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Objective:To explore the effect of core muscle strength training intervention on postoperative rehabilitation of patients after total knee arthroplasty, and to provide reference for the rehabilitation of patients after total knee arthroplasty.Methods:A total of 109 patients with total knee arthroplasty who were admitted to Medical Health Group of First People′s Hospital of Xiangshan County from May 2020 to July 2021 were selected as the research objects, and were divided into an intervention group of 54 cases and a control group of 55 cases according to the random number table method. The control group received conventional rehabilitation methods after surgery, and the intervention group received core muscle strength training on the basis of conventional rehabilitation. The intervention time was 6 weeks. The knee joint function, balance function and activities of daily living were evaluated by Hospital for Special Surgery Knee Score, Berg Balance Scale, modified Barthel Index before and after intervention and the results were compared between the two groups.Results:In the end, there were 50 cases in the intervention group and 52 cases in the control group. There was no significant difference in the score of the knee joint function, balance function and activities of daily living before intervention between the two groups( P>0.05). The scores of the knee joint function, balance function and activities of daily living were (74.78 ± 3.12), (46.50 ± 3.82), (92.80 ± 5.17) points in the intervention group, and (72.15 ± 3.31),(44.44 ±3.66),(89.42 ± 4.50) points in the control group, the differences were statistically significant ( t=4.12, 2.78, 3.52, all P<0.01). The knee joint function recovery grade in the intervention group was higher than that in the control group, and the difference was statistically significant ( Z=3.43, P<0.01); the degree of dependence on self-care ability in daily life in the intervention group was lower than that in the control group, and the difference was statistically significant ( Z=3.98, P<0.01). Conclusions:Core muscle strength training can effectively improve postoperative knee function, balance function and activities of daily living in patients with total knee arthroplasty. This program is practical in clinical work and has clinical application value.
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@#Objective To investigate the feasibility and safety of non-intubation anesthesia in thoracic surgery. Methods From September 2017 to December 2019, 296 patients were operated at department of thoracic surgery in our hospital. There were 167 males and 129 females with an average age of 50.69±12.95 years, ranging from 16 to 76 years. The patients were divided into two groups according to whether they were intubated: 150 patients were in a non-intubation group, including 83 males and 67 females with an average age of 49.91±13.59 years, ranging from 16 to 76 years, and 146 patients were in an intubation group including 84 males and 62 females with an average age of 51.49±12.26 years, ranging from 16 to 74 years. Intraoperative data, postoperative recovery, inflammatory response of the two groups were compared. Results There was no statistical difference between the two groups in operation time, blood loss, the lowest oxygen saturation or other indicators (P>0.05). But the highest partial pressure of carbon dioxide of the non-intubation group was higher than that of the intubation group (P=0.012). The non-intubation group was superior to the intubation group in postoperative recovery and inflammatory response (P<0.05). Conclusion The non-intubation anesthesia is safe and maneuverable in thoracic surgery, and it has some advantages in accelerating postoperative rehabilitation.
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BACKGROUND@#Chronic obstructive pulmonary diseases (COPD) affects 45%-63% of lung cancer patients worldwide. Lung cancer patients complicated with COPD have decreased cardiopulmonary function and increased perioperative risk, and their postoperative exercise endurance and lung function are significantly lower than those with conventional lung cancer. Previous studies have shown that postoperative exercise training can improve the exercise endurance of unselected lung cancer patients, but it is unclear whether lung cancer patients with COPD can also benefit from postoperative exercise training. This study intends to explore the effects of postoperative exercise training on exercise endurance, daily activity and lung function of lung cancer patients with COPD.@*METHODS@#Seventy-four patients with non-small cell lung cancer (NSCLC) complicated with COPD who underwent pneumonectomy in the lung cancer center of West China Hospital of Sichuan University from August 5, 2020 to August 25, 2021 were prospectively analyzed. They were randomly divided into exercise group and control group; The patients in the two groups received routine postoperative rehabilitation in the first week after operation, and the control group was given routine nursing from the second week. On this basis, the exercise group received postoperative exercise rehabilitation training for two weeks. Baseline evaluation was performed 3 days before operation and endpoint evaluation was performed 3 weeks after operation.@*RESULTS@#The exercise endurance, daily activity and pulmonary function test results of the two groups decreased from baseline to the end point. However, after the operation and intervention program, the maximum oxygen consumption of Cardiopulmonary Exercise Test and the walking distance of 6-Minute Walking Test in the exercise group were significantly better than those in the control group [(13.09±1.46) mL/kg/min vs (11.89±1.38) mL/kg/min, P=0.033; (297±46) m vs (243±43) m, P=0.041]. The average number of we-chat steps in the exercise group was also significantly better than that in the control group (4,381±397 vs 3,478±342, P=0.035). Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) in the exercise group were better than those in the control group, but the difference did not reach a statistically significant level [(1.76±0.19) L vs (1.60±0.28) L, P=0.084; (1.01±0.17) L vs (0.96±0.21) L, P=0.467].@*CONCLUSIONS@#Postoperative exercise rehabilitation training can improve exercise endurance and daily activity ability of patients with lung cancer complicated with COPD and promote postoperative rehabilitation.
