Objective To understand the current situation of preoperative sleep quality of surgical patients in a tertiary a hospital in Xizang and analyze its influencing factors, so as to provide basis for improving preoperative sleep quality of patients. Method A convenient sampling method was used to select 256 preoperative patients who planned to undergo surgery in the Xizang Autonomous Region People's Hospital from April to July 2022. The self-designed demographic sociological questionnaire and the Athens Insomnia Scale were used to investigate the sleep quality, and the influencing factors of sleep quality were analyzed. Result The rate of sleep disorder before surgery was 43.75% in a tertiary hospital in Xizang. The results of multiple linear regression analysis showed that non-permanent high-altitude population, marriage, high surgical risk grade and high disease understanding were the main factors leading to sleep disorders before surgery (P ＜ 0.05), which could jointly explain 13.4% variance variation of sleep quality before surgery (F ＝ 9.689, R2 ＝ 0.134, P ＜ 0.001). Conclusion The sleep quality of patients before surgery was poor, patients with non-permanent high-altitude population, who were married, who had a high surgical risk rating and who knew more about the disease had worse sleep quality. Health care workers should actively take measures to improve sleep quality and promote wound healing and early recovery.
Objective To investigate the effect of exogenous cholecystokinin octapeptide (CCK-8) on acute pancreatitis and explore the mechanism of CCK-8 inhibiting inflammation through the cholinergic antiinflammatory pathway. Method SD rats were used to establish an acute pancreatitis model and randomly divided into four groups of 18 each: sham surgery group, model group, model preparation combined with CCK-8 group (CCK-8 group), model preparation combined with subphrenic vagus nerve transection and CCK-8 group (transection group). SD rats were euthanized in batches at 3, 6, and 9 hours in each group, and their serum interleukin-6 (IL-6) was detected using an enzyme-linked immunosorbent assay kit tumor necrosis factor (TNF)-α levels were measured, and the pathological changes of pancreatic tissue in rats were observed. Result The serum IL-6 concentration in the sham surgery group rats was lower at various time points, while the serum IL-6 concentration in the model group rats reached a peak at 6 hours. The IL-6 concentration levels in the model group rats were higher than those in the sham surgery group rats at corresponding time points; The IL-6 concentration levels in CCK-8 group rats at 6h and 9h were significantly lower than those in the corresponding time points of the model group rats; The IL-6 concentration levels at 6h and 9h in the cut off group rats were significantly higher than those at the corresponding time points in the CCK-8 group rats, with significant differences (P ＜ 0.05). The concentration of serum TNF-α in sham operated group rats at 9 hours reaches a peak; The serum TNF-α concentration in model group rats reaches a peak at 6 hours. The concentration levels of TNF-α in model group rats at various time points were higher than the concentration levels of TNF-α in the sham surgery group rats at corresponding time points; The concentration levels of TNF-α in CCK-8 group rats is significantly lower than the concentration levels of TNF-α in model group rats at 6h and 9h; At 6h and 9h points in the cut off group rats, the concentration levels of TNF-α is significantly higher than the concentration level of TNF-α in CCK-8 group rats at the corresponding time point, which the differences are significant(P ＜ 0.05). At 3, 6, and 9 hours, the pancreatic pathological changes in each subgroup of CCK-8 group were milder than those in the model group, while at 3, 6, and 9 hours, the pancreatic pathological changes in each subgroup of the amputation group were more severe than those in the CCK-8 group. The pancreatic tissue injury score of the sham surgery group rats was lower at various time points; The pancreatic injury score of the model group rats gradually increased over time, and the evaluation scores at each time point were higher than those of the sham surgery group rats at the corresponding time points (P ＜ 0.05); The pancreatic injury score of CCK-8 group rats showed a gradually increasing trend at various time points, and the pancreatic injury score at each time point was lower than the corresponding time point pancreatic injury score of the model group rats (P ＜ 0.05); The pancreatic injury scores of the cut off group rats were higher than those of the CCK-8 group rats at corresponding time points (P ＜ 0.05), but there was no significant difference in pancreatic injury scores compared to the model group at various time points. Conclusion CCK-8 can active the cholinergic anti-inflammatory pathway and promote the release of vagal acetylcholine, thus to participate in the regulation of inflammatory response, acute pancreatitis were reduced.
Gastric cancer is one of the most common malignant tumors in the world, which possessed high morbidity and mortality. The long-term prognosis of patients with gastric cancer is still not ideal. Inflammatory response and insulin resistance of host affect nutritional status and prognosis of patients with gastric cancer. This article aims to analyze the relationship between the level of inflammatory response, insulin resistance and nutritional status in patients with gastric cancer by reviewing relevant literature, and to explore the application value of inflammatory insulin resistance indicator C reactive protein-serum triglycerides and glucose index(CRP-TyG) in clinical evaluation of nutritional status with Gastric cancer, so as to provide references for early detection and intervention of gastric cancer-related malnutrition.
Micro ribonucleic acid (miRNA) refer to a highly conserved class of endogenous non-coding RNA, each composed of approximately 22 nucleotides. Numerous studies have demonstrated that miRNAs play a crucial role in the initiation and progression of hepatocellular carcinoma (HCC). MiRNAs function as regulatory molecules in the context of gene expression related to HCC. Some miRNAs also participate in the activation of cellular signaling pathways, and these pathways contribute to the occurrence and development of hepatocellular carcinoma. The review provides an overview of the research progress on the role of miRNAs in hepatocellular carcinoma, aiming to contribute insights into the identification of diagnostic markers for HCC and the exploration of moleculartargeted therapies.
