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Objective:To investigate the classification of main pancreatic duct and treatment strategy after linear stapler closure of pancreatic neck in laparoscopic pancreaticoduodenectomy (LPD).Methods:The records of 51 consecutive patients with LPD who were treated by linear staple closure technique of pancreatic neck from February to December 2022 from Binzhou Second People′s Hospital, Shijingshan Campus, Beijing Chaoyang Hospital, Capital Medical University, Rizhao Hepatobiliary-Pancreatic-Splenic Surgery Research Institute, Chaoyang Central Hospital, Shandong Juxian People′s Hospital, Weihai Municipal Hospital, Binzhou Central Hospital, and Affiliated Hospital of Chifeng University were retrospectively reviewed. According to the visibility, position and diameter of the main pancreatic duct at the stump of the pancreas, the type of main pancreatic duct was divided into type I, type Ⅱ, type Ⅲa and type Ⅲb. The number of cases in each main pancreatic duct classification and the corresponding treatment strategies were examined.Results:A total of 51 cases of LPD were successfully completed. Of these patients, the males comprised 56.9%(29/51), and females comprised 43.1%(22/51), with age ranging from 31 to 88 years old. The type of the main pancreatic duct at the stump of the pancreas included 7 cases (13.7%) of type Ⅰ, 39 cases (76.5%) of type Ⅱ, 2 cases (3.9%) of type Ⅲa, and 3 cases (5.9%) of type Ⅲb. Corresponding treatment strategies were adopted according to different main pancreatic duct types, the main pancreatic duct was successfully found, and a support drainage tube was inserted.Conclusion:After linear stapler closure of pancreatic neck, corresponding treatment strategies should be adopted according to the classification of the main pancreatic duct, which would help to improve the success rate of finding the main pancreatic duct and placing a support drainage tube.
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Objective To evaluate the application value of perioperative interventional strategy guided by enhanced recovery after surgery (ERAS) in elderly recipients undergoing liver transplantation. Methods Clinical data of 405 liver transplant recipients were retrospectively analyzed. According to age, all recipients were divided into the elderly (≥60 years, n=122) and non-elderly groups (< 60 years, n=283). All patients received perioperative interventions under the guidance of ERAS. Intraoperative and postoperative indexes, incidence of postoperative complications and discharge were analyzed between two groups. Results There were no significant differences in the duration of anesthesia, operation time, anhepatic phase, hemorrhage volume, blood transfusion volume, lactic acid level before abdominal closure, ventilator-assisted time, the length of intensive care unit (ICU) stay, Caprini score, CHIPPS score, time of gastric tube, urinary tube and drainage tube removal, time to first drinking, time to first physical activity and time to first flatus between two groups (all P > 0.05). In the elderly group, the time to first feeding was later than that in the non-elderly group (P < 0.05). There were no significant differences in the incidence of fever, ascites, pulmonary infection, delayed gastric emptying, hemorrhage and inactive venous thrombosis between two groups (all P > 0.05). No significant differences were observed in the levels of aspartate aminotransferase, total bilirubin, direct bilirubin, serum creatinine before discharge and total length of hospital stay between two groups (all P > 0.05). The alanine aminotransferase level in elderly recipients was lower than that in non-elderly counterparts, and the difference was statistically significant (P < 0.05). No unplanned reoperation was performed within postoperative 30 d in two groups. There was no significant difference in the re-hospitalization rate within 30 d after discharge (P > 0.05). Conclusions ERAS-guided interventional strategy contributes to perioperative recovery of elderly recipients undergoing liver transplantation, and yields equivalent postoperative recovery between elderly and non-elderly recipients.