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Humans , Carcinoma, Non-Small-Cell Lung/surgery , Exercise , Forced Expiratory Volume , Lung Neoplasms/surgery , Pulmonary Disease, Chronic Obstructive/complicationsABSTRACT
Objective: To investigate the feasibility and advantages of the SILS+1 technique in the radical right hemicolectomy, by comparing the short-term efficacy, postoperative recovery of intestinal function, and stress and inflammatory response of patients with right-sided colon cancer undergoing the conventional 5-hole laparoscopic technique or the single incision plus one port laparoscopic surgery (SILS+1). Methods: A retrospective cohort study was performed. Thirty-five patients with right-sided colon cancer undergoing SILS+1 surgery at Department of Gastrointestinal Surgery of Fujian Cancer Hospital from January 2018 to September 2020 were enrolled in the SILS+1 group. Then a total of 44 patients who underwent completely 5-hole laparoscopic right hemicolectomy at the same time were selected as the conventional laparoscopic surgery (CLS) group. The intraoperative observation indexes (operative time, intraoperative blood loss, and incision length) and postoperative observation indexes (time to ambulation after surgery, time to flatus, pain score in the first 3 days after surgery, hospitalization days, number of lymph node dissections, postoperative complication morbidity, and postoperative total protein, albumin and C-reaction protein) were compared between the two groups. Results: There was no conversion to laparotomy or laparoscopic-assisted surgery in both groups. All the patients successfully completed radical right hemicolectomy under total laparoscopy. There were no statistically significant differences in gender, age, body mass index or tumor stage between the two groups (all P>0.05). Compared with the CLS group, the SILS+1 group had shorter incision length [(5.1±0.6) cm vs. (8.5±4.1) cm, t=4.124, P=0.012], shorter time to the first ambulation (median: 27.6 h vs. 49.3 h, Z=4.386, P=0.026), and shorter time to the first flatus (median:42.8 h vs. 63.2 h, Z=13.086, P=0.012), lower postoperative pain score [postoperative 1-d: 2.0 ± 1.1 vs. 3.6 ± 0.9; postoperative 2-d: 1.4 ± 0.2 vs. 2.9±1.4; postoperative 3-d: 1.1 ± 0.1 vs. 2.3±0.3, F=49.128, P=0.003), shorter postoperative hospital stay [(9.1 ± 2.7) d vs. (11.2 ± 2.2) d, t=3.267,P=0.001], which were all statistically significant (all P<0.05). On the second day after surgery, as compared to CLS group, SILS+1 group had higher total protein level [(59.7±18.2) g/L vs. (43.0±12.3) g/L, t=2.214, P=0.003], higher albumin level [(33.6±7.3) g/L vs. (23.7±5.4) g/L, t=5.845, P<0.001], but lower C-reactive protein level [(16.3 ± 3.1) g/L vs. (63.3 ± 4.5) g/L, t=4.961, P<0.001], which were all statistically significant. There were no significant differences in the operative time, intraoperative blood loss, number of harvested lymph node, number of metastatic lymph node, and postoperative complication morbidity (all P>0.05). Conclusions: The SILS+1 technique has good operability and potential for popularization. Under the premise of radical resection, this technology not only reduces incision number and postoperative physical pain, but also speeds up postoperative recovery and shortens hospital stay.
