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Objective:To summarize the combined rehabilitation nursing process of a case of voice and deglutition disorders following surgical removal of intra-and extracranial schwannoma in the jugular foramen area.Methods:A case of hoarseness and dysphagia after surgery for intracranial and extracranial schwannomas in the left jugular foramen region in Xuanwu Hospital, Capital Medical University in October 2020 was collected. Early step-wise voice training assisted by respiratory muscles and tongue muscle exercises was carried out, electronic laryngoscope-based breathing and swallowing methods, assessment of food and bite-size, maintenance of food consistency with the assistance of chewing times, and swallowing and ingestion guidance for the update of dietary methods were performed. The continuous rehabilitation training was provided throughout the process.Results:The grade of GRBAS scale decreased from G3 to G2 after training from home for 3 months following discharge; the voice handicap index of Chinese version reduced from 75 points to 52 points, and the average pronunciation time extended from 2.45 s to 5.32 s. The frequency of choking with food optimized from 0.4 to 0.5 times/min to no choking.Conclusions:Early rehabilitation training of voice and, swallowing and ingestion is a boon for the recovery of hoarseness and dysphagia after resection of schwannomas in the jugular foramen region.
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OBJECTIVE@#To explore the effect of glucose pretreatment in the rapid rehabilitation surgery of hip replacement patients, and to provide reference for the future clinical treatment.@*METHODS@#From June 2016 to June 2018, 168 patients (100 males, 68 females) were treated with hip replacement. The patients were divided into control group and observation group, 84 cases in each group, aged 25 to 90 (52.05±5.73) years old. Both groups were treated with the concept of rapid rehabilitation surgery, the control group was given traditional fasting water deprivation before operation, and the observation group was given glucose pretreatment before operation. The levels of fasting blood glucose(FBG), C-peptide, fasting insulin(FINS), IgG, IgM, IgA and total lymphocyte count (TLC) were compared before and after operation, and the sensitivity of thirst, nausea, fatigue, sweating, stomach discomfort, anxiety, hunger and dizziness were compared.@*RESULTS@#All the 168 patients were followed up. There was no significant difference in FBG, C-peptide and fins levels between the observation group and the control group (>0.05). The levels of FBG, C-peptide and fins in the observation group were higher than those in the control group (0.05);the serum IgG, IgM, IgA and TLC levels after operation were higher than those before operation, and the observation group was higher than the control group(0.05);the degree of anxiety, hunger and dizziness in the observation group was less than that in the control group (<0.05).@*CONCLUSION@#Glucose pretreatment before hip replacement can relieve insulin resistance, improve immunity and change energy storage under fasting, which can be widely used in clinic.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Hip , Blood Glucose , Glucose , Insulin , Insulin ResistanceABSTRACT
BACKGROUND: At present, extrusion is widely used in total knee arthroplasty. Studies have shown that extrusion can aggravate early pain and increase the risk of complications after operation. Therefore, a safer and more effective method it is urgently needed in clinic. OBJECTIVE: To observe the effects of elevation and extrusion of blood-expelling method on clinical outcomes during total knee arthroplasty. METHODS: Sixty-four patients who were scheduled to undergo unilateral total knee arthroplasty for the first time were randomly divided into two groups. During total knee arthroplasty, the control group received extrusion method, while the experimental group received elevation method. The main outcomes of the two groups were compared: Visual analogue scale score, knee joint swelling, C-reactive protein, serum creatine kinase activity and postoperative complications; secondary outcomes: Tourniquet use time, Hospital for Special Surgery score, and SF-36 score. RESULTS AND CONCLUSION: (1) Visual analogue scale scores in the experimental group were significantly lower than those in the control group on the first day, the seventh day, the first month and the third month after operation (P 0.05). (5) Hospital for Special Surgery score and SF-36 score were assessed at 1, 3 and 6 months. The results showed that it was better than before, but there was no significant difference between the two groups (P > 0.05). (6) In conclusion, elevation of blood-expelling method could alleviate early pain response, reduce inflammation reaction and soft tissue injury, and decrease the incidence of skin tension blisters and thromboembolism. It is in line with the concept of rapid recovery. Therefore, during total knee arthroplasty, elevation of blood-expelling method is a safer and more effective method than extrusion.