The incidence of malnutrition in the elderly population is increasing year by year. It can lead to a decline in physical function, susceptibility to infection, and delayed recovery in elderly people, seriously affecting their quality of life and disease prognosis. Therefore, early identification and diagnosis of malnutrition are of great significance for elderly patients in general surgery. At present, the diagnosis of malnutrition in the elderly population mainly includes the Global Leadership Initiative on Malnutrition (GLIM), Subjective Global Assessment (SGA), and so on. GLIM entered clinical application relatively late, and there is still controversy over whether it can comprehensively reflect the nutritional status of the elderly surgical population. This article mainly explores the current application status of GLIM in diagnosing malnutrition in the elderly population of general surgery, aiming to provide reference for the diagnosis of malnutrition in the elderly.
Objective To explore the value of multidimensional preoperative and intraoperative evaluation in complex laparoscopic liver cancer resection. Method Sixty patients who underwent complex laparoscopic liver cancer resection and were hospitalized at the People's Hospital of Gaozhou City from January 2020 to January 2022 were selected. They were divided into groups in the order of admission, with an odd numbered group as the control group and an even numbered group as the observation group, with 30 cases in each group. The control group underwent laparoscopic liver cancer resection surgery using traditional preoperative and intraoperative evaluations, while the observation group underwent laparoscopic liver cancer resection surgery based on multidimensional preoperative and intraoperative evaluations. Compare the surgical conditions, postoperative 7d liver function, and incidence of complications between two groups of patients. Result The intraoperative blood transfusion volume and blood loss of the patients were significantly lower than those of the control group, and the surgery time and hospitalization time were shorter than those of the control group. The postoperative 7d levels of alanine aminotransferase, total bilirubin, and aspartate aminotransferase in the observation group were lower than those of the control group, and the albumin level was higher than that of the control group, with significant differences (P ＜ 0.05). The postoperative 7d complications in the control group and observation group were 20.00% and 3.33%, respectively, and the incidence of postoperative complications was significantly lower than that in the control group (P ＜ 0.05). Conclusion Multidimensional preoperative and intraoperative evaluations are performed on patients undergoing complex laparoscopic liver cancer resection, and the overall effect is good, which is beneficial for patient recovery.
Objective To evaluate the application effect of laparoscopic assisted radical gastrectomy in patients undergoing gastric cancer surgery. Method Sixty hospitalized patients with gastric cancer admitted to Donghai County Traditional Chinese Medicine Hospital in Lianyungang City from September 2022 to August 2023 were selected and divided into a control group and an observation group based on different surgical methods. The control group received conventional gastric cancer radical surgery treatment, while the observation group received laparoscopic assisted gastric cancer radical surgery treatment. Compare the levels of adrenaline, cortisol, adrenocorticotropic hormone, as well as interleukin-6 and tumor necrosis factor-α between two groups of patients before and after surgery, compare the levels of high sensitivity C-reactive protein surgical situation, and the incidence of postoperative complications between the two groups of patients. Result Prior to surgery, levels of adrenaline, cortisol, adrenocorticotropic hormone, as well as interleukin-6 and tumor necrosis factor-α were measured in both groups of patients, the levels of high sensitivity C-reactive protein were all low and there was no significant difference (P ＞ 0.05). After surgery, the levels of adrenaline, cortisol, adrenocorticotropic hormone, as well as interleukin-6 and tumor necrosis factor-α in both groups of patients, the levels of high sensitivity C-reactive protein were all elevated, and the control group was significantly higher than the observation group.The surgical duration and first postoperative exhaust time of the observation group patients were shorter than those of the control group, and the intraoperative bleeding was less than that of the control group, with significant differences(P＜0.05). The total incidence of postoperative complications in the observation group was 3.33%, significantly lower than that in the control group (26.67%), with significant differences (P ＜ 0.05). Conclusion Laparoscopic assisted radical gastrectomy is less stressful for patients undergoing gastric cancer surgery and has a lower incidence of postoperative complications.
Objective To explore the effects of preserving the left colic artery (LCA) in laparoscopic radical resection of rectal cancer on gastric function and complications in patients. Method 57 patients who underwent laparoscopic radical resection of rectal cancer admitted to Dunhua Hospital from December 2020 to November 2023 were randomly divided into a control group (28 cases) and an observation group (29 cases). The control group did not retain LCA during surgery, while the observation group retained LCA during surgery. Compare the incidence of complications, gastric function, urinary function, and anorectal dynamics between two groups. Result Compared with preoperative, the levels of gastrin, motilin, pepsinogen Ⅰ , and calcitonin gene related peptide (CGRP) in both groups of patients increased 30 days after surgery, and the levels of gastrin, motilin, pepsinogen Ⅰ , and CGRP in the observation group were higher than those in the control group. Compared with preoperative data, the resting pressure and maximum systolic pressure of the anal canal in both groups of patients decreased 30 days after surgery, and the resting pressure and maximum systolic pressure of the anal canal in the observation group were higher than those in the control group, with significant differences (P ＜ 0.05). On the 7th day after surgery, the overactive bladder symptom scale (OABSS) scores of both groups of patients decreased compared to before surgery, and the OABSS scores of the observation group were lower than those of the control group, with significant differences (P ＜ 0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group, with a significant difference (P ＜ 0.05). Conclusion Preserving LCA during laparoscopic radical surgery can improve the anorectal motility indicators of rectal cancer patients, quickly restore their gastric and urinary functions, and reduce the risk of complications.
Objective To explore the clinical efficacy of ligation of intersphincteric fistula tract in the treatment of low simple anal fistula. Method 46 patients with low simple anal fistula admitted to Donghai County Traditional Chinese Medicine Hospital in Lianyungang City from February 2020 to February 2023 were selected. Divided into a control group and an observation group using a random number table method, with 23 cases in each group. The control group underwent traditional anal fistula incision surgery, while the observation group underwent LIFT surgery. The clinical efficacy and postoperative recovery of the two groups of patients were compared. Result There was no significant difference in the total effective rate between the two groups (P ＝ 0.310). The wound healing time and hospitalization duration of the observation group were shorter than those of the control group, and the VAS score was lower than that of the control group, with significant differences (P ＜ 0.05). There was no significant difference in preoperative anal incontinence Wexner scores between the two groups of patients. After 1 month and 3 months of surgery, the observation group had lower anal incontinence Wexner scores than the control group, and the difference was significant (P ＜ 0.05). Conclusion The treatment of low position simple anal fistula with LIFT surgery can alleviate patient pain to a certain extent, preserve the function of the patient's sphincter, and lead to faster recovery.