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Humans , Colectomy/methods , Colonic Neoplasms/surgery , Feasibility Studies , Laparoscopy/methods , Length of Stay , Operative Time , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: The use of cold therapy to promote rehabilitation after total knee arthroplasty has a certain theoretical basis, but whether cold therapy can reduce bleeding, reduce pain, and promote early recovery of activity is still controversial. OBJECTIVE: To evaluate the effectiveness of cold therapy in total knee arthroplasty in reducing postoperative bleeding, reducing pain, and promoting recovery of motion range using meta-analysis. METHODS: Medline, EMBASE, Cochrane, China Biomedical Literature Database, CNKI, Wanfang and other databases were searched to find randomized controlled trials of cold therapy and other rehabilitation therapies after total knee arthroplasty. Data were extracted. Statistical analysis was performed using Revman 5.3. Effect values were combined. RESULTS AND CONCLUSION: (1) A total of 10 randomized controlled trials were included, including 1 070 patients. The experimental group received cold therapy after total knee arthroplasty, and the control group received other rehabilitation therapies. (2) Meta-analysis showed that compared with other rehabilitation therapies, cold therapy after replacement alleviated postoperative pain [MD=-0.75, 95%CI (-1.29, -0.21), P=0.006], reduced hemoglobin drop [MD=-12.11, 95%C/(-17.66, -6.56), P< 0.000 1], However, cold therapy could not reduce the amount of opioids usage [MD=0.01, 95%C/(-0.15, -0.16), P=0.92], or improve joint motion range [MD=6.58, 95%C/(-0.54, 13.70), P=0.07]. (3) The results show that the application of cold therapy after total knee arthroplasty can effectively relieve pain and reduce the drop of postoperative hemoglobin, but has no significant effect on reducing the application of opioid analgesics or improving motion range.
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BACKGROUND: In recent years, with the continuous progress of orthopedic surgery technology and the rapid increase in the number of orthopedic surgery, more and more attention has been paid to the postoperative rehabilitation of patients. As a common mental disorder after orthopedic surgery, the occurrence of post-traumatic stress disorder is related to demographic characteristics, psychosocial factors, trauma characteristics, past mental status and perioperative cardiovascular indicators. At the same time, previous studies have shown that postoperative post-traumatic stress disorder is closely related to the rehabilitation of patients. OBJECTIVE: By consulting the related literature of post-traumatic stress disorder and postoperative rehabilitation after orthopedic surgery in recent years, this paper analyzed the occurrence, high risk factors and the relationship between post-traumatic stress disorder and postoperative rehabilitation after orthopedic surgery, in order to guide the early diagnosis and intervention of postoperative post-traumatic stress disorder. METHODS: The first author and the second author searched the related articles in PubMed database, Embase database, China National Knowledge Infrastructure(CNKI) and Wanfang database from January 1990 to October 2019 with the English key words of “orthopedic, surgery/operation, PTSD, risk factor, rehabilitation” and the Chinese words of “orthopedics, surgery, PTSD, high risk factors, rehabilitation”. A total of 94 articles were retrieved, of which 56 met the inclusion criteria. RESULTS AND CONCLUSION:(1) According to the type of operation, about 15%-40% of orthopedic patients may have varying degrees of post-traumatic stress disorder after surgery, and the incidence of post-traumatic stress disorder after lower limb amputation is highest.(2) Youth, female, low income, low education, lack of social support, high genetic susceptibility, poor psychological state before operation, poor psychological elasticity, hypotension, high heart rate and high pain sensitivity are all high risk factors for post-traumatic stress disorder after orthopedic surgery.(3) There is no clear correlation between the severity of preoperative trauma and the trauma of the operation itself and the occurrence of postoperative post-traumatic stress disorder, but the surgery with great influence on the ability of life and work after operation easily causes post-traumatic stress disorder.(4) Patients with postoperative post-traumatic stress disorder may have poor long-term prognosis.
