Table of Content

01 October 2024, Volume 12 Issue 4

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The eff ect of laparoscopic cholecystectomy on the levels of infl ammatory factors, pain scores, and incidence of complications in patients with acute calculous cholecystitis

Guo Yingxi

2024, 12(4):  2. 

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Objective To investigate the eff ects of laparoscopic cholecystectomy on the levels of infl ammatory factors, pain scores, and incidence of complications in patients with acute cholecystitis caused by stones. Method Eighty patients with acute calculous cholecystitis who visited Shantou Chaonan Minsheng Hospital from June 2023 to June 2024 were randomly divided into a control group (small incision cholecystectomy) and a study group (laparoscopic cholecystectomy) using a random number table, with 40 patients in each group. Compare the levels of infl ammatory factors, pain scores, oxidative stress indicators, and incidence of complications between two groups. Result Before surgery, there was no signifi cant diff erence in the levels of interleukin-6, interleukin-8, C-reactive protein, tumor necrosis factor - α, as well as serum malondialdehyde (MDA) and superoxide dismutase (SOD) levels between the two groups of patients (P ＞ 0.05). After surgery, the levels of interleukin-6, interleukin-8, C-reactive protein, tumor necrosis factor - α, and serum MDA in the study group were lower than those in the control group, but the level of SOD was higher than that in the control group, and the diff erences were signifi cant (P ＜ 0.05). At 12 hours, 1 day, and 3 days after surgery, the pain scores of patients in the study group were signifi cantly lower than those in the control group (P ＜ 0.05). The total incidence of postoperative complications in the study group (3.33%) was lower than that in the control group (13.33%), and the diff erence was signifi cant (P ＜ 0.05). Conclusion Laparoscopic cholecystectomy for the treatment of acute calculous cholecystitis can inhibit the body's inflammatory response and postoperative pain, reduce surgical stress response, and lower the risk of complications. 

Clinical comparison of posterior triangle approach and gallbladder plate approach in laparoscopic cholecystectomy

Jiang Liwen, Wang Fei, Wu Ji, Xue Yuan

2024, 12(4):  7. 

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Objective To compare the clinical outcomes of laparoscopic cholecystectomy through the posterior triangle approach and the gallbladder plate approach. Method 96 patients with gallstones and chronic cholecystitis who were scheduled to undergo laparoscopic cholecystectomy treatment at the Huishan District Second People’s Hospital in Wuxi City from January 2020 to October 2023 were selected and divided into Group A and Group B using the odd even method, with 48 patients in each group. Group A underwent laparoscopic cholecystectomy via the posterior triangle approach, while Group B underwent laparoscopic cholecystectomy via the gallbladder plate approach. Observe and compare the surgical time, gastrointestinal function recovery time, hospitalization time, intraoperative blood loss, postoperative pain at 12 hours and 24 hours between two groups of patients, and also compare the incidence of postoperative complications between the two groups of patients. Result The surgical time, gastrointestinal function recovery time, and hospitalization time of patients in group A were shorter than those in group B. The intraoperative blood loss and visual pain simulation score at 12 and 24 hours after surgery were lower than those in group B, and the diff erences were signifi cant (P ＜ 0.05). The incidence of postoperative complications in Group A was lower than that in Group B, and the difference was significant (P ＜ 0.05). Conclusion Compared with the gallbladder plate approach, laparoscopic cholecystectomy through the posterior triangle approach can shorten the patient’s surgery, hospitalization time, and gastrointestinal function recovery time, reduce intraoperative bleeding, lower patient pain, and lower the risk of postoperative complications.

Application of mini-nutritional assessment short-form in nutritional risk screening of elderly patients during perioperative period

Lai Guanhao, Peng Shuanglin , Lu Xueyun , Deng Jingying , Huang Xuemei

2024, 12(4):  11. 

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Objective To observe the application eff ect of the mini-nutritional assessment short-form (MNA-SF) in elderly patients during the perioperative period. Method 100 patients who underwent radical gastrectomy for gastric cancer at Yangjiang People's Hospital from July 2022 to October 2023 were selected. The selected patients were randomly divided into a control group and an experimental group, with 50 patients in each group. All patients in the experimental group underwent MNA-SF nutritional risk screening within 24 hours of admission, and patients at risk of malnutrition were given enteral and parenteral nutrition interventions before surgery. All patients in the control group were screened for nutritional risks using the nutritional risk screening 2002(NRS2002) within 24 hours of admission. Patients at risk of malnutrition were given enteral and parenteral nutrition interventions before surgery. Compare the positive rate of nutritional risk screening and postoperative recovery status between two groups of patients. Result The positive detection rate of nutritional risk screening in the experimental group of elderly patients was higher than that in the control group, and the diff erence was signifi cant (P ＜ 0.05). The experimental group had a shorter postoperative time to get out of bed, wound healing time, and hospitalization time compared to the control group, and a lower incidence of postoperative complications, with signifi cant diff erences (P ＜ 0.05). Conclusion MNA-SF provides a simple and comprehensive assessment framework, which helps to detect nutritional problems in elderly patients early and intervene early, promoting patient recovery.

