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RESUMEN Tres stents traqueales fueron removidos luego de 10, 16 y 22 años, a lo que le siguió la correspondiente curación de la estenosis traqueal. Se reportan dos nuevos casos de estenosis traqueal benigna, tratados con prótesis de silicona, que se presentaron a control luego de muy largas ausencias: 16 años en uno y 22 en otro. Se suman a un caso anteriormente publicado y curado luego de 10 años de permanencia del stent, que también presentó una amplia y estable luz traqueal luego la remoción. Se describen los hallazgos endoscópicos, y se incluyen reflexiones sobre la curación de la estenosis observada en todos ellos y su probable relación con el largo tiempo de permanencia de las prótesis. Se investigan las propiedades físicas de los stents, luego de tan prolongado lapso de implante y se las compara con un dispositivo nuevo. Se emite una propuesta que podría conducir a la curación de las estenosis traqueales con tratamiento endoscópico y stent por tiempo prolongado.
ABSTRACT Three tracheal stents were removed after 10, 16, and 22 years, followed by healing of tracheal stenosis. Two new cases of benign tracheal stenosis are reported, treated with silicone pros theses, which presented for follow-up after very long absences: 16 years in one case and 22 years in the other. They add to a previously published case that was healed 10 years after the stent was implanted, which also had a wide and stable tracheal lumen after removal. The endoscopic findings are described, and reflections are included on the healing of the observed stenosis in all cases and its probable relationship with the prolonged indwelling of the prostheses. The physical properties of the stents are inves tigated after such a long period since implantation, and they are compared with a new device. A proposal is put forward that could lead to the healing of tracheal stenosis with endoscopic treatment and prolonged indwelling of the stent.
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Background: Open peripheral intravenous (IV) catheters have been routinely used in neonates. Closed catheters have resulted in a longer indwelling time and reduction in catheter related complications such as phlebitis in adults. However, there is paucity of data in neonates.Methods: We conducted this pilot study in a pre-post study design. Open catheters were used in the first phase and closed catheters in the second phase. Hundred babies requiring intravenous fluid therapy for at least 24 hours in this neonatal intensive care unit were included in each group. Indwelling time and the complications leading to removal of the catheter were compared between the two groups.Results: Both groups were comparable in terms of gestational age, day of life, site of cannulation, nature of intravenous fluid and drugs administered. In the open catheter group, there was significant increase in use of inotropes (38% vs 22%; p=0.014) and blood products (16% vs 5%; p=0.011). The mean indwelling time (hours) was significantly greater in closed catheter group compared to open catheter group (47.1'19.4 vs 38.04'17.9; p <0.008). Inotrope use was found to decrease the indwelling time. There was an increase in indwelling time by 8.2 (SE 2.67) hours even after adjusting for use of inotropes. The incidence of catheter related complications was similar in both groups.Conclusions: There is a marginal but statistically significant increase in indwelling time when closed peripheral IV catheters are used in neonates. However, our results would be more meaningful if replicated in a larger randomized controlled trial.
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Objective To conduct the contrastive analysis on the indwelling time of fixing indwelling needle by cutting sterile transparent dressing and non-cutting sterile transparent dressing.Methods A total of 236 inpatients in this hospital from August to December 2016 were selected.The patients with odd at last number of admission number served as the experimental group (119 cases),while the patients with even at the last number of admission number served as the control group(117 cases).The indwelling needle type was 18GA,the puncture was once success and the fluid infusion course was more than 5 d.The experimental group used the cutting sterile transparent dressing for fixing the indwelling needle and the extension tube vas completely exposed to the outside of dressing,while the control group adopted the conventional indwelling needle application fixation mode.The blood returning plugging pipe rate,average indwelling time and phlebitis occurrence at 24,48,72,96,＞ 96 h after indwelling needle were recorded.Results The blood returning plugging tube situation at 48,72,96,＞96 h after indwelling needle in the experimental group was superior to that in the control group,the difference was statistically significant(P＜0.05);the average indwelling time in the experimental group was (72.12 ± 3.25)h,while which in the control group was (59.34--3.78) h,and the difference was statistically significant (P＜0.05).Seven cases of phlebitis occurred in the experimental group and 9 cases in the control group,the difference was not statistically significant(P＞0.05).Conclusion Applying cutting sterile transparent dressing for fixing the indwelling needle reduces the plugging pipe rate due to returning blood coagulation,extends the indwelling needle use time,increase the patient's satisfaction,moreover does not increase the phlebitis occurrence risk.