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Objective@#Researching the influence on patients with different eating ways after the operation of mandibular angle osteotomy of inside oral cavity.@*Method@#By using the method of convenience sampling, 50 patients were chosen who had operation of mandibular angle osteotomy of inside oral cavity in orthopedic surgery department of our hospital from January 2017 to December 2017 and the number was arranged according to the order of hospitalization. Patients with singular member were divided into the month feeding group (liquid diet were fed with the injection syringe which linked leather hose of 4-5cm after 6 hours awakening after general anesthesia in operation); patients with even number were divided into the nasal feeding group (stomach tube was put in the operation and nasal feeding was provided after 6 hours awakening after general anesthesia in operation and 5 hours after the operation). In every group, there were 25 patients. Observation scale which was made by themselves was used to evaluate the patients in the two groups and comparison for difference was made in the two groups, including weight change, wound drainage amount, oral wound secretion, the aspects of choke and cough, and the comfortable sensation of eating.@*Results@#For weight, in nasal feeding group, (2.19±0.48) kg were reduced and in month feeding group, (5.78±0.58) kg were reduced; the difference had the statistical significance (t=23.870, P<0.05). For wound drainage amount, in nasal feeding group, the number was(38.00±11.00)ml and in month feeding group, the number was (65.00±13.00) ml, the difference was statistically significant (t=7.927, P<0.01). In the aspects of choke and cough, and wound secreta in oral cavity, in nasal feeding group, the number were 16% (4/25) and 44% (11/25) respectively which was superior to the month feeding group with the number of 44% (11/25) and 76% (19/25), the difference had the statistical significance (χ2=4.667, 5.333, P<0.05). For the comfortable sensation of eating, in the two groups, there was no significant statistical difference (χ2=0.764, P>0.05).@*Conclusion@#The nasal feeding way can improve recovery level for patients after the operation of mandibular angle osteotomy of inside oral cavity and it is worthy of promotion in clinic application.
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Objective Pain is an important factor affecting rapid rehabilitation of the patient after minimally invasive esophagectomy (MIE), and few studies are reported on the analgesic effect of intravenous administration of flurbiprofen (FBP) following MIE. This study was to investigate the role of FBP analgesia in rapid rehabilitation of the patients after MIE. Methods Sixty-four patients with esophageal cancer underwent MIE in the General Hospital of Eastern Theater Command from October 2015 to October 2016. Thirty-two of them received analgesia with a patient-controlled analgesia (PCA) pump (the control group) and the other 32 with FBP plus a PCA pump (the FBP group) postoperatively. We measured the concentrations of serum interleukin 6 (IL-6) and procalcitonin (PCT) at 12, 24, 48 and 72 hours after surgery, recorded the visual analog scale (VAS) pain scores at rest, and compared the parameters obtained between the two groups of patients. Results Compared with the control group, the FBP group showed significantly decreased concentrations of serum IL-6 ([156.53 ± 13.46] vs [120.19±13.52] μg/L, P < 0.05) and PCT ([1.99 ± 0.12] vs [1.89 ± 0.18] μg/L, P < 0.05) at 12 hours after MIE, even more significantly at 24, 48 and 72 hours (P < 0.05). And the VAS scores were markedly lower in the FBP than in the control group at all the four time points (P < 0.05). Conclusion Postoperative intravenous administration of flurbiprofen can significantly reduce inflammatory reaction, relieve pain and contribute to rapid rehabilitation after minimally invasive esophagectomy.
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Retinitis pigmentosa (RP) is a kind of hereditary disease characterized by progressive photoreceptor and pigmented epithelial cell dysfunction.It is also a common cause of blindness worldwide.In recent years,gene therapy,neurotrophic therapy,stem cell therapy and other methods for RP have developed rapidly.Among them,implantation of retinal prosthesis has been used to restore vision of patients with RP and age-related macular degeneration,and has become an international research hotspot.The development of retinal prostheses has undergone a long-term research and experimental process.Currently,retinal prostheses are mainly divided into three categories according to different implantation locations,and each has its own advantages and disadvantages.After implantation,the visual experience obtained by the patient is completely different from before vision loss.Whether the patient can effectively use the re-acquired artificial vision depends largely on the post-operative rehabilitation training process.Although the retinal prosthesis can provide the blindness with the hope of regaining vision,it still faces various challenges.This article will summarize the development history,classification,postoperative rehabilitation and technical challenges of retinal prostheses,and hope to provide reference for its clinical application.
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@#Introduction: Anterior cruciate ligament (ACL) tear is a frequent injury and its reconstruction is among the most commonly performed orthopaedic surgical procedures. ACL reconstruction generally yields good results. However, its recovery can be hampered by the development of postoperative complications. The aim of this study was to review complications following arthroscopic ACL reconstruction done in Hospital Raja Permaisuri Bainun, Ipoh and Hospital Teluk Intan, Perak with the emphasis on arthrofibrosis. Arthrofibrosis is defined as a loss of 15 degrees extension or more, with or without flexion loss compared to the contralateral knee. Materials and Methods: The study is based on a series of retrospective cases, on which medical records of 200 patients who underwent ACL reconstruction surgeries between March 2007 and December 2014 were reviewed. Follow-up treatment records were available for 166 patients (83%). The data was analysed to identify the risk factors for developing complications with an emphasis on arthrofibrosis. Results: Eight patients (5%) developed arthrofibrosis in the post-operative period. Early surgical intervention, preoperative limited range of motion and female gender are the risk factors correlate with arthrofibrosis. However, the type of graft used and meniscal procedure do not have a significant correlation with the development of arthrofibrosis. Other complications encountered are local infections, hypertrophic scar and chronic regional pain syndromes. Conclusion: The 5% incidence of arthrofibrosis following an ACL reconstruction in our centres can be reduced with proper preventive measures which include thorough preoperative evaluation, proper patient selection, restoration of ROM prior to surgery and proper timing of surgery.