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Objective:To investigate the clinical application of ultrafine thoracic drainage tube(Abel, 8FR, 20 cm) after pulmonary uniportal video-assisted thoracoscopic surgery lung tumors.Methods:A total of 2 031 patients who doing lung tumor surgery in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from May 2015 to July 2020 were retrospectively enrolled. According to the types of thoracic drainage tubes, they were divided into the ultrafine drainage tube group(1 026 cases) and the conventional drainage tube group(1 005 cases). The groups were compared in terms of postoperative thoracic drainage at 24 h, 48 h and 72 h, postoperative hospital stay, drainage time, postoperative pain index at three days, postoperative analgesia times and postoperative complications.Results:There was no significant difference between two groups in terms of the postoperative thoracic drainage at 24h, 48h, 72h and drainage time( P>0.05). Notably, there were significant differences between two groups in terms of the postoperative hospital stay, postoperative pain index at three days, postoperative analgesia times and postoperative complications( P<0.05). Conclusion:The use of ultrafine thoracic drainage tube after lung tumor surgery is safe and reliable, can better postoperative drainage, achieve the purpose of relieving pain, speeding up postoperative rehabilitation, and convenient nursing, worthy of clinical promotion and application.
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Objective:To analyze the risk factors of hyperthermia after removal of drainage tubes in patients after neurosurgery.Methods:The clinical data of 146 patients after neurosurgery with indwelling drainage tubes admitted to the department of critical care medicine of Pecking University Third Hospital from January 2019 to July 2021 were analyzed retrospectively. The patients were divided into hyperthermia group (body temperature≥39 ℃) and non-hyperthermia group (body temperature < 39 ℃) according to whether their body temperatures within 24 hours after removal of drainage tubes. General clinical data and outcomes of the two groups were collected, and different tendentious scores were matched with the hyperthermia group and non-hyperthermia group based on Glasgow coma score (GCS), respectively. After such matching, the clinical baseline characteristics [age, gender, admission diagnosis, major complications, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) at admission, GCS], number of days of drainage tubes retention, location of drainage tubes, microbial culture results before removal of drainage tubes, white blood cell (WBC) and neutrophil ratio (NEU%) before and after removal of drainage tubes as well as clinical outcomes of the cohort patients were analyzed. The primarily outcome was in-hospital mortality, and then the length of intensive care unit (ICU) stay.Results:A total of 146 patients after neurosurgery were included, 28 of which developed hyperthermia after removal of drainage tubes. The GCS scores at admission in the hyperthermia group were significantly lower than that in the non-hyperthermia group, while the proportion of hypertension and diabetes in the hyperthermia group was significantly higher than that in the non-hyperthermia group. Based on GCS scores, the two groups, each of which included 28 patients, were matched with tendentious scores, and there was no significant difference in gender, age, GCS scores and the proportion of hypertension and diabetes between the two groups. The main disease for patients upon admission was cerebral hemorrhage (53.6%, 30/56). The proportion of indwelling ventricular drainage tube retention in the hyperthermia group was significantly higher than that in the non-hyperthermia group [32.1% (9/28) vs. 7.1% (2/28), P < 0.05], but there was no significant difference in the location of other drainage tubes between the two groups. The proportion of lumbar puncture in the hyperthermia group was also significantly higher than that in the non-hyperthermia group [25.0% (7/28) vs. 0 (0/28), P < 0.05]. Compared with the non-hyperthermia group, WBC [×10 9/L: 13.0 (9.5, 15.2) vs. 11.5 (8.8, 13.3)] of 1 day before removal of drainage tubes, NEU% [0.892 (0.826, 0.922) vs. 0.843 (0.809, 0.909)] after removal of drainage tubes and positive rate of drainage-fluid culture or drainage-tube-tip culture [7.1% (2/28) vs. 0% (0/28)] in the hyperthermia group increased, but there were not significant differences. There was no significant difference in the proportion of pulmonary, urinary system and blood flow infection before removal of drainage tubes in the two groups. In terms of primary outcomes, compared with the non-hyperthermia group, the length of ICU stay [days: 17.0 (8.0, 32.3) vs. 8.5 (1.0, 16.8), P < 0.05] in the hyperthermia group was significantly prolonged, and the in-hospital mortality [35.7% (10/28) vs. 10.7% (3/28), P < 0.05] in the hyperthermia group was obviously increased. The positive rate of carbapenem-resistant bacteria culture [32.1% (9/28) vs. 3.6% (1/28), P < 0.05] in the hyperthermia group during hospitalization was significantly higher than that in the non-hyperthermia group. Conclusions:Hyperthermia after removal of drainage tubes for patients after neurosurgery can significantly prolong the length of ICU stay and increase the in-hospital mortality, which may be related to the secondary infection caused by indwelling intracranial drainage tubes and the intracranial spread of bacteria caused by removal of drainage tubes, as well as the intracranial multidrug-resistant bacterial infection caused by the drainage tubes.