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Objective@#To analyze retrospectively the effect of rapid rehabilitation group in the perioperative nursing of patients undergoing thoracoscopic lung cancer resection.@*Methods@#Patients receiving the operations of thoracoscopic lung cancer resection from January to December 2017 were enrolled as the rapid recovery group. Patients receiving the same operations from January to December 2016 were chosen as the routine nursing group. The perioperative care of the rapid recovery group was undertaken by the rapid rehabilitation group. The perioperative care of the routine nursing group was performed according to the routine nursing procedure. As the rapid recovery group, more emphasis was placed on the ensuring of physical comfort, active functional exercise, personalized pain relief and psychological care on the basis of the routine nursing measures. The hospitalization days, Visual Analogue Scale (VAS) scores, and the scales of the satisfaction were compared between the two groups.@*Results@#The hospitalization day and VAS score of the rapid recovery group was (8.7 ± 2.3) days, (3.3 ± 1.2) points, and the routine nursing group was (10.3 ± 2.5) days, (4.5 ± 3.1) points. There were significant differences between the two groups (t =3.38, 2.67, all P <0.01). The patients′ scales of the satisfaction in the rapid recovery group was (99.5 ± 1.4) points, and the routine nursing group was (99.1 ± 1.6) points. There was no significant difference between the two groups (P>0.05).@*Conclusions@#The perioperative nursing involved by the rapid rehabilitation group of the thoracoscopic lung cancer resection can shorten the hospitalization day and receive ideal pain control, which are conducive to faster recovery.
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Objective@#To analyze the effect of rapid convalescence surgery on plasma radical prostatectomy in elderly patients with prostate hyperplasia.@*Methods@#A total of 140 elderly patients with prostate hyperplasia who underwent plasma prostatectomy in our hospital from January 2016 to August 2017 were selected as subjects. Divide them into control group (70 cases) and observation group (70 cases) according to random number table method. Patients in the control group were given routine care. The observation group gave a nursing model based on the concept of rapid rehabilitation surgery on the basis of the control group. Compared the bladder irrigation time, postoperative hospitalization time, catheter removal time, anal exhaust time, first time out of bed time, complication rate, postoperative Numerical Rating Scale (NRS) pain score, bladder spasm symptom score and quality of life score between the two groups.@*Results@#The bladder irrigation time, postoperative hospital stay, urinary catheter removal time, anal exhaust time and first time to get out of the observation group were (23.94±3.75) h, (3.49±0.46) d, (3.11±1.50) d, 6.23±3.07) h and (24.70±3.62) d, while the control group were (76.42±9.55) h, (7.06 ±0.44) d, (6.74±2.06) d, (17.41±3.48) h and (90.58±9.75) d, the above observation indexes of the observation group were significantly lower than the control group, the difference was statistically significant (t=11.918-52.998, P<0.01). The incidence of postoperative bladder spasm, bloating, hemorrhage, lung infection and urinary tract infection in the observation group were 1.429% (1/70), 2.857% (2/70), 0, 2.857% (2/70) and 7.143% (5/70), respectively, while the control group were 11.429% (8/70), 14.286% (10/70), 8.571% (6/70), 15.714% (11/70) and 24.143% (19/70), respectively. The incidence of the above complications in the observation group was significantly lower than that of the control group, the difference was statistically significant (χ2=4.275-8.499, P<0.05 or 0.01). The NRS pain score, quality of life score and bladder spasm score were observed in the observation group (31.48±3.60), (1.89±1.03), (2.25±0.47) points, while the control group were (36.20±4.22), (2.77±1.84), and (3.79±0.81) points, respectively. The above three scores in the observation group were significantly lower than those in the control group, the difference was statistically significant (t=7.119, 3.491, 13.756, P<0.01).The nursing satisfaction of patients in the observation group was 95.71% (67/70) which was significantly higher than 80.00% (56/70) of the control group, the difference was statistically significant (χ2=6.695, P<0.05).@*Conclusions@#Rapid rehabilitation surgery for patients with advanced prostatic hyperplasia with plasma prostatectomy can speed up the recovery process, relieve postoperative pain, reduce the incidence of postoperative complications, harmonious doctor-patient relationship, improve the quality of life of patients, it is worthy of extensive clinical promotion.