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Lumbar disc herniation is an important cause of chronic low back pain, for which surgery has a great effect. However, there remain some residual symptoms, such as pain, disability, etc. It's effective for postoperative rehabilitation to relieve pain, and improve the disability and psychological status. However, the optimal rehabilitation program is controversial. So it's necessary to consider various aspects including time, site, frequency, intensity and pattern for an optimal rehabilitation choice, which needs further study. Psychological factors shall be concerned by medical workers as well.
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Objective Researching the influence on patients with different eating ways after the operation of mandibular angle osteotomy of inside oral cavity. Method By using the method of convenience sampling, 50 patients were chosen who had operation of mandibular angle osteotomy of inside oral cavity in orthopedic surgery department of our hospital from January 2017 to December 2017 and the number was arranged according to the order of hospitalization. Patients with singular member were divided into the month feeding group (liquid diet were fed with the injection syringe which linked leather hose of 4-5cm after 6 hours awakening after general anesthesia in operation); patients with even number were divided into the nasal feeding group (stomach tube was put in the operation and nasal feeding was provided after 6 hours awakening after general anesthesia in operation and 5 hours after the operation). In every group, there were 25 patients. Observation scale which was made by themselves was used to evaluate the patients in the two groups and comparison for difference was made in the two groups, including weight change, wound drainage amount, oral wound secretion, the aspects of choke and cough, and the comfortable sensation of eating. Results For weight, in nasal feeding group, (2.19 ± 0.48) kg were reduced and in month feeding group, (5.78 ± 0.58) kg were reduced; the difference had the statistical significance (t＝23.870, P<0.05). For wound drainage amount, in nasal feeding group, the number was (38.00 ± 11.00)ml and in month feeding group, the number was (65.00 ± 13.00) ml, the difference was statistically significant (t＝7.927, P<0.01). In the aspects of choke and cough, and wound secreta in oral cavity, in nasal feeding group, the number were 16% (4/25) and 44% (11/25) respectively which was superior to the month feeding group with the number of 44% (11/25) and 76% (19/25), the difference had the statistical significance (χ2＝4.667, 5.333, P<0.05). For the comfortable sensation of eating, in the two groups, there was no significant statistical difference (χ2＝0.764, P>0.05). Conclusion The nasal feeding way can improve recovery level for patients after the operation of mandibular angle osteotomy of inside oral cavity and it is worthy of promotion in clinic application.
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Resumen: Introducción: Las fracturas de cadera se consideran entre las lesiones incapacitantes más comunes en mayores de 60 años. Se asocian a un alto índice de mortalidad y es la causa más frecuente de internamiento que requiere tratamiento quirúrgico en unidades médicas dedicadas a la traumatología. Métodos: Esta revisión sistemática tiene como objetivo agrupar, clasificar y reportar el mejor nivel de evidencia en el manejo de terapia física y rehabilitación en los pacientes con fractura pertrocantérica y subtrocantérica de cadera después de la cirugía de osteosíntesis en desenlaces de actividades de la vida diaria, independencia y complicaciones. Resultados: Se identificaron 3,389 resúmenes y a través de otras fuentes 1,567 resúmenes, se eliminaron duplicados en la búsqueda y posterior a un cribado se obtuvieron 378 artículos para la eliminación adicional. De los 62 ensayos restantes se incluyeron 21 y 41 fueron excluidos. Conclusiones: Los resultados a largo plazo de la terapia física especializada parecen ser cruciales en los primeros meses y no tan importantes al cabo de cuatro meses. La literatura actual sostiene que las diferencias en las capacidades de la vida diaria e independencia de los pacientes que sobreviven, el tratamiento de una fractura de cadera tiende a ser similar independientemente del programa de rehabilitación que se tenga.