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The management of drainage tube is an important part of nursing work. Patient restraint and tube fixation cannot effectively prevent unplanned extubation (UEX) when the tube is accidentally pulled by violence. The nursing innovation team of Henan Provincial People's Hospital designed a medical drainage tube anti-pull device in order to change the existing technology of preventing drainage tube disconnecting by means of restraint and fixation, and to interfere with the basic cause of drainage tube disconnection, and obtained the national utility model patent (patent number: ZL 2020 2 2843025.1). The design of sleeve and clasp is that when the drainage tube is pulled by accidental violence, the friction fastener clamps the drainage tube mechanically to achieve the purpose of braking the drainage tube and prevent the drainage tube from coming out. Card sleeve ring fracture design can be applied to drainage tubes of different diameters, and the buzzer device at the instant of the snap ring into the card set warning medical staff to the occurrence of risk events, so that the nurse can come in the first place for effective treatment, which is a fuse for surgical drainage tubes and is to timely and effectively prevent UEX.
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Objective:To evaluate the effect of experiential health education on patients discharged from hospital with the tube after pancreaticoduodenectomy.Methods:A total of 65 patients admitted to the General Surgery Department of Peking University Third Hospital for pancreaticoduodenectomy from September 2020 to August 2021 were selected as the study objects by convenience sampling method. The 31 patients with pancreaticoduodenectomy who received routine education about drainage tube from September 2020 to February 2021 were selected as the control group, and 34 patients with pancreaticoduodenectomy who received experiential health education about drainage tube from March 2021 to August 2021 were selected as the study group. The self-nursing ability and self-management of drainage tube of the patients in both groups were observed.Results:The total score of drainage tube self-care ability, drainage bag fixation score, drainage bag replacement score, drainage fluid dumping score, anti-drainage tube pull score, drainage tube extrusion method score were 10.00(10.00, 10.00), 2.00(2.00, 2.00), 2.00(2.00, 2.00), 2.00(2.00, 2.00), 2.00(2.00, 2.00), 2.00(2.00, 2.00) points, Higher than the control group 5.00(4.00, 5.00), 1.00 (1.00, 1.00) and 1.00 (0.00, 1.00), 1.00 (1.00, 1.00) and 1.00 (1.00, 2.00), 1.00 (1.00, 1.00) points, the differences were statistically significant ( Z values were -7.31--5.78, all P<0.05).In the self-management of drainage tubes in the study group, the drainage tube pulling rate, the incidence of exudation around drainage tubes, and the rate of leakage of drainage fluid registration were 8.82% (3/34), 14.7% (5/34), and 5.88% (2/34), respectively, lower than 61.29% (19/31), 41.94% (13/31), and 87.10% (27/31) in the control group, with statistically significant differences ( χ2=19.94, 6.00, 43.28, all P<0.05). Conclusions:Experiential health education can effectively improve drainage tube self-care ability of patients after pancreaticoduodenectomy, promoting postoperative rehabilitation of patients.
