Objective To explore the application value of fine capsule anatomy combined with cricothyroid space exposure of recurrent laryngeal nerve in total thyroidectomy for thyroid cancer patients. Method 90 patients with thyroid cancer in Dongguan Kanghua Hospital from January 2018 to September 2020 were selected. They were randomly divided into two groups, with 45 cases in each group. The control group was treated with conventional total thyroidectomy and inferior thyroid artery exposure of recurrent laryngeal nerve, while the observation group was treated with refined capsule anatomy combined with cricothyroid space exposure of recurrent laryngeal nerve. The operation conditions, changes of thyroid function indexes before and after operation, postoperative complications and recurrence after 6 months of follow-up were compared between the two groups. Result There was no significant difference in the operation time, intraoperative blood loss and the number of lymph node dissection between the two groups (P ＞ 0.05); The detection results of serum parathyroid hormone and Ca2+ in the observation group on 1 day and 3 days after operation were higher than those in the control group, and the difference was significant(P ＜ 0.05); The incidence of recurrent laryngeal nerve injury, hypoparathyroidism and hypocalcemia in the observation group were lower than those in the control group, the difference between the data was significant (P ＜ 0.05); there was no significant difference in the recurrence rate of the two groups after 6 months of follow-up (P ＞ 0.05). Conclusion In total thyroidectomy for patients with thyroid cancer, fine capsule anatomy combined with exposure of recurrent laryngeal nerve in cricothyroid space is beneficial to protect the function of recurrent laryngeal nerve and parathyroid gland.
Objective To study the effect of selective cervical lymph node dissection during radical thyroidectomy. Method A total of 50 patients with thyroid cancer who were admitted to the Red Star Hospital of the 13th Division of Xinjiang Production and Construction Corps from August 2019 to August 2021 were selected and divided into the control group and the research group according to the random number table method, 25 cases in each group. The control group received radical thyroidectomy. Radical thyroid cancer surgery + selective cervical lymph node dissection was used in the research group, and the cervical lymph node metastasis and complications were compared between the two groups. Result The rate of cervical lymph node metastasis in the study group (16.00%) was lower than that in the control group (44.00%), and the difference was significant (χ2=4.667, P=0.031). The incidence of complications in the study group (8.00%) was lower than that in the control group. group (12.00%), the difference was not significant (χ2=0.222, P=0.637). Conclusion Selective cervical lymph node dissection in radical thyroidectomy can reduce postoperative lymph node metastasis and reduce the risk of complications.
Objective To investigate the clinical practice of endoscopic polypectomy in patients with intestinal polyps, and to evaluate its clinical efficacy. Method 80 patients with intestinal polyp in the Second Affiliated Hospital of Nantong University were enrolled in this study, and the corresponding time was 2021. According to the study requirements, all patients were divided into two groups at a ratio of 1 ∶ 1, each group of patients used different treatment methods, specifically involving two types of laparoscopic polypectomy, gastrointestinal polypectomy, comparative Analysis was carried out in the form of control group and observation group. Result The operation time, first exhaust time and hospital stay in the observation group were shorter than those in the control group, and the amount of intraoperative bleeding, surgical removal rate and complication rate were better than those in the control group (P ＜ 0.05). Conclusion From the safety and effectiveness of intestinal polyp surgery, gastrointestinal polypectomy is more valuable than laparoscopic polypectomy.
Objective To compare the clinical effects of laparoscopic appendectomy(LA) and open appendectomy(OA). Method 71 patients undergoing appendectomy in general surgery of Qingyang Hospital of Jiangyin City were selected, they were divided into LA Group (37 cases received LA) and OA group(34 cases received OA). The operation, pain and postoperative complications of the two groups were compared. Result There was no significant difference in the operation time and the first postoperative exhaust time between La group and OA group (P ＞ 0.05); the length of stay in LA group was significantly lower than that in OA group (P ＜ 0.05), but the hospitalization cost in OA group was significantly lower than that in LA group (P ＜ 0.05). The visual analogue scale (VAS) scores at 30 min, 12h and 24h after operation in LA group were lower than those in OA group (P ＜ 0.05), and the total incidence of complications (5.0%) was significantly lower than that in OA group (18.92%). Conclusion
LA can accelerate the rehabilitation of patients with acute appendicitis, reduce postoperative pain and reduce the risk of postoperative complications, but the cost is higher than that of traditional open surgery.
Objective To investigate the effects of the application of sphincter preserving hanging wire method in patients with complex anal fistulas. Method A total of 120 patients with complicated anal fistula who were admitted to Guangzhou Zengcheng District Central Hospital from March 2019 to March 2021 were randomly selected as the study subjects and divided into control and observation groups using the number table method, with 60 patients in each group. The control group was treated by conventional fistula resection, and the observation group was treated by sphincter preserving hanging wire method. Treatment outcomes, intraoperative conditions, as well as postoperative complication rates were compared between the 2 groups. Result patients in the observation group had a higher response rate to treatment than those in the control group (P ＜ 0.05), patients in the observation group had less intraoperative blood loss and a shorter operative time than the control group (P ＜ 0.05), and patients in the observation group had a lower rate of postoperative complications than those in the control group (P＜ 0.05). Conclusion The application of sphincter preserving hanging wire method in the treatment of patients with complex anal fistulas is highly effective, which may promote patient recovery and reduce the occurrence of postoperative complications.
Objective To analyze the clinical effect of Polidocanol combined with Coil embolization in the treatment of varicocele. Method 28 cases of varicocele in Affiliated Hospital of Weifang Medical University from February 2017 to February 2020 were treated with Polidocanol combined with coil embolization. Venous reflux and semen quality improvement were observed before and after operation, and all patients were follow-up for 12 months. The efficacy of embolization therapy were evaluate. Result All 28 patients with varicocele were embolized. After operation, the reverse flow degree of spermatic vein was reduced or disappeared. The average semen volume before operation was (2.54±0.33)ml, which increased to(3.18±0.21)ml and (3.42±0.18)ml at 6 and 12 months after operation, respectively. The average sperm density before operation was (21.55±3.74)×106/ml, increased to (31.46±4.02)×106/ml and (34.69±3.77)×106/ml at 6 and 12 months after operation. The average sperm motility rate before operation was (46.31±4.95)%, 6 and 12 months after operation, which increased to (56.47±5.07)% and
(59.19±5.17)%, respectively. Conclusion Polidocanol combined with Coil embolization in the treatment of Varicocele is effective.
Objective To investigate the clinical effect of high ligation combined with dot and traditional stripping in patients with varicose great saphenous vein. Method 80 subjects were selected from patients with great saphenous varices treated in Xiji Health Center of Tongzhou District in Beijing from September 2018 to July 2021. They were randomly divided into control group and observation group, with 40 cases in each group. The patients in the control group were treated with high ligation of great saphenous vein combined with traditional stripping, and the patients in the observation group were treated with high ligation of great saphenous vein combined with dot stripping. The patients in both groups were followed up to discharge. The hospital stay, operation time, out of bed activity time, intraoperative blood loss and the levels of serum tumor necrosis factor-a, interleukin-6 and nitric oxide before and 3 days after operation were compared between the two groups, the Visual analogue scale (VAS), venous clinical severity score (VCSS), and chronic venous insufficiency questionnaire (CIVIQ) were also compared between the two groups. Result The hospitalization time and operation time of the observation group were shorter than those of the control group, the activity time of getting out of bed was earlier than that of the control group, and the amount of intraoperative bleeding was less than that of the control group (all P ＜ 0.05). Compared with before operation, the levels of serum tumor necrosis factor-a, interleukin-6 and nitric oxide in the two groups increased three days after operation, but the increase range of patients in the observation group was lower than that in the control group (P ＜ 0.05). Compared with before operation, the VAS and VCSS scores of the two groups decreased and CIVIQ scores increased 7 days after operation, and the decrease range of VAS and VCSS scores in the observation group was better than that in the control group(P ＜ 0.05), CIVIQ score increased significantly better than the control group(P ＜ 0.05). Conclusion Compared with traditional stripping, high ligation combined with dot stripping can effectively shorten the time of getting out of bed, operation and hospitalization, reduce intraoperative blood loss, reduce pain and stress reaction, and improve the quality of life of patients with great saphenous vein varicose.
Objective To analyze the clinical effect of recurrent laryngeal nerve (RLN) exposure in unilateral thyroid surgery with or without intraoperative neural monitoring(IONM).Method The clinical data of 66 patients who received the unilateral thyroid surgery in Shunde Hospital of Southern Medical University from January 2019 to November 2020 were retrospectively reviewed and analyzed. The application of IONM served as the categorization basis of two groups, with 33 cases in each group. In the group without nerve monitoring, the recurrent laryngeal nerve was directly exposed by blunt dissection, while in the group with IONM, the RLN was gradually exposed under the guidance of IONM. Then the amount of bleeding, the incidence of RLN injury, the length of stay and medical expenses of the two groups were compared and analyzed. Result There was no significant difference in the amount of bleeding and length of stay between the two groups (P ＞ 0.05). The rate of temporary RLN injury in the group with IONM was lower than that in another group without IONM, but there was no significant difference (P ＞ 0.05). The medical expenses in the group with IONM were significantly higher than that in another group without IONM (P ＜ 0.05). Conclusion Whether the intraoperative neural monitoring is adopted or not, the operation safety and efficacy in the unilateral thyroid surgery is consistent in exposing the recurrent laryngeal nerve. However, the application of nerve monitoring entails a higher cost but helps to reduce the incidence of RLN injury to a certain extent.
Objective To evaluate the predictive value of barium enema in the diagnosis of congenital megacolon. Method The clinical data of 107 infants admitted to the Children’s Hospital of Suzhou University from July 2015 to December 2019 were analyzed retrospectively, the patients were divided into case group and control group according to pathological results. The results were compared between case group and control group.Receiver operator characteristic curve ROC curve, analysis was used to determine the diagnostic ability of the relevant factors. Result Among the 107 children, 51 cases of congenital megacolon(case group) were diagnosed (41 males and 10 females). In univariate analysis, the results of vomiting, abdominal distention, delayed meconium excretion, barium enema and digital rectal examination were significantly compared between the two groups. Multivariate regression analysis showed that the results of barium enema (95%CI 11.718 ～ 999.99) were independent factors affecting congenital megacolon. The area under the ROC curve of barium enema in the diagnosis of neonatal congenital megacolon was 0.949, the diagnostic sensitivity was 92.2%, and the specificity was 94.6%. Conclusion Abdominal distension, vomiting, no meconium excretion in 24 hours, gas in intestinal cavity and bursting sensation after digital rectal examination are relevant factors in the diagnosis of congenita megacolon, and barium enema is an independent factor in the diagnosis of neonatal congenital megacolon.
Objective To analyze the effect of dexmedetomidine on postoperative mental state and sleep quality in patients with gastrointestinal tumors undergoing laparoscopic surgery. Method 60 patients with gastrointestinal tumors treated in Daqing Oilfield General Hospital from January 2020 to January 2021 were randomly divided into study group and control group. Before anesthesia induction, dexmedetomidine was injected by pump in the study group and normal saline was injected by pump in
the control group. The snack rate, mean arterial pressure, self-rating depression scale (SDS), self-rating anxiety scale (SAS) and Athens insomnia scale (AIS) were compared between the two groups. Result Compared with the control group, the heart rate and mean arterial pressure in the study group were lower at T1 ～ 4 (P ＜ 0.05), the SDS and SAS scores were lower at 3 days after operation (P ＜ 0.05), and the AIS scores were lower at 1 and 3 days after operation (P ＜ 0.05). Conclusion Dexmedetomidine is effective in laparoscopic surgery for gastrointestinal tumors. It can not only alleviate depression, anxiety and other adverse psychology, maintain the stability of vital signs, but also improve the quality of sleep.
Objective To investigate the anesthetic effect of remifentanil combined with propofol in laparoscopic cholecystectomy. Method 88 patients who underwent laparoscopic cholecystectomy in Liyang branch of Jiangsu Provincial People's Hospital from July 2020 to July 2021 were selected, they were randomly divided into control group (44 cases, anesthesia with propofol) and observation group (44 cases, anesthesia with remifentanil combined with propofol). The anesthesia recovery effect, adverse
reactions, systolic blood pressure, diastolic blood pressure, heart rate level before and after operation and the score of Mini Mental State Examination (MMSE) were compared between the two groups. Result Compared with the control group, the recovery of orientation, consciousness, extubation and spontaneous breathing in the observation group were shorter, The visual analogue score was lower (P ＜ 0.05). After operation, the levels of systolic blood pressure, diastolic blood pressure and heart rate in the observation group were better than those in the control group (P ＜ 0.05). At 1h and 24h after extubating, the MMSE score in the observation group was higher than that in the control group (P ＜ 0.05). Compared with the incidence of adverse reactions in the control group (13.64%), the incidence of complications in the observation group (2.27%) was lower. Conclusion Remifentanil combined with propofol anesthesia is effective in laparoscopic cholecystectomy, which can shorten the recovery time of patients, has little impact on hemodynamics, is conducive to the recovery of cognitive function and reduce the occurrence of adverse reactions.
Objective To observe the long-term safety of indocyanine green combined with methylene blue in tracing sentinel lymph node biopsy in breast cancer. Method 40 breast cancer patients with axillary negative clinical findings in Nanhai Maternal and Child Health Hospital in Foshan City from June 2017 to June 2018 were treated with indocyanine green combined with methylene blue for sentinel lymph node biopsy and followed up for 06 months in 2021. The situation of postoperative upper limb lymphedema was counted, and the regional lymph node recurrence, disease-free survival and overall survival rate were analyzed. Result In the telephone follow-up, 40 patients completed the follow-up. Among the 10 patients who underwent ALND operation, 1 patient (10.00%) had postoperative upper limb lymphedema, while among the other 30 patients who underwent SLNB only, 3 patients (10.00%) had postoperative upper limb lymphedema, which improved after symptomatic treatment. There was no significant difference between the two groups (P ＞ 0.05). Of the 40 patients, 3 had regional lymph node recurrence, 2 had contralateral breast cancer, and 4 had distant metastasis. Among the 10 patients receiving ALND, 1 had regional lymph node recurrences (10%), 1 had contralateral breast cancer (10%) and 3 had distant metastasis (10%), while only SLNB patients had regional lymph node recurrence (3). There were 1 cases of contralateral breast cancer (3.33%) and 3 cases of distant metastasis (10%). The difference between the two groups was not significant (P ＞ 0.05). 2 patients died of distant metastasis of breast cancer during the follow-up period, with a mortality rate of 6.67%. DFS was 85.00%, 0s was 95.00%. Conclusion Indocyanine green combined with methylene blue for tracing sentinel lymph node biopsy in breast cancer has long term safety and is worthy of clinical application.
Objective To investigate the inflammatory index analysis of thyroid cancer resection in thyroid cancer patients. Method Thirty patients of thyroid cancer treated at Xuancheng Renjie Hospital from January 2019 to September 2021 were randomly divided into two groups, the control group used the thyroid lobectomy plus contralateral subtotal resection, and the observation group
used the thyroid lobectomy, compared the two groups with the operating indexes, complication rate, thyroid hormone index, parathyroid hormone (PTH) and blood calcium levels. Result The operation time, intraoperative bleeding amount, postoperative analgesia time and hospital stay in the observation group were shorter than those in the control group (P ＜ 0.05);The incidence of incision infection, hypocalcemia, hypothyroid function, and recurrent laryngeal nerve injury was significantly lower than that in the control group (P ＜ 0.05); Total triiodothyronine(TT3), total thyroxine (TT4), PTH and blood calcium were significantly higher than the control group (P ＜ 0.05), and free triiodothyronine (FT3), free thyroxine (FT4) were significantly lower than the control group (P ＜ 0.05). Conclusion Thyroid lobectomy has small trauma to thyroid cancer and low incidence of postoperative complications, which can partially retain the physiological function of the thyroid, maintain thyroid hormone levels, and avoid the continuous reduction of PTH and blood calcium levels, which has positive clinical significance.
Objective To investigate the clinical effect of laparoscopy in patients. Method 40 cases of gallbladder gallstone patients with gallstone, 40 patients in Yizheng Hospital of Nanjing Gulou Hospital Group from May 2018 to May 2021 were randomly divided into two groups, study group 20 cases using conventional open treatment of gallstone, control group 20 cases using laparoscopic combined endoscopic therapy. The two groups of patients with total efficiency, quality of life index score, hospital time, surgical bleeding and operation time were compared. Result After treatment, the total efficiency and quality of life index were higher in the study group than in the control group, the hospital stay time, operation time and surgical bleeding volume were lower than in the control group, and the incidence of related complications was lower than in the control group (P ＜0.05). Conclusion The clinical treatment of patients reduces the incidence of related complications and is beneficial to the recovery.
Objective To investigate the safety and feasibility of complete mesocolon resection in elderly patients with colon cancer. Method 74 elderly patients with colon cancer treated in Xintai Second People's Hospital from March 2018 to March 2020 were divided into intervention group and control group by doubleblind method, with 37 cases in each group. The operation method of the intervention group was complete mesocolon excision, and the operation method of the control group was traditional colectomy. The incidence of complications, the recurrence rate of colon cancer, the number of lymph node clearance, the amount of
postoperative bleeding, the survival rate of 1 and 3 years after operation and the effective rate of operation were compared between the two groups. Result The incidence of postoperative complications and colon cancer recurrence in the intervention group were lower than those in the control group, There was significant difference (P ＜ 0.05); the number of lymphatic clearance in the intervention group was more than that in the control group, and the amount of postoperative bleeding was less than that in the control group, the difference was significant (P ＜ 0.05); the 1-year and 3-year survival rate and operation effective rate in the intervention group were higher than those in the control group, the difference was significant (P ＜ 0.05). Conclusion The effect of complete mesocolon excision in elderly patients is excellent, the amount of postoperative bleeding is less, and the postoperative survival rate of elderly patients is significantly improved, which has high safety and feasibility.