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Objective To analyze the effect of rapid convalescence surgery on plasma radical prostatectomy in elderly patients with prostate hyperplasia. Methods A total of 140 elderly patients with prostate hyperplasia who underwent plasma prostatectomy in our hospital from January 2016 to August 2017 were selected as subjects. Divide them into control group (70 cases) and observation group (70 cases) according to random number table method. Patients in the control group were given routine care. The observation group gave a nursing model based on the concept of rapid rehabilitation surgery on the basis of the control group. Compared the bladder irrigation time, postoperative hospitalization time, catheter removal time, anal exhaust time, first time out of bed time, complication rate, postoperative Numerical Rating Scale (NRS) pain score, bladder spasm symptom score and quality of life score between the two groups. Results The bladder irrigation time, postoperative hospital stay, urinary catheter removal time, anal exhaust time and first time to get out of the observation group were (23.94±3.75) h, (3.49±0.46) d, (3.11±1.50) d, 6.23±3.07) h and (24.70±3.62) d, while the control group were (76.42±9.55) h, (7.06 ±0.44) d, (6.74 ± 2.06) d, (17.41 ± 3.48) h and (90.58 ± 9.75) d, the above observation indexes of the observation group were significantly lower than the control group, the difference was statistically significant (t=11.918-52.998, P<0.01). The incidence of postoperative bladder spasm, bloating, hemorrhage, lung infection and urinary tract infection in the observation group were 1.429% (1/70), 2.857% (2/70), 0, 2.857% (2/70) and 7.143% (5/70), respectively, while the control group were 11.429% (8/70), 14.286% (10/70), 8.571% (6/70), 15.714% (11/70) and 24.143% (19/70), respectively. The incidence of the above complications in the observation group was significantly lower than that of the control group, the difference was statistically significant ( χ2=4.275-8.499, P<0.05 or 0.01). The NRS pain score, quality of life score and bladder spasm score were observed in the observation group (31.48 ± 3.60), (1.89 ± 1.03), (2.25 ± 0.47) points, while the control group were (36.20±4.22), (2.77±1.84), and (3.79±0.81) points, respectively. The above three scores in the observation group were significantly lower than those in the control group, the difference was statistically significant (t=7.119, 3.491, 13.756, P<0.01).The nursing satisfaction of patients in the observation group was 95.71% (67/70) which was significantly higher than 80.00% (56/70) of the control group, the difference was statistically significant ( χ2=6.695, P<0.05). Conclusions Rapid rehabilitation surgery for patients with advanced prostatic hyperplasia with plasma prostatectomy can speed up the recovery process, relieve postoperative pain, reduce the incidence of postoperative complications, harmonious doctor-patient relationship, improve the quality of life of patients, it is worthy of extensive clinical promotion.
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Objective@#To understand the status and progress of rapid rehabilitation nursing on orthopedics, to discuss the future direction, in order to grasp the development trend.@*Methods@#PubMed and Wanfang database were searched for the statistical materials. According to the quantity, age, country, subordinates of orthopedics and nursing strategies, all the papers were analyzed.@*Results@#Until February 2017, PubMed and Wanfang collected a total of 60 papers on the rapid rehabilitation nursing of Orthopedics, the number of papers in Chinese occupied the main position, 35 articles accounting for 58.3%.@*Conclusions@#Researchers in this field are focusing on health education, psychological comfort, rehabilitation training and pain control. The mainly research methods include observation, improvement and summary ofclinical nursing, so the conclusions of descriptiveness are more than quantitative conclusions which are from rigorous randomized controlled trials (RCTs).