Objective To explore the therapeutic value of microwave therapy in the treatment of hemorrhoids. Method 128 inpatients with hemorrhoids admitted to Baiyunshan Hospital in Guangzhou from February 2022 to January 2023 were selected and randomly divided into an experimental group and a control group, with 64 cases in each group, using a random number table method. The control group received automatic hemorrhoid ligation surgery, while the experimental group received microwave therapy. The treatment effects and incidence of complications were compared between the two groups. Result The treatment duration, first defecation time, and wound healing time of the experimental group were significantly shorter than those of the control group (P ＜ 0.05). After treatment, the visual analogue scale (VAS) scores of the experimental group patients were lower than those of the control group at 12 and 48 hours, and their VAS scores gradually decreased with the prolongation of treatment time (P ＜ 0.05). Compared with the control group, the experimental group had a higher total effective rate of treatment (87.50% compared to 96.88%), and a significantly lower overall incidence of symptoms, with significant differences (P ＜ 0.05). Conclusion The application of microwave therapy in hemorrhoid patients can improve the degree of pain, enhance treatment effectiveness, reduce the incidence of complications, and promote the improvement of the condition.
Objective To explore the preventive effect of sufentanil on breakthrough pain after discontinuation of remifentanil in laparoscopic appendectomy. Method Seventy patients who underwent laparoscopic appendectomy and received remifentanil anesthesia at Jiaozhou Hospital Affiliated to Tongji University from November 2022 to May 2023 were selected. They were randomly divided into two groups, with 35 patients in each group. The study group and the control group were treated with different drugs to prevent breakthrough pain after remifentanil anesthesia. The study group received intravenous injection of 0.1mg/kg sufentanil 30 minutes before skin suture, while the control group received intravenous injection of the same dose of physiological saline. Observe the pulse oxygen saturation (SpO2), heart rate, systolic blood pressure, diastolic blood pressure, and pain score of two groups of patients 5 minutes (T1), 15 minutes (T2), and 30 minutes (T3) after surgery, and record the postoperative complications such as nausea, vomiting, and irritability in both groups of patients. Result The pain scores of the study group at T1, T2, and T3 were significantly lower than those of the control group, while the heart rate, systolic blood pressure, and diastolic blood pressure were significantly lower than those of the control group, with significant differences (P ＜ 0.05). There was no significant difference in SpO2 levels between the two groups at different time points (P ＞ 0.05), and there was no significant difference in postoperative complications such as nausea, vomiting, irritability, and respiratory depression (P ＞ 0.05). Conclusion Intravenous injection of 0.1mg/kg sufentanil 30 minutes before the end of surgery can effectively prevent postoperative breakthrough pain after remifentanil anesthesia, with good analgesic effect and no impact on awakening quality.
Objective Exploring the impact of micro teaching method combined with 3H nursing on the perioperative period of patients undergoing laparoscopic cholecystectomy. Method 126 hospitalized patients who underwent laparoscopic cholecystectomy admitted to Yangzhou Hospital of Traditional Chinese Medicine from March to December 2022 were randomly divided into a control group and an observation group, with 63 patients in each group, using a random number table method. The control group received routine nursing intervention, while the observation group received micro teaching method combined with 3H nursing on the basis of the control group. Compare the disease awareness rate, perioperative situation, and incidence of complications between two groups of patients. Result The observation group had a higher disease knowledge awareness rate than the control group (87.30% vs. 50.79%); Postoperative C-reactive protein, interleukin-6, and tumor necrosis factor-α levels in patients were all lower than those of the control group, and the differences were significant (P ＜ 0.05). After intervention, the Hamilton anxiety scale, self rating depression scale, and Pittsburgh sleep quality index scores of the observation group were lower than those of the control group, and the incidence of postoperative complications was lower than that of the control group (3.17% vs. 12.70%), with significant differences(P ＜ 0.05). Conclusion Microteaching combined with 3H nursing is beneficial to improve the excellent rate of patients' knowledge of disease, relieve the stress reaction and bad mood of patients, improve the sleep quality of patients, and reduce the possibility of complications.
Objective To observe the effect of perioperative refined nursing intervention on patients undergoing acute appendicitis surgery. Method Ninety hospitalized patients with acute appendicitis who underwent surgical treatment at Huangpu Hospital of Guangdong Second Traditional Chinese Medicine Hospital from July 2020 to August 2022 were selected. They were divided into a control group (receiving routine perioperative care) and an observation group (receiving refined perioperative care) according to different nursing methods, with 45 patients in each group. The perioperative nursing effects of the two groups were compared. Result The observation group had shorter first anal exhaust time, time to get out of bed, and length of hospital stay than the control group, and the nursing satisfaction rate was significantly higher than the control group, with significant differences (P ＜ 0.05). Two patients in the observation group experienced complications after surgery, including one respiratory infection and one incision infection, with a complication rate of 4.44% (2/45); There were 9 postoperative complications in the control group, including 4 cases of respiratory infection, 2 cases of incision infection and abdominal abscess, and 1 case of intestinal adhesion. The incidence of complications was 20.00% (9/45). The total incidence of complications in the observation group was significantly lower than that in the control group (χ2 ＝ 5.075, P ＝ 0.024). Conclusion When treating acute appendicitis patients with surgery in clinical practice, fine nursing during the perioperative period can significantly reduce postoperative complications, promote rapid postoperative recovery, and improve patient satisfaction with nursing.