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Objective To explore the effect of sitting and lateral sputum aspiration on the retention time of tracheal cannula in patients with neurosurgical tracheotomy. Methods Totally 120 cases of neurosurgery tracheotomy in hospitalized patients complicated with pulmonary infection by random number table method, 58 cases were divided into experimental group and control group 62 examples, two groups of patients with sputum top all joint taps to the back of the chest, the experimental group after taps take seat effectively causes cough; In the control group, the lateral position was used to effectively cough or induce cough, and the daily sputum volume of the two groups of patients was observed. To observe the time when the body temperature was restored to normal after the phlegm of the two groups of patients, the time of the lung auscultation, and the time of the tracheal tube retention. Results Implementing position row of phlegm daily sputum volume within a week the experimental group were (44.84±6.85) ml, (44.60±6.80) ml, (43.79±5.98) ml, (44.38±5.42) ml, (42.22±5.45) ml, (38.12±4.77) ml, (36.88±4.57) ml and control group were(36.13±7.34) ml, (35.15±7.34) ml, (36.13±7.34) ml, (37.13±7.34) ml, (37.13±7.34) ml, (32.97±7.17) ml, (31.35±4.36) ml, the difference had statistical significance (t=4.30-7.31, P<0.01);In the two groups, the time of normal body temperature recovery, the time of hearing and the time of the lung and the time spent in the tracheal tube were compared, and the experimental group were respectively (9.93±2.02) d, (32.33±1.50) d, (37.33±1.50) d, while control group were(15.77±1.05) d, (37.63 ± 2.33) d, (42.63 ± 2.33) d, the difference had statistical significance (t=20.04, 14.71, P<0.01). Conclusions It is better to reduce the retention time of tracheal tube in patients with neurosurgical patients than the lateral position.
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AIM: To investigate the effect of indwelling time of lacrimal silicone drainage tube on chronic dacryocystitis and its effect on visual acuity.?METHODS: The clinical data of 92 patients ( 110 eyes ) with chronic dacryocystitis treated with lacrimal drainage tube in our hospital from January 2013 to December 2016 were retrospectively analyzed. According to the indwelling time, the patients were divided into 6wk group (42 patients 50 eyes ) and 12wk group ( 50 patients 60 eyes). Comparison of two groups on clinical efficacy, vision, overflow symptoms, complications and recurrence was taken.?RESULTS:The effective rate was significantly higher in the 6wk group than in the 12wk group (P<0. 05). The visual acuity and incidence of epilepsy symptoms at 3mo after extubation was not signifcantly different (P<0. 05). The incidence of complication was 14. 0％ (7/50) at 3mo after extubation in 6wk group and significantly lower than that in the 12wk group which was 38. 3％ (23/60, P<0. 05). The recurrence rate was 2. 0％ (1/50) in the 6wk group, which was significantly lower than that in the 12wk group (18. 3％, 11/60;P<0. 05).?CONCLUSION: The clinical efficacy of lacrimal silicone drainage tube for 6wk and 12wk is similar to patients with chronic dacryocystitis. There is also little difference in the visual acuity of patients with dacryocystitis, but with the prolongation of the lacrimal duct drainage tube, rinse patency rate, increase the difficulty of extubation, complications and recurrence rate, the clinical situation should be based on the patient as much as possible to shorten the lacrimal duct silicone drainage tube retention time.
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Objective To improve the fixation method of indwelling needle inserted in the tail vein in rats to keep the inserted needle for a longer indwelling time .Methods One hundred healthy Wistar rats ( age 5~6 months, male:female=1:1) were randomly divided into two groups: the experimental group and the control group .Rats in both groups received the same tail vein indwelling needle puncture and cannulation .The control group got the traditional fixation , namely fixed by sticking with 3M transparent dressing paste .The experimental group received in addition to the traditional fixation, a 0.1 mm-thick aluminum tube placed outside the needle fixation site .The indwelling time in the rats were recorded and analyzed .Results The indwelling time was (166.86 ±9.03) h and (20.24 ±5.04) h in the experimental and control groups, respectively (t =68.546, P<0.01).Conclusions Our improved method is safe and reliable.It can prolong the indwelling time of the punctured intravenous indwelling needle , and provides a useful rat model in studies on the complications of intravenous indwelling needle kept for a longer time .
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Objective To discuss the influence of health education pathway on detaining time of thoracic drainage tube and standardize the nursing procedure for postoperative patients.Methods Forty five patients after thoracotomy from March to December in 2006 were set as the control group.Fifty patients of the same kind from January to September in 2007 were named the test group.The control group received conventional nursing education.The test group received health education on the day of operation,the first,second,third and fourth day after operation from specified nurses according to health education pathway.The contents included psychological nursing,pain management,respiratory function and physical training and enhancement of drainage efficacy.The average indwelling time of thoracic drainage tube was recorded.Results The average indwelling time of thoracic drainage tube in the test group and the control group was(74.40±8.88)h and(91.68±10.08)h respectively,which showed statistical difference,P＜0.01.Conclusions Application of health education pathway effectively shortened indwelling time of thoracic drainage tube as well as reduced pain and medical costs of patients.
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OBJECTIVE To investigation central venous catheter-related infections(CRI) in critical patients. METHODS Fifty-nine cases from Jul 2006 to Jun 2007 in intensive care unit (ICU) of our hospital were analysed retrospectively. RESULTS Among 59 cases, 27 cases were with positive results of fungi (51.85%) and bacteria(48.15%) in which G+(25.93%) and G-(22.22%). CONCLUSIONS CRI is related to the indwelling time, fungi are the major pathogens. It is important to prevent CRI through careful nursing. We must pull out the catheters if recessary and antibiotics should be used reasonablly.