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Objective:To explore the relationship between the diameter of drainage used in closed thoracic drainage (CTD) and the prognosis of patients with thoracic trauma.Methods:This study was a retrospective cohort study, a total of 146 patients who were admitted to the 971st Navy Hospital due to thoracic trauma from April 2017 to June 2021 and received closed thoracic drainage were selected as the research subjects. According to the prognosis, they were divided into a good group ( n=96) and a poor group ( n=50), and the clinical efficacy, general data and postoperative complications of the two groups were compared and analyzed. Multivariate Logistic regression was used to analyze the risk factors for poor prognosis, and a nomogram prediction model was established, and the model was evaluated. The relationship between the size of drainage diameter and the prognosis of patients with thoracic trauma was analyzed by Pearson correlation. The normally distributed measurement data was expressed by the ( ± s), and the independent samples t test was used for comparison between groups; The chi-square test was used for comparison of count data between groups. Results:The clinical efficacy of CTD was good, with a total effective probability of 87.67%; and 3 weeks after surgery, the patient′s prognosis was good, with a good prognosis probability of 65.75%. Logistic analysis showed that age 60 years old ( OR=1.501, 95% CI: 1.105-2.177), excipient replacement time of 2-3 d ( OR=2.543, 95% CI: 1.729-3.168), drainage bottle higher than thoracic cavity ( OR=1.692, 95% CI: 1.314-2.482), long wound healing time ( OR=1.971, 95% CI: 1.479-2.720), frequent cough ( OR=2.259, 95% CI: 1.564-2.924), and drainage tube diameter 16 F ( OR=3.087, 95% CI: 2.074-3.793) were independent risk factors for poor prognosis ( P<0.05). The size of drainage diameter was positively correlated with hospitalization and wound healing time, pain VAS score ( P<0.05), and negatively correlated with Barthel Index ( P<0.05). Conclusion:Drainage tube diameter 16 F is one of the independent risk factors for poor prognosis of patients. The smaller the drainage diameter, the shorter the postoperative hospital stay, faster wound healing, lighter pain and stronger ability of life and activity.
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Objective:To explore the chest drainage effect of use different diameter thoracic drainage tube after biportal thoracoscopic radical resection for lung cancer.Methods:300 patients with lung cancer who received biportal thoracoscopic radical resection were divided into group A and group B from January 2018 to September 2020. Group A: 150 patients with single 28# thoracic drainage tube after surgery. Group B: 150 patients with single 20# thoracic drainage tube and a negative pressure drainage ball after surgery. The postoperative drainage volume, drainage time, postoperative pain, postoperative thoracic puncture, hospital stay and total hospital expenses were compared.Results:No significant difference between the two groups in terms of sex, age, postoperative pathological type and resection range. There no significant difference between the two groups in total drainage volume [(1 010.31±525.29)ml vs.(985.35±403.93)ml] and total drainage time [(5.69±2.55)days vs.(5.42±1.94)days]. The difference of different diameter thoracic drainage tube used [(5.69±2.55)days vs.(2.88±0.64)days] was statistically significant. There were significant differences between two groups in terms of hospital stay[(12.64±2.89)days vs.(11.25±1.62)days] and total hospital expenses[(62 899.00±1 588.82) yuan vs.(64 327.00±3 587.04)yuan]. No significant differences on the postoperative first day, second day and third day in VAS pain scores. However, on the postoperative fifth day, the difference was statistically significant. In addition, the rate of group A postoperative thoracic puncture was 10%, group B was 0, the comparison was statistically significant.Conclusion:Using a single thin thoracic drainage tube and plus a negative pressure drainage ball after biportal thoracoscopic radical resection for lung cancer will not cause pain increase, shorten hospital stay days, control the rate of postoperative thoracic puncture and then reduce patients total hospital expenses.
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Objective:To investigate the clinical application effect of self -made frenum fixator in the secondary fixation of drainage tube with full gauze coverage around the incision after limb fracture surgery. Methods:120 cases of patients with limb fracture treated by trauma surgery from October 2019 to June 2020 were selected and divided into control group (50 cases) and experimental group (70 cases) by drawing lots. The control group used the traditional 3M tape platform method to fix the drainage tube, and the experimental group used the homemade lace up fixator to fix the drainage tube. The difference of fixtion effect between the two groups was observed and compared.Results:The incidence of catheter-related risk events was 1.4% (1/70) in the experimental group, which was lower than 14% (7/50) in the control group (2 value was 7.408, P = 0.009); the change interval of fixation materials was (5.10±0.39) d, which was significantly higher than (1.68±0.23) d in the control group ( t value was 60.168, P<0.001); the fixed material reuse rate was 97.1% (68/70) and comfort 97.1% (68/70), which were higher than 0 and 48.% (24/50) in the control group, the differences were statistically significant (2 values were 112.00 and 39.37, P<0.001). Conclusion:The self -made lace up fixator has reliable fixation effect and can effectively reduce the occurrence of catheter -related risk events. It is feasibility and safety.