Objective A prognostic model for pancreatic cancer(PC) based on cuproptosis-related long noncoding RNA (CRL) was constructed to predict the traditional Chinese medicine that regulates cuproptosis- related gene(CRG). Method A risk model for forecasting PC prognosis was constructed by utilizing Cox regression and Pearson correlation analysis, utilizing clinical data and RNA-seqs of 183 PC patients sourced from theTCGA. Screening CRL through LASSO regression, and the nomogram was formed by uniting the risk score and clinical features. To test the model's accuracy, receiver operator characteristic curve (ROC) and C-index were employed. An assessment was made of the correlation between risk scores and immunoinfi ltration and chemotherapy/targeted agents. The potential Chinese medicines for controlling CRG were predicted through the utilization of Coremine Medical database. Result The PC risk model was developed based on the risk scores of six CRLs (MIR1915HG, PRECSIT, AC004982.1, AC023043.4, AC010999.2, FOXCUT).The AUC for forecasting 1-year, 3-year and 5-year survival rates in PC patients was 0.782, 0.786 and 0.912 respectively, as revealed by the risk model, surpassing age, grade and TNM stage. A relationship was found between the risk score and the enrichment of tumor-infi ltrating lymphocytes, the presence of regulatory T cells, and the sensitivity of fourteen chemotherapeutic/targeted drugs. There are ninety-eight Chinese medicines that potentially regulate CRG; their eff ects primarily involve heat clearing and detoxifying properties attributed mainly to liver spleen and lung meridians. Traditional Chinese medicine Tenacissoside may have potential regulatory effects on key gene FDX1 involved in copper death mechanism. Conclusion A risk signature constructed based on six CRLs could assess the prognosis and immunity of PC, and Tenacissoside may have important regulatory effi cacy on the mechanism of coppercuproptosis.
Objective Exploring the comparison of the effi cacy and recurrence rate of endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and endoscopic submucosal resection (ESE) in the treatment of rectal neuroendocrine tumors under the precise localization of tumor volume and level using endoscopic ultrasound. Method Retrospective analysis of clinical data of patients who received endoscopic minimally invasive treatment at Qingdao Municipal Hospital from October 2018 to July 2022 and were pathologically diagnosed with rectal neuroendocrine tumors. Analysis of preoperative imaging features, endoscopic ultrasound diagnosis, surgical data, pathological data, and postoperative follow-up of EMR, ESD, and ESE surgical methods for rectal neuroendocrine tumors. Result A total of 95 patients were included in the clinical data, including 52 who underwent ESD surgery, 30 who underwent EMR surgery, and 13 who underwent ESE surgery. The average maximum diameter of lesions removed in the ESD group was signifi cantly larger than that in the EMR group, and the ESD group had a larger tumor resection area compared to the EMR group, with signifi cant diff erences (P＜0.05). The surgical time of ESD group and ESE group was signifi cantly longer than that of EMR group, and the diff erence was signifi cant (P ＜ 0.05). There was no signifi cant diff erence among the three methods in terms of intraoperative surgical rescue, postoperative margin involvement rate, occurrence of postoperative complications, postoperative discharge time, and postoperative recurrence rate(P ＞ 0.05). Endoscopic ultrasound examination shows that most of the lesions are hypoechoic, with clear boundaries and intact tube walls. The lesions mainly originate from the submucosal layer and mucosal muscle layer. Conclusion Before surgery, the most suitable endoscopic minimally invasive surgery method is selected based on the localization of tumor volume and level by endoscopic ultrasound. By utilizing the advantages of EMR, ESD, and ESE, the surgical safety can be improved.
Objective To explore the feasibility and clinical application value of laparoscopic cholecystectomy in the treatment of complex cholecystitis. Method A retrospective analysis was conducted on the clinical data of 80 patients with complex cholecystitis admitted to Jimo People's Hospital Affi liated to Binzhou Medical College from March 2020 to March 2023. According to diff erent surgical methods, they were divided into a control group and an experimental group, with 40 cases in each group. The experimental group patients underwent laparoscopic cholecystectomy, while the control group underwent percutaneous transhepatic gallbladder puncture and drainage followed by laparoscopic cholecystectomy in the second phase during the same period. Compare the diff erences between two groups of patients in terms of surgical time, intraoperative bleeding, postoperative bile leakage, incision infection, residual bile duct stones, bile (intestinal) duct injury, treatment effectiveness, and length of hospital stay. Result There were no perioperative deaths in either group of patients. The experimental group had a longer surgical time and more surgical bleeding compared to the control group, with signifi cant diff erences (P ＜ 0.05). There was no signifi cant diff erence in the conversion rate to open surgery, intraoperative biliary injury rate, intestinal injury, postoperative hospital stay, and postoperative bleeding between the two groups of patients(P ＞ 0.05). Conclusion Laparoscopic cholecystectomy for complex cholecystitis can shorten the treatment cycle.
Breast cancer has become one of the most common malignant tumors in women, and its incidence is increasing year by year and getting younger. Modified radical mastectomy is a common surgical method for breast cancer. The continuous care can improve the quality of life and nursing satisfaction of patients after modifi ed radical mastectomy, and reduce the cost of medical services and the recurrence rate of breast cancer. This paper reviews the concept of the continuous care, and the stage, content and method of the continuous care in breast cancer patients with modifi ed radical surgery, so as to provide the theoretical basis for future study.
