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Objective:To explore the latent profile of discharge readiness of patients with lower extremity arteriosclerosis obliterans and analyze its influencing factors, so as to provide theoretical basis for individualized management of discharge readiness in patients with lower limb arteriosclerosis obliterans.Methods:From February 2022 to December 2022, 194 patients with arteriosclerosis obliterans of lower limbs who received surgical treatment in the vascular surgery department of Shandong Provincial Hospital Affiliated to Shandong First Medical University were investigated by using general information questionnaire, Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale and Family APGAR Index for a cross-sectional survey. Latent profile analysis was used to identify different categories, and Logistic regression analysis was used to explore its influencing factors.Results:Totally 182 valid questionnaires were collected, of which 127 males and 55 females, and patients over 60 years old were the majority, accounting for 81.9%. Three latent profile models were identified in this study, namely, low discharge readiness group (27.47%), medium discharge readiness-high expected support group (41.21%) and high discharge readiness group (31.31%). Logistic regression analysis showed that first hospitalization ( OR=19.218, 95% CI 2.949-125.237), the quality of discharge guidance ( OR=0.896, 95% CI 0.857-0.937) were the predictive factors of medium discharge readiness-high expected support group ( P<0.05); family function ( OR=0.185, 95% CI 0.097-0.353) and the quality of discharge guidance ( OR=0.823, 95% CI 0.764-0.888) were the predictive factors of the low discharge readiness group of patients with arteriosclerosis obliterans (all P<0.05). Conclusions:There are different types of discharge readiness of patients with arteriosclerosis obliterans, and patients with poor quality of discharge guidance and poor family function are more likely to have a trend of low discharge readiness. Patients with low quality discharge guidance and first hospitalization are more likely to have a trend of moderate discharge readiness-high expected support. For this kind of patients, medical staff should take corresponding measures to improve their readiness for discharge.
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Objective:To explore any effect of following an individualized exercise program on the cardio-pulmonary health of elderly persons with stable chronic obstructive pulmonary disease (COPD).Methods:A total of 120 elderly COPD patients were randomly divided into an experimental group and a control group, each of 60. Both groups were given medication and routine rehabilitation treatment for 3 months, but the experimental group also followed an individualized exercise program based on the cardiopulmonary exercise test. Before and after the treatment, Borg scoring was used to assess the subjects′ degree of dyspnea. Forced expiratory volume (FEV 1), forced vital capacity (FVC), maximum oxygen uptake (VO 2max), anaerobic threshold (AT), heart rate (HR) and a heart index (CI) were also recorded. The 6-minute walk test (6 MWD) was administered to evaluate the rehabilitation effect. Results:There were no significant differences in the average Borg scores, cardiopulmonary function indexes or 6MWD distances between the two groups before treatment. After the treatment significant improvement was observed in all of the measurements in both groups, but at that point all of the experimental group′s averages were better than those of the control group.Conclusion:Individualized exercise based on the cardiopulmonary exercise test can alleviate the symptoms of dyspnea in elderly COPD patients, improve their cardiopulmonary functioning and exercise endurance and improve the rehabilitation effect.
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Objective To evaluate the effect of early exercise intervention on deep venous thrombosis (DVT) after joint replacement.Methods 100 patients with joint replacement were divided into observation group including 50 cases and control group including 50 cases by random number table method.Early exercise intervention was used in observation group and usual nursing was used in control group.The hemodynamic index (femoral vein blood flow peak velocity and average velocity) and DVT incidence were compared between the two groups.Results After the intervention for 3 days,the femoral vein blood flow peak velocity and average velocity of observation group respectively were (43.5±4.1) cm/s and (27.3±3.2) cm/s,those of control group respectively were(36.6±3.7) cm/s and (20.2±2.8) cm/s.The difference between the two groups was statistically significant (t=2.987,2.895,P < 0.05).After the intervention for 7 days,the femoral vein blood flow peak velocity and average velocity of observation group respectively were (56.1±4.7) cm/s and (32.1±3.9) cm/s,those of control group respectively were (41.3±3.9) cm/s and (22.4±4.3) cm/s.The femoral vein blood flow peak velocity and average velocity of observation group significantly higher than control group(t=3.675,2.929,P < 0.05).The DVT incidence of control group and observation group respectively were 40.0%(20/50) and 14.0%(7/50),showed significant differences between the two groups(x2=8.574,P=0.003).Conclusions Using the early exercise intervention on patients with joint replacement can effectively improve the lower limb venous blood flow velocity and prevent DVT.