Objective To analyze the efficacy and safety of neoadjuvant chemoradiotherapy combined with total mesenterectomy in the treatment of locally advanced rectal cancer. Method The clinical data of 100 patients with locally advanced rectal cancer who underwent total mesenterectomy in The Fourth Affiliated Hospital of Guangxi Medical University from June 2017 to June 2020 were retrospectively analyzed, and they were divided into nCRT group (n=50) and non nCRT group (n=50) according to whether they underwent neoadjuvant chemoradiotherapy (nCRT) or not. The clinical indicators, postoperative complications and tumor stage before and after neoadjuvant chemoradiotherapy were compared between the two groups. Result The tumor stage decreased significantly after neoadjuvant radiotherapy and chemotherapy. The amount of intraoperative bleeding, operation time, postoperative hospital stay and protective stoma rate in nCRT group were higher than those in non nCRT group, and the number of lymph node dissection and anus preservation rate were lower than those in non nCRT group (P ＜ 0.05). There was no significant difference in the overall incidence of complications between nCRT group and non nCRT group (P ＞ 0.05). Conclusion Neoadjuvant chemoradiotherapy combined with total mesenterectomy can increase the protective stoma rate, prolong the operative time and increase the operative bleeding in rectal cancer patients, but can significantly reduce the tumor stage.
Objective To investigate the clinical effect of ulinastatin combined with low molecular weight heparin in the treatment of acute pancreatitis. Method 160 patients with acute pancreatitis treated in Beijing Integrated Traditional Chinese and Western Medicine Hospital from February 2015 to March 2021 were randomly divided into two groups, 80 cases in each group. Both groups were routinely treated with gastrointestinal decompression, inhibition of gastric acid and pancreatic juice secretion, antiinflammatory
and rehydration. The control group was additionally treated with low molecular weight heparin calcium, and the observation group was additionally treated with ulinastatin+low molecular weight heparin calcium. The inflammatory factors [interleukin(IL)-1, IL-10, tumor necrosis factor (TNF)-α] and intestinal mucosal barrier related indexes [diamine oxidase (DAO), D-lactic acid and urinary lactulose / mannitol] were observed and compared between the two groups, and the outcome of the disease. Result The levels of IL-1 and TNF -α in the observation group were lower than those in the control group 7 days after treatment. The levels of IL-10 in the observation group were higher than those in the control group (P ＜ 0.05); The levels of Dao, D-lactic acid and urinary lactulose/mannitol in the observation group were lower than those in the control group (P ＜ 0.05); The disease remission rate in the observation group was higher than that in the control group (P ＜ 0.05). Conclusion Ulinastatin combined with low molecular weight heparin in the treatment of acute pancreatitis can help to reduce the
inflammatory response, improve the damage of intestinal mucosa, and is conducive to the remission and benign prognosis of the disease.
Objective To analyze the clinical efficacy of Jiawei Dahuang Mudan pi Decoction combined with antibiotics in the treatment of patients with acute simple appendicitis. Method A total of 124 patients with acute simple appendicitis admitted to Zhaoping County Hospital of Traditional Chinese Medicine in Hezhou from August 2019 to October 2021 were selected as the research subjects. After randomization, different treatment measures were taken. Among them, 62 patients in the control group were treated with antibiotics, and the study group 62 patients were treated with modified Dahuang Mudan pi Decoction on the basis of antibiotic therapy. The changes in clinical symptom scores, treatment effects, and adverse reactions were observed and compared between the two groups before and after treatment. Result After treatment, the scores of symptoms such as nausea, vomiting, and fatigue in the study group were lower than those in the control group (P ＜ 0.05). Compared with the control group, patients in the study group had better treatment effects and lower probability of adverse reactions (P ＜ 0.05). Conclusion The treatment of acute simple appendicitis with modified Dahuang Mudan pi Decoction combined with antibiotics has good clinical results. The patient's symptoms have improved well without increasing the occurrence of adverse reactions.
Objective To study the effect of Rupi Sanjie tablets combined with tamoxifen on progesterone level and long-term prognosis in patients with benign breast hyperplasia. Method 60 patients with benign breast hyperplasia who were diagnosed and treated in the Affiliated Shunde Hospital of Jinan University from November 2019 to November 2020 were randomly divided into two groups (a coin toss random method), with 30 in the control group and 30 in the observation group. The control group was treated with tamoxifen as a single agent, and the observation group was treated with Rupi Sanjie tablets combined with tamoxifen, the effects of progesterone and long-term prognosis between the two groups were compared. Result There was no significant difference in curative effect between the two groups (P ＞ 0.05). The improvement of breast pain time, tumor diameter and serum progesterone level in the observation group was better than that in the control group after treatment, and the difference was statistically significant (P ＜ 0.05). Conclusion Rupi Sanjie tablet combined with tamoxifen has a significant effect in the treatment of benign breast hyperplasia. It can promote the recovery of progesterone as soon as possible.
Objective To explore the feasibility of applying the enhanced recovery after surgery (ERAS) concept to the rehabilitation treatment plan for early postoperative activities of daytime laparoscopic cholecystectomy (LC) patients. Method Randomly enrolled 100 patients undergoing LC in Deyang People's Hospital from January 2018 to January 2021, according to different nursing methods, they were divided into control group and ERAS group, with 50 cases in each group. Patients in ERAS group were treated with the concept of daytime ward ERAS for perioperative management, and patients in control group were treated with traditional perioperative management in general ward. The intraoperative and postoperative related indexes of the two groups and the effect of ERAS concept on the early postoperative activities of the patients were compared. Result The earliest time of getting out of bed in ERAS group was 6.8h and the latest was 26.3h, The average time of getting out of bed was
(8.2 ± 0.8) h, including 90% within 12 hours and 6% within 12 ～ 24 hours, which were significantly higher than those in the control group (P ＜ 0.05); 88.0% (44/50) of patients in ERAS group had the intention of early activities, the satisfaction rate of first getting out of bed activities was 84.0% (42/50), and the rehabilitation self-efficacy score was (70.22 ± 5.32), which was significantly higher than that in the control group (P ＜ 0.05); The eating time and postoperative gastrointestinal ventilation time in ERAS group were significantly shorter than those in the control group, the pain score at 6h and 12h after operation was lower, and the incision healing time was shorter, the difference was significant (P ＜ 0.05). There were no complications such as bleeding, urinary retention, hematoma in the two groups. Only 1 patients developed nausea in ERAS group, and 1 patients had abdominal distension, the incidence of adverse reactions was significantly lower than that of the control group (P ＜ 0.05). Conclusion It is feasible to apply the ERAS concept to the rehabilitation treatment plan for early postoperative activities of LC patients in the day ward, which is conducive to the postoperative rehabilitation of the patients and improves the prognosis of the patients.
Objective To explore the application value of clinical nursing pathway in perioperative nursing of thyroid tumor. Method 68 patients with thyroid tumor treated in the General Surgery Department of Shuyang County Zhongxing Hospital from October 2019 to April 2021 were selected as the research object. They were randomly divided into control group (34 cases, routine nursing) and observation group according to different perioperative nursing methods. Result The time of getting out of bed (8.14±1.06)h, hospital stay (5.11±1.21)d and indwelling time of drainage tube (46.12±5.38)h in the observation group were significantly shorter than those in the control group (12.77 ± 2.54)h, (7.12 ± 1.05)d and (51.25 ± 3.68)h (P＜0.05); The incidence of complications in the observation group was 8.8% lower than 29.4% in the control group, with significant difference (P ＜ 0.05); The nursing satisfaction of patients in the observation group was 97.1% higher than 76.5% in the control group, with significant difference(P ＜ 0.05). Conclusion Clinical nursing pathway intervention in perioperative nursing of thyroid tumor can significantly promote postoperative rehabilitation, reduce surgical complications and improve patient satisfaction.
Objective To explore the application effect of humanized nursing mode in operating room nursing. Method 100 surgical patients in the Operating Room of Traditional Chinese Medicine Hospital of Rugao were randomly divided into humanized nursing group and control group. The control group took routine operating room nursing program. The humanized nursing group adopted the
humanized nursing mode scheme on the basis of the control group. The nursing satisfaction and the incidence of adverse events were compared between the two groups. Result The total nursing satisfaction of patients in humanized nursing group was 98%, and that of patients in control group was 84.0%, the total satisfaction of the humanized nursing group was significantly higher than that of the control group (P ＜ 0.05). The incidence of adverse events such as hypothermia, infection and delayed awakening in the humanized nursing group within 3 days was significantly lower than that of the control group (all P＜ 0.05). The scores of psychological function, physiological function, social function and material life in the humanized nursing group were higher than those in the control group (all P ＜ 0.05). Conclusion The application of humanized nursing management in the nursing management of operating room can significantly improve patients' satisfaction and postoperative quality of life, and effectively reduce the incidence of nursing adverse events.
Objective To investigate the effect of total thyroidectomy and unilateral lobectomy in the treatment of T1 and T2 differentiated thyroid cancer. Method 72 patients with T1 and T2 differentiated thyroid cancer treated in Shunde Hospital Guangzhou University of Chinese Medicine from January 2016 to July 2020 were selected as the research objects, and they were divided into groups according to their different surgical methods. 32 patients in the control group underwent total thyroidectomy; total thyroidectomy was performed in 40 cases in the experimental group. The treatment effect, operation index, hospital stay,complication rate and disease recurrence of the two groups were analyzed. Result The total effective rate was 93.8% in the control group and 95.0% in the experimental group. There was no significant difference between the two groups (P ＞ 0.05); The operation time, bleeding volume and complications in the control group were lower than those in the experimental group (P ＜ 0.05). There was no significant difference in the amount of bleeding and postoperative hospital stay between the two groups (P ＞ 0.05), and there was no significant difference in the short-term recurrence rate (P ＞ 0.05). Conclusion Total thyroidectomy and unilateral thyroidectomy have certain value in the treatment of patients with T1 and T2 differentiated thyroid cancer. Unilateral total thyroidectomy can reduce the amount of bleeding, operation time and complication rate, and the short-term treatment effect is the same as that of total thyroidectomy.
Objective To screen out the aging genes that are significantly related to the prognosis of breast cancer through bioinformatics. Method Clinical data and mRNA sequencing data were downloaded from the cancer genome atlas (TCGA) database collected by the National Cancer Center from September, 2010 to June, 2015. Aging genes were downloaded from the Aging Atlas database. Differential express genes between the normal tissue and the cancer tissue were compared. Single factor Cox and Lasso regression were applied to obtain prognostic-related aging genes. Then the signature was constructed, the patients were divided into high-risk group and low-risk group with the median of risk coefficient as the cut-off value. Univariate and multivariate regression were used to identify the independent factor, then Nomogram was constructed. Gene set enrichment analysis (GSEA) software was used for the functional enrichment analysis of key genes. Result 119 differential aging genes and 10 prognostic-related genes were obtained, including 2 tumor suppressor genes(NRG1, IL2RG) and 8 cancer-promoting genes (EIF4EBP1,MMP1, PLAU, MMP13, RAD51, FGF7, DLL3, IGFBP1). The 10-aging-gene signature was constructed by Cox. The prognosis between the high risk and low risk group was significantly differently. The Nomogram showed good performance in predicting the overall survival of breast cancer patient. The GSEA showed the high-risk group was significantly enriched in signal pathways such as cell cycle and homologous recombination. The genes of lowrisk group was significantly enriched in the JAK-STAT signaling pathway, cytokine-receptor-interaction pathway. Conclusion The signature based on aging related genes had a good performance on predicting the prognosis of breast cancer patients.
Objective To investigate the clinical effect of double-endoscopy combined with open surgery in patients with cholecystolithiasis complicated with common bile duct stones. Method From July 2018 to October 2021, 72 patients with cholecystolithiasis complicated with common bile duct stones in Zhangjiagang Third People's Hospital were randomly divided into groups, patients treated with open surgery alone were the control group, and patients treated with double-endoscopy combined technique were selected as the observation group,36 cases in each group. In the observation group, clinical indicators such as operation time were recorded, postoperative complications were counted, and differences in postoperative long-term efficacy were evaluated. Result The operation time, intraoperative blood loss and postoperative exhaust time of the observation group were significantly better than those of the control group (P ＜ 0.05). It was lower than that of the control group (16.67%, P ＜ 0.05); the excellent and good rate of the observation group was 100%, which was significantly better than that of the control group (88.89%, P ＜ 0.05). Conclusion Compared with traditional laparotomy, patients with cholecystolithiasis and common bile duct stones treated with dual-endoscope combined technique have significantly better surgical effect and less injury.
Objective To explore the clinical effect of laparoscopic radical resection of colorectal cancer in the elderly. Method 100 elderly patients with colorectal cancer treated in Wujin Hospital Affiliated to Jiangsu University from December 2016 to March 2021 were selected as the research object. They were divided into control group (n=50) and study group (n=50) by different surgical methods. The patients in the control group were treated with traditional open surgery, and the patients in the study group were treated with laparoscopic radical resection of colorectal cancer. The operation implementation, postoperative complications, quality of life and gastrointestinal function were compared between the two groups. Result The scores of postoperative quality of life in the two groups were significantly higher than those before intervention, and the scores of patients in the study group were higher than those in the control group (P ＜ 0.05); the incidence of postoperative complications in the study group was 14.00%, which was significantly lower than that in the control group (P ＜ 0.05); during the operation, the operation time, intraoperative bleeding, postoperative exhaust time, postoperative hospital stay and resection length in the study group were significantly better than those in the control group (P ＜ 0.05); the levels of motilin and gastrin in the study group were significantly higher than those in the control group (P ＜ 0.05). Conclusion The clinical effect of laparoscopic radical resection of colorectal cancer in elderly patients is better. It can effectively reduce the incidence of complications in elderly patients, with less trauma and higher safety. It is of positive significance to improve the quality of life of elderly patients with colorectal cancer.
Objective To investigate the clinical efficacy of laparoscopic and open surgery in the treatment of colorectal cancer. Method 74 patients with colorectal cancer who underwent surgery in Nanjing Gaochun People's Hospital from January 2021 to December 2021 were divided into study group (laparoscopic surgery) and control group (open surgery) according to different surgical methods,37 cases in each group . The postoperative related conditions and curative effects of the two groups were compared. Result The operation time, hospital stay, postoperative anal exhaust time, getting out of bed time and postoperative eating time in the study group were shorter than those in the control group, and the amount of intraoperative bleeding was less than that in the control group (P ＜ 0.05); The incidence of postoperative complications in the study group was lower than that in the
control group (P ＜ 0.05). Conclusion Both laparoscopic and open surgery have good results in the treatment of colorectal cancer, but laparoscopy has less trauma, higher safety and can promote the rapid recovery of patients.
Objective To compare the clinical efficacy and postoperative complications of traditional laparotomy and laparoscopic surgery in patients with colorectal cancer. Method A total of 60 patients with colorectal cancer admitted to our hospital from January 2018 to September 2021 were selected as the research subjects, and were divided into traditional open surgery group (control group) and laparoscopic surgery group (observation group) by different surgical methods, with 30 patients in each group. The clinical treatment effects of the two groups were compared, and the oxidative stress level and postoperative complications were compared before and 3 days after surgery. Result The amount of intraoperative bleeding in the observation group was (70.35±23.32)ml, which was less than that in the control group (164.83±43.24)ml. The operation time was (146.48±15.34)
min, the recovery time of intestinal function was (60.35±13.43)h and the hospital stay was (11.83±5.32)d, which were shorter than those in the control group (P ＜ 0.05). Before treatment, there was no significant difference in the levels of superoxide dismutase(SOD) and serum malondialdehyde(MDA) between the two groups (P ＞ 0.05); after treatment, the levels of SOD and MDA in the observation group were (85.30±12.99)kU/L and (6.01±1.83)mmol/L respectively, and those in the control group were (74.81±11.23)kU/L and (7.29±1.92)mmol/L respectively (P ＜ 0.05). The total incidence of complications in the observation group was lower than that in the control group (P ＜ 0.05). Conclusion Laparoscopic surgery is better than open surgery in the treatment of colorectal cancer, the patients have less trauma, rapid recovery and high safety.
Objective To investigate the clinical effect of precise preservation of left colonic artery in laparoscopic surgery in elderly patients with rectal cancer. Method 68 elderly patients with rectal cancer treated in Wuxi traditional Chinese medicine hospital from May 2017 to August 2021 were selected as the research object. According to different operation methods, they were divided into 30 cases in the control group (without retaining the left colonic artery during operation) and 38 cases in the experimental group (retaining the left colonic artery during operation). The operation indexes and postoperative recovery of the two groups were compared. Result There was no significant difference in intraoperative bleeding (P=0.774), total number of lymph nodes
cleaned (P=0.642), number of lymph nodes cleaned (P=0.571) and anastomotic bleeding (P=0.865) between the experimental group and the control group (P ＞ 0.05), but the operation time of the experimental group was longer (P=0.003), the postoperative hospital stay and anal ventilation time were shorter than those of the control group (P=0.006 and 0.001 respectively), and the incidence of anastomotic leakage was also lower than that of the control group (P=0.046). Conclusion For elderly patients with rectal cancer, preserving the left colonic artery during laparoscopic radical resection has no negative impact on the efficiency of lymph node dissection, and the risk of bleeding has not increased. At the same time, it can effectively shorten the postoperative exhaust time and reduce the incidence of anastomotic leakage.
Objective To investigate the effect of anesthesia and analgesia and the influence on cognitive function of different routes of nerve block guided by ultrasound in breast cancer patients. Method A total of 100 breast cancer patients admitted to the 73rd Group Military Hospital of the PLA Army from January 2020 to January 2021 were selected and divided into a control group (intercostal nerve block + general anesthesia, 50 patients) and observation group (50 cases with chest wall nerve block + general anesthesia)by different surgical methods. The anesthesia and analgesia effect, cognitive function and occurrence of adverse reactions were compared between the two groups. Result Compared with the control group, the pain scores of patients in the observation group were significantly lower after leaving the recovery room and 24 hours after operation (P ＜ 0.05); after operation, the level of cognitive function in the observation group was significantly higher than that in the control group (P
＜ 0.05); the incidence of adverse reactions in the observation group was 8.00%, significantly lower than 24.00% in the control group (P ＜ 0.05). Conclusion For breast cancer patients, the use of chest wall nerve block has achieved good results in analgesia, greatly improved the patient's cognitive function, reduced the adverse reaction rate.
With the increasing incidence of thyroid cancer, thyroid surgery has become an important surgical treatment for thyroid diseases. The recurrent laryngeal nerve into the larynx is easily damaged due to its unique location and complicated anatomy. The protection of recurrent laryngeal nerve into the larynx is often the most important part of thyroid surgery. In this paper, based on the research status and progress at home and abroad, combined with clinical practice, the relevant situation and intraoperative treatment of recurrent laryngeal nerve into the larynx were summarized, aiming to provide help for clinical work.