Objective To observe the effect of abdominal compression operation in preventing hypoxemia in painless gastroscopy anesthesia. Method 188 patients who underwent painless gastroscopy examination in the outpatient and inpatient departments of Yanbian University Affi liated Hospital from September 2021 to November 2022 were randomly divided into an observation group and a control group, with 94 patients in each group, using a random number table method. The control group was treated with nasal cannula oxygen inhalation, while the observation group was assisted with abdominal compressions on the basis of the control group. The lowest pulse oxyhemoglobin saturation (SpO2) level, incidence of hypoxemia, gastroscopy examination time, incidence of withdrawal and suspension of examination, total amount of propofol used, awakening time, and incidence of postoperative adverse reactions were compared between the two groups of patients. Result The lowest SpO2 level of the observation group patients was higher than that of the control group, and the gastroscopy examination time was shorter than that of the control group. The incidence of dropout and hypoxemia were both lower than those of the control group, and the diff erences were signifi cant (P ＜ 0.05). However, there was no signifi cant diff erence in heart rate and incidence of adverse reactions between the two groups of patients when they reached the lowest SpO2 level (P ＞ 0.05). Conclusion Abdominal compression operation can eff ectively prevent the occurrence of hypoxemia in painless gastroscopy, maintain a high SPO2 level, shorten the time of gastroscopy, and improve the effi ciency of gastroscopy.
Objective Exploring the effect of using five-tiered nutritional intervention in perioperative chemotherapy patients with gastrointestinal tumors. Method 88 patients with perioperative chemotherapy gastrointestinal tumors admitted to the Brain Hospital of Guangxi Zhuang Autonomous Region from February 2021 to February 2024 were selected. They were randomly divided into a reference group and a study group, with 44 cases in each group, using a random number table method. The reference group patients received routine dietary intervention, while the study group implemented fi ve-tiered nutritional intervention. The nutritional status, immune function indicators, tumor marker levels, improvement in nutritional levels, and bone marrow suppression results of the two groups of patients were observed before and after intervention. Result Before intervention, there was no signifi cant diff erence in nutritional related biochemical indicators, immune function indicators, tumor marker levels, and nutritional levels between the two groups of patients (P ＞ 0.05). After intervention, the nutritional related biochemical indicators, immune function indicators, tumor marker levels, and nutritional levels of the two groups of patients were signifi cantly improved (P ＜ 0.05). In addition, the levels of albumin, hemoglobin, transferrin, and prealbumin, CD3+, CD4+ T lymphocytes, IgM, IgA, and IgG in the study group were higher than those in the control group, and the PG-SGA score, CEA, and CA19-9 levels were lower than those in the control group, with signifi cant diff erences (P ＜ 0.05). After intervention, there was no signifi cant diff erence in the incidence of platelet and hemoglobin inhibition between the two groups of patients (P ＞ 0.05), but the incidence of white blood cell and granulocyte inhibition in the study group was lower than that in the control group, with a signifi cant diff erence (P ＞ 0.05). Conclusion Gastrointestinal tumor chemotherapy patients can be intervened with a fi ve-tiered nutritional guidance program during the perioperative period, which not only improves the patient’s nutritional level, but also improves their immune function, reduces the level of tumor markers, enhances anti-tumor ability, reduces bone marrow suppression, and alleviates chemotherapy adverse reactions during the perioperative period. It has a good nutritional intervention eff ect.
Objective To explore the eff ect of placing drainage tubes or not after laparoscopic cholecystectomy (LC) on the treatment of acute suppurative cholecystitis and its impact on traumatic inflammatory response. Method 86 patients with acute suppurative cholecystitis admitted between January 2022 and September 2023 were all treated with LC. They were divided into groups based on whether to place a drainage tube after surgery. Group A had 43 patients who did not place a drainage tube after surgery, while Group B had 43 patients who placed a drainage tube after surgery. The perioperative indicators, infl ammatory indicators, and postoperative complications between two groups were compared. Result The postoperative anal exhaust time, mobilization time, and hospitalization time of Group A patients were shorter than those of Group B, with signifi cant diff erences (P＜ 0.05). There was no signifi cant diff erence in preoperative C-reactive protein, white blood cell count, and interleukin-6 levels between the two groups of patients (P ＞ 0.05); 3 days after surgery, the levels of the above indicators in Group A were better than those in Group B, with signifi cant diff erences (P ＜ 0.05). The incidence of postoperative incision pain, infection, bile leakage, and shoulder pain in Group A patients was signifi cantly lower than that in Group B (P ＜ 0.05). Conclusion Patients with acute suppurative cholecystitis who undergo LC without placement of drainage tubes can shorten their postoperative recovery time and reduce the risk of complications.
Objective To explore the application effect of bevacizumab combined with chemotherapy in targeted therapy for colorectal cancer. Method A retrospective analysis was conducted on the clinical data of 68 patients with colorectal cancer admitted to Guangzhou Baiyunshan Hospital from June 2022 to June 2023. They were divided into a control group (chemotherapy, 33 cases) and a study group (bevacizumab+chemotherapy, 35 cases) based on diff erent treatment plans. The therapeutic effi cacy, tumor marker levels, and incidence of adverse reactions were compared between the two groups of patients. Result The disease control rate of the study group patients was 94.29%, higher than that of the control group (72.73%), with a significant difference (P ＜ 0.05). Before treatment, there was no signifi cant diff erence in the levels of carbohydrate antigen (CA) 19-9, CA 72-4, and carcinoembryonic antigen between the two groups (P ＞ 0.05); After treatment, the average levels of CA 19-9, CA 72-4, and carcinoembryonic antigen in the study group were signifi cantly lower than those in the control group (P ＜ 0.05). There was no signifi cant diff erence in the total incidence of adverse reactions between the two groups of patients (P ＞ 0.05). Conclusion Bevacizumab combined with chemotherapy can signifi cantly improve the disease control rate of colorectal cancer patients, reduce the level of tumor markers in the body, and there is no increase in the risk of adverse reactions.