The eff ect of regorafenib combined with microwave ablation and transcatheter arterial chemoembolization in the treatment of primary liver cancer

Chen Feng

2024, 12(4):  16. 

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Objective To investigate the efficacy of regorafenib combined with microwave ablation and percutaneous transhepatic arterial chemoembolization (TACE) in the treatment of primary liver cancer. Method Seventy four patients with primary liver cancer admitted to the Tianjin Second People's Hospital from October 2023 to April 2024 were selected and divided into an observation group and a control group using the medical record number envelope drawing method, with 37 patients in each group. The control group received microwave ablation combined with TACE treatment, while the observation group received regorafenib combined with microwave ablation and TACE treatment. The short-term efficacy, tumor markers, biomarkers, liver function, and adverse reactions of the two groups were compared. Result The disease control rate of the observation group patients was signifi cantly higher than that of the control group, and the diff erence was signifi cant (P ＜ 0.05). After treatment, the levels of cytokeratin 19, alpha fetoprotein, carcinoembryonic antigen, as well as alanine aminotransferase and alanine aminotransferase in the observation group were significantly lower than those in the control group. The levels of fragile histidine triad, P16 protein, and albumin were higher than those in the control group, and the diff erences were signifi cant (P ＜ 0.05). Nine patients in the observation group experienced adverse reactions, while ten patients in the control group experienced adverse reactions. There was no signifi cant diff erence in the incidence of adverse reactions between the two groups of patients (P ＞ 0.05). Conclusion Primary liver cancer treated with regorafenib combined with microwave ablation and TACE can improve short-term effi cacy, alleviate liver function damage, and with high safety.

Eff ect of diff erent pneumoperitoneum pressure on the quality of recovery period after laparoscopic radical resection of colorectal cancer patients

Huang Liqing, Li Xiaomin, Wen Xiaoling

2024, 12(4):  22. 

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Objective To investigate the effects of different pneumoperitoneum pressures on patients undergoing laparoscopic colorectal cancer surgery (LCS) and their impact on the quality of postoperative recovery period. Method 70 patients with LCS admitted to Gaozhou Traditional Chinese Medicine Hospital from October 2022 to October 2023 were selected and divided into a control group (controlled at 13 ～ 15mmHg) and an observation group (controlled at 8 ～ 12mmHg) based on diff erent levels of artifi cial pneumoperitoneum pressure, with 35 patients in each group. Result Compare the quality of recovery, cognitive function, stress response indicators, and gastrointestinal function recovery between two groups of patients. There was no significant diff erence in extubation time and anesthesia recovery time between the two groups of patients (P ＞ 0.05). The incidence of agitation during the awakening period in the observation group was lower than that in the control group, and the recovery of bowel sounds, anal exhaust, and postoperative fasting time were shorter than those in the control group, with signifi cant diff erences (P ＜ 0.05). The scores of the simple mental state examination scale for both groups of patients on postoperative day 1, 3, and 7 were lower than those on preoperative day 1, and the scores of the observation group were higher than those of the control group, with signifi cant diff erences (P ＜ 0.05). Compared with T0, the levels of cortisol and C-reactive protein in both groups increased from T1 to T3, and the levels of cortisol and C-reactive protein in the observation group were lower than those in the control group at the same time, with signifi cant diff erences (P ＜ 0.05). Conclusion Compared with high pneumoperitoneum pressure, adopting low pneumoperitoneum pressure in LCS treatment has less impact on patients' cognitive function, gastrointestinal function, and stress response, and can reduce the risk of agitation during the recovery period.

Clinical analysis of diff erent methods of tension-free hernia repair for the treatment of inguinal hernia

Xu Wenqiang

2024, 12(4):  27. 