Objective To investigate the related factors of hypoparathyroidism after thyroidectomy. Method The clinical data of 150 patients who underwent thyroidectomy in Wuhan Xinzhou District People's Hospital from January 2018 to March 2020 were analyzed retrospectively. According to whether there was hypoparathyroidism after operation, they were divided into hypoparathyroidism group (29 cases) and normal function group (121 cases). The incidence of hypoparathyroidism after thyroidectomy was counted, the clinical data of patients with hypoparathyroidism and normal function were compared, and the risk factors of hypoparathyroidism after thyroidectomy were analyzed. Result There were 29 cases (19.33%) of hypoparathyroidism in 150 patients after thyroidectomy. Thyroid capsule invasion, lymph node dissection, parathyroid MIS resection, tumor diameter ＞4cm, no nano carbon tracer and open operation were the risk factors of parathyroid dysfunction after thyroidectomy (OR=3.963,3.658,3.281,3.357,3.943,4.187,P ＜ 0.05). Conclusion Patients with hypoparathyroidism after thyroidectomy have a high probability of hypoparathyroidism. The risk factors of hypoparathyroidism include thyroid capsule invasion, lymph node dissection, parathyroid MIS resection, tumor diameter ＞ 4cm, no application of nano carbon tracer and open surgery. According to this, clinical patients can be given targeted treatment and intervention measures after thyroidectomy, to reduce the risk of hypoparathyroidism.
Objective To compare the difference between endoscopic-assisted small incision thyroidectomy and traditional open thyroidectomy in the treatment of benign thyroid tumors, and to observe the safety of the operation. Method 70 patients with benign thyroid tumors treated in Kunshan Zongrenqing Memorial Hospital from September 2019 to September 2020 were divided into two groups by different surgical method, 35 cases in each group. Among them, those who received traditional open thyroidectomy were the control group, and those who received endoscopic-assisted small neck incision thyroidectomy were the study group, the operation indexes, treatment time, scar satisfaction, complications, pain degree and recurrence rate were compared under different schemes. Result The operation time in the study group was longer than that in the reference group, but the amount of intraoperative bleeding and postoperative drainage were lower than those in the reference group (P ＜ 0.05).
The time of recovery and discharge in the study group was shorter than that in the reference group, and the patients'
satisfaction with scar was higher than that in the reference group (P ＜ 0.05), and the incidence of complications was lower than that in the reference group (P ＜ 0.05). There was no significant difference in the degree of pain between the two groups before treatment (P ＞ 0.05), and there was no significant change in the degree of pain in the reference group after treatment (P ＞ 0.05), while the degree of pain in the study group was lower than that before treatment and in the reference group (P ＜ 0.05). There was no significant difference in recurrence rate between the two groups within 1 year (P ＞ 0.05). Conclusion Endoscopic-assisted neck small incision thyroid surgery is better than traditional open thyroid surgery in the treatment of benign thyroid tumors. Although the operation time has increased, it can reduce the amount of bleeding and drainage, reduce the pain of patients, reduce the incidence of complications, and patients are more likely to accept the remaining scars.
Objective To investigate the efficacy of laparoscopic hernia repair and open tension-free hernia repair in the treatment of adult inguinal hernia. Method 84 adult patients with inguinal hernia treated in Rugao People's Hospital from April 2016 to April 2021 were randomly divided into control group and observation group. The control group was treated with open tension-free hernia repair, and the observation group was treated with laparoscopic hernia repair. The operation time, bleeding volume and recovery time of the two groups were recorded, the occurrence of complications of the two groups were observed, and the degree of postoperative pain was measured. Result The operation time of the observation group was significantly longer than that of the control group, the amount of intraoperative bleeding was less than that of the control group, and the postoperative pain relief time, postoperative eating time, postoperative out of bed time and hospital stay were significantly shorter than those of the control group (P ＜ 0.05). The incidence of complications in the observation group was 7.14%, which was significantly lower than 26.19% in the control group (P ＜ 0.05). The effective rate of the observation group was 97.62%, which was significantly higher than 83.33% of the control group (P ＜ 0.05). Conclusion Compared with open tension-free hernia repair, laparoscopic hernia repair for adult inguinal hernia can reduce the amount of intraoperative bleeding, accelerate the recovery of gastrointestinal tract, shorten the length of hospital stay, and the postoperative pain subsides rapidly, with fewer complications and high safety.
Objective To analyze the clinical effect of painless colonoscopy with titanium clip combined with high-frequency electrocoagulation electrotomy in the treatment of colorectal polyps. Method 80 patients with colorectal polyps treated in Dongguan Renkang Hospital from February 2020 to January 2021 were divided into control group (40 cases, treated by painless colonoscopy with high-frequency electrocoagulation) and observation group (40 cases, treated by painless colonoscopy with titanium clip combined with high-frequency electrocoagulation)by different surgical method. The short-term and long-term clinical indexes of the two groups were compared. Result There was no significant difference in operation time between the two groups (P ＞ 0.05). The wound healing time and hospitalization time of the observation group were shorter than those of the control group (P ＜ 0.05); the incidence of perioperative bleeding in the observation group was significantly lower than that in the control group (P ＜ 0.05). There was no significant difference in hemoglobin levels between the two groups at admission and discharge (P ＞ 0.05). The incidence of postoperative complications and recurrence rate 3 months after operation in the observation group were significantly lower than those in the control group (P ＜ 0.05). Conclusion Titanium clip combined with high frequency electrocoagulation and resection under painless enterostomy can achieve good short-term and long-term results in the treatment of colorectal polyps.
Objective To analyze the clinical efficacy of interventional therapy in lower limb thrombo angitis obliterans. Method 100 patients of lower limb thrombo angitis obliterans were treated in the Vascular Surgery of Liaocheng People's Hospital from Jan 2019 to Jun 2021 were selected as the study subjects, they were divided into treatment group (n=50) and control group (n=50)by different treatment methods. Conservative treatment was applied for patients in the control group while interventional treatment was applied for patients in treatment group, clinical efficacy was compared between the two groups. Result After treatment, the blood flow velocity of external iliac artery, ankle brachial index, percutaneous oxygen partial pressure and the diameter of dorsalis pedis artery in the treatment group were significantly improved compared with those before treatment (P ＜ 0.05), and were better than those in the control group. However, in the control group, only blood flow velocity of external iliac artery and ankle brachial index were improved after treatment (P ＜ 0.05), and there was no significant difference in percutaneous oxygen partial pressure and dorsalis pedis artery diameter (P ＞ 0.05). The total effective rate of the treatment group was significantly higher than that of the control group (P ＜ 0.05). Conclusion In the clinical treatment of thrombo angitis obliterans, interventional treatment can significantly improve the patient's condition, improve the efficiency of clinical treatment.
Objective To investigate the correlation between abdominal fat and bone mineral density in obese and overweight patients with different levels of glucose metabolism. Method A total of 86 untreated obese and overweight patients with age ≤ 60 years and body mass index (BMI) ≥ 25kg/m2 were selected and divided into normal glucose tolerance group (NGT group, 30 cases), impaired glucose tolerance group (IGT group, 31 cases) and diabetes mellitus group (DM group, 25 cases) according to their glucose metabolism status. Abdominal fat and L1 ～ L3 vertebral bone mineral density (BMD) were measured by quantitative CT. Clinical data related to patients were collected, including patients' age, BMI, total abdominal fat area, visceral fat area, subcutaneous fat area, mean liver fat content, mean pancreas fat content, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, fasting, fasting blood glucose, etc. The correlation between intraperitoneal fat area and bone mineral
density and the difference of bone mineral density among the three groups were analyzed respectively, and the correlation between bone mineral density and various clinical indicators was analyzed. Result There was a negative correlation between intraperitoneal fat area and bone mineral density in NGT group, IGT group and DM group (all P ＜ 0.05), and the correlation between intraperitoneal fat area and bone mineral density in NGT group was higher (r=-0.525, P ＜ 0.05). BMD of NGT group and IGT group was higher than that of DM group, respectively, with statistical significance (P ＜ 0.05). There was no significant difference in bone mineral density between the NGT group and the IGT group (P ＞ 0.05). The results of multivariate regression analysis showed that the intraperitoneal fat area was influence factor of bone mineral density (P ＜ 0.05). Conclusion Intraperitoneal fat area was negatively correlated with bone mineral density in both obese and overweight people regardless of abnormal glucose metabolism. The relationship between abdominal fat and BMD is complex, and abdominal fat may be a factor affecting bone mineral density in obese patients.
Objective Improve the cognition and clinical diagnosis and treatment level of appendix mucinous cystadenoma. Method Clinical data of 17 misdiagnosed appendix mucinous cystadenoma from February 2005 to June 2020 in Central Theater Command Air Force Hospital were retrospectively analyzed, including clinical manifestations and treatment, the diagnosis and treatment of mucinous cystadenoma of appendix were summarized. Result Not clinically specific in 17 patients.5 cases were misdiagnosed as ovarian cysts;7 cases were misdiagnosed as appendix abscess;3 cases were misdiagnosed as ileocecal tumor;1 case was misdiagnosed as abdominal tuberculosis;1 case was misdiagnosed as a right ureteral tumor. All of the 17 cases were treated surgically, postoperative pathology was confirmed as appendix mucinous cystadenoma.14 cases were followed up for10
months to 12 years. Recurrence and metastasis were found in 2 cases, and one of them died. Conclusion Appendix mucinous cystadenoma has no characteristic clinical manifestations, the misdiagnosis rate is high, Delaying the diagnosis and treatment can have serious consequences. Early diagnosis and the correct surgical method are the key to the treatment of the disease.
Objective To observe the value of nutritional support therapy after distal subtotal gastrectomy combined with Roux-en-Y anastomosis in patients with gastric cancer. Method 50 patients with gastric cancer treated in Nanjing Gaochun People's Hospital from February 2020 to October 2021 were divided into 25 cases in the control group (postoperative parenteral nutrition support treatment) and 25 cases in the experimental group (enteral nutrition support treatment)by different nutritional treatments. The indexes of the two groups were compared and analyzed. Result The first postoperative exhaust time, first defecation time, hospital stay and gastrointestinal recovery time in the experimental group were shorter than those in the control group (P ＜ 0.05). Before the intervention, there was no significant difference in the levels of serum prealbumin, plasma albumin and total protein between the two groups (P ＞ 0.05);after the intervention, the levels of serum prealbumin, plasma albumin and total
protein in the experimental group were significantly higher than those in the control group (P ＜ 0.05). On the first day after operation, there was no significant difference in the levels of IgA, IgG and IgM between the two groups (P ＞ 0.05); the levels of IgA, IgG and IgM in the experimental group were significantly higher than those in the control group on the seventh day after operation (P ＜ 0.05). There was no significant difference in the incidence of complications between the two groups (P ＞ 0.05). Conclusion The effect of enteral nutrition support is better in the postoperative nutritional support treatment of patients with gastric cancer, which can significantly improve the nutritional and immune indexes of patients.
Objective To analyze the effect of sequential enteral and parenteral nutrition on nutrition and prognosis of elderly cancer patients in intensive care unit. Method 92 elderly cancer patients admitted to the intensive care unit of Yunnan Cancer Hospital from March 2020 to May 2021 were randomly divided into two groups with 46 cases in each group by different nutritional treatment methods. The control group was given parenteral nutrition support, and the observation group was given enteral and parenteral nutrition support in sequence. The changes of nutritional indexes, immune indexes, hospitalization and complications before and after intervention were compared between the two groups. Result There was no significant difference in the levels of serum protein, prealbumin and hemoglobin between the two groups before intervention (P ＞ 0.05). After intervention, the levels of serum protein, prealbumin and hemoglobin in the observation group were higher than those in the control group (P ＜ 0.05). There was no significant difference in the levels of IgG and IgM between the two groups before intervention (P ＞ 0.05). After intervention, the levels of IgG and IgM in the observation group were higher than those in the control group (P ＜ 0.05). The ventilator time and hospital stay in the observation group were shorter than those in the control group (P ＜ 0.05), and the incidence of complications was 13.0%, lower than 37.0% in the control group (P ＜ 0.05). Conclusion Sequential enteral and parenteral nutrition can improve the nutritional status of elderly cancer patients in intensive care unit, improve their immune ability, shorten the length of hospital stay, reduce the incidence of complications and promote rehabilitation. It is of great significance to improve their prognosis.
Objective To observe the effect of acupoint massage combined with reverse motion combined with the concept of enhanced recovery after surgery(ERAS) on the recovery of intestinal function in postoperative patients with rectal cancer. Method A total of 114 patients with rectal cancer who underwent surgical treatment in Qingdao Municipal Hospital from August 2020 to May 2021 were selected as the research objects. They were divided into control group and observation group by random number table method, 57 cases of each group. The control group received conventional nursing measures, and the observation group received a set of acupoint massage combined with reverse movement nursing measures developed under ERAS concept, the first exhaust, defecation time, bowel sound recovery time, hospital stay and intestinal recovery were compared between the two groups. Result The time of first exhaust, defecation and bowel sound recovery in the observation group were significantly
earlier than those in the control group, the length of hospitalization in the observation group was shorter than that in the control group, and the functional dyspepsia symptom score in the observation group was higher than that in the control group, the difference was statistically significant (P ＜ 0.05). Conclusion Acupoint massage combined with reverse motion combined with the concept of accelerated rehabilitation surgery can effectively promote the recovery of intestinal function in postoperative patients with rectal cancer.
Objective To explore the effect of five element music therapy combined with 6 minute walking test (6MWT) in perioperative accelerated rehabilitation surgery nursing of rectal cancer patients. Method From June 2019 to January 2021, 90 patients with rectal cancer who needed radical resection of rectal cancer in Huazhong University of Science and Technology Union Shenzhen Hospital were selected as the research objects. They were numbered according to the order of admission and divided into experimental group and control group according to the random number table, with 45 cases in each group. The control group received routine perioperative accelerated rehabilitation surgical nursing, while the experimental group received five element music therapy combined with 6MWT. The effect of 6MWT before and after intervention, postoperative eating time, exhaust
time, length of hospital stay and postoperative complications were compared between the two groups. Result There was no significant difference between the two groups before the intervention (P ＞ 0.05). The 6MWT result after the intervention in the experimental group was (375.07 ± 21.95) m, which was significantly higher than that before the intervention (228.66 ± 15.69) m, and also higher than that in the control group (P ＜ 0.05). The postoperative eating time, exhaust time and hospital stay in the experimental group were shorter than those in the control group, and the incidence of postoperative complications was also lower than that in the control group (P ＜ 0.05). Conclusion Five element music therapy combined with 6MWT nursing can accelerate the postoperative rehabilitation of patients with rectal cancer, reduce postoperative complications and improve the postoperative clinical outcome.
Objective To explore and analyze the effect of Xiaoyao Loubei Decoction combined with emotional therapy of traditional chinese medicine on hyperplasia of mammary glands. Method A total of 126 patients with hyperplasia of mammary glands admitted to Xingbin District People's Hospital of Laibin from June 2018 to June 2020 were selected as the research objects, and randomly divided into the control group and the observation group, with 63 cases in each group. The control group was treated with Xiaoyao Loubei Decoction; The observation group was treated with emotional therapy of traditional chinese medicine on the basis of the control group, and the treatment effect, sex hormone levels and symptoms and signs scores before and after treatment were compared between the two groups. Result The effective rate of treatment in the observation group was significantly higher than that in the control group (P ＜ 0.05). After 3 months of treatment, the serum progesterone levels in both groups increased, while the serum estradiol and prolactin levels decreased. After treatment, the serum progesterone
levels in the observation group were significantly higher than those in the control group (P ＜ 0.05), and the serum estradiol and prolactin levels were significantly lower than those in the control group (P ＜ 0.05). After 3 months of treatment, the scores of symptoms and signs in both groups decreased, and the observation group was significantly lower than the control group (P ＜ 0.05). Conclusion Xiaoyao Loubei Decoction combined with emotional therapy of traditional chinese medicine can effectively improve the treatment efficiency of patients with hyperplasia of mammary glands, reduce the level of sex hormones and symptoms of patients.
Objective To study the improvement of tumor marker levels in patients with breast cancer treated with docetaxel combined with pirarubicin chemotherapy. Method A total of 72 breast cancer patients who were treated in Liangshan County People's Hospital in Jining City from January 2019 to December 2019 were included in this study. They were divided into groups according to the coin toss method. The control group (typeface)of 36 patients received paclitaxel combined with pirarubicin. 36 cases in the observation group (flower face) were treated with docetaxel combined with pirarubicin. The tumor marker levels, toxic and side effects, disease control, 1-year survival rate and recurrence rate were compared between the two groups. Result After chemotherapy, the levels of CEA, CA125, CA153 and the 1-year recurrence rate in the observation group were lower than those in the control group, and the disease control rate was higher than that in the control group, and the difference was statistically
significant (P ＜ 0.05). There was no significant difference between the incidence rate and the 1-year survival rate (P ＞ 0.05). Conclusion Cetaxel combined with pirarubicin chemotherapy for breast cancer patients has an ideal effect, which can improve the level of tumor markers, and does not increase the incidence of adverse drug reactions and recurrence.
Objective To study the muscle relaxation effect of rocuronium combined with cisatracurium in laparoscopic cholecystectomy. Method 60 patients who underwent laparoscopic cholecystectomy in Liyang People's Hospital from June 2019 to June 2021 were included in the study. They were randomly divided into two groups with 30 cases in each group. Anesthesia group 1: rocuronium anesthesia. Anesthesia group 2: rocuronium combined with cisatracurium atracurium anesthesia. The heart rate, mean arterial pressure, the onset time of muscle relaxation, the maintenance time of muscle relaxation effect, the time of recovery room, the number of additional muscle relaxation drugs during operation and the time of extubation after operation were compared between the two groups. Result There was no significant difference in heart rate and mean arterial pressure between the two groups before anesthesia induction, 1 min after anesthesia induction and 5 min after anesthesia induction (P ＞0.05); In anesthesia group 2, the onset time of muscle relaxation was (105.58 ± 1.15) s, the maintenance time of muscle relaxation was (51.38 ± 3.23) min, the time of recovery room was (32.58 ± 8.15) min, and the time of extubation after operation was (11.52 ± 3.09) min, which was lower than (112.34 ± 2.47) s, (40.41 ± 3.14) min, (43.34 ± 8.47) min and (17.49 ± 3.12) min in anesthesia group 1 (P ＜ 0.05); The number of additional muscle relaxants in the anesthesia group 2 was (1.01 ± 0.05), which was less than that in the anesthesia group 1 (1.88 ± 0.13) (P ＜ 0.05). Conclusion Rocuronium combined with cisatracurium atracurium anesthesia in laparoscopic cholecystectomy has a good muscle relaxation effect, and has no significant effect on hemodynamics.