Objective To analyze the impact of laparoscopic radical resection of colorectal cancer on liver and kidney function in patients. Method 120 patients with colorectal cancer who received treatment at Rong’an County People’s Hospital in Liuzhou City from March 2021 to March 2023 were selected and randomly divided into a control group and an experimental group (each with 60 cases) using a random number table method. The control group received traditional open surgery, while the experimental group received laparoscopic radical resection for colorectal cancer. The liver and kidney function indicators and postoperative complications of the two groups of patients were compared. Result On the fi rst day before surgery, there was no signifi cant diff erence in liver and kidney function indicators between the two groups of patients (P ＞ 0.05). Three days after surgery, the lactate dehydrogenase levels in the experimental group patients increased signifi cantly compared to the fi rst day before surgery (P ＜ 0.05); The total protein, cholinesterase, and albumin levels of the experimental group patients were signifi cantly lower than those of the control group, and the uric acid level was signifi cantly lower than that of the control group, with signifi cant diff erences (P ＜ 0.05). The incidence of postoperative complications in the experimental group was signifi cantly lower than that in the control group (5.00% vs. 16.67%; P=0.040). Conclusion Laparoscopic radical surgery for colorectal cancer can impose a burden on the liver function of patients and have a smaller impact on their renal function. Compared to traditional open surgery, the risk of complications is lower.
Objective Analyze the clinical effi cacy of totally extraperitoneal laparoscopic hernia repair (TEP) in the treatment of inguinal hernia patients. Method Eighty male patients with initial inguinal hernia admitted to the Dongting Branch of Xishan People's Hospital in Wuxi from January 2018 to May 2023 were selected and divided into a control group (n=40, who underwent open tension-free hernia repair surgery) and an observation group (n=40, who underwent modifi ed TEP) based on diff erent surgical procedures. Analyze perioperative indicators, spermatic vein diameter, spermatic vein blood flow velocity, incidence of complications, and Nottingham health profile (NHP) scores for two groups of patients. Result The surgical time, hospitalization time, and anal exhaust time of the observation group patients were shorter than those of the control group, and the incidence of postoperative complications was lower than that of the control group, with signifi cant diff erences (P ＜ 0.05). Before surgery, there was no signifi cant diff erence in the diameter and blood fl ow velocity of the spermatic vein between the two groups of patients (P ＞ 0.05); Two weeks after surgery, the diameter of the spermatic vein in the observation group was smaller than that in the control group, and the blood fl ow velocity of the spermatic vein was faster than that in the control group, with a signifi cant diff erence (P ＜ 0.05). Before surgery, there was no signifi cant diff erence in NHP scores between the two groups of patients (P ＞ 0.05); Two weeks after surgery, the NHP scores in all dimensions of the two groups of patients decreased compared to before surgery, but the observation group was signifi cantly lower than the control group, with a signifi cant diff erence (P ＜ 0.05). Conclusion The improved TEP treatment for inguinal hernia patients has shown good therapeutic eff ects, minimal damage to the spermatic vein, and faster postoperative recovery.
Objective To explore the relationship between therapy and survival of hepatocellular carcinoma bone metastasis(HCC-BM) patients, and analyze the factors aff ecting the survival of HCC-BM patients. Method The clinical data of HCC-BM patients admitted to Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2019 to January 2023 were retrospectively analyzed, the Kaplan-Meier method was used to calculate the median survival time and draw the survival curve. Log-Rank test was used for comparison between groups with or without primary tumor treatment, with or without bone metastasis treatment, and various treatment regimens for primary tumor. Factors that may affect the survival of patients such as gender, age, alpha-fetoprotein were included in the Cox regression model for univariate regression analysis, and signifi cant variables were included in the multivariate Cox regression model to identify the independent risk factors aff ecting the survival of HCC-BM patients. Result A total of 81 HCC-BM patients were enrolled, the median interval of HCC-BM patients was 10.5 months, the median survival time was 7.3 months, and the 1-, 2-, and 3-year survival rates were 37.0%, 17.3%, and 6.2%, respectively. Log-Rank test showed that there were statistically signifi cant diff erences in survival time between HCC-BM patients with or without primary tumor treatment, monotherapy or combination therapy and HCC-BM patients without primary tumor treatment, and bone metastasis treatment or not (all P ＜ 0.05). Univariate regression analysis showed that alpha-fetoprotein and alkaline phosphatase levels, vascular invasion, Child-Pugh score, number of bone metastases, systemic multiple bone metastases, treatment of the primary tumor, treatment of bone metastases, and targeted combined immunotherapy were associated with the prognosis of HCC-BM patients (all P ＜ 0.05). Multivariate regression analysis showed that alpha-fetoprotein ≥ 400μg/L, systemic multiple bone metastases, no primary tumor treatment, and no targeted combined immunotherapy were independent risk factors for poor prognosis of HCC-BM patients (all P ＜ 0.05). Conclusion The morbidity of HCC-BM is high, and the interval and survival time of HCC-BM are short. Treatment of bone metastases can prolong the survival of HCC- BM patients. Combined therapy targeting the primary lesion significantly improves survival outcomes in HCC- BM patients, which is expected to become a better choice for HCC-BM treatment. Alpha-fetoprotein ≥ 400μg/L, systemic multiple bone metastases, no primary tumor treatment, and no targeted therapy combined immunotherapy are independent risk factors for poor prognosis of HCC-BM patients.
Objective To study the effect of time of laparoscopic cholecystectomy (LC) performed after percutaneous transhepatic gallbladder drainage (PTGD) in patients with acute calculous cholecystitis (ACC) on the fi nal outcome. Method Retrospective analysis of clinical data of 80 ACC patients admitted to Tongzhou District Traditional Chinese Medicine Hospital in Beijing from January 2021 to December 2022, all patients underwent LC treatment after PTGD. According to the interval time of LC after PTGD, patients were divided into experimental group ( ＞ 60 days) and control group ( ≤ 60 days), and the surgical effi cacy of the two groups was compared.Result The thickness of the gallbladder wall before LC in the experimental group was thinner than that in the control group, and the time for LC surgery and postoperative hospitalization were shorter than those in the control group. The amount of bleeding during LC surgery was less than that in the control group, and the rate of conversion to open surgery and postoperative complications were lower than those in the control group, with significant diff erences (P ＜ 0.05). The levels of adrenocorticotropic hormone (ACTH) in the experimental group after LC were signifi cantly lower than those in the control group (P ＜ 0.05). Conclusion Patients with ACC treated with LC 60 d after PTGD had better surgical performance, shorter surgical time, etc. while also improving intraoperative and postoperative safety and reducing patient stress.
