RESUMEN
Objective:To understand clinical effect of a homemade infants wrist hand thumb joint fixtures to prevent the unplanned extubation (UEX) in radial arterial puncture tube in children with congenital heart disease.Methods:From October 2016 to October 2019, 150 cases infants patients with simple congenital heart disease in cardiac surgery of the First Affiliated Hospital of University of Science and Technology of China were selected as the research objects, and the radial artery invasive manometric tube was routinely indwelling after operation. Subjects were randomly divided into observation group and control group, with 75 cases in each group. In the observation group, the wrist joint of children was fixed with homemade fixation device. The control group used conventional fixation methods to fix the wrist joint of infants. The incidence of pressure injury and unplanned extubation were compared between the two groups.Results:There was 1 case (1.33%) pressure injury in the observation group and 2 cases (2.67%) in the control group, and there was no statistical significance in the two groups ( P>0.05). The unplanned extubation rate of radial artery pressure tube occurred in 5 cases (6.67%) in the observation group, and lower than that in the control group (17/75, 22.67%) ( χ2=7.67, P<0.01). When children in the state of agitation and very agitation, the incidence of unplanned extubation rate in the observation group was 0 and 4.35%(1/23), lower than that in the control group 15.79%(6/38) and 35.00% (7/20), respectively ( χ2=6.19, 6.64, both P<0.05). With the extension of ICU time, the incidence of unplanned extubation rate was increased. The incidence of unplanned extubation rate was 4.76% (2/42) and 9.09% (3/33) in the observation group and 18.18%(8/44) and 29.03% (9/31) in the control group when ICU time was ≤24 h and>24 h, respectively. The difference was statistically significant ( χ2=5.51, 4.17, both P<0.05). Conclusions:The homemade wrist thumb joint fixtures device for infants does not increase the pressure injury of the fixed part, and can reduce the incidence of unplanned extubation of radial artery manometric tube in children with congenital heart disease.
RESUMEN
<p><b>OBJECTIVE</b>To investigate the possibility and short-term effect of high dose chemotherapy with peripheral blood stem cell support in the preoperative therapy of breast cancer, and-its influence on the following operation and would healing.</p><p><b>METHODS</b>Three patients with T(3)N(1)M(0) (III(a)), T(4)N(1)M(0) (III(b)), T(4)N(1)M(1) (IV) of breast cancer were diagnosed histopathologically. After receiving HDC/APBSCT, the 3 patients were operated on. HDC/APBSCT process included 2 cycles of FEC induction chemotherapy; PBSC mobilization, APBSC collection and cryopreservation and PBSC infusion; and high-dose chemotherapy, APBSC infusion and supportive therapy. The therapy consisted of CTX2.5 g/m(2), VP-16 600 mg/m(2), and cerboplatin 600 mg/m(2) delivered on day 1, APBSC infusion 48 h later, rhG-CSF (150 microg, BID) was administered 4 h after infusion of APBSC until WBC was higher than 10 x 10(9)/L. During HDC/APBSCT, the patients were protected in the air laminar flow room with supportive therapy of antibiotics, anti-virus and anti-fungus drugs. They left the air laminar flow room after their WBC was greater than 2 x 10(9)/L. Case 1 was treated by radical mastectomy, Case 2 by improved radical mastectomy, Case 3 by improved radical mastectomy and transplantation of skin for the large area.</p><p><b>RESULTS</b>Rapid recovery of bone marrow function was observed in all 3 patients. Operation was performed 4 weeks after HDC/PBSCT in Cases 1, 2 and 33 days in Case 3. No influence was seen on operative procedure and would healing, especially in Case 3 with a large area of skin transplantation. Two patients with stage III(a) and III(b) have been alive since the treatment for 30 months and the other with stage IV died of brain metastasis 16 months later.</p><p><b>CONCLUSIONS</b>HDC/APBSCT as a preoperative therapy for breast cancer has no influence on the coming surgery and would healing, even on skin transplantation for a large area. It has a practical response in stage III(a) and III(b), but it is still controversial in stage IV. This method as a salvage therapy for patients with breast cancer of intemuediate or stage.</p>