Objective To investigate the application of case nursing combined with psychological care in microwave ablation of thyroid gland disease and its effect on pain perception, negative emotion and compliance behavior. Method A total of 114 patients with thyroid disease admitted to Huanggang Central Hospital from January 2020 to January 2021 were selected and divided into two groups according to different nursing method, including 57 cases in the observation group and 57 cases in the control group. Both groups received microwave ablation treatment. The control group only received routine perioperative intervention, and the observation group received individual nursing combined with psychological care. The changes of pain perception, negative emotion and compliance behavior before and after intervention were compared between the two groups. Result Before
intervention, there were no significant differences in pain perception, negative emotion and compliance between the two groups (P ＞ 0.05). After intervention, the pain score, self-rating anxiety scale score, self-rating depression scale score and compliance of the observation group were significantly better than those of the control group, with statistically significant differences (P ＜ 0.05). Conclusion Individual nursing combined with psychological nursing intervention microwave ablation for thyroid patients has a good effect.
Objective To explore the application effect of evidence-based nursing in pipeline nursing in gastrointestinal surgery. Method 178 patients admitted in our hospital from January 2019 to October 2021 were divided into control group and observation group by different nursing methods, 89 cases in each group. The control group with routine nursing mode, the observation group with evidence-based nursing model, The incidence of unplanned extubating, nursing effect, degree of pain, quality of life and bad mood were compared between the two groups before and after nursing. Result The nursing quality, nursing effect and quality of life in the observation group were higher than those in the control group (P ＜ 0.05). The degree of pain and bad mood in the observation group were lower than those in the control group (P ＜ 0.05). Conclusion evidence-based nursing model, can
effectively reduce the incidence of unplanned extubating, improve quality of life, relieve pain, reduce bad mood In
gastrointestinal surgery patients,, nursing effect is significant.
Objective To investigate the effect of perioperative nursing intervention in patients undergoing radical gastrectomy for gastric cancer and its impact on nursing quality. Method A total of 42 patients with gastric cancer who underwent radical surgery in our hospital from May 2020 to May 2021 were selected for research, and they were divided into groups according to different nursing methods, namely the control group (implementing routine nursing intervention) and the observation group (implementing routine nursing intervention). Perioperative nursing intervention), 21 cases in each group, the levels of gastrointestinal hormones, nutritional indicators and nursing quality scores before and after nursing in the two groups were analyzed. Result After nursing, the motilin and serum ghrelin of the observation group were (189.22±22.63) ng/L and (61.58±5.73) ng/L, respectively,which were higher than those of the control group (168.53±21.42) ng/L and (46.27±5.88) ng/L, and vasoactive intestinal peptide of the observation group was (62.35±7.07) ng/L, which was lower than that of the control group (83.18±7.14) ng/L, and the difference was significant (P ＜ 0.05). The albumin of the control group and the observation group after nursing were (36.25±3.49) g/L, (42.77±4.96) g/L, retinol binding protein were (29.97±3.02) mg/L, (36.65±3.28) mg/L, hemoglobin were (87.13±5.56) g/L, (97.32±5.71) g/L, the latter was significantly higher than the former (P ＜ 0.05); the scores of nursing methods, nursing attitudes, nursing skills and nursing environment of the observation group were (74.13±6.48) points, (71.02±5.95) points, (68.22±6.34) points and (72.13±6.34) points, respectively, which were significantly higher than those of the control group (56.23±5.47) points, (48.23±5.29) points, (51.17±4.57) points and (57.15±4.92) points (P ＜ 0.05). Conclusion Perioperative nursing plays an important role in gastric cancer patients undergoing radical operation, which can improve their nutritional status and gastrointestinal function, and the overall nursing quality is high.
Objective To explore the effect of comprehensive nursing model in patients with endoscopic gastrointestinal polypectomy. Method 84 patients with gastrointestinal polyps treated in Zhanjiang First Hospital of Traditional Chinese Medicine from January 2020 to December 2021 were selected as the research object. They were divided into experimental group and control group by different nursing methods, with 42 cases in each group. The control group was treated with routine nursing mode, and the experimental group was treated with comprehensive nursing mode on the basis of the control group. The treatment effect, psychological state and postoperative complications of the two groups were compared. Result After nursing, the cure rate of the experimental group was higher than that of the control group, but there was no significant difference (P ＞ 0.05); the hospitalization time was significantly shorter than that in the control group (P ＜ 0.05); the scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) in the experimental group were lower than those in the control group, and the incidence of postoperative complications was significantly lower than that in the control group (P ＜ 0.05). Conclusion The application of comprehensive nursing model in patients with endoscopic polypectomy is effective, which can effectively reduce the length of hospital stay, improve the negative psychological state of patients, and reduce the incidence of postoperative adverse reactions.
Objective To study the effect of holistic nursing intervention in the operating room during laparoscopic resection of primary liver cancer. Method 60 patients with primary liver cancer treated by laparoscopic resection in Shiyan Yunyang Traditional Chinese Medicine Hospital from August 2019 to August 2021 were divided into experimental group and control group by different nursing methods, with 30 cases in each group. The control group was treated with routine operating room nursing, and the experimental group was treated with integrated operating room nursing. The operation time and bleeding volume, postoperative recovery related indexes, incidence of complications and nursing satisfaction were compared between the two groups. Result The operation time and bleeding volume in the experimental group were less than those in the control group; the postoperative
recovery related indexes were better than those in the control group; the total incidence of complications in the experimental group (3.33%) was significantly lower than that in the control group (26.67%); the nursing satisfaction of the experimental group (96.67%) was significantly higher than that of the control group (76.67%),all differences were significant（P ＜ 0.05）. Conclusion During the operation of patients with primary liver cancer, the implementation of integrated nursing in the operating room has a good effect, which can significantly reduce the incidence of complications, shorten the clinical recovery time of patients and improve nursing satisfaction.
Objective To analyze the effect of postoperative nursing measures on patients with pancreatic cancer complicated with type 2 diabetes. Method From July 2019 to November 2021, 43 patients with pancreatic cancer and type 2 diabetes mellitus in Nanjing Gaochun People's Hospital were selected and divided into control group (n=22) and observation group (n=21)by different nursing methods. The control group was given routine nursing, and the observation group was given postoperative nursing measures. The wound healing time, postoperative hospital stay, complication rate and quality of life were compared between the two groups. Result After nursing, the wound healing time and postoperative hospital stay in the observation group were lower than those in the control group (P ＜ 0.05). After nursing, the total incidence of infection, hypoglycemia and lower extremity deep venous thrombosis in the observation group was 4.76%, which was lower than 27.27% in the control group (P ＜ 0.05). After nursing, the scores of physical function, psychological function, material function and social function in the observation group were higher than those in the control group (P ＜ 0.05). Conclusion Appropriate nursing intervention for patients with pancreatic cancer and type 2 diabetes can improve the healing time of incision, reduce the incidence of complications, promote early recovery and discharge of patients, and improve the quality of life of patients.
Objective To study the effect of fecal bacteria transplantation on intestinal flora and intestinal motility in patients with chronic functional constipation. Method A total of 30 patients diagnosed as chronic functional constipation in the Department of Gastroenterology of the Sixth Affiliated Hospital of South China University of Technology from January 2020 to December 2020 were included. The transplanted fecal bacteria were prepared by hand, the distribution of intestinal flora, gastrointestinal motility and quality of life before and after fecal bacteria transplantation treatment were compared. Result After fecal bacteria transplantation, intestinal flora richness (t=4.382, P ＜ 0.001), Shannon-Wiener index (t=2.948, P=0.006) and maximum Shannon-Wiener index (t=3.213, P=0.003) were significantly increased. However, there was no significant improvement in the uniformity of intestinal flora before and after treatment (t=1.303, P=0.203). The mean amplitude (t=21.283, P ＜ 0.01) and mean frequency (t=4.584, P ＜ 0.001) of preprandial electrointestinogram were significantly improved after fecal bacteria transplantation. There also showed statistically significant improvements in mean postprandial amplitude (t=12.394, P ＜ 0.001) and mean frequency (t=2.945, P=0.006). The gastrointestinal quality of life index (GIQLI) of gastrointestinal quality of life was (79.39±16.43) before treatment, and (120.48±22.14) after 1 month oftreatment, the difference was statistically significant compared with that before treatment (t=23.483, P ＜ 0.001). Conclusion Fecal bacteria transplantation can effectively improve the intestinal flora richness of patients with chronic functional constipation, improve intestinal motility, and improve the quality of life of patients, which is worthy of clinical promotion.
Objective To investigate the safety and feasibility of transanal natural orifice specimen extraction surgery (NOSES) laparoscopic surgery for sigmoid colon cancer and high rectal cancer. Method A retrospective analysis of clinical datas of 30 patients who underwent transanal NOSES laparoscopic surgery for sigmoid colon cancer and high rectal cancer(the observation group) and 30 patients who underwent conventional laparoscopic surgery for sigmoid colon cancer and high rectal cancer(the control group) during the same period, in Putian City from October 2018 to October 2020. A comparative analysis was conducted between these two groups in regard to the operation time, the intraoperative blood loss, the intraoperative lymph node dissection, the postoperative pain score of day 1, the postoperative complications and the postoperative local recurrence and distant metastasis. Result There were no significant differences in the intraoperative blood loss, the intraoperative lymph node dissection and the postoperative complications of both groups (P ＞ 0.05). The operation time of the observation group was longer than that of the control group, the postoperative pain score of day 1 of the observation group was lower than that in the observation group, the postoperative exhaust time of the observation group was shorter than that in the control group, the postoperative fluid diet time in observation group was shorter than that in control group, the postoperative hospital stay in the observation group was shorter than that in the control group, the differences are significant (P ＜ 0.05). Patients in both groups were followed up and no local and distant recurrence was observed.Conclusion Transanal NOSES laparoscopic surgery for sigmoid colon cancer and upper rectal cancer is safe and feasible. It has the advantages of light postoperative pain, quick recovery, short hospital stays, and the radical tumor treatment effect is comparable to that of traditional laparoscopic surgery.
Objective To explore the safety and feasibility of laparoscopic combined with endoscopic sinus surgery for gastric stromal tumors (GST). Method The clinical data of 8 cases of GST hospitalized patients undergoing laparoscopic extracranial tumor wedge resection after application of the electronic gastroscope positioning were retrospectively analyzed from August 2018 to November 2019 in the Donggang Branch of the First Hospital of Lanzhou University. Result 8 patients with GST were treated with laparoscopic tumor outside the gastric cavity wedge resection after electronic gastroscope positioning and the operation was successfully completed without metastatic laparotomy and intraoperative death. The operation time(71.6±9.8)min, intraoperative blood loss (35.0 ± 10.8) ml, postoperative gastrointestinal function recovery time (2.8±0.7) d, postoperative bedtime (1.0±0.4) d, Time for feeding semi liquid food (2.7±0.5) d, and postoperative hospital stay (6.8±1.7) d. 8 patients had no anastomotic bleeding, anastomotic fistula, anastomotic stenosis, incision infection, intestinal obstruction, urinary tract infection and pulmonary infection and other complications, and pathological biopsy confirmed GST, margin were not seen tumor organization. 8 patients were followed up for 6 months. All follow-up cases were examined by computed tomography and electron microscopy, no recurrence and metastasis were observed. Conclusion Laparoscopic combined with endoscopic sinus surgery for the treatment of GST is a safe and feasible precision minimally invasive surgical method, with accurate positioning, short operation time, less intraoperative bleeding and low complications.
Objective To observe the effect of ultrasound-guided transverse abdominis block anesthesia on stress response in patients with colon cancer after laparoscopic surgery. Method 80 patients with colon cancer undergoing laparoscopic surgery in Yichang Fifth People's Hospital from August 2019 to August 2021 were randomly divided into control group (routine anesthesia, 40 cases) and observation group (ultrasoundguided transverse abdominal block anesthesia, 40 cases). The sedation, pain, stress index, immune function and hemodynamics were compared between the two groups. Result Compared with the control group, the Ramsay score and visual analogue score of the patients in the observation group were lower, and the stress index, immune function and hemodynamics were improved significantly (P ＜ 0.05). Conclusion Ultrasound-guided transverse abdominis block anesthesia in laparoscopic colon cancer patients can achieve better sedative effect, reduce pain and stress response, maintain good hemodynamics, and promote the improvement of postoperative immune function.
Pancreatic cancer is a kind of malignant tumor with high mortality and low early diagnosis rate, therefore, studies of epidemiology and risk factors of pancreatic cancer may help develop effective screening measures so as to reduce mortality. Accurate staging of pancreatic cancer is of great significance for the formulation of standardized comprehensive treatment and prognosis. 32 recurrently mutated genes in pancreatic carcinogenesis are identified, and aggregate into 10 pathways, include KRAS, TGF-β, WNT, NOTCH, ROBO/SLIT signaling, G1/S transition, SWI-SNF, chromatin modification, DNA repair and RNA processing. Malignant cells often represent the minority of tissue mass in a pancreatic tumor, with the remainder of the tumor composed of extracellular matrix, pancreatic stellate cells, fibroblasts, endothelial cells and immune cells, etc. To some extent, therapeutic failures of chemotherapy, targeted therapy, and immunotherapy have been attributed to the pancreatic cancer
microenvironment. This review summarizes the pathology, microenvironment of pancreatic cancer, and explains how each cell type contributes to form an immunosuppressive, hypoxic, and desmoplastic tumor microenvironment.
Anorectal disease is a common and frequent clinical disease. Hemorrhoids and rectal prolapse are both anorectal diseases that occur in the anorectal area, and they often affect people's quality of life and physical health. The Dai people have a unique understanding and rich clinical experience in the treatment of hemorrhoids and prolapse of anus in anorectal diseases in the long-term process of disease prevention, treatment and life practice. Among them, Nanya (sitting medicine therapy) is an external therapy commonly used by Dai doctors in the treatment of hemorrhoids and prolapse of the anus. This article reviews the application of Dai medicine difficult and elegant (sitting medicine therapy) in the treatment of anorectal disease hemorrhoids and rectal prolapse.
Rectocele is essentially a posterior vaginal wall hernia caused by a weak rectovaginal septum, The prevalence rate of women over 50 years old is 30% ～ 50%. Its outstanding clinical manifestations are difficulty in defecation, a sense of incomplete defecation, and often accompanied by distension and discomfort in the perineal area, some patients often help defecate by hand. Enduring the torment of these syndromes for a long time causes great burden to patients psychologically and physically. The conservative treatment of moderate and severe rectocele is not effective, and the patients finally choose surgical treatment to strengthen the weak and defective rectovaginal septum and eliminate the abnormal protrusion structure. At present, clinical studies have reported that combined with internal sphincteral lysis is effective in the treatment of rectocele, but the indication of this operation is not clear. This article mainly reviews the progress of the application of internal sphincteral lysis in the surgical
treatment of rectocele, to further clarify the indications of this operation, and to provide a reference for operators to choose the best operation for patients with rectocele.
Objective To study the protective effect of bipolar electrocoagulation tweezers combined with rapid detection of parathyroid hormone (PTH) on parathyroid gland during operation. Method 205 patients with thyroid tumors treated by open thyroid surgery in Macheng People's Hospital from February 2020 to August 2021 were randomly divided into control group (n=102) and intervention group (n=103). The patients in the control group were treated with routine operation. The surgeon in charge of the operation used ultrasonic scalpel and judged the parathyroid gland by experience and naked eyes. The intervention group used bipolar electrocoagulation forceps and performed rapid PTH detection. The operation time, intraoperative bleeding volume, postoperative drainage volume, total hospital stay, PTH value, serum calcium value, incidence of hypoparathyroidism and quality of life were compared between the two groups. Result The operation time and postoperative drainage volume in the control group were (201.84±16.37) min and (80.46±7.69) ml respectively, while those in the intervention group were (153.09±11.82) min and (51.37±4.75) ml respectively, with significant difference (P ＜ 0.05); there was no significant difference in the amount of intraoperative bleeding and total length of stay between the two groups (P ＞ 0.05). On the 3rd day after operation, the PTH value and serum calcium value in the control group were (5.83±0.54) pg/ml and (1.90±0.15) mmol/l respectively, and those in the intervention group were (11.06±0.97)pg/ml and (2.07±0.16) mmol/l respectively, which were significantly higher than those in the control group (P＜ 0.05); there was no significant difference in PTH and serum calcium between the two groups one month after operation (P ＞ 0.05). The incidences of temporary hypoparathyroidism and permanent hypoparathyroidism in the control group were 77.45% (79/102) and 4.90% (4/102), while those in the intervention group were 51.46%(56/103) and 0 respectively, which were significantly lower than those in the control group (P ＜ 0.05). The score of thyroid cancer specific quality of life scale in the control group was (19.70±1.52) and that in the intervention group was (22.07±1.83), which was significantly higher than that in the control group (P ＜ 0.05). Conclusion Bipolar
electrocoagulation forceps and PTH rapid detection technology in open thyroid surgery can shorten the operation time, reduce the body damage, better protect the parathyroid gland, and improve the quality of life.
Objective To investigate the value and safety of ultrasound-guided radiofrequency ablation in thyroid carcinoma. Method 78 patients with thyroid cancer treated in Nanjing Gaochun People's Hospital from November 2018 to June 2021 were selected and divided into the study group and the control group with 39 cases in each group according to the simple random number table method. The control group was treated with ultrasoundguided microwave ablation, and the study group was treated with ultrasound-guided radiofrequency ablation of thyroid gland. The tumor control effect, the level of inflammatory stress indexes before and after operation and the incidence of complications were analyzed. Result The lesion volume of the two groups decreased at 1 week, 1 month, 3 months and 6 months after operation (P ＜ 0.05), but there was no significant difference between the two groups at different time after operation (P ＞ 0.05). One day after operation, the levels of serum interleukin (IL)-6, tumor necrosis factor (TNF)-α and malondialdehyde (MDA) in the two groups were higher than those before operation, and the levels of superoxide dismutase (SOD) were lower than those before operation (P ＜ 0.05), but there was no significant difference between the study group and the control group (P ＞ 0.05). The incidence of fever (7.69%) and pain (5.13%) in the study group was lower than that in the control group (25.64% and 20.51%, respectively)(P ＜ 0.05). Conclusion Ultrasound-guided radiofrequency ablation is as effective as microwave ablation in the treatment of thyroid cancer. The inflammatory stress caused by operation is mild, and can reduce the incidence of fever and pain.