Objective To investigate the effects of propofol combined with isoflurane inhalation anesthesia on stress response and pain level in patients undergoing neck thyroidectomy for thyroid cancer. Method Eighty patients with thyroid cancer who underwent elective cervical thyroidectomy at the branch of Huai'an First People's Hospital from January 2022 to January 2024 were selected and randomly divided into an observation group and a control group, with 40 patients in each group, using a random number table method. The control group received sufentanil combined with propofol anesthesia induction, while propofol combined with remifentanil was used to maintain anesthesia during surgery. The observation group received isofl urane inhalation to maintain anesthesia based on anesthesia induction and maintenance in the control group. Compare the stress responses of two groups of patients before surgery, 5 minutes after anesthesia, and at the end of surgery, as well as the degree of pain at diff erent time points after surgery. Result The levels of cortisol and C-reactive protein in both groups of patients increased 5 minutes after anesthesia and at the end of surgery compared to before surgery. However, the levels of cortisol and C-reactive protein in the postoperative observation group were lower than those in the control group, and the diff erences were signifi cant (P ＜ 0.05). After 2 hours postoperatively, the VAS scores of both groups of patients increased signifi cantly compared to 30 minutes postoperatively (P ＜ 0.05). At 4 and 12 hours postoperatively, the VAS scores of both groups of patients decreased signifi cantly compared to 2 hours postoperatively (P ＜ 0.05). The VAS scores of the observation group were signifi cantly lower than those of the control group at 30 minutes, 2 hours, and 4 hours after surgery (P ＜ 0.05), while there was no signifi cant diff erence in VAS scores between the two groups at 12 hours after surgery (P ＞ 0.05). Conclusion For thyroid cancer patients undergoing cervical thyroidectomy, propofol combined with isofl urane inhalation anesthesia can signifi cantly alleviate stress reactions and reduce postoperative pain.
Objective To explore the clinical effi cacy of using circular areola and radial incision treatment for benign breast tumors. Method Fifty patients with benign breast tumors admitted to our hospital from September 2019 to January 2024 were divided into two groups using a random number table method, with 25 cases in each group. The research group underwent circumareolar incision surgery, while the control group underwent radial incision surgery. Compare the clinical efficacy, perioperative indicators, breast aesthetics score, sensory nerve function in the areola area, and complications between two groups. Result Compared with the control group, the study group had a higher overall treatment effi cacy, shorter surgical scar length, longer surgical time, more bleeding, higher satisfaction with breast aesthetics, better postoperative recovery of sensory nerve function in the areola area,
and lower incidence of complications, with signifi cant diff erences (P ＜ 0.05). Conclusion Both types of incision surgery can eff ectively treat benign breast tumors. However, patients undergoing circumareolar incision surgery have smaller residual scars on the body surface, resulting in better treatment outcomes. Additionally, postoperative patients have a higher satisfaction with breast aesthetics and will not aff ect the sensory nerve function in the areola area. With fewer complications, it is safe and reliable.
Objective To explore the efficacy of minimally invasive rotational mastectomy and traditional surgical treatment in patients with multiple breast masses. Method 300 female patients with multiple breast masses admitted to Mengzi People’s Hospital from January 2019 to December 2023 were selected and divided into two groups of 150 patients each according to diff erent surgical methods. The control group underwent traditional surgical treatment, while the observation group underwent minimally invasive rotational mastectomy. The perioperative indicators, pain levels, breast appearance improvement rate, and treatment efficacy of the patients were observed. Result The observation group had shorter surgical time, incision healing time, and hospitalizationtime compared to the control group. The intraoperative blood loss was less than that of the control group, and the incision length was shorter than that of the control group, with signifi cant diff erences (P ＜ 0.05). Before treatment, there was no significant difference in VAS scores between the two groups of patients. After treatment, the VAS scores of the observation group were signifi cantly lower than those of the control group, and the diff erence was signifi cant (P ＜ 0.05). The observation group had a higher incidence of excellent breast appearance compared to the control group, and the clinical effi cacy was signifi cantly better (P ＜ 0.05). Conclusion Minimally invasive rotational resection surgery for multiple breast masses has significant therapeutic effects, effectively removing lesions and being superior to traditional treatment methods. It can eff ectively reduce the trauma caused by surgery to the body, shorten the recovery period, and ensure the beauty of the patient’s breast, promoting early recovery of health.
Objective To explore the impact of laparoscopic cholecystectomy on the gastrointestinal quality of life in patients with gallstones and common bile duct stones. Method 100 patients with gallstones and choledocholithiasis who received treatment at Wuchuan People's Hospital from March 2022 to March 2024 were selected and randomly divided into a control group and an observation group, with 50 cases in each group, using a random number table. The control group was treated with traditional surgical methods, while the observation group was treated with laparoscopic cholecystectomy. The gastrointestinal quality of life, infl ammatory indicators, and liver function of the two groups of patients were compared before and 3 days after surgery. Result Before surgery, there was no signifi cant diff erence in the gastrointestinal quality of life scores between the two groups of patients [the control group (79.25±4.73) points compared to the observation group (80.21±4.77) points, t=1.011，P=0.315]. On postoperative day 3, the gastrointestinal quality of life score of the observation group was (137.86±6.33), signifi cantly higher than that of the control group (122.19±6.48), and the diff erence was signifi cant (t=12.233, P ＜ 0.001). On postoperative day 3, the levels of CRP, TNF-α, and white blood cell count in both groups increased compared to preoperative levels, but the values in the observation group were lower than those in the control group, and the difference was significant (P ＜ 0.001). On postoperative day 3, the levels of γ-glutamyl transferase, alanine aminotransferase, and aspartate aminotransferase in both groups decreased compared to preoperative levels, and the values in the observation group were higher than those in the control group, with signifi cant diff erences (P ＜ 0.001). Conclusion The application of laparoscopic cholecystectomy in the treatment of patients with gallstones and common bile duct stones can improve their postoperative gastrointestinal quality of life, reduce their postoperative infl ammatory response, and alleviate the impact of surgery on their liver function.
