Résumé
@#Objective To explore the factors that affect the drainage time of da Vinci robot lung cancer surgery, to analyze the coping strategies, and to provide a basis for shortening the drainage time of patients after surgery and speeding up the patients' recovery. Methods The clinical data of 131 patients who underwent da Vinci robot lung cancer surgery at the Department of Thoracic Surgery, General Hospital of Northern Theater Command from January 2019 to October 2019 were retrospectively analyzed. Among them, 68 were males and 63 were females, with an average age of 59.84±9.66 years. According to the postoperative thoracic drainage time, the patients were divided into two groups including a group A (drainage time≤ 5 days) and a group B (drainage time >5 days). Univariate analysis and logistic multivariate regression analysis were used to analyze the factors that may affect postoperative drainage time, and the correlation between different influencing factors and thoracic drainage time after da Vinci robot lung cancer surgery. Results Logistic multivariate analysis showed that age≥60 years (P=0.014), diabetes mellitus (P=0.035), operation time≥130 min (P=0.018), number of lymph node dissections≥15 (P=0.002), and preoperative albumin<38.45 g/L (P=0.010) were independent factors affecting the drainage time of da Vinci robot lung cancer surgery. Conclusion For elderly patients with diabetes mellitus during the perioperative period, blood glucose should be actively controlled, reasonable surgical strategies should be formulated to ensure the safety and effectiveness of the operation, while reducing intraoperative damage and shortening the operation time. After the operation, patients should be guided to strengthen active coughing, expectoration and lung expansion. Thereby it can shorten drainage time and speed up the recovery of patients after operation.
Résumé
BACKGROUND: Topical application of tranexamic acid can reduce the drainage after total hip arthroplasty for degenerative diseases. However, there are few reports on the application of tranexamic acid in primary total hip arthroplasty for simple elderly femoral neck fracture. OBJECTIVE: To analyze the safety and effectiveness of topical application of tranexamic acid to reduce drainage of elderly femoral neck fractures after total hip arthroplasty. METHODS: Forty-five elderly femoral neck fractures patients undergoing total hip arthroplasty in the Zhengzhou People’s Hospital from January to December 2019 were enrolled in this study, including 19 males and 26 females at the age of 59-82 years old. Twenty-one patients in the observation group were injected with tranexamic acid retrogradely through the drainage tube after total hip arthroplasty. Twenty-four patients in the control group were injected with normal saline retrogradely through the drainage tube after total hip arthroplasty. The postoperative drainage volume and adverse events were recorded; the wound healing was closely observed; and the coagulation function was checked. This study was approved by the Medical Ethics Committee of Zhengzhou People’s Hospital. RESULTS AND CONCLUSION: (1) All patients’ incisions healed grade A, and no myocardial infarction, cerebral infarction, pulmonary embolism, or deep vein thrombosis of the lower extremities occurred. (2) At postoperative 3 days, total drainage and hemoglobin loss were less in the observation group than those in the control group (P 0.05). (4) Results suggested that topical application of tranexamic acid in total hip arthroplasty for elderly femoral neck fractures is safe and effective. It can significantly reduce postoperative drainage without affecting coagulation function.
Résumé
【Objective】 To investigate the effect of autologous blood transfusion(ABT) drainage system and simple drainage(using drainage bags) on the prognosis of patients after lumbar surgery. 【Methods】 The patients admitted to the Department of Orthopedics of our hospital from August 2018 to September 2020 who underwent posterior open lumbar internal fixation and fusion were divided into two groups according to different drainage methods adopted after surgery: 50 patients were randomly selected from the patients who received postoperative ABT system for drainage as ABT group, and 50 patients were randomly selected from the patients who received postoperative drainage by drainage bag as simple drainage bgroup(the control group). The postoperative drainage volume, actual postoperative drainage, total dominant blood loss, total autologous blood transfusion volume, as well as the postoperative anemia indexes, infection indexes and albumin levels in d1, d3 and d7 of the 2 groups were retrospectively analyzed. 【Results】 The gender, age, operation duration and operation segment of the 2 groups were comparable (P>0.05), and preoperative Hb, Hct, ALB, WBC, NE%, intraoperative blood loss, intraoperative autologous blood transfusion volume and actual postoperative drainage volume were similar (P>0.05). There were no significant differences in Hb, Hct, ALB, WBC, NE% and CRP in postoperative d1, d3 and d7, as well as in preoperative and postoperative Hb, Hct and ALB, and in postoperative and preoperative WBC, NE% and CRP (P>0.05). The postoperative drainage volume (mL) and total dominant blood loss (mL) in ABT group and the control group were 554.40±176.82 vs 337.80±102.43, and 1 048.40±282.87 vs 791.80±277.02, respectively (P<0.05). 【Conclusion】 The use of ABT drainage system after lumbar surgery increased the drainage volume compared with simple drainage, but the improvement of anemia, albumin and infection was not obvious. ABT system should not be used routinely for drainage after lumbar surgery.
