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Objective To analyze the prospective coping styles of nurses in operation room of plastic surgery department and its influencing factors. Methods A total of 169 nurses of two tertiary first-class hospitals and two secondary hospitals in Yuncheng city were selected as the research objects by convenient sampling from January 2016 to January 2017, their general data, dispositional hope, occupational expectations, occupational values, occupational maturity and prospective coping styles were analyzed. The influencing factors of prospective coping style were analyzed. Results The quality of hope was (31.78±4.24) points, occupational expectation was (72.41±7.24) points, professional values were (86.63 ± 7.02) points, professional maturity was (94.58 ± 6.25) points, and prospective coping style was (40.64 ± 6.13) points in the nurses in plastic surgery operation room. The results of multivariate linear regression model showed that the longer working time, high professional title, high degree of education, high monthly income, longer working hours in plastic surgery operation room, high hope quality, high career expectation, high occupational values and high career maturity were all the prospective coping styles of nurses in the operation room. Significant factors (P <0.05). Conclusions The nurses in the plastic surgery operation room have a certain prospective coping style, improve the treatment of nurses, set up their active work goals, improve their hope traits, career expectations, occupational values and career maturity, which can significantly enhance the level of prospective coping style.
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Objective To evaluate the efficacy and security of one-stop hybrid cardiac surgery for the treatment of elderly patients with complex heart disease.Methods From November 2013 to March 2014,a total of 5 patients[4 male,age:71-78years] underwent one-stop hybrid approach in the hybrid operating room with chronic obstructive pulmonary disease (COPD) in 3 cases,2 cases of diabetes,3 cases of hypertension,valvular heart disease in 3 cases,PDA in 1 case,4 patients with multivessel coronary disease.Right minimally invasive cardiac surgery(coronary artery bypass grafting or valvular surgery) and percutaneous intervention were performed in an enhanced operative unit.The efficacy and security of one-stop hybrid cardiac surgery were evaluated after the procedure.Results The one-stop hybrid procedure was successful in all patients.Operation time was (125 ± 28) minutes,CPI time was (65 ± 33) minutes,CPB time was (60 ± 23) minutes,Aortic cross clamping time was (42 ± 18) minutes,postoperative mechanical ventilation time was (20.5 ±6.5)hours and ICU monitoring time was (68.9 ± 16.6)hours.Hospitalization time was (9.8 ± 3.7) days.Patients remained free from angina,prosthetic valve dysfunction and patent ductus arteriosus recanalisation(rang 1 to 5 months) follow-up period.Conclusion One-stop hybrid cardiac surgery provides a reasonable,feasible and safe alternative for treating elderly patients with complex heart disease.
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Objective To evaluate the effects of the modified opration of benign tumor in parotid gland on the prevention of Frey syndrome.Methods the Parotid benign tumor resection in 28 cases were selected,according to the different treatment methods were divided into observation group of 12 cases,16 cases of the control group.The modified surgical patients in the observation group,two flap method,preservation,preservation of parotid masseter fascia in the branches of the great auricular nerve and parotid region resection,the control group was treated by routine tumors of the parotid gland and parotid superficial lobectomy or resection.Patients were followed up for 6 months to 1 years,underwent minor test,the incidence of Frey syndrome in 2 cases were recorded,postoperative incidence of Frey syndrome were compared.Results The incidence of Frey syndrome in the observation group was significantly reduced compared with the control group.The difference was statistically significant (χ2 =7.479,P <0.05 ). Conclusion The effects of modified opetation combined with secondry disc method in benign tumor of parotid gland on the prevention of Frey syndrome has obvious advantages comparing with the control.