Abstract: Introduction: Hip fractures are considered among one of the most disabling injuries in patients older than 60 years of age. This fractures are associated with a high incidence of mortality and it is the leading cause of hospital admission that requires surgical treatment in Orthopaedic Trauma Centers. Methods: This systematic review aimed to group, classify and report the best level of evidence of physical therapy and rehabilitation of patients that have been treated with osteostynthesis after trochanteric or subtrochanteric fracture. The outcomes of efficacy and safety were return to activities of daily living, independence and rate of complications. Results: We identified 3,889 abstracts from PubMed, and 1,567 abstracts from other sources, after eliminating duplicates, and posterior to a thorough screening 378 abstracts were read. From these, 316 abstracts were excluded, and 62 articles were considered eligible. After reading for relevant outcomes 41 articles were excluded. Synthesis was based in 21 studies. Conclusions: Long term results of specialized physical therapy, appear to be crucial in the first months after surgery, and not that important after the four months after surgery. Recent literature supports that the differences of daily activities and independence of the patients that survive a hip fracture tend to be similar with no difference in the type of physical therapy.
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Humans , Aged , Hip Fractures/rehabilitation , Activities of Daily Living , Middle AgedABSTRACT
Objective To contribute the patient-centered nursing mode and discuss its influence on stress reaction at peri-operational period and postoperative rehabilitation of emmergency surgical patients. Methods A total of 108 emergency surgery patients admitted to Xiangyang No.1 People's Hospital Affiliated of Hubei University of Medicine from January 2014 to January 2017 were enrolled as research subjects, and they were divided into an observation group and a control group according to difference in nursing modes, 54 cases in each group. During the peri-operational period, the patients in control group were given routine nursing mode, while in the observation group, the patients received patient-centered nursing mode. The blood pressure, heart rate and levels of various kinds of hormone (insulin, cortisol, epinephrine) and interleukin-6 (IL-6) before and after intervention were measured; the Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the psychological stress changes; after operation, the rate of using analgesics, incidence of postoperative infection, Visual analogue scale (VAS), anus exhaust time, off-bed activity time and sleep quality scale scores were recorded to evaluate the quality of patients' postoperative rehabilitation. Results The diastolic blood pressure, systolic blood pressure, heart rate and levels of insulin, cortisol and IL-6 in two groups before operation and 2 hours after operation were significantly higher than those on admission, while the levels of epinephrine were lower than the level on admission, the degrees of increase or decrease of the observation group were slower than those of the control group, and the changes were more significant at 2 hours after operation [diastolic blood pressure (mmHg, 1 mmHg = 0.133 kPa) was 120.58±13.09 vs. 135.35±15.44, systolic blood pressure (mmHg) was 74.69±10.97 vs. 80.50±11.34, heart rate (bpm) was 83.47±11.64 vs. 92.59±12.00, insulin (mmol/L) was 12.58±1.62 vs. 15.96±1.46, cortisol (μg/L) was 128.72±20.53 vs. 140.47±21.58, epinephrine (ng/L) was 38.96±7.24 vs. 35.25±8.01, IL-6 (ng/L) was 157.64±27.06 vs.183.45±29.37, all P ＜ 0.05]. After interference, the HAMA and HAMD scores of the two groups were significantly lower than those before intervention, and the degree of decrease in the observation group was more obvious (HAMA score: 11.58±2.16 vs. 16.74±2.80, HAMD score: 9.42±2.03 vs. 13.38±2.71, both P ＜ 0.05); the rate of using analgetic [25.93% (14/54) vs. 57.41% (31/54)], incidence of postoperative infection [3.70% (2/54) vs. 16.67% (9/54)], VAS scores (4.63±1.21 vs. 6.87±1.74), anus exhaust time (days: 1.53±0.33 vs. 1.86±0.26), off-bed activity time (days: 1.57±0.19 vs. 1.72±0.24) and sleep quality scale scores (5.84±2.07 vs. 9.33±2.39) in observation group were significantly less than those in control group (all P ＜ 0.05). Conclusion The contribution and application of patient-centered nursing mode in treating emmergency surgery patients during peri-operational period is helpful to ameliorate the patients' degree of physiological and psychological stress reactions, and this mode has important significance in promoting the quality of patients' postoperative rehabilitation.