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Objective:To explore the clinical application effect of early removal of drainage tube in rapid postoperative recovery of patients with thyroid cancer.Methods:A total of 90 thyroid cancer patients admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from June 2018 to June 2019 were selected and divided into a control group and a study group according to the order of operation time. Patients in the control group were given routine extubation, and patients in the study group were removed early during rapid recovery after surgery. The complication rate, postoperative hospital stay, satisfaction, extubation time distribution, and drainage port healing rate 3 days after surgery were compared between the two groups of patients.Results:In the study group, the incidence of complications after drainage tube removal during rapid recovery after surgery was 6.7% (3/45), which was significantly lower than that of the control group, 26.7% (12/45), and the difference was statistically significant ( χ2 value was 6.48, P <0.05). The postoperative hospital stay in the study group was (3.25±0.89) days, and the satisfaction score was (97.83±7.25), which was significantly shorter than the control group's (5.68±0.96) days and (92.36±12.19). The difference was statistically significant ( t value was 12.45, 2.59, P <0.05). Conclusions:Early removal of the drainage tube during rapid postoperative recovery of patients with thyroid cancer can effectively reduce the trauma of the drainage tube orifice, shorten the hospital stay, and improve patient satisfaction.
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@#Objective To compare the clinical effect of single mediastinal drainage tube and both mediastinal drainage tube and closed thoracic drainage tube for the patients who received thoracoscopic radical resection of esophageal carcinoma. Methods We enrolled 96 esophageal carcinoma patients who received thoracoscopic radical resection from June 2016 to October 2018. Of them, 49 patients were indwelt with both mediastinal drainage tube and closed thoracic drainage tube (a chest & mediastinal drainage group, a CMD group) while the other 47 patients were indwelt with single mediastinal drainage tube (a single mediastinal drainage group, a SMD group). The total drainage volume, intubation time and incidence of postoperative complications (postoperative atelectasis, pulmonary infection, pleural effusion and anastomotic leakage) between the two groups were compared. The pain score and comfort score were also compared between the two groups. Results The total drainage volume and intubation time in the SMD group were not significantly different from those in the CMD group (1 321±421 mL vs. 1 204±545 mL, P=0.541; 6.1±3.7 d vs. 6.4 ±5.1 d, P=0.321). The incidence of postoperative complications (postoperative atelectasis, pulmonary infection, pleural effusion and anastomotic leakage) in the SMD group was not significantly different from that in the CMD group (10.6% vs. 6.1%, P=0.712; 4.3% vs. 10.2%, P=0.656; 6.4% vs. 12.2%, P=0.121; 2.1% vs. 4.1%, P=0.526). The numerical rating scale (NRS) pain scores on the first to the fifth day after surgery and during extubation in the SMD group were significantly lower than those in the CMD group (3.2±2.1 vs. 5.1±2.4, P=0.041; 2.8±0.6 vs. 4.8±1.4, P=0.015; 2.1±0.4 vs. 4.5±0.4, P=0.019; 1.7±0.7 vs. 4.0±0.8, P=0.004; 1.8±0.7 vs. 3.2±1.2, P=0.006; 1.4±0.2 vs. 2.5±3.4, P=0.012). The VAS comfort scores in the SMD group were significantly lower than those in the CMD group (3.6±1.7 vs. 6.6±3.7, P=0.018; 2.9±2.0 vs. 5.1±3.4, P=0.007; 2.1±1.4 vs. 5.5±2.4, P=0.004; 3.0±0.9 vs. 4.6±3.8, P=0.012; 1.8±1.1 vs. 4.2±2.7, P=0.003; 2.4±3.2 vs. 5.3±1.7, P=0.020). Conclusion The clinical effect of single mediastinal drainage tube in thoracoscopic resection of esophageal carcinoma is similar to that of both mediastinal drainage tube and closed thoracic drainage tube, but it can significantly improve the comfort of the patients.
