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【Objective】 To discuss the prevention and control strategies of physical examination and health consultation for apheresis donation during the COVID-19 outbreak, and to verify its necessity and efficiency. 【Methods】 A three-stage (Hubei import period, Jan 23 to 31; local(Zhejiang) epidemic period( Feb 1 to Mar 1); overseas import period, Mar 2 to 22) prevention and control strategy for physical examination and health consultation during the COVID-19 outbreak from January 23 to March 22, 2020 was adopted by our center, and the consultation of residence history, contact history, and the investigation of related symptoms were added to health consultation.The deferral rates of health consultation and physical examination during the COVID-19 outbreak were compared with the same period in 2019. The deferral rates in each stage were compared, containing those contributed by first-time and regular apheresis donors. 【Results】 The deferral rates of health consultation during the epidemic period and the same period in 2019 were 2.31%(100/4 371) vs 1.62%(78/4 740) (P0.05) The deferral rate of travel contact history was the highest at 2.05%(40/1947)during local epidemic period, and respiratory symptoms at 1.29%(5/388)during Hubei import period. The deferral rates of blood pressure during the three stages were1.85%(7/378)vs 3.57%(67/1877)vs 4.08(82/2009)(P>0.05). The deferral rate of health consultation and physical examination in first-time and regular apheresis donors were 5.86%(38/649)vs 1.65%(61/3 696)and 5.79%(35/604)vs 3.41%(124/3 635)(P<0.01). 【Conclusion】 The deferral rates of health consultation and physical examination increased significantly during the COVID-19 epidemic. Therefore, it is necessary to formulate and adopt a targeted consultation strategy during the epidemic period to block COVID-19 transmission to the greatest extent.
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Objective To explore the effects of enhanced recovery after surgery (ERAS) on postoperative recovery, psychological state and complications of patients with laparoscopic gastrointestinal surgery. Methods Ninety-eight patients with laparoscopic gastrointestinal surgery admitted to Huzhou Central Hospital from January 2016 to December 2017 were enrolled and they were divided into two groups (49 cases in each group) according to difference in nursing. During peri-operative period, the routine nursing group was given routine nursing; while the ERAS nursing group received the nursing of ERAS. The postoperative recovery, inflammatory response and nutritional status, complications, psychological state and nursing satisfaction were compared between the two groups. Results Compared with the routine nursing group, the gastrointestinal tract exhaust time, common food intake time, incision healing time, ambulation time and hospital stay were significantly shorter in ERAS nursing group [gastrointestinal tract exhaust time (days): 2.43±1.02 vs. 3.46±1.15, common food intake time (days): 4.24±1.36 vs. 6.23±1.52, incision healing time (days): 7.62±1.54 vs. 9.63±1.63, ambulation time (days): 8.80±2.32 vs. 11.24±2.02, hospital stay (days):10.23±2.12 vs.14.56±2.37, all P < 0.05]. After operation, the high-sensitivity C-reactive protein (hs-CRP) in the two groups was increased first and then decreased, and the levels of transferrin (TRF) and prealbumin (PA) were decreased first and then increased, and the differences were statistically significant at different time points within-groups (P < 0.05), and the changes of indexes in the 5 days after operation in the ERAS nursing group were more significant than those in the routine nursing group [hs-CRP (mg/L): 27.4±6.2 vs. 35.6±9.1, TRF (g/L): 1.89±0.05 vs. 1.81±0.06, PA (mg/L):340±20 vs. 280±20, all P < 0.05]. The postoperative incidences of nausea and vomiting and sore throat in ERAS nursing group were significantly lower than those in routine nursing group [nausea and vomiting: 32.65% (16/49) vs. 67.35% (33/49), sore throat: 12.24% (6/49) vs. 51.02% (25/49), both P < 0.05], and there were no significant differences in postoperative incidences of abdominal distension, incision infection, pulmonary infection and anastomotic leakage between the two groups [abdominal distension: 4.08% (2/49) vs. 6.12% (3/49), incision infection: 4.08% (2/49) vs. 6.12% (3/49), pulmonary infection: 2.04% (1/49) vs. 6.12% (3/49), anastomotic leakage: 2.04% (1/49) vs. 4.08% (2/49), all P >0.05]. The scores of self-rating anxiety scale (SAS) at discharge in the two groups were lower than those before operation, and the degree of decrease in ERAS nursing group was greater than that in routine nursing group (39.21±4.64 vs. 46.56±4.53, P < 0.05). The nursing satisfaction rate in ERAS nursing group was significantly higher than that in routine nursing group [95.92% (47/49) vs. 77.55% (38/49), P < 0.05]. Conclusion ERAS for laparoscopic gastrointestinal surgery not only can promote the recovery of gastrointestinal function, improve the nutritional status and reduce inflammatory response and postoperative complications, but also can relieve anxiety, shorten hospital stay and elevate nursing satisfaction, therefore it is worthy to promote and apply in clinical nursing.
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Objective To study the efficacy of immunization combination of pregnant women and infants in preventing intrauterine HBV infection. Methods One hundred and twenty six HBsAg positive pregnant women were divided into two groups randomly.In the combination group,126 cases were injected with hepatitis B immunoglobulin(HBIG) during pregnancy since the 28 th week of gestation and HBVac 20 ?g at 1、2、7 month combining HBIG 200 IU at 0、15 day was injected to their infants, while 90 cases pregnant women in control group were not injected with HBIG. The serum HBV IgM of pregnant women and infant were tested using ELISA and was followed up for one year. Results The incidence of intrauterine HBV infection and the rate of chronic HBV infection in the infants of combination group were significantly lower than that of the control group (19.51% vs 35.56%, 13.33% vs 3.97% respectively). The detection rate of anti HBs in newborns and protective anti HBs in 1 year were significantly higher in combination group than that in the control group (80.95% vs 0,96.03% vs 86.67%). Conclusion Combining therapy of pregnant women and infant may prevent intrauterine HBV infection effictively and increase the rate of success immunoprophylaxis significantly, and decrease the rate of chronic HBsAg infection.