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Objective To study of short-term rehabilitation index and its relationship with medium-term function in male rectal cancer after laparoscopic surgery. Methods A retrospective analysis was made of 60 cases with rectal cancer who received laparoscopic radical resection in our hospital. In the observation group,the pelvic autonomic nerves were retained in 30 cases,and 30 cases in the control group were not retained. The levels of se-rum prealbumin(PA),C reactive protein(CRP),white blood cell count(WBC)and blood cortisol(Cor)were compared between the 2 groups. The independent influence factors of erectile and ejaculatory disorder were fol-lowed up at 6 months after operation. Results Postoperative exhaust time,defecation time,postoperative extuba-tion time,ambulation time,postoperative hospitalization time in the observation group were significantly shorter than those in the control group(P < 0.05). The level of serum CRP,WBC and Cor in the observation group was significantly lower than those of the control group at 3 d after operation,and the level of PA was significantly high-er than that of the control group(P < 0.05).The independent influence factors of erectile dysfunction were the level of PA and CRP at 3d after operation(P < 0.05).The independent influence factors of ejaculatory dysfunction were PA level at 3D after operation(P < 0.05). Conclusion Pelvic nerve protection in laparoscopic surgery is helpful to promote the postoperative recovery. High PA at short term after operation may be one of the medium-term protec-tion mechanisms for sexual function.
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Objective:Our study was aimed to analyze the therapeutic effect of early sequential enteral nutrition on postoperative rehabilitation in patients with gastric cancer.Methods:Patients with gastric cancer receiving surgery at our hospital from 2016 to 2017 included and the clinical information was prospective collected and analyzed.Patients were randomly divided into two groups using random number table.Patients in group A were sequentially given amino acid type,short peptide type and then whole protein type,while those in group B received whole protein formulation only.The recovery of gastrointestinal function,postoperative systemic inflammatory response,six-minutes walking test,and enteral nutrition-related complications were compared between the two groups.Results:A total of 71 patients were included in this study (Group A 36 cases,Group B 35 cases).There was no significant difference in terms of the restart anal exhaust between the two groups (P ＞ 0.05).Patients in group A had a significantly shorter postoperative hospitalization (t =4.070;P ＜ 0.01) and the earlier restoration of oral intake than that of Group B (t =3.400;P =0.001).One week after surgery,the levels of CRP (t =2.547;P =0.013) and IL-6 (t =3.172;P =0.002) were significant lower in group A when compared with group B.In addition,patients in group A had a significant higher six minutes walk steps than those in Group B [(416.1 + 36.7) m vs (358.9 ± 32.7) m;t =6.927,P ＜ 0.01].However,no significant difference in enteral nutrition-related complications was found between the two groups (P ＞ 0.05).Conclusion:In patients with gastric cancer,early sequential enteral nutrition can effectively accelerate the postoperative rehabilitation.
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@#Objective To analyze the effect of SWOT analytical method on the activities of daily living, shoulder mobility and quality of life of patients with aerobic training after oncoplastic breast surgery.Methods From January to December 2017, 80 patients after modified radical mastectomy for breast cancer in the breast surgery of our hospital were randomly divided into control group and observation group, with 40 cases in each group. Both groups were performed aerobic training of the affected extremity, and the observation group were performed with evaluations and detailed analysis on the internal strengths and weaknesses, and the external opportunities and threats using SWOT analytical method, so that the corresponding solutions to the rehabilitation exercise of the affected extremity could be used to instruct postoperative patients. They were assessed with Activities of Daily Living Scale (ADL), shoulder mobility and Functional Assessment of Cancer Therapy (FACT) three days, four weeks and eight weeks after operation.Results Three days after operation, there was no significant difference in the scores of ADL, shoulder mobility and quality of life between two groups (t<0.23, P>0.05). Four weeks and eight weeks after operation, the scores of ADL, shoulder mobility and quality of life were significantly better in the observation group than in the control group (t>6.14, P<0.001).Conclusion The application of SWOT analytical method in the analysis and guidance on the rehabilitation exercise of the affected extremity is beneficial to the postoperative rehabilitation of patients, in aspects of activities of daily living, shoulder mobility and quality of life.