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Studies have shown that postoperative disseminated intravascular coagulopathy (DIC) occurs in some patients with cardiac disease, acute aortic dissection, and ruptured abdominal aortic aneurysm. The specific pathophysiology of DIC in these settings are related to low cardiac function, shock, infection and sepsis as well as activation of coagulation cascade in the aneurysm sac or dissected aorta. A soluble form of recombinant human thrombomodulin (rhsTM) was approved in 2008 for the treatment of DIC. This report describes the safety and efficacy of rhsTM for the treatment of DIC in patients with cardiovascular disease operated in our department. Between October 2010 and March 2012, 35 patients with postoperative DIC were treated with rhsTM. Diagnosis of DIC was based on the diagnostic criteria for DIC of the Japanese Association for Acute Medicine (JAAM). During the first 6 months of the study period, after a diagnosis of DIC was made, the patients were treated with gabexate mesilate and antithrombin III, and if patients showed no improvement with conventional treatment, they received rhsTM for 6 days. During the last 10 months of the study period, patients received rhsTM soon after a diagnosis of DIC was made. Twenty seven patients survived for 28 days after rhsTM treatment, and the mortality rate was 22.9% (8/35). Patients who survived showed improvement in acute phase DIC scores, FDP levels, D-Dimer, fibrinogen and platelet counts during rhsTM treatment, but no improvement was observed in patients who died. No serious adverse events were found up to 28 days after the start of rhsTM administration. In conclusion, this study showed no adverse events of rhsTM, and further studies are needed to confirm that rhsTM administration is an effective therapeutic modality in the management of DIC after cardiovascular surgery.
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Objective To investigate the clinical effect and safety of laparoscopy on ovarian benign tumor. Methods The data of 68 patients, underwent laparoscopic operations on ovarian benign tumor from Jan 2009 to Jan 2010, were analyzed retrospectively. Sixty eight patients underwent laparotomy were randomly enrolled as control. The operative time, the blood loss, the average admission day and the average postoperative exhaust time were compared between two groups. Results We found no significant differences in the comparation of operative time ( [ 63.60 ± 7.71 ] min vs. [ 62. 40 ± 8. 90 ] min, t = 0. 663, P ＞ 0. 05 ), while the blood loss, the average postoperative exhaust time, the average admission day of the treatment group were significantly lower in the objectives than control ( [ 68.00 ± 14. 90 ] ml vs. [ 119.00 ± 19. 60 ] ml, [ 17.30 ±2.40]h vs. [34.60 ±2.80] h, [3.90 ± 1.40] days vs. [7.70 ± 1.50] days,t =2.664, 2. 523,2.724,Ps ＜0. 05). Conclusion Laparoscopy is the first choice of method in treating ovarian benign tumor given its minimal invasion and rapid recovery.
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Objective To investigate the influential factors on the effectiveness of the first 131I ablation therapy on thyroid remnant and of 131I treatment on metastatic lesions in differentiated thyroid cancer (DTC) patients. Methods Retrospectively,46 DTC cases (divided into complete-ablation group and incomplete-ablation group) of first 131I ablation were enrolled,and 40 DTC cases (divided into remission group and in-remission group) of consecutive 131I treatments on metastatic lesions were enrolled. Influential factors were analyzed (t-test,t'-test,x2-test,Fisher exact test) and logistic regression analysis was performed. Results For the first 131I ablation effectiveness,surgical method,remnant thyroid weight,thyroid stimulating hormone (TSH) level,interval between surgery and 131I ablation therapy,metastatic status were selected as influential factors (x2 = 5. 804,t' = - 5. 258,t' = 7. 376,x2 = 8. 867,x2 = 8. 615,all P ＜0. 05). After logistic regression analysis,formula was obtained as y = 3. 766 - 0. 947x1 ( remnant thyroid weight) -3. 149 x2 (lymph node metastasis) -3. 373 x3 (distant metastasis). For metastatic treatment effectiveness,remission rate of papillary DTC was higher than that of follicular DTC,remission rate of patients with lymph node metastasis was higher than that of distant metastasis,remission rate of total thyroidectomy was higher than that of other types of thyroidectomy ( Fisher exact test,x2 = 7. 278,P ＜ 0. 05 ). In remission group,serum TSH level was much higher and thyroglobulin (Tg) level was much lower before the first ablation therapy (t =4. 489,t' = -4.906,all P ＜0.01 ). After logistic regression analysis,formula was obtained as y = - 0. 363 + 0. 065 x4 ( TSH level) - 0. 250 x5 ( Tg level). Conclusions Influential factors of success rate of the first 131I ablation therapy included surgical method,remnant thyroid weight,TSH level,interval between surgery and 131I ablation therapy and metastatic status,while determinant factors were thyroid remnant weight,lymph node metastatic status and distant metastatic status. The influential factors of success rate of 131I treatment on metastatic lesions included pathological type,surgical method,metastatic status,TSH level and Tg level,while determinant factors were TSH level and Tg level before the first 131I ablation therapy.