Résumé
@#Objective 聽 聽To investigate the correlation between the postoperative day 1 (POD1) drainage volume and postoperative pulmonary complications (PPCs). Methods 聽 聽The clinical data of 254 non-small cell lung cancer (NSCLC) patients undergoing thoracoscopic lobectomy at our department from January 2014 to June 2018 were retrospectively reviewed. According to whether there were PPCs after operation, patients were divided into a PPCs group (51 patients, 33 males and 18 females, aged 65.2卤7.3 years) and a non-PPCs group (203 patients, 110 males and 93 females, aged 62.4卤8.2 years). The correlation between POD1 drainage volume and PPCs was analyzed. Results 聽 聽The POD1 drainage volume in the PPCs group was significantly more than that in the non-PPCs group (337.5卤127.4 ml vs. 208.7卤122.9 ml, P=0.000). The result of regression analysis showed that POD1 drainage volume was an independent risk factor for the occurrence of PPCs. Receiver operating characteristic curve (ROC curve) analysis showed that POD1 drainage volume of 265 ml was the cut-off point to predict PPCs. The rate of PPCs in the group of POD1 drainage volume less than 265 ml was significantly lower than that in the group of drainage volume more than 265 ml (8.3% vs. 43.0%, P=0.000). Conclusion 聽 聽The POD1 drainage volume is closely related to the occurrence of PPCs, which can be used to predict the occurrence of PPCs.
Résumé
Objective To compare the effect of postoperative single or twin-tube suction drainage after breast cancer surgery.Methods This study was a retrospective review of 148 patients undergoing surgical treatment using the silica gel pipe joint negative pressure ball drainage for breast cancer from February 2013 to December 2014.The twin-tube group was with 88 patients and single-tube group was with 60 patients,and the effect was compared between two groups.Results The incidence of seroma was 18.3％(11/60) and 15.9％(14/ 88) in single-tube group and twin-tube group.The seroma puncture frequency,total drainage volume were (7.48±2.85) times,(300.25±112.37) ml in single-tube group and (4.99±1.89) times,(500.73±96.68) ml in twintube group,and there were significant differences (t=6.097,8.321,P=0.013,0.046).There were no significant differences in drainage time,hospital stay and effusion quantity between two groups(t=1.239,2.018,2.098,P ＞ 0.05).Conclusions It suggests that single tube could be use postoperative drainage instead of two tubes.
Résumé
Objective To discuss application of double pipe for negative pressure drainage in reducing intra-abdominal infections after gastrointestinal operation.Methods 85 patients with intra-ahdominal drainage after gastrointestinal operation were randomly divided into the control group (43 patients) and the observation group(42 patients).The control group used traditional latex drainage,the observation group took the double cannula negative pressure continued drainage.The intra-abdominal infection and bacterial number distribution,patients drainage time,drainage volume and drainage tube occlusion were observed.Results 25 bacterial cultures were positive in two groups of patients.Compared between the two groups,the bacterial number detection rate were significant.31 pathogenic bacteria were detected in 25 specimens.Compared between these two groups,staphylococcus aureus,clearing time of drainage,drawing tube time after drainage liquid being clear,the total catheterization time,average daily drainage volume were all significantly different.Conchrsious Double pipe negative pressure drainage for postoperative abdominal drainage can effectively reduce abdominal infection,shorten drainage time,and its effect is very good.