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Objective:To carry out evidence-based nursing for standardized management of stress hyperglycemia in perioperative period of gastrointestinal tumor patients, and to formulate indicators, analyze obstacles and promoting factors, formulate action strategies.Methods:Guided by the Johns Hopkins evidence-based nursing model, evidence were searched, evaluated and summarized. Clinical indicators and review methods were formulated to carry out quality review. From November 2021 to April 2022, the medical staff and patients in the gastrointestinal surgery department of the First Affiliated Hospital of Anhui Medical University who met the inclusion criteria were conducted, and the incidence of compliance rate was calculated. Based on the results of the baseline review, the obstacles and contributing factors were analyzed.Results:A total of 26 pieces of best evidence were included and 14 indicators were formulated for 48 medical staff and 45 patients to clinical review, among which the compliance rate of 7 indicators was less than 60%. The main obstacle factors were lack of procedures and instruments for management of perioperative stress hyperglycemia in gastrointestinal tumor patients, lack of knowledge of medical staff, etc. The main promoting factors were organizational support, good atmosphere of medical team cooperation, strong willingness to change, etc.Conclusions:There is a big gap between the clinical practice and the best evidence of perioperative stress hyperglycemia management in patients with gastrointestinal tumor. Action strategies should be put forward for obstacles and promoting factors to promote evidence transformation.
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BACKGROUND:Different weaving methods of autologous tendon lead to various treatment efficacies on cruciate ligament rupture, but the preferred method is stil controversial. OBJECTIVE:To comparatively analyze the clinical efficacy of single-bundle and double-bundle autografts on anterior cruciate ligament reconstruction. METHODS:A retrospective analysis of 48 cases of anterior cruciate ligament rupture was performed. According to the composition of graft beam, these 48 patients were divided into two groups:double-bundle group (n=24) and single-bundle group (n=24). Al surgical patients underwent autologous anterior cruciate ligament reconstruction by arthroscopy, and were fol owed up for at least 6 months. The function of knee joint after operation was comprehensively analyzed through IKDC and Lysholm scores. RESULTS AND CONCLUSION:Al of the patients (n=48) exhibited no joint complications postoperatively, such as intra-articular infection, joint effusion and incision inflammation. The IKDC scores and Lysholm scores in the double-bundle group were better than those in the single-bundle group, but there was no statistical y significant difference (P>0.05). This study demonstrated that single-bundle and double-bundle autografts both have good curative effects on anterior cruciate ligament reconstruction by arthroscopy. But in contrast, the curative effects of double-bundle autografts are better.