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Late acute type A aortic dissection after coronary artery bypass grafting (CABG) is rare, and only a few cases have been published in the literature. It is important to treat cases of living graft during reoperation. We report a successful surgical treatment in a case of late acute type A aortic dissection after CABG. A 68-year-old man underwent a triple CABG (to the left anterior descending artery with left internal thoracic artery, to the left circumflex artery with left radial artery, and to the right coronary artery with right gastroepiploic artery) beating heart procedure using a centrifugal pump and pulmonary assist with closed circuit due to unstable angina pectoris in December 2007 and had presented with sudden anterior chest pain, and was found to have an ascending aortic dissection (type A) on enhanced computed tomography in May, 2009. We performed ascending artery replacement, paying special attention to the living graft performed through a median sternotomy. The postoperative course was uneventful and he was discharged on the 22nd postoperative day.
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Objective To investigate the strategy and announcements of surgery in primary retroperitoneal. tumor for improving the rescetable rate and decreasing the surgical risk.Methods Clinical data of 50 cases undergoing surgery of retroperitoneal tumor in our hospital from January 2004 to December 2008 were retrospectively analyzed.Results Tumors were benign in 20 cases and malignant in 30 cages.Complete resection was achieved in 39 cases(78%).in which combined organ resection carried out in 10 cases(20%),3 cases(6%)underwent partial resection.non-resection and had biopsy only were performed in 8 cases(16%),so the rescetable rate of this clinical weTe 84%(42/50).Conclusions Abundant preoperative preparation,wide open operation field and distinct anatomical dissection were the essential condition of the resecting primary retroperitoneal tumor.The relevant surgical skill should decrease the surgical risk.The tumor should be completely reaeeted in principle,and invaded neighboring organs should be resected with the discretion at the gane time.Completely resected was the key 10 improving the surviral rate and the strategy to decreasing the reeurence rate for recurrent retroperitoneal tumor.
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Objective To investigate the surgical approach of the reasonable radical resection for carcino-mas of pancreatic head. Method 35 of 110 patients with carcinomas of pancreatic head underwent the surgical ap-proach of the posterior aspect of the radical resection for carcinomas of pancreatic head, and histopathological findings and prognosis were analyzed. Results The rate of curative resection rate was 31.82%. 3 patients underwent pancre-atoduodenectomy with partial resection of SMV for 9 patients with macroscopic suspicion of invasion of the SMV. The survival rate of the 5 years was 17.14% and the patients exceed 10 years. Conclusion Surgical approach of the reasonable radical resection for carcinomas of pancreatic head allows the reasonable radical resection,and may lead to increasing the resectability rate and the prognosis in the patients with carcinomas of pancreatic head.
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@#ObjectiveTo explore the diagnosis and the surgical operation of concealed penis, and raise the therapeutic efficacy.Methods16 cases of concealed penis were reviewed retrospectively.ResultsAll 16 cases were treated by Devine surgery and got the satisfactory effect, the penis recovered to its good external appearance. All 16 cases had been followed up for four months to two years. The revelation of penis and its external appearance were all satisfied. No complications such as hydrophallus, skin ischemia, haematoma and erection ache occurred.ConclusionThe real concealed penis should be strictly distinguished from buried penis, microphallus and redundant prepuce, and suitable operation pattern can obtain satisfactory effect.