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Objective To explore the clinical effi cacy of laparoscopic plain tension-free hernia repair and hernia ring filling tension-free hernia repair in the treatment of inguinal hernia. Method Ninety patients with inguinal hernia admitted to Qingyang Hospital in Jiangyin City from January 2021 to December 2023 were selected and divided into a study group and a routine group, with 45 patients in each group, based on diff erent surgical methods. The conventional group underwent tension-free hernia repair with hernia ring filling, while the study group underwent laparoscopic plain mesh tension-free hernia repair. The surgical related indicators, treatment outcomes,and complications of the two groups were compared. Result The overall treatment effi cacy rate of the study group patients (97.78%) was significantly higher than that of the conventional group (75.56%). The surgical duration and postoperative time to get out of bed of the study group patients were shorter than those of the conventional group, and the intraoperative blood loss was less than that of the conventional group, with signifi cant diff erences (P ＜ 0.05). The incidence of complications in the study group was 2.22% (1/45), signifi cantly lower than that in the conventional group [6.67% (3/45)], and the difference was significant (χ2=4.406, P=0.036). Conclusion Laparoscopic plain fi lm tension-free hernia repair is safe and eff ective in the treatment of inguinal hernia, with a lower risk of complications.

The eff ect of ketamine combined with remifentanil in anesthesia for appendectomy and its impact on postoperative pain and adverse reactions in patients

Feng Xiaolei, Wu Qin

2024, 12(4):  30. 

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Objective To explore the anesthetic effect of ketamine combined with remifentanil on appendectomy and its impact on postoperative pain and adverse reactions in patients. Method 102 patients who underwent appendectomy at the Huai'an First People's Hospital Branch from January 2023 to March 2024 were selected and randomly divided into an observation group (n=51) and a control group (n=51) according to the principle of random number table. Both groups adopted the same anesthesia induction protocol, with the control group receiving remifentanil anesthesia during surgery and the observation group receiving a combination of ketamine and remifentanil anesthesia during surgery. Result Compare the perioperative vital signs, postoperative pain, and incidence of adverse reactions between two groups of patients. There was no signifi cant diff erence in heart rate and mean arterial pressure between the two groups of patients when they entered the operating room (P ＞ 0.05); The heart rate and mean arterial pressure at 1 minute and 5 minutes of anesthesia were lower than those at the time of entering the operating room (P ＜ 0.05), while there was no signifi cant diff erence at the end of the operation compared to entering the operating room (P ＞ 0.05). The heart rate and mean arterial pressure of the observation group patients were signifi cantly higher than those of the control group at 1 minute and 5 minutes of anesthesia (P ＜ 0.05). The VAS scores of the observation group were signifi cantly lower than those of the control group at 4, 8, and 12 hours after surgery (P ＜ 0.05), while there was no signifi cant diff erence in VAS scores between the two groups at 24 hours after surgery (P ＞ 0.05). There was no signifi cant diff erence in the occurrence of adverse reactions between the two groups of patients (P ＞ 0.05). Conclusion For patients undergoing appendectomy, the anesthesia eff ect of using ketamine combined with remifentanil is satisfactory, with mild postoperative pain and a lower incidence of adverse reactions.

The clinical eff ect of applying the nursing mode of day surgery ward to patients undergoing laparoscopic tension-free inguinal hernia repair surgery

Chen Tingting

2024, 12(4):  34. 

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Objective To explore the eff ect of nursing mode in the day surgery ward on patients undergoing laparoscopic tension-free inguinal hernia repair. Method A retrospective analysis was conducted on 117 patients who underwent laparoscopic tension-free inguinal hernia repair surgery at Lufeng People's Hospital from January 2022 to January 2024. The patients were divided into an inpatient surgery group (59 cases, intervened with conventional nursing methods) and a daytime surgery group (58 cases, intervened with nursing mode in the daytime surgery ward) according to diff erent surgical times. Result The diff erences in intraoperative bleeding, hospitalization time, daytime mobilization time, and incidence of complications between the two groups were compared. The results showed that the postoperative hospitalization time, surgery time, and postoperative mobilization time of patients in the daytime surgery group were shorter than those in the inpatient surgery group, and the intraoperative bleeding and total consumption were both less than those in the inpatient surgery group, with signifi cant diff erences (P ＜ 0.05). The total incidence of complications in the daytime surgery group (22.41%) was signifi cantly lower than that in the inpatient surgery group (47.46%), and the diff erence was signifi cant (P ＜ 0.05). Conclusion The intervention of nursing mode in the daytime surgical ward can signifi cantly improve the clinical treatment eff ect of patients undergoing laparoscopic lower abdominal inguinal hernia repair, with lower complications.

Infl uence of Tonglin Gushen Moxibustion combined with comprehensive nursing of traditional Chinese medicine on the risk of urinary retention in patients after operation of mixed hemorrhoids

Cai Xuezhen, Tang Jianrong

2024, 12(4):  38. 