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Objective To study the effect of fast tract surgery (FTS) used in patients undergoing total knee arthroplasty (TKA). Methods For the experimental group, 341 inpatients with TKA in the Joint Surgery Department of Shandong Provincial Hospital from June 2014 to June 2015 were treated with FTS nursing measures. For the control group, 355 inpatients with TKA of the same department from January 2013 to May 2014 were treated with conventional nursing measures. The effects of FTS nursing measures, the parameters of patients′ postoperative complications, average hospitalization days and the function recovery of knee joint were evaluated respectively. Results After implementing the FTS nursing measures , the incidence of deep venous thrombosis of lower limbs reduced from 8.45%(30/355) to 2.35%(8/341) (χ2=2.340, P<0.05). The average hospitalization days treated without/with FTS nursing measures were:unilateral knee (14.49±3.62) days (without FTS) vs. (11.95±4.53) days (with FTS), bilateral knees (15.80± 3.01) days (without FTS) vs. (13.19±4.08) days (with FTS)(t=3.166, P<0.05). Two weeks after surgery, the HSS scores in the experimental group was 65.72 ± 5.54, while the HSS scores in the control group was 52.43 ± 7.32 (t=2.452, P < 0.05). Three months after surgery, the HSS scores in the experimental group was 88.72 ± 7.10, while the HSS scores in the control group was 72.14 ± 8.73 (t=2.528, P < 0.05). Conclusions FTS nursing measures could significantly reduce the incidence of deep venous thrombosis of lower limbs, shorten the hospitalization days of inpatients, and promote the functional recovery of knees.
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Objective To evaluate the image quality and obtained by the tube current modulation base on time bolus peak in low voltage in CTPA.Methods 30 consecutive patients suspected pulmonary embolism(PE)were prospectively enrolled,and satisfy the following conditions.The study was performed by 64-slice spiral CT system (lightspeed VCT-XT,GE healthcare),Tube voltage was set at 80 kV.Tube current settings related to the attenuation of ROIs by test bolus peak.The injection parameters were set up by injection flow rate (4 mL/s),contrast medium dose (28 mL),and saline flushing dose (40 mL).All images were evaluated by two observers blinded to pulmonary CTA protocol,including attenuation,noise,SNR and CNR.The image quality was evaluate by 4-score.To evaluate the relationship between influential factor and image quality using Pearson correlation analysis.A P-value 0.05 ).The mean attenuation,noise,SNR and CNR on pulmonary trunk was (628.63±146.46)HU,(53.92±14.07)HU,12.02±3.1 7 and 10.81±3.10,respectively.The percentage of assessable pulmonary arteries was 95.82%.Conclusion The tube current modulation base on time bolus peak in low voltage could offer assessable image quality and raise image stability.
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To investigate the difference of CO_2 transport during continuous flow apneic ventilation (CFAV) between with 100% 0_2 and with 60%N_2O-40% O_2. Method: Twelve dogs were randomly divided into equally group N_2O and group O_2. A catheter was introduced into each main-stem bronchus using a fiberoptic bronchoscope and endotraeheal tube positioned in place for CFAV. With 60%N_2O-40% O_2 in group N_2O and 100% O_2 in group O_2 lungs were ventilated at flow rate of 1L?kg~(-1)?min~(-1) Blood gas analysis, HR, MAP and SaO_2 were recorded every 30min during period of 180min. Result: In group O_2, PaCO_2 increased from 4.88?0.63kPa to 8.73?1.11kPa. In Group N_2O, PaCO_2 were increased gradually from 5.51?0.94kPa to 6.18?0.67kPa. There was significant difference in PaCO_2 between the two groups (P