Objective To analyze the ultrasonic features of papillary thyroid microcarcinoma (PTMC) and the related factors of false negative and false positive extrathyroid invasion. Method 70 patients with suspected PTMC admitted to Daping Hospital of the Army Medical University from October 2019 to September 2021 were selected for ultrasound examination. Based on the postoperative pathological diagnosis, the ultrasonic characteristics of PTMC were observed, the value of extrathyroid invasion in PTMC was evaluated, and the influencing factors of false negative and false positive were analyzed. Result The ultrasonic features of PTMC were as follows: lesion diameter ≤ 1cm, irregular shape, unclear boundary, aspect ratio ≥ 1, blood flow grade Ⅰ ～ Ⅱ , cystic
consolidation, hypoechoic solid part, silent halo and calcification. In 70 cases, 69 cases of PTMC were detected by pathological diagnosis. The sensitivity, specificity and accuracy of ultrasonic diagnosis of PTMC were 97.1%, 100.0% and 97.1% respectively. There was no significant difference compared with pathological diagnosis (P＞ 0.05). Among 69 cases of PTMC, 29 cases of extrathyroid invasion were detected by pathological diagnosis. The sensitivity, specificity and accuracy of ultrasonic diagnosis were 58.6%, 75.0% and 73.9%, respectively, with significant difference compared with pathological diagnosis (P ＜ 0.05); the true negative and false positive cases of PTMC without extrathyroid invasion had significant difference in lesion diameter, and the proportion of false positive diameter above 5mm was higher (P ＜ 0.05); the true positive and false negative cases of PTMC extrathyroid invasion had significant difference in lesion diameter, and the proportion of false negative diameter
≤ 5mm was higher (P ＜ 0.05); The proportion of false negative lesions with aspect ratio ≥ 1 was higher (P＜ 0.05); The proportion of false negative adjacent trachea was lower (P ＜ 0.05); The proportion of false negative bilateral lobe lesions was lower (P ＜ 0.05). Conclusion Ultrasound has high sensitivity, specificity and accuracy in the diagnosis of PTMC. In the diagnosis of extrathyroid invasion of PTMC, the main cause of false positive was the diameter of lesion > 5mm, the diameter of lesion ≤ 5mm, the aspect ratio of lesion ≥ 1, adjacent trachea and bilateral lobe lesions. In the process of ultrasonic diagnosis of PTMC, in-depth analysis of the above factors can reduce the missed diagnosis and misdiagnosis rate of extrathyroid invasion, and provide a reliable basis for surgical treatment.
Objective To investigate the safety and cosmetic effect of gynecomastia under endoscopy through transaxilla. Method From January 2020 to January 2022, there were 19 patients analyzed retrospectively who treated under axillary endoscopic subcutaneous mastectomy in the General Surgery First Department of Qingdao Municipal Hospital, summarize the treatment, complications and follow-up results of patients. Result All 19 patients completed the operation, unilateral operation time is (1.6±0.8)h, bilateral time is (3.3±1.1)h, blood volume is (10±5)ml. The pathological examination showed that 12 cases were mixed type, 2 cases were fat type and 3 cases were glandular type; there are no nipple areola necrosis and subcutaneous effusion occurred in all cases; we followed two years, one patient had local nipple depression half a year after operation, and improved after autologous adipose tissue filling. Conclusion Axillary endoscopic treatment of gynecomastia is safe and effective,
and the cosmetic effect is good.
Objective To compare the clinical efficacy of single-hole axillary endoscopic mastectomy and traditional open incision in the treatment of gynecomastia. Method 33 patients with gynecomastia grade Ⅱ ～ Ⅲ (including 15 cases in an experimental group and 18 in a control group)from April 2020 to May 2021 were enrolled in the retrospective study. Among them, 18 cases were unilateral and 15 cases were bilateral. The operation and postoperative recovery of the two groups were compared. Result The median operation time for the axillary single-hole endoscopic surgery group was 88.67 minutes, the median extubation time was 4.40 days, and the median time for hospitalization was 7.67 days. In the traditional surgery group, the median operation time was 58.06 minutes, the median extubation time was 1.94 days, and the hospitalization median time was 4.89 days. There
was no statistical difference between two groups(P ＞ 0.05). In terms of postoperative complications, there was no infection in both groups. There was one postoperative hematoma in the axillary approach single hole endoscopic group and 2 cases of partial nipple necrosis in the traditional surgical group. There was no significant difference in the incidence of postoperative hematoma and partial papillary necrosis between the two groups (P ＞ 0.05). In terms of postoperative satisfaction, 13 patients in the axillary approach single-hole endoscopic group were rated as very satisfied with the postoperative appearance, and 5 patients in the traditional surgery group were very satisfied. There was a statistically significant difference between two groups (P=0.001). Conclusion Single-hole axillary endoscopic mastectomy for gynecomastia can be widely used in clinic, with better cosmetic effect and higher satisfaction.
Objective To study the effect of preserving serratus anterior fascia of pectoralis major in immediate breast reconstruction. Method Twenty patients who received early breast cancer treatment in People's Hospital of Yangchun City from April 2021 to March 2022 were randomly selected as the research subjects, and divided into two groups according to the numerical expression method. Among them, 10 patients who received latissimus dorsi flap metastatic breast reconstruction surgery were selected. As the control group, another 10 patients who underwent immediate breast reconstruction with serratus anterior fascia preservation were set as the observation group, and the operation efficiency, appearance satisfaction, and complication rates were compared between the two groups. Result After surgical intervention, the effective rate of operation in the observation group was 90%, and the effective rate in the control group was 60%. There was a significant difference in the indicators between the two groups (P＜0.05). Appearance satisfaction was 70%, and the comparison of satisfaction between the two groups was statistically
significant (P ＜ 0.05). The incidence of complications in the observation group was 10%, and the incidence of complications in the control group was 40%. Significance (P ＜ 0.05). Conclusion The effect of preserving the serratus anterior fascia of the pectoralis major muscle in immediate breast reconstruction is very significant, which improves the patient's appearance satisfaction to a certain extent, and the operation is less traumatic and safe, and reduces the occurrence of complications.
Objective To observe the operation time, incision size, patient tolerance, patient physical condition and complications, improvement of postoperative nutritional status and recovery time, so as to understand the advantages and benefits of this operation. Method Selected Cancer Hospital of Datong Second Hospital from January 2019 to January 2022 endoscopic linear cutting anastomosis stapler tubular gastrostomy 76 patients, randomly divided into observation group (n=38) and control group (n=38)according to the random number table method, observation group endoscopic linear cutting stapler tube gastrostomy, control group conventional operation mode, compare the two groups of operation time, incision size, bleeding. Result After surgery, the operation time, incision size and bleeding volume in the observation group were better than the control group, with significant differences (P ＜ 0.05).The trauma to the patient's body can be minimized, resulting in better results；The probability of postoperative complications in the observation group was 7.89%, significantly lower than 31.58%, and the difference was significant (P ＜ 0.05). Conclusion Endoscopic linear cutting stapler for tubular gastrostomy has the advantages of simple operation and convenient postoperative nursing, which reduces the burden of patients, solves the problem of malnutrition caused by long-term inability to eat, and effectively improves the quality of life of patients.
Objective To explore the application of Rouviere sulcus anatomical localization in laparoscopic cholecystectomy (LC). Method 180 patients with LC in Danyang Third People's Hospital from January 2020 to December 2021 were retrospectively analyzed. They were divided into two groups according to different anatomical localization methods. The control group was given traditional blunt anatomy (n=90) and the observation group was given Rouviere sulcus anatomical localization (n=90). The operation related indexes (operation time, intraoperative bleeding, activity on the first day after operation) and the incidence of adverse events were analyzed and compared between the two groups. Result The operation time of the observation group was shorter than that of the control group, and the intraoperative blood loss was lower than that of the control group (P ＜ 0.05); The activity of patients in the observation group was higher than that in the control group on the first day after operation (P＜0.05). The total incidence of adverse events in the observation group was 2.22%, there was no significant difference (P
＞ 0.05). Conclusion For patients receiving LC treatment, the application of Rouviere groove to establish a safe operation area under the guidance of surgery, the effect of accurate gallbladder triangle anatomy technology is ideal, which is superior to the traditional blunt anatomy of gallbladder triangle, shortens the operation time, improves the activity ability of patients on the first day after operation, and is conducive to doctors' accurate positioning operation, reducing the amount of intraoperative bleeding and the incidence of adverse events.
Objective To analyze the effect and influence of laparoscopic radical cholangiocarcinoma and percutaneous transhepatic gallbladder drainage and Interventional therapy in the treatment of cholangiocarcinoma. Methods 60 patients with cholangiocarcinoma admitted to the First Clinical Medical College of Yangtze University from January 2019 to January 2022 were selected and divided into control group and observation group according to different treatment methods. The patients in the control group were treated with percutaneous transhepatic gallbladder drainage ang intervention therapy, and the patients in the observation group were treated with laparoscopic radical cholangiocarcinoma. The stress response, liver function level and clinical treatment effect of the two groups before and after treatment were compared. Result There was no significant difference in stress response and liver function between the two groups before treatment (P ＞ 0.05), and the indexes of the two groups
after treatment were better than those before treatment (P ＜ 0.05). The indexes of the observation group were significantly better than those of the control group (P ＜ 0.05); The total effective rate of the observation group (96.67%) was significantly higher than that of the control group (80.00%) (P ＜ 0.05). Conclusion Compared with percutaneous transhepatic gallbladder drainage for patients with cholangiocarcinoma, laparoscopic radical cholangiocarcinoma can not only improve the safety of treatment, but also improve the condition of patients.
Objective To investigate biomarks and ultrasonic doppler in the diagnosis and management of early hepatic artery thrombosis after liver transplantation Method One patient with early hepatic artery thrombosis after liver transplantation successfully underwent vascular reconstruction and intravascular interventional therapy. The changes of biochemical indexes and color doppler ultrasound during the treatment were analyzed retrospectively. Combined with the relevant literature at home and abroad, the changes of biochemical indexes and color Doppler ultrasound during the treatment of early hepatic artery thrombosis after liver transplantation were summarized. Result The patient developed hepatic artery thrombosis, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase γ-Glutamyl transpeptidase increased significantly, among which γ-Glutamyl transpeptidase began to increase as early as 3 days before the diagnosis of thrombosis. Cholinesterase decreased after hepatic artery thrombosis. The changes of the above biochemical indexes reached the peak on the second day after blood flow recovery, and began to decline on the third day after blood flow recovery. Doppler ultrasound could detect that the velocity of portal vein increased significantly 3 days before thrombosis. Conclusion Early hepatic artery thrombosis after liver transplantation should been considered when γ-Glutamyl transpeptidase was rising and/or the inspection and measurement of biomarks and Subsequent ultrasonic doppler showed that the velocity of portal vein was rising.
Objective To investigate the efficacy of laparoscopic left hemi hepatectomy via middle hepatic vein approach in the treatment of intrahepatic bile duct stones and its effect on stress and inflammatory response. Method 80 patients with intrahepatic bile duct stones treated in Taizhou People's Hospital from January 2019 to January 2022 were randomly divided into control group (conventional laparoscopic left hemi hepatectomy, n=40) and observation group (laparoscopic left hemi hepatectomy via middle hepatic vein, n=40). The related indexes of the two groups were compared, and the preoperative and postoperative cortisol, serum The levels of C-reactive protein and interleukin-6 were used to evaluate the state of stress and inflammation, and the incidence of complications in the two groups was statistically analyzed. Result All the patients in the two groups successfully completed the operation. There was no significant difference between the two groups in operation time, bleeding volume, time
out of bed, exhaust time and hospital stay (P ＞ 0.05). The levels of cortisol, C-reactive protein and interleukin-6 in the observation group were lower than those in the control group (P ＜ 0.05), and the incidence of complications was lower than that in the control group (P ＜ 0.05). Conclusion Laparoscopic left hemi hepatectomy through the middle hepatic vein is safe and effective in the treatment of intrahepatic bile duct stones, which can reduce stress and inflammatory reaction, and reduce the risk of complications.
Objective To explore the efficacy of laparoscopic radical gastrectomy and open radical gastrectomy in the treatment of early gastric cancer. Method 60 patients with early gastric cancer treated in Binyang People's Hospital from July 2018 to June 2021 were randomly divided into two groups according to the random number table method, with 30 cases in each group. The control group was treated with open radical gastrectomy and the observation group was treated with laparoscopic radical gastrectomy. The operation related indexes, postoperative recovery, immune function and postoperative complication rate were compared between the two groups. Result The intraoperative blood output of the observation group was lower than that of the control group (P ＜ 0.05), the operation time of the observation group was longer than that of the control group (P ＜ 0.05), and there was no difference in the number of lymph node dissection between the two groups (P ＞ 0.05). The postoperative exhaust time, defecation time, out of bed activity time and hospital stay in the observation group were shorter than those
in the control group (P ＜ 0.05). The peripheral blood IgA, IgM and IgG in the observation group were lower than those in the control group (P ＜ 0.05). The postoperative complication rate in the observation group was 3.33%, lower than 20.00% in the control group (P ＜ 0.05). Conclusion Laparoscopic radical gastrectomy can achieve the short-term effect similar to open radical gastrectomy, reduce the amount of intraoperative bleeding, shorten the postoperative recovery time, reduce the damage of immune function and reduce the incidence of postoperative complications.
Objective To investigate the efficacy and safety of Kimura method in laparoscopic pancreatectomy with spleen preservation. Method The clinical data of 32 patients with splenopancreatic body caudal lesions treated in Suzhou Hospital Affiliated to Nanjing Medical University from January 2018 to December 2021 were retrospectively analyzed. The 20 patients treated with Kimura method of spleen preserving laparoscopic pancreatectomy were the observation group, and the 12 patients treated with traditional surgery were the reference group. The relevant clinical indicators and complications of the two groups were compared. Result The amount of intraoperative bleeding in the observation group was less than that in the reference group, and the operation time, postoperative ambulation time, postoperative exhaust time, postoperative drainage time and hospitalization
time were shorter than those in the reference group (P ＜ 0.05); the incidence of complications in the observation group was lower than that in the reference group（ P ＜ 0.05）. Conclusion Kimura method of laparoscopic tail and body pancreatectomy with spleen preservation is more effective in the treatment of patients. Compared with the traditional surgical treatment, Kimura method of laparoscopic tail and body pancreatectomy with spleen preservation causes less trauma and lower risk of complications, which can effectively promote the postoperative recovery of patients.
Objective To investigate the clinical effect of partial hepatectomy combined with choledochoscopy in the treatment of intrahepatic bile duct stones. Method 84 patients with intrahepatic bile duct stones who underwent partial hepatectomy in Hepatobiliary Hospital of Jilin from July 2020 to June 2021 were randomly divided into resection group and combination group. Partial hepatectomy was performed in the resection group, and partial hepatectomy combined with choledochoscopy was performed in the combined group. The changes of operation related indexes in the two groups were compared, and the postoperative complications and liver function were monitored. Result The intraoperative blood loss in the combined group was less than that in the resection group. The recovery time of postoperative bowel sounds, postoperative defecation time, postoperative out of bed activity time and hospital stay in the resection group were significantly shorter than those in the resection group (P ＜ 0.05); the incidence of complications in the combination group (9.52%) was significantly lower than that in the resection group (26.19%) (P ＜ 0.05). The recurrence rate of the combined group was significantly lower than that of the resection group (11.90%) (P ＜ 0.05). The levels of alanine aminotransferase, aspartate aminotransferase, total bile acid and total bilirubin in the combination group were significantly lower than those in the resection group (P ＜ 0.05). Conclusion Partial hepatectomy combined with choledochoscopy can reduce intraoperative blood loss, promote patients' recovery as soon as possible, effectively reduce the risk of complications and recurrence rate, and improve the level of postoperative liver function indicators.
Objective To investigate the effect of laparoscopic radical resection of right colon cancer on the recovery of gastrointestinal function in patients with colon cancer. Method 66 patients with colon cancer admitted to Suzhou Municipal Hospital from January 2020 to December 2021 were selected and divided into observation group and control group with 33 cases in each group according to the results of blue-green ball lottery. The patients in the control group were treated with open radical resection of right colon cancer, and the patients in the observation group were treated with laparoscopic radical resection of right colon cancer. The postoperative recovery of the two groups were recorded and compared, and the changes of gastrointestinal function and immune function indexes before and after operation and the occurrence of postoperative complications were compared between the two groups. Result The recovery of bowel sounds, exhaust, defecation and hospital stay in the observation group were significantly shorter than those in the control group (P ＜ 0.05). There was no significant difference in preoperative gastrointestinal function and immune function between the two groups (P ＞ 0.05); the levels of
motilin and gastrin in the observation group were higher than those in the control group, CD4+ T cell was higher than that in the control group, and CD8+ T cell was lower than that in the control group (P ＜ 0.05). In addition, the total incidence of postoperative complications in the observation group was lower than that in the control group (P＜ 0.05). Conclusion Laparoscopic radical resection of right colon cancer can effectively promote the postoperative recovery of patients with colon cancer, with little impact on gastrointestinal function, less complications and ideal safety.
Objective To analyze the value of laparoscopic radical resection and traditional laparotomy in the treatment of colorectal cancer. Method 80 patients with colorectal cancer admitted to the Guangzhou Zengcheng District Central Hospital from March 2019 to February 2022 were selected as the research objects. They were randomly divided into two groups with 40 patients in each group. The control group was treated with traditional open surgery, and the observation group was treated with laparoscopic radical surgery. The short-term efficacy, immune stress indicators and complications of the two groups were compared. Result The amount of bleeding in the observation group was less than that in the control group, and the exhaust time, hospitalization time and eating time were significantly lower than those in the control group (P ＜ 0.05); The levels of CD3+, CD4+, CD8+ T cell in the observation group were higher than those in the control group, and the complication rate was lower than that in the control group (P ＜ 0.05). Conclusion Laparoscopic radical resection for colorectal cancer can shorten the time of exhaust, eating and hospitalization, improve the immune function, and avoid all kinds of postoperative complications affecting the prognosis.
Objective To analyze the clinical efficacy of laparoscopic appendectomy and open appendectomy in the treatment of appendicitis. Method The clinical data of 104 patients of Enshi Huiyi Hospital Affiliated to Hubei Enshi College from March 2020 to March 2022 were retrospectively analyzed. According to the different surgical methods, they were divided into control group and observation group, with 52 cases in each group. The patients in the control group received open appendectomy, and the patients in the observation group received abdominal endoscopic surgery. The relevant indicators of the operation of the two groups were analyzed, and the postoperative complications and surgical effects were compared. Result The amount of surgical bleeding in the observation group was less than that in the control group, and the visual analogue score was lower than that in the control group. The operation duration, bowel sound recovery time, first exhaust time, first defecation time, bed rest time and hospitalization time were shorter than those in the control group, with significant differences (P ＜ 0.05). The total incidence of complications in the control group was significantly lower than that in the control group, and the overall curative effect was significantly better than that in the control group (P ＜ 0.05). Conclusion Compared with open appendectomy, laparoscopic appendectomy is more effective in the treatment of appendicitis, which is characterized by smoother operation, less trauma, higher safety, less postoperative complications.