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Objective@#To explore the application effect of improved drainage bag carrying method in the nursing of biliary drainage tube.@*Methods@#Sixty-five patients with biliary drainage tube were divided into two groups by convenient sampling. There were 33 cases in the control group and 32 cases in the observation group. When going out of bed, the observation group used the improved drainage bag carrying method to carry the drainage bag, and the control group used the traditional hand-held method or the S-hook external drainage bag. The catheter drainage failure rate, decoupling rate, retrograde infection rate, and satisfaction of tube activity in the two groups were compared between the two groups.@*Results@#There were no significant differences in catheter drainage failure rate, decoupling rate and retrograde infection rate between the two groups (P>0.05). The satisfaction of the tube with the improved drainage bag carrying method was (10.22±0.94) points, while (7.36±1.03) points in the contrast group. There was statistically significance between the two groups (t=11.685, P< 0.05).@*Conclusion@#The improved drainage bag carrying method has improved the quality of care in the department of catheter care, and the patient′s satisfaction with the nursing staff has also been improved.
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OBJECTIVE: To clarify the value of unconventional prophylactic drain placement in laparoscopy assisted D2 gastrectomy for gastric cancer.METHODS: The clinical data of 193 patients with gastric cancer who underwent laparoscopy-assisted D2 Gastrectomy in Department of General Surgery,Chinese PLA General Hospital between February 2017 and February 2018 were analyzed retrospectively.The patients were divided into two groups according to whether the abdominal drain was placed.The drain group comprised 150 patients with routine prophylactic intraabdominal drain placement and the no drain group comprised 43 patients without intra-abdominal drain placement after laparoscopy-assisted D2 gastrectomy.The general information,post-operative recovery and the incidence of postoperative complications were compared in the two groups.RESULTS: There was no significant difference in the general information and postoperative complications in the two groups.The no drain group had shorter hospital stay[(7.17±0.14)d vs.(10.88±0.88) d,(P<0.05)],and shorter exhaust time[(3.39±0.21)d vs.(4.30±0.16)d,P<0.01],less pain [VAS(3.23±0.61) vs.(5.39±0.42),(P<0.05)] and less times of wound dressing change after operation [(3.53±0.52)vs.(7.81±1.05),(P<0.05)] compared with the drain group.CONCLUSION: The unconventional prophylactic drain placement in laparoscopy assisted D2 gastrectomy is safe and feasible.Unnecessary drain placement should be avoided.
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@#AIM: To investigate the best time for indwelling catheter of patients with chronic dacryocystitis after lacrimal drainage tube implantation.<p>METHODS: Totally 143 eyes of 143 patients with chronic dacryocystitis after lacrimal drainage tube implantation were selected in our hospital. They were divided into 3 groups including group A(50 eyes of 50 cases)with indwelling catheter in 9wk after tube implantation, group B(57 eyes of 57 cases)with indwelling catheter in 12wk after tube implantation, and group C(36 eyes of 36 cases)with indwelling catheter in 6wk after tube implantation. The clinical efficacy, visual acuity, incidence of epiphora, recurrence rate and incidence of postoperative complications with followed-up among three groups were compared.<p>RESULTS: On the day of extubation, the total effective rates of the three groups were 94%, 93% and 39%, the difference was statistically significant(<i>P</i><0.0167). The total effective rates of group A and group B were better than those of group C, and the difference was statistically significant(χ2=30.830, 32.056, <i>P</i><0.001). At 3mo after extubation, the total effective rates of the three groups were 56%, 51% and 36%, there was no significant difference(χ2=3.454, <i>P</i>=0.178). At 3mo after extubation, there was no significant difference in the visual acuity and the incidence of epiphora among the three groups(<i>P</i>>0.05). At 6mo after extubation, the recurrence rates of the three groups showed no significantly different(<i>P</i>=0.056). The incidence of postoperative complications in three groups were 4%(2/50), 7%(4/57)and 25%(9/36), the difference was statistically significant(χ2=11.048, <i>P</i>=0.004). The incidence of postoperative complications in group C was higher than that in groups A and B(χ2=6.499, 5.934; <i>P</i>=0.011, 0.015).<p>CONCLUSION: The clinical benefits of 6wk and 9wk after lacrimal drainage tube implantation are better than that of 12wk.
