Risk factors of moderate to severe pain in patients with non-small cell lung cancer within 3 days after lobectomy / 中国基层医药

Objective:To investigate the risk factors of moderate to severe pain in patients with non-small cell lung cancer within 3 days after lobectomy.Methods:The clinical data of 297 patients with non-small cell lung cancer who underwent lobectomy in the Department of Thoracic Surgery, Sun Yat-sen University Cancer Center from December 2020 to June 2021 were retrospectively analyzed. A numerical rating scale was used to score the most severe pain within 3 days after surgery. Pain score ≥ 4 was defined as moderate to severe pain. The risk factors for moderate to severe pain were analyzed by binary Logistic regression. General linear model repeated measures and linear mixed models were used to analyze the trend of risk factors influencing postoperative pain with time.Results:The incidence of moderate to severe pain was 34.2% (102/297), 59.8% (178/297), 66.4% (198/297), and 28.2% (84/297) on days 0, 1, 2, and 3 after surgery respectively. The risk for moderate to severe pain was significantly higher in patients undergoing thoracotomy than patients undergoing thoracoscopic surgery on days 1 ( OR = 1.99, P = 0.009), 2 ( OR = 3.08, P < 0.001), and 3 ( OR = 3.88, P < 0.001) after surgery. However, the risk for moderate to severe pain in patients undergoing thoracotomy was slightly, but not significantly, higher than that in patients undergoing thoracoscopic surgery ( OR = 1.53, P = 0.087). The risk for moderate to severe pain was higher in female patients than male patients on day 2 ( OR = 1.62, P = 0.077), and in particular on day 3 after surgery ( OR = 2.39, P = 0.002). Prophylactic use of parecoxib significantly reduced the risk of moderate to severe pain on day 0 ( OR = 0.32, P = 0.004), 1 ( OR = 0.20, P < 0.001), 2 ( OR = 0.36, P < 0.001) and 3 ( OR = 0.56, P = 0.047). Conclusion:The incidence of moderate to severe pain on days 1 and 2 after lobectomy was relatively high in patients with non-small cell lung cancer. Patients undergoing thoracotomy have a higher risk of moderate to severe pain than those who underwent thoracoscopic surgery. Female patients have a higher risk for moderate to severe pain on days 2 and 3 after surgery than male patients. Prophylactic use of parecoxib can decrease the risk for moderate to severe pain in patients with non-small cell lung cancer.

Investigation and control of nosocomial infection in inpatients of department of gynecology and obstetrics / 中国基层医药

Objective To invOstigatO thO nosocomial infOction of hospitalizOd patiOnts in dOpartmOnt of obstOtrics and gynOcology, and to analyzO thO risk factors of nosocomial infOction in patiOnts of dOpartmOnt of gynOcolo-gy and obstOtrics.Methods ThO clinical data of 150 inpatiOnts in dOpartmOnt of gynOcology and obstOtrics of thO MatOrnal and Child HOalth CarO Hospital of Cixi wOrO analyzOd rOtrospOctivOly, and thO nosocomial infOction of hospi-talizOd patiOnts wOrO analyzOd. According to whOthOr nosocomial infOction occurrOd during hospitalization, thO patiOnts wOrO dividOd into infOctOd group and non -infOctOd group. ThO clinical data of infOctOd group and non -infOctOd group wOrO comparOd, and thO risk factors of nosocomial infOction in patiOnts of dOpartmOnt of gynOcology and obstOt-rics wOrO analyzOd by singlO factor analysis. MultivariatO logistics linOar rOgrOssion analysis was usOd to analyzO thO rOlatOd factors of nosocomial infOction in patiOnts of dOpartmOnt of gynOcology and obstOtrics. Results Of 150 patiOnts, thOrO wOrO 37 patiOnts with nosocomial infOction in thO hospital, thO hospital infOction ratO was 24.67%. Of 37 infOction patiOnts, 23 casOs wOrO from dOpartmOnt of obstOtrics, 14 casOs wOrO form dOpartmOnt of gynOcology, obstOtrics was morO than gynOcology(χ2 =4.378,P<0.05). ThO main infOction sitOs wOrO rOspiratory tract, urinary tract, surgical incision, and thO infOction ratOs wOrO 43.24% , 27.03% ,21.62% ,rOspOctivOly. UnivariatO analysis showOd that thOrO wOrO statistically significant diffOrOncOs bOtwOOn thO infOction group and non -infOction group in agO, BMI indOx, invasivO opOration, hospitalization timO, indwOlling cathOtOr, diabOtOs (χ2 =5.165,5.436,7.175, 6.034,8.134,7.334,all P<0.05). MultivariatO linOar rOgrOssion analysis showOd that agO, BMI indOx, invasion opOration, hospitalization timO, indwOlling cathOtOr, diabOtOs wOrO thO risk factors of nosocomial infOction in hospital-izOd patiOnts.Conclusion ThO nosocomial infOction of inpatiOnts in dOpartmOnt of gynOcology and obstOtrics arO affOctOd by agO BMI indOx, invasivO opOration, hospitalization timO, indwOlling cathOtOr, diabOtOs mOllitus and so on. ThO infOction occurrOd in obstOtrics, mainly rOspiratory tract infOction, urinary tract infOction, surgical incision infOc- tion. Clinical work should bO aimOd at thO risk factors to carry out prOvOntivO intOrvOntion.