Objective To explore and analyze the effects of laparoscopic surgery and open surgery on acute appendicitis in adults. Method 110 adult patients with acute appendicitis diagnosed in Fuzhou Jin'an District Hospital from March 2019 to March 2022 were randomly divided into the observation group and the control group, with 55 cases in each group. The observation group was operated by laparoscopy, and the control group was operated by laparotomy. The operation related indicators, postoperative pain scores (6h, 24h, 48h, 72h) and postoperative complication rates of the two groups were counted. Result The operation time, postoperative exhaust time, postoperative eating time, postoperative out of bed time and average hospital stay of the patients in the observation group were shorter than those in the control group, with significant differences (P ＜ 0.05); The incision length of the observation group was shorter than that of the control group, and the amount of intraoperative bleeding
was less than that of the control group, the difference was significant (P ＜ 0.05). The pain scores at 6h, 24h, 48h and 72h after operation in the observation group were lower than those in the control group, and the total incidence of complications was lower than that in the control group, with significant differences (P ＜ 0.05). Conclusion Laparoscopic surgery for adult acute appendicitis has ideal surgical effect, mild postoperative pain symptoms and fewer postoperative complications.
Objective To investigate the effects of laparoscopic transabdominal preperitoneal herniorrhaphy (TAPP) on serum parameters and pain in patients with inguinal hernia. Method A total of 88 patients with inguinal hernia who received treatment in Wuchuan People's Hospital from August 2020 to August 2021 were selected as the subjects of this study, the patients were divided into control group (n=41) and observation group (n=47) according to the operation plan. The control group was treated with open tension-free hernia repair, and the observation group was treated with TAPP. The surgical serum indexes, pain degree, indicators and complications of the two groups were compared. Result 36h after surgery, the levels of C-reactive protein and interleukin-6 in 2 groups were higher than those before surgery, but significantly lower in observation group than control group (P ＜ 0.05). Visual analogue scale was used to score the pain degree of patients 3, 10 and 24 hours after surgery, and the pain degree of
the observation group was lower than that of the control group (P ＜ 0.05). The operation time, intraoperative blood loss and hospital stay in observation group were shorter than those in control group (P ＜ 0.05). The incidence of postoperative complications in observation group was less than that in control group (P ＜ 0.05). Conclusion TAPP for patients with inguinal hernia can reduce the occurrence of inflammation, effectively reduce the pain degree of patients, promote the recovery of patients.
Objective To evaluate the effect of laparoscopic hernia repair and open tension-free hernia repair in adult inguinal hernia. Method 98 adult patients with inguinal hernia hospitalized in Rugao Motou Hospital from January 2018 to February 2021 were randomly divided into two groups with 49 cases in each group. Laparoscopic hernia repair was used in the study group and open tension-free hernia repair was used in the control group. The total effective rate, surgical indicators, postoperative recovery and postoperative complications were compared between the two groups. Result The total effective rate of the study group was significantly higher than that of the control group (P ＜ 0.05); The operation time of the study group was shorter than that of the control group, and the intraoperative bleeding and hospitalization expenses were significantly less than those of the control group (P＜ 0.05). The duration of pain, time of getting out of bed, time of returning to normal activities and hospital stay in the study group were shorter than those in the control group (P ＜ 0.05), and the incidence of postoperative complications was significantly lower than that in the control group (P ＜ 0.05). Conclusion Compared with the traditional open tension-free hernia repair, laparoscopic hernia repair can improve the curative effect and reduce the postoperative complications, which is of great significance to the postoperative recovery of patients.
Objective To investigate the clinical effect of preperitoneal tension-free herniorrhaphy on hernia in the elderly. Method The clinical data of 80 elderly hernia patients treated in Beijing Huimin Hospital from March 2015 to October 2019 were analyzed retrospectively. 38 cases underwent tension-free mesh repair and 42 cases underwent preperitoneal tension-free herniorrhaphy. The clinical efficacy and surgical data's of the two groups were compared and analyzed. Result Compared with the flat tension-free mesh repair group, the patients in the preperitoneal tension-free herniorrhaphy group had less bleeding, shorter operation time, recovery time and hospital stay, and the difference was significant (P were 0.015, 0.004, 0.006 and 0.012, respectively). There was no significant difference in postoperative pain between the two groups (P ＞ 0.05). No serious postoperative
complications occurred in the two groups, and there was no recurrence during the follow-up period. Conclusion Preperitoneal tension-free herniorrhaphy has better clinical effect than tension-free mesh repair on operation time, postoperative recovery. The therapeutic effect is safe and reliable, does not increase the probability of complications and recurrence.
Objective To investigate the effect of tissue-selecting therapy stapler (TST) and procedure for prolapse and hemorrhoids (PPH) on postoperative defecation in patients with non-circular severe internal hemorrhoids. Method 80 patients with non-circular severe internal hemorrhoids admitted to Xing'an Jieshou Orthopedics Hospital from October 2019 to October 2021 were randomly divided into TST group and PPH group, with 40 cases in each group. TST group was treated with TST, PPH group with PPH. The operation, postoperative defecation and postoperative complications were compared between the two groups. Result The bleeding volume, operation time, hospital stay and wound healing time in TST group were shorter than those in PPH group (P＜0.05); the first postoperative defecation time in TST group was shorter than that in PPH group (P ＜ 0.05); the total
incidence of postoperative complications in TST group was 15.00%, which was lower than 2.50% in PPH group (P＜ 0.05). Conclusion Compared with PPH, TST has lower intraoperative bleeding, shorter operation time, faster postoperative recovery time, better postoperative defecation and lower risk of postoperative complications.
Objective To investigate the efficacy of percutaneous transhepatic gallbladder drainage (PTGD) and laparoscopic cholecystectomy in the sequential treatment of acute suppurative cholecystitis. Method A total of 94 patients with acute suppurative cholecystitis admitted to Shishou Changheng Rehabilitation Hospital from February 2020 to February 2021 were selected and divided into experimental group (n=47) and reference group (n=47) by random number table method. The control group was treated with laparoscopic cholecystectomy. The experimental group received sequential treatment with PTGD and laparoscopic cholecystectomy. The time of operation, amount of surgical blood loss, postoperative temperature recovery time, drainage time, pain degree, length of hospital stay and the probability of conversion to laparotomy were counted between the two groups, and the incidence of postoperative infection, abdominal effusion, biliary bleeding, biliary leakage and other related complications were followed up and compared between the two groups. Result The amount of surgical bleeding in the experimental group was less than that in the reference group, and the operation time, postoperative temperature recovery time,
drainage time and hospitalization days were shorter than that in the reference group, and the pain degree score was lower than that in the reference group, with significant differences (P ＜ 0.05). The conversion rates of patients in the experimental group and the reference group were 4.26% (2/47) and 17.02% (8/47), respectively, with significant difference (χ2=4.029, P ＜0.05). The incidence of postoperative complications was 6.38% in the experimental group and 21.28% in the reference group, and the difference was significant (P ＜ 0.05). Conclusion Sequential treatment of acute suppurative cholecystitis with PTGD and laparoscopic cholecystectomy can reduce the probability of patients switching to open, promote postoperative recovery and reduce the risk of postoperative complications.
Objective To analyze the clinicopathoiogic characteristics of gastric reactive nodular fibrous pseudotumor (RNFPT), to improve the understanding and preoperative diagnosis of the disease, and to prevent misdiagnose and clinical over-medication. Method Combined with a case of RNFPT admitted to the First Affiliated Hospital of Gannan Medical College, the clinical and pathological characteristics were analyzed through literature review. Result The pathological features of RNFPT is the tumors appear as a disorderly arrangement of fusiform or stellate cells, with clear boundaries, with keloid-like coarse collagen fibers，and with mucoid degeneration or hyaline degeneration. Conclusion Gastric RNFPT is considered to be a rare fibrotic inflammatory lesion caused by inflammatory stimuli or abdominal surgery. it is easy to be confused with gastric carcinoma，as there is no specific imaging manifestation. So it is very necessary to perform intraoperative rapid frozen section for preventing misdiagnosis and clinical over-medication.
Objective To explore the nursing experience of aromatherapy combined with fresh ginger tablets in alleviating nausea and vomiting reaction of postoperative chemotherapy patients with colon cancer. Method 60 patients with postoperative chemotherapy of colon cancer from the 970th Hospital of PLA in November 2018 to May 2020 were selected and randomly divided into control group (n=30) and experimental group (n=30). The control group received routine nursing, on the basis of the control group, the experimental group was given aromatherapy plus fresh ginger tablets to relieve nausea and vomiting after chemotherapy. The antiemetic efficiency and nursing satisfaction of the two groups during chemotherapy were compared. Result The effective rate of antiemesis and nursing satisfaction in the experimental group were higher than those in the control group at 12, 24 and 48 hours after chemotherapy, the difference is significant (P ＜ 0.05). Conclusion The application of
aromatherapy combined with fresh ginger can effectively alleviate the nausea and vomiting symptoms of patients with colon cancer after chemotherapy, so as to improve appetite, improve the nutritional level of patients, and improve nursing satisfaction.
Objective To analyze the effect and pain of tension-free hernia repair in elderly patients with inguinal hernia. Method 65 elderly Patients with inguinal hernia who were treated in Sheyang County People's Hospital of Yancheng City from January 2019 to February 2022 were selected as the research objects. They were randomly divided into routine group (n=32, laparoscopic hernia repair) and experimental group (n=33, hernia tension-free repair). The operation related indexes, pain and complications were compared between the two groups. Result There was no significant difference in hospitalization time between the two groups (P ＞ 0.05). The time of getting out of bed and exhausting air in the experimental group was shorter than that in the conventional group, and the hospitalization cost was lower than that in the conventional group (P ＜ 0.05). Before treatment, there was no significant difference in pain scores between the two groups (P ＞ 0.05); After treatment, the pain score of the experimental group was lower than that of the routine group (P ＜ 0.05). The total incidence of incision infection, urinary retention, scrotal hematoma, lower extremity venous thrombosis and other complications in the experimental group was not significantly different from that in the conventional group (P ＞ 0.05). Conclusion Tension-free hernia repair is effective in the treatment of senile inguinal hernia with less postoperative adverse reactions and can relieve the pain of patients.
Objective To compare and analyze the clinical efficacy of tissue-selecting therapy stapler (TST) and low anastomosis combined with latent dissection and Ruiyun procedure for hemorrhoid (RPH) combined with external dissection and internal ligation in the treatment of stage Ⅳ mixed hemorrhoids. Method 75 patients with stage Ⅳ mixed hemorrhoids treated in Yixing Fourth People's Hospital from January to December 2020 were randomly divided into observation group (40 cases) and control group (35 cases). The patients in the observation group were treated with TST and low anastomosis combined with latent dissection, and the patients in the control group were treated with RPH combined with external dissection and internal ligation. The intraoperative indexes, recovery indexes, complication rate, curative effect and recurrence rate were compared between the two groups. Result The amount of bleeding and operation time in the observation group were less than those in the control group (P ＜ 0.05). The incidence of postoperative anal edema in the observation group was less than that in the control group (P ＜0.05), but there was no significant difference in the incidence of postoperative bleeding, anal distension and incision infection between the two groups (P ＞ 0.05). There was no significant difference in the total effective rate and recurrence rate between the observation group and the control group (P ＞ 0.05), but the cure rate of the observation group was higher than that of the control group (P ＜ 0.05). Conclusion for patients with stage Ⅳ mixed hemorrhoids, the clinical efficacy of TST low anastomosis combined with latent dissection is equivalent to that of RPH combined with external dissection and internal ligation. However, TST low anastomosis combined with latent dissection has the advantages of small injury, light pain, rapid postoperative recovery, low incidence of edema and high cure rate.
Objective To analyze the value of ruiyun procedure for hemorrhoid (RPH) in the treatment of mild to moderate hemorrhoids. Method 96 patients with mild to moderate hemorrhoids treated in Zhangjiagang Hospital Affiliated to Suzhou University from January 2019 to March 2022 were selected as the research objects. The clinical data were retrospectively analyzed. The patients in the control group (n=46) were treated with traditional surgery, and the patients in the observation group (n=50) were treated with RPH. The surgical indicators, postoperative complications, treatment effects, quality of life and symptom scores of the two groups were compared. Result The postoperative pain score of the observation group was lower than that of the control group, the amount of intraoperative bleeding was less than that of the control group, and the healing time and operation time were shorter than those of the control group (P ＜ 0.05). The incidence of complications in the observation group was 6.00%,
significantly lower than 23.91% in the control group (P ＜ 0.05). The total effective rate in the observation group was 96.00%, which was significantly higher than 78.26% in the control group(P ＜ 0.05). The scores of quality of life in the observation group were higher than those in the control group after treatment, and the symptom scores after intervention were lower than those in the control group (P ＜ 0.05). Conclusion RPH is effective in the treatment of mild to moderate hemorrhoids with less complications.
Objective To investigate the effect of ultrasound-guided nerve block in laparoscopic cholecystectomy and its effect on postoperative pain. Method 62 patients who underwent laparoscopic cholecystectomy in Mianyang 404 Hospital from January 2020 to October 2021 were randomly divided into control group (31 cases, local infiltration analgesia) and observation group (31 cases, nerve block anesthesia and analgesia under ultrasound guidance). The clinical indexes, postoperative pain degree and adverse reactions of the two groups were analyzed. Result The recovery time of patients in the observation group was shorter than that in the control group; The dosage and frequency of additional analgesic drugs were less than those in the control group (P ＜ 0.05). The scores of visual analogue scale (VAS) in the observation group were lower than those in the control group at awake, 6h, 24h and 48h after operation (P ＜ 0.05). The incidence of postoperative adverse reactions in the control
group and the observation group were 6.45% and 12.90% respectively, with no significant difference (P ＞ 0.05). Conclusion The application of ultrasound-guided nerve block in patients undergoing laparoscopic cholecystectomy can not only shorten the postoperative recovery time, reduce the dosage and times of analgesic drugs, but also reduce the degree of postoperative pain.
Objective To investigate the effects of modified thoracic nerve block combined with general anesthesia on blood flow parameters and complications in patients undergoing radical mastectomy of breast cancer. Method A total of 80 patients undergoing radical mastectomy of breast cancer in our hospital from February 2018 to December 2020 were selected as the research subjects, and they were divided into routine group and study group by random number table method, with 40 cases in each group. The conventional group was treated with general anesthesia, while the study group was treated with modified thoracic nerve block combined with general anesthesia. The hemodynamic parameters, intraoperative sufentanil dosage, time of recovery and incidence of complications were compared between the two groups at before anesthesia (T0), before intubation (T1), during intubation (T2) and extubation (T3). Result At T1, T2 and T3, the fluctuation range of diastolic blood pressure, systolic blood pressure and heart rate in the study group were lower than those in the control group (P ＜ 0.05). Meanwhile, the recovery
time of sufentanil in the study group was shorter than that in the conventional group (P ＜ 0.05). The incidence of complications in the study group (5.00%) was lower than that in the conventional group (20.00%) (P ＜ 0.05). Conclusion Modified chest nerve block combined with general anesthesia in radical mastectomy of breast cancer can effectively stabilize the hemodynamic parameters of patients, reduce their intraoperative sufentanil, shorten the recovery time and reduce the incidence of complications.
Objective To investigate the effect of dexmedetomidine on stress response in elderly patients undergoing laparoscopic cholecystectomy under general anesthesia. Method The clinical data of 70 elderly patients with laparoscopic cholecystectomy under general anesthesia treated in Jiangning Hospital Affiliated to Nanjing Medical University from January 2021 to February 2022 were retrospectively analyzed. According to different anesthesia intervention methods, they were divided into control group and study group, with 35 cases in each group. The patients in the control group were treated with propofol, and the patients in the study group were treated with dexmedetomidine hydrochloride injection. The hemodynamic indexes, stress indexes and operation conditions of the two groups were compared before anesthesia induction (T0), during tracheal intubation (T1), during pneumoperitoneum establishment (T2), during tracheal extubation (T3) and 5min after extubation (T4). Result The heart rate and mean arterial pressure of the study group at T0 ～ T3 were lower than those of the control group (P ＜ 0.05), and there was no significant difference between the two groups at T4 (P ＞ 0.05). The level of plasma cortisol in the study group at T0 ～ T3 was lower than that in the control group (P ＜ 0.05), and the level of angiotensin Ⅱ in the study group at T4 was lower than that in the control group (P ＜ 0.05), and there was no significant difference between the two groups at T4 and at T0 ～ T3 (P ＞ 0.05). The duration of pain, time of getting out of bed, time of abdominal drainage tube removal and hospital s tay in the study group were shorter than those in the control group (P ＜ 0.05). Conclusion Dexmedetomidine used in elderly patients undergoing laparoscopic cholecystectomy under general anesthesia can improve hemodynamic and stress indicators, shorten the duration of pain, out of bed and hospitalization, and is conducive to postoperative recovery.
Objective To analyze the effect of early detection of D-dimer on the diagnosis of deep venous thrombosis (DVT). Method 52 patients with DVT (DVT group) and 52 healthy subjects (healthy group) admitted to Jiaozhou Hospital of Dongfang Hospital Affiliated to Tongji University from May 2020 to December 2021 were analyzed. D-dimer detection was performed in both groups, and the results of D-dimer detection were observed and compared between the two groups. Result The level of D-dimer in DVT group was significantly higher than that in healthy group (P ＜ 0.05); in the DVT group, 52 cases were positive for D-dimer, and in the healthy group, 15 cases were positive for D-dimer. The sensitivity and specificity of D-dimer were 98.08% and 100.00%. Conclusion The detection of D-dimer has high sensitivity and specificity, and can effectively predict the early formation of DVT.