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Objective To summarize the methods and results of treatment of displaced humeral su rgical neck fractures with closed reductio n and percutaneous pin fixation.Methods We reviewed 46patients who had been diagnosed as the displaced hume ral surgical neck fractures and trea ted with closed reduction and percut aneous pin fixation using?2.5mm Kirschner wire with terminal t hread from January 2001to December 2002in our hospital.Results34patients received a complete follow-up.The mean follow-up time was 22months(10to 34months).Evaluation was done with Constant-M urley rating system.The mean absolu te Constant-Murley score was 92(76～100).86%(29/34)of the cases were excellent or good,14%(5/34)were fair,and none were poor.All the fractures united 6to 8weeks after operation,a nd no fixation failure or humeral hea d necrosis was found.Conclusion Treatment of displaced humeral surg ical neck fractures with closed reduction and percutaneous pin fixation can shorten operation time,lead to minimal soft tissue lesion and reliable fixation,and allow early functional exercis e after op-eration and easy removal of the wire. [
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Purpose:To evaluate the effects of intra-arterial infusion plus radiation therapy as a treatment for invasive bladder cancer. Methods:24 cases of invasive bladder cancer were treated from 1995 to 2003. All were treated with intra-arterial infusion chemotherapy plus radiation therapy. Results:CR+PR was 91.6%(22?24). In the 22 cases with indications for total cystectomy, the normal bladder function was preserved. The quality of life and the survival period improved. Conclusions:Intra-arterial infusion chemotherapy plus radiation therapy is an effective method for invasive bladder cancer, especially for the patients who can not tolerate burden or do not accept cystectomy.[
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Objective To review the experience of minimally invasive incision for open-heart surgery in 56 children with congenital heart diseases.Methods There were secundum atrial septal defect (ASD)25 cases, ventrilcular septal defect (VSD) 26 cases, double-chambered right ventricle (DCRV) 2 cases and pulmonary arterial stenosis (PS) 3 cases,right anterior-lateral thoracotomy for 23 cases in heart beat CPB and ministernotomy for 33 cases participated in the study.Results No death or serious complications happened,and the patients' postoperative recovery rapidly,mean hospital stay was 8 days .Conclusions Minimally invasive incision has followe as advantages,such as :less trauma, cosmetic, less pain, recovery rapid, safeness, effectiveness, and shorter hospital stay,especially for repairing the secundum atrial septal defect, membranous or para-membranous ventrilcular septal defect.
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Objective To analyze the clinical features and treatment and prognosis of Paget's diseases.Method 7 cases of Paget's disease of the extramammary have been encountered. Results 3 patients with groin matastases were died within 5 years, the patients without groin matastases were all surrived.Conclusions Surgery is the treatment of first choice for Paget's disease. Prognosis of patient with groin matastases is very poor.
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Objective To study the results of intraventricular tunnel procedure for double outlet right ventricle(DORV) with subaortic ventricular septal defect(VSD).Methods Nine children with DORV complicated with subaortic VSD underwent intraventricular tunnel procedure.Five of them had stenosis of pulmonary valve or subpulmonary stenosis,and one had double-chambered right ventricle. An intraventricular tunnel procedure was performed under cardiopulmonary bypass. Right ventriculotomy was made to repair the VSD with teflon patch. An internal tunnel was made between the left ventricle and the aorta.The right ventricle connected with the main pulmonary artery. Results All children survived and recovered finally. Echocardiography showed that the internal tunnel function was well.Conclusion With correct diagnosis and selection of procedure, intraventricular tunnel procedure is a satisfactory method for the treatment of DORV with subaortic VSD.