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Objective: To investigate the effect of adductor canal block combined with local infiltration anesthesia on the rehabilitation of primary total knee arthroplasty (TKA). Methods: A total of 104 patients who met the selection criteria for the first unilateral TKA between March 2017 and August 2017 were included in the study. They were randomly divided into trial group (53 cases) and control group (51 cases). In the trial group, the adductor canal block with intraoperative local infiltration anesthesia were performed. In the control group, only intraoperative local infil-tration anesthesia was performed. There was no significant difference in gender, age, body mass index, diagnosis, effected side, and the preoperative American Society of Anesthesiologists (ASA) grading between 2 groups ( P>0.05). The operation time, length of stay, and complications were compared between 2 groups, as well as visual analogue scale (VAS) score of incision at rest and during activity, the range of motion (ROM) of knee flexion and extension activity, limb swelling (thigh circumference), walking distance, and pain VAS score while walking. Results: The operation time of the trial group was significantly shorter than that of the control group ( t=-2.861, P=0.005). However, there was no significant difference in length of stay between 2 groups ( t=-0.975, P=0.332). The wound effusion occurred in 1 patient of trial group and 2 of control group; hematoma occurred in 2 patients of trial group and 3 of control group; no symptom of intermuscular venous thrombosis occurred in 1 patient in each of 2 groups; ecchymosis occurred in 14 patients of trial group and 15 of control group; there was no significant difference in the incidence of related complications between 2 groups ( P>0.05). There was no significant difference in the preoperative VAS score at rest and during activity, ROM of knee flexion and extension activity, and thigh circumference between 2 groups ( P>0.05). However, there were significant differences in the VAS score at rest and during activity after 2, 4, 8, and 12 hours, ROM of knee flexion and extension activity after 1 and 2 days, and the walking distance on the day of discharge, pain VAS scores while walking after 1 and 2 days and on the day of discharge, and thigh circumference after 1 day between 2 groups ( P<0.05). Conclusion: For the primary TKA, the adductor canal block combined with local infiltration anesthesia can early relieve the initial pain of the incision, shorten the operation time, and promote the mobility and functional recovery of the knee joint.
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OBJECTIVE:To investigate the effects of tramadol combined with midazolam on prognosis of patients underwent tumor resection in gastrointestinal surgery department. METHODS:In retrospective study,200 tumor patients of gastrointestinal sur-gery department were divided into observation group(100 cases)and control group(100 cases). Observation group was given Tra-madol hydrochloride tablet 100 mg,3 times a day+Midazolam injection 30 mg,added into 0.9% Sodium chloride injection 60 mL,via intravenous pump,2.5 mL/h,for consecutive 24 h,for consecutive 3 d. Control group was given Tramadol hydrochloride injection 100 mg,intramuscular injection,3 times a day,for 3 d. The hospitalization duration,postoperative ambulation time, sleep quality score,pain degree score,the occurrence of postoperative hypostatic pneumonia,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The hospitalization duration and postoperative ambulation time of observation group were significantly shorter than those of control group;the sleep quality score of observation groups was significantly higher than that of control group;the severity of pain,the incidence of hypostatic pneumonia were significantly lower than control group,with statisti-cal significance(P0.05). CONCLU-SIONS:Midazolam combined with tramadol can significantly reduce the postoperative pain of tumor patients in gastrointestinal tu-mor surgery department,shorten hospitalization time and postoperative ambulation time,improve the sleep quality of patients and reduce the incidence of hypostatic pneumonia with good safety.
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Objective To study the effect of postoperative rehabilitation of meditation training on repeat cesarean section patients. Methods A total of 86 cases of repeat cesarean section from October 1st, 2014 to October 1st, 2016 were collected. The patients were divided into the observation group (43 cases) and the control group (43 cases) by random digits table method. The observationgroup received meditation therapy by a well-trained nurse based on the routine treatment. The control group was treated with routine treatment. The two groups were compared by postoperative pain score, anxiety and depression scores, the first breastfeeding time, the first urination time and satisfaction. Results After intervention, the postoperative pain visual scores of the observation group and the control group were 3.21 ± 1.51 and 5.41±1.45 respectively, the difference was statistically significant (t=3.817, P6 h/failure:2.32%(1/43). While the data of the control group were 6 h/failure: 13.95%(6/43), the differences were statistically significant (t=6.114, P<0.05). The satisfaction of the observation group and the control group were 98.47% (42/43) and 91.69% (39/43) respectively, the difference was statistically significant. (χ2=7.679, P<0.01). ConclusionsMeditation can effectively reduce the postoperative pain, reduce the incidence of anxiety, shorten the first time of breastfeeding and urination, and improve patients′satisfaction.