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Objective To explore the application of rapid rehabilitation concept in perioperative period of colorectal cancer.Methods A total of 110 patients with rectal cancer admitted in our hospital from June 2012 to July 2015 were enrolled in the research group(55 cases)and control group(55 cases).The observation group was treated with rapid rehabilitation method,and the control group was treated by traditional perioperative method.Observation of the two groups of patients was in the hands of the amount of bleeding,operation time,the first time the patient exhaust time,postoperative time to get out of bed and other indicators.We observed the two groups of patients with surgical incision infection,intestinal obstruction,pulmonary infection and other complications.Results The difference of the amount of bleeding and the length of the incision in the two groups was statistically significant(t=9.618,7.846,P<0.01).The first time of exhaustive time,the first defecation time,the time of eating,the time of getting out of bed and the postoperative hospital stay of research group were significantly lower than those of the control group(P<0.01).The incidence of complications such as incision infection,intestinal obstruction and pulmonary infection of the research group was lower than those in the control group,and the difference was statistically significant(χ2=4.767,P<0.05).Conclusion The application of rapid recovery concept in perioperative period of colorectal cancer can reduce the incidence of surgical complications.
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Objective To investigate the safety and effectiveness of ultrasound-guided paravertebral anaes-thesia combined with propofol in the thoracoscopic sympathectomy. Methods Total 63 male and 59 female patients with hyperhidrosis were recruited. The patients were equally divided into two groups:group A and C. Patients in group A received ultrasound-guided paravertebral anaesthesia combined with propofol. Patients in group C received general intravenous anesthesia with endotracheal intubation. The heart rate (HR),mean arterial pres-sure(MAP)and the oxygen saturation(SpO2)at the time of entering the operating room(T0),completing anesthe-sia(T1),incising the skin(T2),cutting the T4 sympathetic trunk(T3),completing the operation were record-ed. The awake time after operation ,VAS score after operation and postoperative throat discomfort were also record-ed. Results The two groups successfully completed the surgery. There were no significant differences of the HR , MAP and SpO2 at T0-T4 between the two groups. There were significant differences of the awake time after opera-tion,postoperative feeding time and hospitalization expenses. The VAS score after operation of group A were better than group C(P<0.05)at T2 h,T4 h,T8 h,and T12 h. There was no significant difference of VAS score at T24 h between the two groups. Conclusion Ultrasound-guided paravertebral anaesthesia combined with propofol can pro-vide a safe and effective approach for patients receiving the thoracoscopic sympathectomy.
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Objective To explore the role of combined respiratory function combined with drug therapy in the rapid recovery of lung cancer patients, and to provide reference for clinical treatment. Methods Forty patients with early non-small cell lung cancer (NSCLC) who underwent surgical treatment from January 2012 to December 2015 were selected as subjects and were randomly divided into intervention group and control group (n=20) according to the order of admission. All patients were treated with routine chemotherapy on the basis of routine chemotherapy of lung cancer, and routine perioperative care was carried out. The intervention group received comprehensive respiratory function exercise on the basis of them. There were psychological nursing, health education, perioperative respiratory function exercise and so on. The incidence of postoperative pulmonary complications, quality of life improvement and postoperative rehabilitation were compared between the two groups. Results The incidence of pulmonary complications in the intervention group was 5％ (1/20, only one case of pneumonia), the incidence of pulmonary complications in the control group was 35％ (7/20, 4 cases of pneumonia, two cases of atelectasis, one case of hypoxemia),the incidence of postoperative pulmonary complications in the intervention group was significantly lower than that in the control group (P<0.05). The scores of SF-36 in the intervention group were higher than those in the control group, the difference was statistically significant (P<0.05). The extubation time and postoperative hospital stay in the intervention group were shorter than in the control group. The 6-minute walking test (6MWK) was longer than the control group, the difference was statistically significant (P<0.05).Conclusion Comprehensive respiratory function combined with treatment with etestin hydrochloride can reduce the early postoperative pulmonary complications in patients with early non-small cell lung cancer, improve its quality of life and promote rapid postoperative rehabilitation.