Objective To investigate the diagnostic value of leukocyte count and serum C reactive protein levels in the onset of acute appendicitis and changes in the condition. Method 150 patients with acute appendicitis treated in Guihang Guiyang Hospital from October 2018 to June 2021 were selected as the observation group, including 63 cases of simple appendicitis, 52 cases of suppurative appendicitis and 35 cases of gangrenous appendicitis according to the pathological type. 50 patients with abdominal pain suspected of appendicitis were selected as the control group. The leukocyte count and serum C reactive protein level of the two groups were compared, and the leukocyte count and serum C reactive protein level of patients with acute appendicitis of different pathological types were compared. The diagnostic efficacy of leukocyte count and serum C reactive protein level for acute appendicitis was calculated, and the receiver operating characteristic curve (ROC curve) was drawn. Result The leukocyte count and serum C reactive protein level in the observation group were significantly higher than those in the control group (P ＜ 0.01). The leukocyte count and serum C reactive protein level in patients with gangrenous appendicitis were significantly higher than those in patients with suppurative appendicitis and simple appendicitis. The leukocyte count and serum C reactive protein level in patients with suppurative appendicitis were significantly higher than those in patients with simple appendicitis (P ＜ 0.01). ROC curve analysis showed that the area under ROC curve (0.8952) of leukocyte count ＞ 10×109/L combined with C reactive protein ＞ 50mg/L was the highest in the diagnosis of acute appendicitis, which was significantly higher than that of other diagnostic methods (P＜ 0.05). Conclusion Leukocyte count and serum C reactive protein levels in patients with acute appendicitis are significantly increased and are closely related to the change of condition, which has certain diagnostic value for the onset and evaluation of acute appendicitis, while combined diagnosis can improve diagnostic efficacy and have high clinical significance.
Objective To explore the application value of ultrasound-guided improved puncture in open venous indwelling needle catheterization for patients undergoing surgery. Method A total of 253 patients who were admitted to Suizhou Zengdu Hospital from October 2020 to June 2021 and needed peripheral venous indwelling needle were randomly divided into two groups: A (128 cases) and B (125 cases), in which group A underwent improved ultrasound-guided puncture and group B underwent conventional puncture. The success rate of onetime puncture and catheterization was compared between the two groups. The number of puncture times, operation time and pain degree during puncture were compared between the two groups. The incidence of complications was compared between the two groups. Result The success rate of one-time puncture catheterization in group A was 82.81%, which was significantly higher than that in group B (P ＜ 0.05). Operation time and numerical rating scale score in group A were significantly lower than those in group B (all P ＜ 0.05). The total incidence of puncture
complications in group A was significantly lower than that in group B (P ＜ 0.05). Conclusion The improved puncture guided by ultrasound can significantly improve the puncture efficiency, reduce the pain and effectively prevent the puncture complications in the operation of open venous indwelling needle.
Objective To analyze the effect of comprehensive nursing intervention applied to patients with laparoscopic anterior inguinal hernia. Method 40 patients with indirect inguinal hernia treated in Huaiyin Hospital in Huai'an City from January 2021 to November 2021 were selected. All patients were treated with laparoscopic anterior inguinal hernia patch implantation. The patients were divided into study group and control group by computer blind selection, with 20 cases in each group. Routine nursing was used in the control group during perioperative period, and comprehensive nursing intervention was used in the study group to compare the nursing effects. Result The anal exhaust time, ambulation time, defecation time and hospitalization time in the study group were (20.25±5.50)h, (16.31±4.61)h, (32.56±3.54)h and (3.55±1.14)d, respectively, shorter than those in the control group(24.02±5.33)h, (20.50±4.33)h, (37.76±4.62)h and (4.92±1.03)d, with significant differences
(P ＜ 0.05). The pain scores of the study group on the 1st and 3rd day after operation were (2.33±1.03) and (1.72±0.63) respectively, which were significantly lower than those of the control group (P ＜ 0.05). The scores of Hamilton Anxiety Scale and depression scale in the study group were (8.24±1.58) and (11.58±1.26) respectively, which were lower than those in the control group (P ＜ 0.05). Conclusion Comprehensive nursing intervention during the perioperative period can significantly improve patients' pain and promote their recovery. At the same time, nursing satisfaction and complications are good.
Objective To observe the nursing effect of accelerated rehabilitation surgery in patients with large gastrectomy. Method 82 patients admitted from large gastrectomy in Zhangqiu District People's Hospital of Jinan from January 2021 to January 2022, were randomly divided as 41 patients with control (routine care) and observation (accelerated rehabilitation surgical care), and the postoperative recovery and complications of the two groups were compared. Result The bowel recovery time, first exhaust time, anal exhaust time and hospitalization time were lower than the control group, and the incidence of complications was lower than that of the control group (P ＜ 0.05); the quality of life score and excellent recovery rate of the observation group were higher than the control group (P ＜ 0.05). Conclusion Accelerating rehabilitation surgical care in patients undergoing major gastrectomy helps to reduce the incidence of complications, improve the quality of life of patients, and promote the
recovery of patients.
Objective To explore the influence involved in the healing of pressure sores homecare patients instructed by Procedure dressing change. Method 79 cases of homecare patients suffer from pressure sores who consulted and was operated dressing change in Qingdao Municipal Hospital between March 2019 and October 2021 was selected. Grouped according to random number table method. The contrast group was the 40 cases which was instructed with regular dressing change. The study group was the 39 cases instructed with procedure dressing change. The effective healing rate、Recurrence rate of pressure sore wound and Correct rate of dressing change of family members was compared between the two groups. Result The effective healing rate in study group was much higher than that in the contrast group(P ＜ 0.05). Recurrence rate of pressure sore in the study group was much lower than that in the contrast group(P ＜ 0.05). The correct rate of dressing change of family members in study group was significantly higher than that in the contrast group(P ＜ 0.01). Conclusion Instructing by procedure dressing change can effectively promote healing the pressure wounds of homecare patients and Shorten healing time and reduce recurrence rate. It can improve the cognition of pressure ulcers and self-care skills of patients and their families, and improve the quality of life of patients.
Objective To analyze the preventive effect of cluster nursing intervention on postoperative inflammatory intestinal obstruction in the clinical nursing of patients undergoing gastrointestinal surgery. Method 80 patients with gastrointestinal surgery treated in Nantong Tongzhou District Hospital of Traditional Chinese Medicine from January 2020 to July 2021 were selected as the research samples. They were divided into the experimental group and the reference group by double-blind method, with 40 cases in each group. The experimental group was treated with cluster nursing intervention, and the reference group was treated with routine nursing intervention. The recovery and the incidence of postoperative complications of the two groups were compared. Result The first exhaust time, the first defecation time and the recovery time of bowel sounds in the experimental
group were shorter than those in the reference group, the abdominal distension score was lower than that in the reference group, the difference was significant (P ＜ 0.05), and the incidence of complications was lower than that in the reference group, the difference was significant (P ＜ 0.05). Conclusion The application of cluster nursing intervention in the clinical nursing of patients undergoing gastrointestinal surgery can prevent the occurrence of postoperative inflammatory intestinal obstruction and shorten the recovery time of patients.
Objective To study the application value of vacuum-assisted rotary resection system in the treatment of benign breast tumors. Method 120 patients with breast benign tumors who were operated in Pingdu Maternal and Child Health Hospital from November 2018 to October 2019 were selected and divided into the observation group (60 cases) and the control group (60 cases) according to different surgical methods. The observation group adopted vacuum assisted rotary resection technology, and the control group adopted traditional open surgery. The operation related indexes, postoperative complications and patient satisfaction were compared between the two groups. Result The operation time (12.08±3.69)min, incision length (3.78±0.78)mm and intraoperative bleeding (6.65±3.01)ml in the observation group were significantly better than those in the control group (P ＜ 0.05). The incidence of postoperative complications in the observation group was 15.00% (9/60), lower than 31.67% (19/60) in the control group. Postoperative pain and patient satisfaction were better than those in the control group, with significant differences (P ＜ 0.05). Conclusion The vacuum assisted rotary resection system can be used to treat benign breast tumors. The operation time is short, the surgical incision is small, the amount of bleeding is small, the healing is fast, the postoperative pain is relieved in time, the cosmetic effect is good, and the postoperative patient satisfaction is high.
Objective To analyze the effect of esophageal stent and percutaneous gastrostomy in the treatment of esophageal malignant obstruction. Method 70 patients with esophageal cancer obstruction admitted to Renhuai People's Hospital from January 2020 to December 2021 were selected and divided into two groups according to different treatment methods, 35 patients in each group. The patients in the control group were treated with esophageal stent implantation, while the patients in the study group were treated with percutaneous gastrostomy under the guidance of computed tomography. The level of nutritional indicators, recovery of related indicators and complications were compared between the two groups. Result The body mass index, serum albumin, prealbumin and hemoglobin levels in the study group were significantly higher than those in the control group (P ＜ 0.05).
The operation time of the patients in the study group was shorter than that in the control group, the amount of intraoperative bleeding was less than that in the control group, and the postoperative pain score was lower than that in the control group, and the quality of life score was higher than that in the control group, with significant differences (P ＜ 0.05). The patients in both groups had a high tolerance during the operation. The operation was carried out smoothly. The success rate of the operation was 100%. There were no fatal serious complications. The patient's condition and vital signs were stable after the operation. There were no serious complications in the two groups, such as fistula exchange catheter falling off, massive hemorrhage, gastrointestinal injury, etc. The total incidence of complications in the study group was 20.00% (7/35), and 22.86% (8/35) in the control group,there was no significant difference (χ2=3.426,P=0.386). Conclusion In the treatment of esophageal obstruction, percutaneous gastrostomy is more effective than esophageal stent in improving patients' nutritional indicators, and has higher clinical safety.
Objective To investigate the effect of PhysioTouch negative pressure lymphatic return promotion system combined with manual lymphatic drainage technology combined with comprehensive rehabilitation in patients with upper limb lymphedema after breast cancer surgery. Method 132 patients with upper limb lymphedema after breast cancer surgery who were admitted to Enshi Central Hospital from May 2020 to June 2021 were selected. According to the random number table, they were divided into a bare hand group (bare hand lymphatic drainage technology) and a negative pressure group (PhysioTouch negative pressure lymphatic reflux
promotion system), 66 cases in each group. Both groups were given comprehensive rehabilitation treatment. The clinical effect and shoulder joint function of the two groups were observed. Result After treatment, the total effective rate of the negative pressure group was 93.94% higher than that of the unarmed group 81.82%, and the scores of shoulder joint function, muscle strength, activity ability and daily activity ability were higher than those of the unarmed group, with significant differences (P ＜ 0.05). Conclusion PhysioTouch negative pressure lymphatic drainage promotion system and bare handed lymphatic drainage technology combined with comprehensive rehabilitation can improve shoulder joint function and clinical efficacy in patients with upper limb lymphedema after breast cancer surgery. PhysioTouch negative pressure lymphatic drainage promotion system has obvious advantages in improving shoulder joint pain, muscle strength, mobility, and daily action ability.
Objective To analyze laparoscopic common bile duct exploration (LCBDE) combined with laparoscopic cholecystectomy (LC) and endoscopic retrograde pancreatic angiography (ERCP) combined with LC in the treatment of common bile duct calculi clinical effect and safety of gallstone disease. Method A total of 300 patients with choledocholithiasis and cholecystolithiasis undergoing surgical treatment in The Affiliated Hospital of Gansu Medical College from February 2020 to February 2022 were randomly divided
into LCBDE+LC group and ERCP+LC group, with 150 cases in each group. Patients in the two groups were treated with LCBDE+LC and ERCP+LC respectively, and the operative indicators and postoperative recovery of patients in the two groups were compared. Result There was no case of conversion to laparotomy in the two groups. The operative time and intraoperative blood loss in the ERCP+LC group were less than those in the LCBDE+LC group, but the utilization rate of abdominal drainage tube was lower than that in the LCBDE+LC group (P ＜ 0.05). There were no significant differences in the success rate of intraperitoneal adhesion, stone removal and stone removal rate between 2 groups (P ＞ 0.05). The postoperative exhaust time and recovery time of PATIENTS in LCBDE+LC group were shorter than those in ERCP+LC group (P＜ 0.05). There was no significant difference in the incidence of postoperative complications between 2 groups (P ＞ 0.05). Conclusion Both LCBDE+LC and ERCP+LC can achieve good surgical results in the treatment of choledocholithiasis and cholecystolithiasis, but the choice of surgical method should be considered comprehensively according to the age of patients, clinical symptoms and other factors, so as to improve the success rate of treatment.
Objective To discuss the clinical value of 3D laparoscopic radical gastrectomy for gastric cancer. Method 72 patients with gastric cancer treated in our hospital from April 2020 to October 2021 were randomly divided into control group and study group, with 36 cases in each group. The control group received 2D laparoscopic radical gastrectomy for gastric cancer and the study group received 3D laparoscopic radical gastrectomy for gastric cancer. The perioperative indicators, serum indicators and the incidence of complications were compared between the two groups. Result The operation time, exhaust time, diet recovery time, hospitalization
time and lymph node cleaning time of patients in the study group were lower than those in the control group, and the amount of bleeding during operation, the number of wrong grasping during operation were less than those in the control group, and the number of lymph node cleaning was higher than that in the control group, with significant differences (P ＜ 0.05); The levels of albumin, prealbumin, transferrin and retinol binding protein in the study group were higher than those in the control group, while the level of C reactive protein was lower than that in the control group, and the incidence of complications was lower than that in the control group, with significant differences (P ＜ 0.05). Conclusion 3D laparoscopic radical gastrectomy for gastric cancer is effective for patients with gastric cancer. It can effectively accelerate the rehabilitation process of patients, maintain the stability of serum indicators, and reduce complications. It has great clinical value.
Objective To explore the application of multiple serum tumor markers in the diagnosis of primary liver cancer. Method 105 patients with primary liver cancer, benign liver disease and non liver disease who were treated in Wuzhou Workers' Hospital from January 2019 to December 2021 were selected, and 35 patients were included in the liver cancer group, the benign liver disease group and the control group respectively according to different diseases. Detect the abnormal prothrombin (DCP), alpha fetoprotein (AFP) α- L-fucosylase(AFU), carbohydrate antigen 19-9 (CA19-9), and evaluate the diagnostic value of the above indicators alone and in
combination. Result The DCP, AFP, AFU, CA19-9 water of patients with liver cancer were higher than those of the other two groups on average, and there was significant difference between the two groups (P<0.05). According to the analysis of the working characteristic curve of the subjects, the best diagnostic thresholds of serum DCP, AFP, AFU and CA19-9 were 39.38mAU/ml, 48.35μg/L, 25.93U/L and 50.54U/ml, respectively. The Jordan index of the tandem test of AFP+AFU and DCP+AFP+AFU was the largest, 0.757. Conclusion Among serum DCP, AFP, AFU and CA19-9, AFP combined with AFU has the highest diagnostic efficacy.
Objective To investigate the clinical efficacy and safety of automatic elastic thread ligation combined with external hemorrhoidectomy for patients with mixed hemorrhoids. Method 160 patients with mixed hemorrhoids were selected from December 2019 to March 2022 in Jinhu County Hospital of Traditional Chinese Medicine in Huai'an City. According to the results of random red and white ball lottery, they were divided into the control group (80 patients with white balls) and the observation group (80 patients with red balls). The control group was treated with traditional external incision and internal ligation, and the observation group was treated with the combined scheme of automatic elastic thread ligation and external hemorrhoid resection. The pain, edema, and bleeding of the patients in the two groups 1 day, 3 days, and 6 days after surgery were observed and
evaluated The changes of symptoms such as anal distension were observed and the incidence of complications such as wound bleeding and urine retention was observed and counted. Result The pain score, edema symptom score and anal distension score of patients in the observation group on the 1st, 3rd and 6th day after operation were lower than those in the control group (P ＜ 0.05). The difference is significant between the two groups in the probability of complications such as wound bleeding and urine retention (P ＜ 0.05). Conclusion The combination of automatic elastic thread ligation and external hemorrhoidectomy is the first choice for clinical treatment of mixed hemorrhoids. Compared with the traditional treatment, it can effectively reduce the postoperative pain, edema, anal distension and other symptoms, with fewer complications and ideal safety.
Due to the particularity of the operation site, the operation of mixed hemorrhoids often adopts open treatment after the operation. The risk of wound contamination is high. The poor growth of wound granulation tissue, edema, and slow wound healing are common problems that anorectal surgeons have when treating patients. In recent years, the understanding of related mechanisms of wound repair has been deepened, especially the application of new materials and technologies, providing more clinical options. Traditional Chinese medicine has the advantages of precise curative effect, high safety and low price in the treatment of wounds, and is widely used in clinical practice. This paper reviews the research progress of traditional Chinese and western medicine on wound repair.
Hepatocellular carcinoma (HCC) is one of the six most common malignant tumours globally. Early diagnosis and timely surgical resection can maximise the benefits for patients. However, based on the unique pathophysiological characteristics of the liver, most patients have been in the advanced stage of the tumour at the initial diagnosis and lost the opportunity of surgical resection; transcatheter arterial chemoembolisation (TACE) is its definitive treatment, but HCC patients with portal vein tumor thrombus (PVTT) are relatively contraindicated to TACE treatment. Hepatic artery infusion chemotherapy (HAIC) using the characteristics of liver first-pass effect, continuous high-concentration infusion of chemotherapeutic drugs directly into tumour blood supply arteries has made remarkable achievements in middle and advanced HCC in recent years. However, there is no unified diagnosis and treatment standard and specification for HAIC. This paper reviews the clinical application of HAIC in advanced HCC.
Objective To explore the effect of percutaneous abdominal puncture and drainage in the diagnosis and treatment of closed abdominal injury combined with splenic contusion and laceration. Method From January 2016 to June 2021, 52 patients with closed abdominal injury combined with splenic contusion and laceration admitted to Hechi People's Hospital were selected for non-surgical treatment through percutaneous abdominal puncture and drainage. The clinical data of the patients were analyzed retrospectively, and the clinical diagnosis and treatment results, complications and improvement of quality of life were counted. Result Among 52 patients with closed abdominal injury and splenic contusion and laceration, 51 patients had positive puncture results. The positive rate and accuracy of puncture were 98.08%. One case was false positive due to puncture complications. The
incidence of puncture complications was 1.92%. Moreover, none of the patients in this study had non therapeutic laparotomy and death. Among them, except for 1 case of secondary bleeding and 1 case of delayed intestinal perforation, the remaining 50 cases were cured and discharged after conservative treatment, and the success rate of conservative treatment was 96.15%. After 3 months of follow-up, there were no complications except 1 case of adhesive intestinal obstruction, and the quality of life score of the patients was significantly higher than that before discharge (P ＜ 0.05). Conclusion Percutaneous abdominal puncture and catheter drainage for the treatment of abdominal closed injury combined with splenic contusion and laceration has a high positive rate of puncture and diagnostic accuracy. At the same time, it can reduce puncture complications, improve the success rate of
conservative treatment, and improve the quality of life of patients.
