweating, skin artifacts, and electrocardiogram artifact. Conclusions There is a significant negative correlation between patient's BCS and the occurrence of artifacts during VEEG monitoring. Comfort evaluation and comfort care before monitoring has great significance in raising the long-term VEEG monitoring accuracy.
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This study was conducted to evaluate the discomfort level of students from the Polytechnic Kuching Sarawak while they were sitting on chairs. Polytechnic Kuching students (n=500) completed a set of questionnaires utilizing a survey form which showed the body chart discomfort using Borg’s CR-10 Scale. The students was asked to identify body areas experiencing discomfort and to rate this discomfort using score rating groups (0 to 5) where score 0-1.99 = No discomfort (1), score 2.00-3.99 = Discomfort (2) and score 4.00-5.00 = Very uncomfortable (3). The evaluation of seating discomfort levels showed acceptable levels for the students and possible outstanding problems. Students were asked to rank over an order 10 statements about comfort and choose three responses which gave the most consistent equal interval scale. The results showed that the main response of discomfort indicated the students felt cramped, stiff, numb, sore and tender muscle, unbearable pain, barely comfortable and uncomfortable. This project was identified to evaluate the comfort level for classrooms chairs of polytechnic students. Overall, there was a significant discomfort level for the students whilst sitting on chairs and a possible solution put forward is to design a new type of classroom chair made of natural fibre reinforced composite.