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Objective To observe the effect of Tonglin Gushen Moxibustion combined with traditional Chinese medicine comprehensive nursing on the risk of urinary retention in patients with mixed hemorrhoids after operation. Method 102 patients with mixed hemorrhoids who underwent external stripping and internal ligation surgery at Sanshui Hospital of Foshan Traditional Chinese Medicine Hospital from July 2022 to October 2023 were selected and randomly divided into a control group and an experimental group, with 51 patients in each group, using a random number table method. The control group of patients received comprehensive traditional Chinese medicine nursing, while the experimental group of patients received a combination of Tonglin Gushen Moxibustion and comprehensive traditional Chinese medicine nursing. The incidence of urinary retention, perioperative related indicators, and urination status of the two groups were compared, and the abdominal distension of the patients was evaluated with the self-made abdominal distension scale. Result The fi rst spontaneous urination time of the experimental group patients after surgery was shorter than that of the control group, and the residual urine volume in the bladder was less than that of the control group, but the urine volume was greater than that of the control group, with signifi cant diff erences (P ＜ 0.05). The incidence of urinary retention in the test group was 3.92% (2/51), signifi cantly lower than 19.6% (10/51) in the control group, and the score of urination status and abdominal distention in the patients were signifi cantly lower than those in the control group (P ＜ 0.05). Conclusion Tonglin Gushen moxibustion combined with comprehensive nursing of traditional Chinese medicine can significantly reduce the incidence of urinary retention in patients with mixed hemorrhoids after operation, shorten the time of first urination, increase the amount of urination, reduce the amount of residual urine in the bladder, promote the smooth discharge of urine, and improve the abdominal distension of patients.




The implementation eff ect of integrated medical care and accelerated rehabilitation surgery nursing in the perioperative period of colorectal cancer patients

Qian Lidan, Chen Churong

2024, 12(4):  42. 

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Objective To explore the implementation effect of integrated medical and nursing accelerated rehabilitation surgical nursing based on postoperative rehabilitation indicators, incidence of complications, and hospital satisfaction evaluation in the perioperative period of colorectal cancer patients. Method 66 patients with colorectal cancer admitted to the Second Affiliated Hospital of Shantou University School of Medicine from January 2021 to January 2024 were selected and divided into a control group (January 2021 to June 2022, n=33) and an experimental group (July 2022 to January 2024, n=33) according to the filing time. The control group received routine nursing during the perioperative period, while the experimental group received integrated medical

and accelerated rehabilitation surgical nursing. Statistics on postoperative rehabilitation indicators, incidence of complications during implementation, and satisfaction with hospitalization the day after implementation for two groups. Result The infusion treatment, fi rst anal exhaust, and hospitalization time of the experimental group patients were significantly shorter than those of the control group (P ＜ 0.05). The incidence of postoperative complications in the experimental group (9.09%) was lower than that in the control group (33.33%), and the hospital satisfaction rate (93.94%) was higher than that in the control group (72.73%), with signifi cant diff erences (P ＜ 0.05). Conclusion Implementing integrated accelerated rehabilitation surgical nursing for colorectal cancer patients during the perioperative period can promote postoperative recovery, reduce the incidence of complications, and improve hospital satisfaction.

Exploration of the impact of preventive nursing in operating rooms on pressure injuries in elderly surgical patients

Zhu Shenglong, Li Tianxing, Chen Qi

2024, 12(4):  46. 

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Objective To explore the value of implementing operating room nursing in reducing the incidence of surgical pressure injuries. Method Sixty surgical patients admitted to Guangzhou University of Traditional Chinese Medicine Meizhou Hospital from March 2022 to November 2023 were collected and randomly divided into a control group and an observation group, with 30 patients in each group, using a random number table method. The control group received routine operating room care, while the observation group received preventive care in the operating room. The incidence of pressure ulcers, pressure ulcer risk assessment, and patient satisfaction were evaluated in both groups. Result The incidence of pressure ulcers in the observation group was lower than that in the control group, the area of pressure ulcers was smaller than that in the control group, and the patient satisfaction was higher than that in the control group, with signifi cant diff erences (P ＜ 0.05). The Braden scores of the observation group patients before and after nursing were (13.36±2.66) and (19.27±2.47) points, respectively, while the Braden scores of the control group patients before and after nursing were (13.28±2.56) and (16.23±2.25) points, respectively. After nursing, the Braden scores of both groups increased compared to before nursing, and the Braden scores of patients in the observation group were higher than those in the control group, with a signifi cant difference (t=4.984, P ＜ 0.001). Conclusion Scientific evaluation of pressure injuries and the development of corresponding operating room nursing plans based on the actual situation of elderly patients can help reduce the risk of pressure ulcers and improve patient satisfaction.