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Objective To explore the application effect of improved drainage bag carrying method in the nursing of biliary drainage tube. Methods Sixty-five patients with biliary drainage tube were divided into two groups by convenient sampling. There were 33 cases in the control group and 32 cases in the observation group. When going out of bed, the observation group used the improved drainage bag carrying method to carry the drainage bag, and the control group used the traditional hand-held method or the S-hook external drainage bag. The catheter drainage failure rate, decoupling rate, retrograde infection rate, and satisfaction of tube activity in the two groups were compared between the two groups. Results There were no significant differences in catheter drainage failure rate, decoupling rate and retrograde infection rate between the two groups (P>0.05). The satisfaction of the tube with the improved drainage bag carrying method was (10.22±0.94) points, while (7.36±1.03) points in the contrast group. There was statistically significance between the two groups (t=11.685, P< 0.05). Conclusion The improved drainage bag carrying method has improved the quality of care in the department of catheter care, and the patient′s satisfaction with the nursing staff has also been improved.
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@#AIM: To investigate the efficacy and independent influencing factors of YAG laser combined with RS drainage tube in the treatment of lacrimal duct obstruction.<p>METHODS: Retrospective analysis of the cases of 250 patients with lacrimal duct obstruction treated by laser combined drainage tube in our hospital from 2015-01/2018-01, summarized the efficacy and analyzed the independent factors of efficacy.<p>RESULTS: The total effective rate of clinical treatment was 87.9%; course of disease(<i>OR</i>=8.654, 95% <i>CI</i>: 3.740-20.023), frequency of lacrimal passage(<i>OR</i>=3.480, 95% <i>CI</i>: 2.128-5.691), length of lacrimal duct obstruction(<i>OR</i>=0.518, 95% <i>CI</i>: 0.238-1.131), extubation time(<i>OR</i>=0.386, 95% <i>CI</i>: 0.237-0.628)and initial surgery(<i>OR</i>=14.717, 95% <i>CI</i>: 10.798-20.059)were the independent factor influencing the efficacy.<p>CONCLUSION: YAG laser combined with RS disposable drainage tube is effective in the treatment of lacrimal duct obstruction. Early treatment, avoiding multiple operations, proper irrigation of lacrimal passage after operation, and controlling extubation time, which are beneficial to improve the curative effect and improve the prognosis of patients.
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@#Objective To explore the feasibility of single mediastinal drainage tube in treatment of esophageal carcinoma after thoracoscopic combined with laparoscopic surgery. Methods There were 90 esophagus cancer patients treated by surgery in our hospital between June 2015 and October 2016. The patients were allocated into two groups including a single-drainage tube group and a two-drainage tube group. There were 45 patients with 24 males and 21 females at age of 48-78 years in the two-drainage tube group and 45 patients with 23 males and 22 females at age of 45-84 years in the single-drainage tube group.The clinical effect of the two groups was compared. Results There was no statistical difference in gender and age, bleeding amount and surgical duration in operation, thoracic drainage amount, incidence of atelectasis, pneumothorax, and encapsulated effusion between the two groups(P<0.05). Discussion Single-drainage tube group displays less postoperative pain, faster recovery, and more convenient clinical care without complication.
