ABSTRACT
@#Objective To explore the causes of conversion to thoracotomy in patients with minimally invasive esophagectomy (MIE) in a surgical team, and to obtain a deeper understanding of the timing of conversion in MIE. Methods The clinical data of patients who underwent MIE between September 9, 2011 and February 12, 2022 by a single surgical team in the Department of Thoracic Surgery of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. The main influencing factors and perioperative mortality of patients who converted to thoracotomy in this group were analyzed. Results In the cohort of 791 consecutive patients with MIE, there were 520 males and 271 females, including 29 patients of multiple esophageal cancer, 156 patients of upper thoracic cancer, 524 patients of middle thoracic cancer, and 82 patients of lower thoracic cancer. And 46 patients were converted to thoracotomy for different causes. The main causes for thoracotomy were advanced stage tumor (26 patients), anesthesia-related factors (5 patients), extensive thoracic adhesions (6 patients), and accidental injury of important structures (8 patients). There was a statistical difference in the distribution of tumor locations between patients who converted to thoracotomy and the MIE patients (P<0.05). The proportion of multiple and upper thoracic cancer in patients who converted to thoracotomy was higher than that in the MIE patients, while the proportion of lower thoracic cancer was lower than that in the MIE patients. The perioperative mortality of the thoracotomy patients was not significantly different from that of the MIE patients (P=1.000). Conclusion In MIE, advanced-stage tumor, anesthesia-related factors,extensive thoracic adhesions, and accidental injury of important structures are the main causes of conversion to thoracotomy. The rate varies at different tumor locations. Intraoperative conversion to thoracotomy does not affect the perioperative mortality of MIE.
ABSTRACT
Objective Through retrospective analysis of the causes of organ damage after in vitro fertilization embryo transfer,we put forward targeted prevention and take corresponding nursing measures to promote the prognosis of patients. Methods Selected 14 patients who suffered from organ damage after paracentes is in vitro fertilization and embryo transfer in our hospital.The causes were analyzed,and the treatment and nursing protocols were determined according to the kind and severity of the injured organs. Results 14 cases of organ injury patients with treatment and nursing gauze to stop bleeding, antibiotics, conservative treatment, hemostatic anti shock, indwelling catheter bladder irrigation, ureteral catheter and surgery were given symptomatic, were cured, hospitalization time was 3- 10 days. Conclusions The reasons for such patients, clinical observation and analysis of nursing treatment, let clinical nurses accumulate nursing experience in such patients, can timely take corresponding nursing measures,In order to improve the related nursing level of assisted reproductive technology.
ABSTRACT
Objective To investigate the causes of recurrent hemoptysis one week after interventional treatment.Methods 56 patients with massive hemoptysis were included in this study.All patients underwent emergent interventional therapy, including angiography and embolization therapy of bronchial artery, intercostal artery, internal thoracic artery, external thoracic artery and phrenic artery via femoral artery puncture.Results 6 cases had rebleeding within one week after interventional therapy,including 2 cases with primary lung cancer,1 case with bronchiectasis,1 case with pulmonary tuberculosis,1 case with esophageal cancer after surgery,1 case with esophageal cancer after radiotherapy.Then, these patients once again underwent angiography and embolization therapy of bronchial artery,intercostal artery,internal thoracic artery,external thoracic artery and phrenic artery.Conclusion The use of vasoconstrictive drugs before intervention, diversification of pulmonary feeding artery, wide range of lesions, inappropriate embolic material and poor image quality can lead to recurrent hemoptysis after interventional treatment.
ABSTRACT
Objective To propose the nursing measures with the analysis of free tissue transplant donor site poor healing.Methods 19 cases which suffered wound poor healing were analysed and gived donor site expansion training strengthen,nutrition support,reduce the tension of incision to reduce the incidence of complications.Results 19 cases which suffered wound poor healing with free tissue transplantation were all delayed healed.The reasons could be summed up in four aspects as high tension incision,incision liquefaction,incision hematoma,infection of incision.Conclusions Predictive nursing intervention,postoperative close observation of incision condition,early treatment can effectively prevent complications of donor site.
ABSTRACT
Objective To discusses the reason and effective prevention and control nursing measures in severe craniocerebral injured patients complicated with secondary pulmonary aspergillosis.Methods The reason of 21 severe craniocerebral injury patients infected by pulmonary aspergillosis were analyzed,and comprehensive nursing care was given to these patients,including strict disinfection and isolation,strengthening management of hospital environment,early close observation of disease,applying effective antifungal drugs in time,strengthening the medication nursing and nutrition support,standard antibiotic application,attention to the respiratory tract management,basic and college nursing.Results 13 cases were recovered,4 cases were better,4 cases died,the mortality rate was 19％.Conclusions Reasonable treatment and nursing care to the severe craniocerebral injury patients complicated with secondary pulmonary aspergillosis can effectively prevent and control the spread of pulmonary aspergillosis in the hospital,improve the cure rate,reduce the complications and the mortality rate,and ensure the safety of patients.
ABSTRACT
Objective To analyze the reasons of hypoglycemia in patients with diabetic ophthialmopathy,and summarize the corresponding nursing measures in order to reduce the incidence of hypoglycemia in patients with diabetic ophthialmopathy. Methods The reasons for hypoglycemia were analyzed for 43 patients with diabetic ophthalmopathiy in our hospital from January 2009 to November 2011. Results Taking the hunger-cure arbitrarily,no regular diet,no corresponding adjustment for the insulin quantity after stopping taking hormone medicine,and also after the diabetic symptoms relieved,besides,less food-intake caused by high pressure of eyes,vomiting and appetite decreasing after the vitreous body dissection,and the paramedic had no enough cognition for the harm caused by hypoglycemia,combination medication with cardiovascular medicine were the primary reasons for the occurence of hypoglycemia in patients with diabetic ophthalmopathy. Conclusions Many reasons can cause hypoglycemia in patients with diabetic ophthalmopathy,We should strengthen management,propaganda and education,observation of medication and disease condition as well as improve the attention of eye health care workers for hypoglycemia in order to reduce the incidence of hypoglycemia.
ABSTRACT
OBJECTIVE To analyze the reason for delayed healing of obstetric abdomen vertical cut and discuss the preventive nursing countermeasure.METHODS The discharged cases during Jul 2005 Jun 2006 and the inpatient cases during Jul 2006 to Jun 2007 were observed and monitored and at the same time the preventive nursing countermeasure was provided and the statistic of clinic material of two years was analyzed.RESULTS A satisfying effect has been made by taking objective monitoring and preventive nursing countermeasure the rate of delayed healing of obstetric abdomen vertical cut been reduced from the original 2.75% to the current 0.93%.CONCLUSIONS The key to prevent the delayed healing of obstetric abdomen vertical cut is prevention.Taking objective monitoring and preventive nursing countermeasure play an importment role in promoting healing of obstetric abdomen vrtical cut.
ABSTRACT
Nurses often face ethical dilemmas in clinical practice,originating from nurses themselves,nursing measures,and nursing management as well.Only by correctly recognizing and analyzing the causes of ethical dilemmas in nursing care,can help nurses get out of the ethical dilemmas and make reasonable ethical decisions in nursing care.