Objective To investigate the effect of laparoscopic posterior triangular approach combined with blunt cold separation in laparoscopic cholecystectomy. Method From January 2020 to December 2021, 74 patients undergoing laparoscopic cholecystectomy in Suqian Integrated Traditional Chinese and Western Medicine Hospital were selected. All patients were dissected by blunt cold separation method during the operation. According to different surgical approaches, they were divided into the test group (41 cases via the posterior triangle approach of the gallbladder) and the control group (33 cases via the anterior triangle approach of the gallbladder). The basic surgical indicators of the two groups were compared and the complications were counted. Result The operation time (51.37±7.84)min in the test group was shorter than that in the control group (56.85±7.36)min, and the
amount of intraoperative bleeding (30.22±5.68)ml was less than that in the control group (34.49±6.30)ml, the difference was statistically significant (P ＜ 0.05). There was no significant difference in gastrointestinal function recovery and discharge time between the two groups (P ＞ 0.05). The conversion rate of the test group (0) was lower than that of the control group (12.12%), and the incidence of surgical complications (2.44%) was lower than that of the control group (15.15%), with statistically significant differences (P ＜ 0.05). Conclusion Laparoscopic cholecystectomy through the posterior triangle approach can better expose the gallbladder and its adjacent relationship with surrounding tissues, facilitate the identification of extrahepatic bile duct structure and variation, combine with blunt cold separation, shorten the operation time, effectively prevent and reduce iatrogenic bile duct
injuries, reduce conversion to laparotomy, and is safe and effective.
Objective To investigate the effect of propofol combined with etomidate anesthesia induction on hemodynamics and inflammatory factors in patients undergoing laparoscopic cholecystectomy. Method 80 cases of laparoscopic cholecystectomy patients admitted to Qinghai Tibetan Hospital from January 2020 to January 2022 were selected and divided into two groups with 40 cases each according to the method of numerical random table. The control group was anesthetized with propofol, and the observation group was anesthetized with propofol and etomidate. The hemodynamic changes at different time points during the operation were compared between the two groups, the changes of inflammatory factors were detected in the two groups, and the adverse reactions of anesthetic drugs were evaluated. Result After induction, the heart rate and mean arterial pressure in the observation group were significantly higher than those in the control group (P ＜ 0.05); the level of inflammatory indicators in the
observation group was lower than that in the control group on the first day after operation, and the recovery time of eye opening, catheter removal and directional force was shorter than that in the control group, with significant differences (P ＜ 0.05). There was no significant difference in the incidence of adverse reaction to anesthesia between the two groups (P ＞ 0.05). Conclusion Propofol combined with etomidate anesthesia induction for laparoscopic cholecystectomy has good effect, stable hemodynamics and high safety.
Objective To investigate the clinical effect of percutaneous transhepatic cholangioscopy (PTCS) hard lens lithotripsy in the treatment of intrahepatic bile duct stones. Method From March 2019 to January 2022, 40 patients with hepatolithiasis admitted to Yanting County People's Hospital, were selected and divided into the observation group and the control group according to the random number table, with 20 patients in each group. The patients in the control group were treated with traditional laparoscopic intrahepatic bile duct lithotomy, and the patients in the observation group were treated with PTCS hard lens lithotripsy. The patients in both groups were followed up for 3 months after operation. The operation related indexes, liver function level, quality of life, recurrence and complications of the two groups were compared. Result The intraoperative bleeding volume of the patients in the observation group was lower than that in the control group, and the hospital stay, postoperative exhaust time, and operation time were shorter than those in the control group. The success rate of primary lithotripsy and the stone clearance rate 2 weeks after operation were higher than those in the control group, with significant differences (P ＜ 0.05). The levels of serum alanine aminotransferase, glutamic oxaloacetic transaminase, total bilirubin and serum albumin in the two groups were significantly lower than those in the control group 2 weeks after operation; The scores of physiological function, somatic pain, health status and emotional function of the patients in the two groups increased 3 months after operation compared with those before operation, and the scores in the observation group were significantly higher than those in the control group; Within 3 months after operation, the total incidence of complications and recurrence rate in the observation group were lower than those in the control group, with significant differences (P ＜ 0.05). Conclusion PTCS hard lens lithotripsy can effectively reduce liver injury, restore liver function, improve patients' quality of life, reduce the risk of complications and the possibility of stone recurrence.
Objective To investigate the efficacy and safety of the posterior triangle approach in laparoscopic cholecystectomy for patients with cholecystolithiasis and chronic cholecystitis. Method From January 2019 to April 2022, 120 patients with cholecystolithiasis and chronic cholecystitis who were admitted by Chuzhou Hospital of Traditional Chinese Medicine in Huai'an City were selected, all of whom received laparoscopic surgery. According to different approaches, the observation group (60 cases) and the control group (60 cases) were divided into two groups. The control group adopted the triangular approach through the gallbladder, and the observation group implemented the posterior triangular approach through the gallbladder. The clinical indicators of the two groups
were recorded and compared, Detect and analyze the difference of inflammatory level and immune function changes between the two groups before and after operation, and observe and count the total incidence of postoperative complications in each group. Result The total operation time and recovery time of patients in the observation group were shorter than those in the control group, and the intraoperative bleeding was less than that in the control group (P ＜ 0.05). At 72h after operation, the TNF-α and IL-6 levels in the observation group were lower than those in the control group, and the percentage of CD4+and CD8+T cells were higher than those in the control group (P ＜ 0.05). Conclusion Laparoscopic cholecystolithiasis with chronic cholecystitis can be performed by the posterior triangle approach, which can effectively reduce the inflammatory reaction caused by surgery, and has less postoperative complications and high safety.
Objective To analyze the effect of acupoint sticking combined with rehabilitation therapy on postoperative gastrointestinal function recovery in elderly patients. Method From February 2020 to February 2022, 300 elderly patients after gastrointestinal surgery in the Second People's Hospital of Pingliang were selected as the research objects, and divided into the control group (150 cases, receiving conventional treatment) and the observation group (150 cases) by random number table method. , and acupoint sticking combined with rehabilitation therapy), the recovery of gastrointestinal function, the improvement of quality of life and the improvement of nutritional status were compared between the two groups. Result The hospitalization time, defecation time, eating
time, bowel sound recovery time and anal exhaust time of the observation group were shorter than those of the control group, and the difference was significant (P ＜ 0.05). There was no significant difference in the quality of life between the two groups before treatment (P ＞ 0.05). After treatment, the scores of various indicators of the quality of life in the two groups were improved, and the observation group was more prominent than the control group (P ＜ 0.05). There was no significant difference in the levels of albumin and hemoglobin between the two groups before treatment (P ＞ 0.05). After treatment, the levels of albumin and hemoglobin in the two groups were increased, and the observation group was higher than the control group, and the difference was significant (P ＜ 0.05). Conclusion The application of acupoint sticking combined with rehabilitation therapy in elderly patients is beneficial to the recovery of gastrointestinal function after operation, improves the quality of life and nutritional status of patients, and promotes the recovery of patients.
Objective To analyze the application of accelerated rehabilitation surgery (ERAS) in colorectal cancer surgery. Method 120 colorectal cancer patients hospitalized in Nanjing Gaochun People's Hospital from May 2018 to May 2021 were selected and randomly divided into control group and observation group with 60 patients each. The control group received traditional rehabilitation intervention and the observation group received ERAS intervention. The postoperative recovery indicators, serum inflammation indicators and the total incidence of complications of the two groups were compared. Result The first anal exhaust, defecation time and hospitalization time in the observation group were shorter than those in the control group, with significant differences (P ＜ 0.05). The serum tumor necrosis factor-α, C reactive protein and interleukin-6 in the observation group were lower than those in the control group 3 days after operation, and the total incidence of complications (1.67%) was lower than
that in the control group (13.33%), with significant differences (P ＜ 0.05). Conclusion ERAS can shorten recovery time, reduce inflammatory response and reduce complications in colorectal cancer patients.
Objective To analyze the value of different schemes in the treatment of small colorectal polyps. Method From January 2020 to January 2021, 60 patients with small colorectal polyps admitted to Jilin Cancer Hospital were selected and randomly divided into two groups (30 patients in each group). The control group was treated with hot snare resection under enteroscope, and the observation group was treated with cold snare resection under enteroscope. The clinical efficacy, complications, surgery and recovery, and recurrence rate of the two groups were compared. Result The clinical efficacy of the observation group (96.67%) was higher than that of the control group (80.00%), and the incidence of complications (6.67%) was lower than that of the control group (26.67%), with significant differences (P<0.05). The number of polyps removed and the diameter of polyps in the observation group were not significantly different from those in the control group, but the polyp removal time and colonoscopy
operation time were shorter than those in the control group, with significant differences (P ＜ 0.05). There was no significant difference between the observation group and the control group in the time of underground activity and hospitalization expenses, but the hospitalization time was shorter than the control group, and the incision size was larger than the control group, with significant differences (P ＜ 0.05). Conclusion Compared with the treatment of small colorectal polyps with hot snare resection under colonoscopy, cold snare resection under colonoscopy is safer and more effective. By shortening the resection time, it can promote patients to go to the ground and leave hospital as soon as possible.
Objective To analyze the effect of laparoscopic surgery and traditional open surgery in the treatment of inguinal hernia. Method From July 2018 to July 2021, 50 male patients with inguinal hernia from Xingpu Hospital in Suzhou Industrial Park were selected and randomly divided into the reference group (treated with traditional open surgery) and the research group (treated with laparoscopic surgery) by using the method of random color ball sampling. There were 25 patients in each group, and the surgical indicators and postoperative quality of life of the two groups were compared. Result The incidence of complications such as scrotal hematoma and incision infection in the study group was significantly lower than that in the control group (P ＜ 0.05); The
operation time, hospital stay and bed rest time of the patients in the study group were shorter than those in the reference group, and the amount of intraoperative bleeding was less than that in the reference group, with a significant difference (P ＜ 0.05). The post-operative pain scores of patients in the study group were lower than those in the reference group, and the quality of life scores were higher than those in the reference group, with significant differences (P ＜ 0.05). Conclusion Laparoscopic surgery is more effective in the treatment of inguinal hernia, which can reduce complications, optimize surgical indicators, promote postoperative recovery, reduce pain.
Objective To compare the effect of plug tension-free hernioplasty (Rutkow method) and traditional hernioplasty (Bassini method) in inguinal hernia. Method 100 patients with inguinal hernia admitted to Pingliang Second People's Hospital from March 2019 to March 2021 were selected and divided into the control group and the observation group according to the random number table method, with 50 of each group. The patients in the observation group received filling Rutkow tension-free hernia repair, while the patients in the control group received traditional Bassini hernia repair. The incidence of complications, perioperative indicators, treatment satisfaction, as well as quality of life and microenvironment related indicators before and after treatment were compared between the two groups. Result The amount of bleeding during operation in the observation group was less than that in the
control group, the duration of pain, the time of getting out of bed and hospitalization were shorter than those in the control group, but the operation time was longer than that in the control group, with significant differences (P ＜ 0.05). The incidence of wound infection, hematoma, scrotal effusion, urinary retention and other complications in the observation group was lower than that in the control group, and the treatment satisfaction, improvement of microenvironment related indicators and quality of life in the observation group were significantly better than those in the control group (P ＜ 0.05). Conclusion Filling tension-free hernioplasty for inguinal hernia patients can effectively shorten the duration of pain, the time of getting out of bed and hospitalization, reduce intraoperative bleeding, reduce the incidence of complications, improve treatment satisfaction, and improve microenvironment
indicators and quality of life.
Objective To observe the difference between laparoscopic transperitoneal preperitoneal prosthesis (TAPP) and open tension free hernioplasty (OTFH) in the treatment of adult inguinal hernia. Method 80 adult patients with inguinal hernia admitted to Guiping People's Hospital from January 2019 to December 2021 were selected and divided into the observation group (TAPP treatment) and the control group (OTFH treatment) according to the random number table. Record the surgical indicators of patients, compare the changes of stress indicators, evaluate the clinical efficacy and follow up the complications. Result The operation time and activity time of the patients in the observation group were shorter than those in the control group, and the amount of
intraoperative bleeding was less than that in the control group, with significant differences (P ＜ 0.05), but there was no significant difference in the hospital stay between the two groups (P ＞ 0.05). After operation, the levels of stress indicators in both groups were increased, while those in the control group were significantly higher; The levels of stress indexes in the observation group were significantly higher than those in the control group (P＜0.05). There was no significant difference in the total effective rate between the two groups (97.50% vs 92.50%, P=0.608). The total incidence of complications in the observation group was lower than that in the control group (20.00%), with a significant difference (P ＜ 0.05). Conclusion TAPP is more effective and safe than OTFH in treating adult inguinal hernia.
Objective To investigate the effect of moxa stick moxibustion on gastrointestinal function recovery of patients after laparoscopic appendectomy. Method From June 2021 to December 2021, 74 patients with laparoscopic appendicitis in Taixing Hospital of Traditional Chinese Medicine were selected and randomly divided into control group (n=37) and study group (n=37). The control group received routine postoperative care, while the study group received moxibustion intervention on this basis. Objective and subjective indexes of gastrointestinal function recovery were compared between the two groups. Result After intervention, the time of first exhaust, first defecation and recovery of bowel sounds in the study group were lower than those in the control group (P ＜ 0.05). Before intervention, there was no significant difference in the subjective indexes of gastrointestinal function recovery between the two groups (P ＞ 0.05); After intervention, the abdominal distension syndrome and VAS score in the study group were lower than those in the control group (P ＜ 0.05). Conclusion Through this study, it can be seen that the implementation of moxa stick moxibustion intervention in patients after laparoscopic appendicitis surgery can significantly improve gastrointestinal function, shorten the recovery time of rapid exhaust, defecation and bowel sounds after surgery, relieve pain, improve abdominal distension syndrome, accelerate the improvement of the patient's condition, and facilitate the patient's recovery.
Objective To explore the effect of cooperative nursing mode on self-efficacy and quality of life of patients with rectal cancer after colostomy. Method From April 2020 to February 2022, 70 patients with colostomy after rectal cancer surgery in Nanjing Liuhe District People's Hospital were selected as the study samples, and they were divided into the experimental group and the conventional group according to the different nursing methods, with 35 patients in each group. Traditional nursing mode was adopted in the conventional group, and cooperative nursing mode was adopted in the experimental group. The self-efficacy and quality of life of the two groups were compared. Result After nursing, the self-efficacy scores of the two groups showed an upward trend, and the self-efficacy scores of the experimental group were higher than those of the conventional group, the difference
is significant (P ＜ 0.05). After nursing, the scores of physical function, role function, cognitive function and emotional function in the experimental group were higher than those in the conventional group, the difference is significant (P ＜ 0.05). Conclusion On the basis of routine nursing, the application of cooperative nursing mode has a significant effect on the patients with rectal cancer after colostomy. It can improve their self-efficacy, improve their quality of life, which is conducive to the improvement and recovery of the disease.
Objective To observe the effect of nursing intervention in patients with rectal cancer after operation under the positive incentive mode. Method From January 2019 to January 2022, 80 patients with rectal cancer after operation in Nanjing Liuhe District People's Hospital were selected and divided into control group and study group according to different nursing methods, with 40 patients in each group. The control group was given routine nursing mode, while the study group was given positive incentive nursing mode on this basis. The emotion and self-care ability of the two groups were analyzed and compared. Result Before nursing, there was no significant difference in the scores of self rating anxiety scale (SAS) and self rating depression scale (SDS) between the two
groups (P ＞ 0.05); after nursing, the SAS and SDS scores of patients in the study group were lower than those in the control group (P ＜ 0.05). Before nursing, there was no significant difference in self-care ability between the two groups (P ＞ 0.05); after nursing, the scores of self-care responsibility, skills, knowledge and self-concept of patients in the study group were higher than those in the control group, with significant differences (P ＜ 0.05). The improvement of patients in the study group after nursing was better than that before nursing. Conclusion Based on the conventional nursing mode, the application of positive incentive mode in the postoperative patients with rectal cancer can reduce the patients' negative emotions, enhance the patients' self-care ability, improve the prognosis and shorten the rehabilitation time.
Objective To summarize the nursing experience of endovascular therapy in patients with limb arterial thrombosis. Method The clinical data of 52 patients with limb arterial thrombosis treated by endovascular treatment were retrospectively analyzed, and the nursing problems and corresponding nursing measures in the perioperative period of endovascular treatment mainly based on catheter-directed thrombolysis (CDT) were discussed. Result The patients in this group were able to tolerate transluminal surgery, and the success rate of surgery was 94.2% (49/52), 23 cases of CDT alone, 19 cases of CDT+percutaneous transluminal angioplasty (PTA), 10 cases of CDT+PTA+ stent angioplasty, and no perioperative deaths. Conclusion Through comprehensive and
meticulous preoperative preparation, real-time communication with patients during surgery, listening to patient complaints, close observation of the disease and prevention of the occurrence of various complications after surgery, etc, the occurrence of adverse events is avoided in a timely and effective manner, and nursing protection is provided for the success of surgery. The implementation of comprehensive and predictive nursing measures is an important prerequisite for the satisfactory results of intraluminal technology in the treatment of patients with limb arterial thrombosis.
Objective To explore the application value of enhanced recovery after surgery (ERAS) concept combined with pathologic health education in patients with Arteriosclerotic obliterans (ASO). Method A total of 124 ASO inpatients in Renmin Hospital of Wuhan University from October 2018 to October 2021 were selected as the study subjects. According to the random number table method, they were divided into control group and ERAS group, 62 cases in each group. The control group received routine nursing intervention during perioperative period. ERAS group received perioperative nursing intervention based on routine nursing intervention using ERAS concept combined with path-based health education nursing intervention. Postoperative recovery and incidence of complications were observed between the two groups, and changes in disease-related knowledge, mental resilience
level and quality of life were compared before and after intervention. Result The time of getting out of bed for the first time and hospitalization in ERAS group were shorter than those in the control group. The score of visual analog scale (VAS) and the incidence of complications in ERAS group were lower than those in the control group (P ＜ 0.05); The 6-minute walking test (6MWT) walking distance in ERAS group was significantly higher than that in control group (P ＜ 0.05); After the intervention, the scores of disease related knowledge, psychological resilience and quality of life in the two groups were higher than those before the intervention (P ＜ 0.05), and the ERAS group was higher than the control group, with significant differences (P ＜ 0.05). Conclusion ERAS concept combined with path-based health education can effectively promote postoperative rehabilitation of ASO patients in lower limbs, reduce the incidence of postoperative complications, and improve disease cognition, mental resilience
and quality of life.