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@#Objective To explore the effect of 16F gastric tube on pain relief in postoperative lung cancer patients. Methods A total of 118 lung cancer patients were treated with radical resection of lung cancer in our hospital between January 2015 and May 2016. The patients were assigned into two groups: a 16F gastric tube group (16F group, 60 patients, 30 males and 30 females at age of 41-73 (52.13±7.83) years and a 28F drainage tube group (28F group, 58 patients, 25 males and 33 females at age of 45-75 (55.62±4.27) years. Clinical effects were compared between the two groups. Results There was no statistical difference in drainage time (4.47±1.03 d vs. 4.24±1.16 d, P=0.473), drainage amount (560.37±125.00 ml vs. 656.03±132.45 ml, P=0.478), incidences of pneumothorax (5/60 vs. 2/58, P=0.439), pleural effusion (6/60 vs. 3/58, P=0.522), and subcutaneous emphysema (3/60 vs. 1/58, P=0.635) between the two groups (P>0.05). The pain caused by the drainage tube in the16F group was less than that in the 28F drainage tube group with a statistical difference (F=4 242.996, P<0.001). The frequency of taking analgesics in the 16F group was significantly less than that in the 28F group (12/60 vs. 26/58, P<0.001). Conclusion The effects of draining pleural effusions and promoting lung recruitment are similar between the 16F group and the 28F group. However, the wound pain caused by 16F gastric tube is significantly less than that by 28F drainage tube.
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@#AIM: To explore the application effect of mitomycin C in lacrimal duct obstruction during anterograde lacrimal drainage tube implantation. <p>METHODS:Totally 78 cases of lacrimal duct obstruction(82 eyes)were randomly divided into the observation group(39 cases, 42 eyes)and the control group(39 cases, 40 eyes), and the control group was treated with lacrimal drainage tube implantation. The observation group was based on this combined mitomycin C treatment and compared the effect of two groups. <p>RESULTS: The total effective rate of the observation group was 81%, which was significantly higher than that of the control group(62%), and the difference between the two groups was statistically significant(<i>P</i><0.05). The eye surface change score(26.25±1.67)and tear SP content(256.32±10.07pg/mL)were lower than that of the control group after treatment. The tear film rupture time(8.85±0.89s)was shorter than that of the control group(9.58±0.92s), and the two groups were statistically significant(<i>P</i><0.05). <p>CONCLUSION: Mitomycin C can improve the efficacy of anterograde lacrimal drainage tube implantation for the treatment of lacrimal duct obstruction and improve prognosis.
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Objective To summarize our therapeutic experiences on patients with pediatric spontaneous biliary duct perforation.Methods We retrospectively analyzed the clinical data of patients diagnosed as spontaneous biliary duct perforation who were admitted into the Department of Pediatric General Surgery,the Beijing Children Hospital from January 2008 to December 2014,and summarized the therapeutic experiences.Results There were 7 boys and 18 girls,with a average age of 2.4 years (range 11 months to 10 years).Twenty-one patients (84.0％) were diagnosed by ultrasonography.Two patients were treated with conservative therapy and were discharged home.The remaining 23 patients were treated with emergent surgery.Of these patients,9 were treated with cholecystostomy and abdominal drainage (the cholecystostomy group),and the remaining 14 were treated with choledochal drainage and abdominal drainage (the choledochal drainage group).The mean hospitalization stay for the cholecystostomy group was 25.2 days,and 3 patients developed comphcations (33.3％).The mean hospitalization stay for thecholedochal drainage group was 16.1 day,and 2 patients developed complications (14.2％).Twenty-four patients were diagnosed to suffer from congenital choledochal cysts or pancreaticobiliary maljunction by imaging studies during or after surgery.Elective choledochal cystectomy with hepaticojejunostomy were performed on 23 stable patients who developed no severe complications.Conclusions Pediatric spontaneous bile duct perforation is closely related with congenital choledochal cysts,and the pathological basis in diagnosis is pancreaticobiliary maljunction.Bile duct elastic fiber hypogenesis and specific blood supply are important to the onset of perforation.Abdominal ultrasonography plays an important role in the diagnosis.Patients with peritoneal irritation and non-localized perforation should be operated in time,and choledochal drainage with abdominal drainage is a good treatment choice.All patients diagnosed as congenital choledochal cysts or pancreaticobiliary maljunction should undergo elective choledochal cystectomy with hepaticojejunostomy.