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Objective To study effect of rapid rehabilitation surgery on the curative effect and pulmonary function of elderly patients with lung cancer. Methods 240 patients of lung cancer who received therapy from March 2014 to March 2016 in Ningbo Yinzhou People's Hospital were selected as research objects. According to the draw method divided into control group and experimental group, 120 cases ineach group. The control group was treated with routine nursing intervention, while the experimental group was treated with concept intervention of rapid rehabilitation surgery. Then extubation time, exhaust time, antibiotic use time, ambulation time, hospitalization time, lung function index, the MOS item short from health survey (SF-36) and Visual Analogue Scale/Score(VAS ) , adverse reactions rate of two groups were compared. Results The extubation time, exhaust time, antibiotic use time, ambulation time and hospital stay in the experimental group were significantly lower than those in the control group, the difference was statistical y significant (P<0.05); The levels of forced expiratory volume in one second (FEV1), forced vital capacity(FVC), forced expiratory volume in one second(FEV1/ FVC)were significantly higher than those of the control group, the difference was statistical y significant (P<0.05),Psychological quality, role quality, physiological quality and social quality score were significantly higher than those of the control group, the difference was statistical y significant (P<0.05), VAS scores were significantly lower than those in the control group, the difference was statistical y significant (P<0.05). The total incidence of adverse reactions was significantly lower than that of the control group, the difference was statistically significant (P<0.05). Conclusion The concept of rapid rehabilitation surgery has significant curative effect on elderly patients with lung cancer surgery, can improve the pulmonary function, reduce the incidence of complications, reduce the length of stay and benefit the prognosis of patients.
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OBJECTIVE:To investigate the effect of rapid rehabilitation surgery assisted to fluorouracil,oxaliplatin,leucovo-rin(FOLFOX)on postoperative recovery,complications and quality of life in patients with colorectal cancer. METHODS:60 pa-tients with colorectal cancer were randomly divided into control group(30 cases)and observation group(30 cases). After resection of colorectal cancer,control group received 85 mg/m2 Oxaliplatin for injection,2 h intravenous infusion,d1+200 mg/m2 Calcium le-vofolinate for injection,intravenous infusion,once a day,d1-2+400 mg/m2 Fluorouracil injection,intravenous infusion,once a day, d1-5 then 600 mg/m2 for 22 h intravenous infusion,d1-2. Observation was additionally given rapid rehabilitation surgery. 2-week was regarded as 1 course,it lasted 12 courses. Urinary retention time,anal exhaust time,first defecation time,postoperative hospital-ization time,scores of life quality (overall health,emotional function,mental health,physiological functions,physical function,so-matic pain,vitality,social function)in 2 groups were observed,and the incidence of postoperative complications was recorded. RE-SULTS:The urinary retention time,anal exhaust time,first defecation time,postoperative hospitalization time in observation group were significantly shorter than control group,the incidence of postoperative complications in observation group was signifi-cantly lower than control group,overall health,emotional function and mental health score were significantly higher than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Rapid rehabilitation sur-gery assisted to FOLFOX chemotherapy can reduce the incidence of postoperative complications in patients with colorectal cancer, improve quality of life,shorten hospitalization time and promote postoperative recovery.
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Objective To investigate the effect of rapid rehabilitation nursing mode on postoperative complications in elderly patients with appendicitis. Methods Forty-eight elderly patients with appendicitis underwent surgery from July 2013 to June 2014 were set as the control group, and another fifty-three elderly patients from July 2014 to June 2015 as observation group. The patients in the control group were treated with routine care while the patients in the observation group with rapid rehabilitation nursing. Operative complications, gastrointestinal tumor recovery and postoperative hospitalization time were compared within one week after the operations between two groups. Result The rates of constipation, abdominal distention, chills and dysuria in the observation group were significantly lower than those of the control and the time of anal first exhaust, defecation and postoperative hospitalization in the observation group were significantly lower or shorter than those in the control group (all P<0.05). Conclusion The rapid rehabilitation nursing mode based on evidence can reduce surgery complications in elderly patients, promoter recovery and shorten hospitalization time.