Summary of the best evidence for pulmonary rehabilitation in patients undergoing upper abdominal surgery / 中国实用护理杂志

Objective:To summarize the best evidence of pulmonary rehabilitation in adult patients undergoing upper abdominal surgery and provide evidence-based basis for clinical intervention.Methods:Systematically searched clinical decisions, guidelines, expert consensus, evidence summary, systematic review and randomized controlled trial studies on pulmonary rehabilitation for patients undergoing upper abdominal surgery in UpToDate, Cochrane Library, Web of Science, PubMed, Embase, CINAHL, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, National Comprehensive Cancer Network, Guidelines International Network, Medlive, British Thoracic Society, European Respiratory Society, American Association for Cardiovascular and Pulmonary Rehabilitation, Canadian Thoracic Society, American Thoracic Society, WanFang Database, China National Knowledge Infrastructure, VIP Database, and China Biology Medicine. The retrieval time limit was from March 11, 2012 to March 11, 2022. Evidence was extracted, summarized and recommended after strict evaluation of literature quality.Results:A total of 19 pieces of literature were eligible for inclusion. They were 2 clinical decisions, 4 expert consensuses, 4 systematic evaluations, and 9 randomized controlled studies.The best evidence included 22 recommendations in 7 dimensions, namely pulmonary rehabilitation team, patient assessment, sports training, respiratory muscle training, drug rehabilitation, health education and quality control.Conclusions:Summary of the best evidence of pulmonary rehabilitation in patients undergoing upper abdominal surgery can provide evidence-based guidance for clinical intervention, but medical staff should also develop personalized training programs according to the actual situation of patients when applying the evidence.

Clinical study of symptom management in thirst of patients with liver cancer after general anesthesia / 中国实用护理杂志

Objective:To establish a postoperative thirst management strategy for liver cancer patients to improve patient comfort.Methods:A total of 100 patients with liver cancer resection in the First Affiliated Hospital of Guangxi Medical University from July to December 2020 were chosen as the research objects by convenient sampling method. They were divided into observantion group and control group by random number table method, 50 cases in each group. The control group received routing nursing, and the observation group adopted the thirst management strategy. The thirst score, salivary flow rate, salivary pH value, lip mucosa moistening degree and oral comfort score of the two groups were compared.Results:The scores of thirst at 2 h, 4 h and 6 h after operation in the observation group were (7.09 ± 1.01), (5.24 ± 0.94), (3.24 ± 1.03) points, which were significantly lower than (7.97 ± 1.26), (7.00 ± 1.25), (5.67 ± 1.34) points in the control group, the differences were statistically significant ( t=-3.12, -6.46, -8.24, all P<0.05); the salivary flow rate at 2 h, 4 h and 6 h after operation in the observation group were 0.18 (0.15, 0.20), 0.23 (0.20, 0.26), 0.30 (0.25, 0.33) ml/min, which were significantly higher than 0.13 (0.13, 0.18), 0.18 (0.15, 0.20), 0.23 (0.18, 0.25) ml/min in the control group. The differences were statistically significant ( Z=-3.94, -5.81, -6.85, all P<0.05); there was no significant difference in salivary pH between the observation group and the control group after intervention ( P>0.05). The scores of oral mucosa moistening degree at 2 h, 4 h and 6 h after operation in the observation group were 3 (2, 3), 3 (3, 3), 4 (4, 4), which were significantly higher than 2 (2, 2), 3 (2, 3), 3 (3, 3) in the control group, the difference was statistically significant ( Z=-4.04, -5.02, -8.70, all P<0.05); the oral comfort of the observation group after the intervention was (5.73 ± 1.04) points, significantly higher than (4.42 ± 0.61) points, the difference was statistically significant ( t=6.20, P<0.05). Conclusion:The symptom management strategy can effectively improve the thirst of patients after liver cancer resection and improve the comfort of patients.

Research on the relationship between the body mass index and rewarming in the hypothermia patients with primary liver cancer after surgery / 中国实用护理杂志

Objective To evaluate the rewarming and?anesthetic recovery regularity in different body mass index(BMI) patients with primary liver cancer by the same rewarming measures. Methods The data of 67 primary liver cancer patients with hypothermia after surgery were analyzed retrospectively and divided into three groups (low BMI group:BMI<18.50 kg/m2,normal BMI group: BMI 18.50-22.99 kg/m2, and high BMI group: BMI≥23.00 kg/m2) according to the standard of Asian BMI. Rewarming time and speed, spontaneous breathing recovery time,waking time and shivers in the three groups were observed and compared. Results Rewarming time, spontaneous breathing recovery time,waking time were (114.75± 21.91), (62.60±23.47), (94.65±20.54) min in low BMI group, (93.46±30.39), (41.19±21.47), (66.11±24.78) min in normal BMI group and (61.43±16.37), (25.81±8.90), (50.57±10.41) min in high BMI group,there were significant differences among three groups (F=25.300, 18.962, 25.647, all P<0.05). Rewarming speed was (0.85±0.13) ℃/h in high BMI group, (0.44±0.10) ℃/h in normal BMI group, (0.47±0.16) ℃/h in low BMI group,there were significant differences among three groups(F=65.810, P<0.05). Conclusions Rewarming for a long time in the primary liver cancer patients with low BMI and hypothermia after surgery by the same measures.More attentions should be paid to management of low BMI patients in the rewarming process, and aggressive measures should be taken to restore body temperature to normal.

Comparative analysis of the core competence between the upgraded and the full-time bachelor nurses / 中国实用护理杂志

Objective To provide the effective references for reasonable arrangement of nursing post by comparison on the core competence level and characteristics between the upgraded and the fulltime bachelor nurses.Methods Questionnaire survey based on the basic demographic data and the Competency Inventory for Chinese Registered Nurse for 391 clinical nurses from 13 three level of firstclass hospitals.Results The core competence score of the upgraded and the full-time bachelor nurses showed a moderate degree of satisfaction; the full-time bachelor nurses' total scores were higher than those of the upgraded nurses,and there were statistically significant differences among 6 dimensions included critical thinking and scientific research ability; there was no significant difference in clinical nursing dimension.Conclusions The full-time bachelor nurses' core competence is higher than that of the upgraded nurses in general,but no significant difference exists in clinical nursing dimension.

Study in influence of different body postures on the measurement of central venous pressure for patients after upper abdominal surgery / 中国实用护理杂志

Objective To explore the changes on the value of CVP with different body postures after upper abdominal surgery in order to provide accurate basis for better monitoring of central venous pressure(CVP). Methods The CVP, blood pressure,pulse,respiration of 43 patients after upper abdom-inal surgery with indwelling central venous catheter were measured under supine position, 15°dorsal ele-vated position and 30°dorsal elevated position.The data were collected for correlation and regression analysis. Results The CVP value increased with the elevation of body postures,the CVP value under supine position was linearly positively correlated with the other two positions(P<0.01).The regression e-quation of supine position and 15°dorsal elevated position was:Y=1.009X1+0.811; the regression equation of supine position and 30°dorsal elevated position was:Y=1.005X2+1.630. Conclusions Through moni-toring the CVP value under 15°dorsal elevated position and 30°dorsal elevated position,and substitute it in equation,we can evaluate the CVP value under supine position.