Objective To observe the clinical effi cacy of endovenous laser ablation (EVLA) and endoscopic submucosal perforator surgery (SEPS) in the treatment of lower limb varicose veins with pathological perforating venous insuffi ciency. Method 83 patients with lower limb varicose veins accompanied by pathological perforating venous insuffi ciency treated in Dunhua City Hospital from April 2021 to March 2024 were selected and divided into EVLA group (n=42) and SEPS group (n=41) according to diff erent treatment methods. Compare the surgical related indicators, pain level, stress response, and quality of life between two groups of patients. Result The surgical time, incision length, hospitalization time, and postoperative bed rest time of patients in the EVLA group were shorter than those in the SEPS group, and the intraoperative blood loss was less than that in the SEPS group, with significant differences (P ＜ 0.05). There was no significant difference in the incidence of postoperative complications between the two groups of patients (P ＞ 0.05). At 3, 12, 24, and 48 hours postoperatively, the NRS scores of patients in the EVLA group were signifi cantly lower than those in the SEPS group (P ＜ 0.05). Before surgery, there was no signifi cant diff erence in cortisol and adrenaline levels between the two groups of patients (P ＞ 0.05). Two days after surgery, the levels of cortisol and adrenaline in both groups of patients increased compared to preoperative levels, and the cortisol and adrenaline levels in the EVLA group were lower than those in the SEPS group, with signifi cant diff erences (P ＜ 0.05). Before surgery, there was no signifi cant diff erence in CIVIQ scores between the two groups of patients (P ＞ 0.05). Three months after surgery, the CIVIQ scores of both groups of patients increased compared to preoperative levels. The CIVIQ score of the EVLA group was higher than that of the SEPS group, and the diff erence was signifi cant (P ＜ 0.05). Conclusion For patients with lower limb varicose veins accompanied by pathological perforating dysfunction, EVLA and SEPS have similar eff ects in reducing the incidence of complications. However, EVLA can shorten the recovery time of patients, reduce stress reactions and body pain, and improve their quality of life.
Objective To analyze analyze the clinical eff ects of diff erent closure methods for appendiceal stump during laparoscopic appendectomy. Method A retrospective analysis was conducted on the clinical data of 280 patients who underwent laparoscopic appendectomy at the Second People's Hospital of Xining City from January 2023 to January 2024. The appendiceal stump was divided into two groups based on diff erent treatment methods: the observation group was treated with Hem-o-lok clamp, and the control group was treated with purse string embedding, with 140 patients in each group. Observe the recovery level, length of hospital stay, and postoperative complications of two groups of patients. Result The surgical time, hospitalization time, and anal exhaust time of the observation group patients were shorter than those of the control group, but the hospitalization costs were higher than those of the control group, and the diff erences were signifi cant (P ＜ 0.05). There was no signifi cant diff erence in the total incidence of postoperative complications between the two groups of patients (P ＞ 0.05). Conclusion The use of Hem-o-lok clamping technology can better treat residual appendicitis and improve the recovery speed of patients. Due to its low complication rate, it has advantages over using purse string embedding technology, but the cost may be more expensive.
Objective To investigate the anesthetic eff ect and adverse reactions of ropivacaine combined with sufentanil in mixed hemorrhoid surgery. Method Eighty patients with mixed hemorrhoids who were admitted to Chang'an Xin'an Hospital in Dongguan City from January 2021 to December 2023 and required elective surgery were selected. They were randomly divided into an observation group and a control group, with 40 patients in each group. All patients underwent stapled hemorrhoidectomy and external hemorrhoidectomy. The control group was anesthetized with ropivacaine, while the observation group was anesthetized with ropivacaine combined with ropivacaine. The postoperative period was continuously monitored for one week. Compare the anesthesia eff ects, anesthesia blockade, postoperative anal contraction recovery, and adverse reactions between two groups of study subjects. Result There was no signifi cant diff erence in the levels of vital signs between the two groups of patients at T0 and T3 (P ＞ 0.05). The heart rate, systolic blood pressure, and diastolic blood pressure levels of the observation group patients decreased at T1 compared to T0, while there was no signifi cant diff erence in vital sign indicators between T1 and T0. The heart rate, systolic blood pressure, and diastolic blood pressure of the control group decreased on average at T1 and T2 compared to T0. The vital sign indicators of the observation group were higher than those of the control group at T1 and T2, and the diff erences were signifi cant (P ＜ 0.05). The maintenance time of sensation and motor block in the observation group was shorter than that in the control group, and the diff erences were signifi cant (P ＜ 0.05). There was no signifi cant diff erence in the onset time of sensation and motor block between the two groups of patients (P ＞ 0.05). The incidence of adverse reactions in the observation group was signifi cantly lower than that in the control group, and one week after surgery, the recovery rate of anal
contraction in the observation group (92.50%) was signifi cantly higher than that in the control group (75.00%), with a signifi cant diff erence (χ2=4.500, P=0.034). Conclusion For patients undergoing surgery for mixed hemorrhoids, the combination of ropivacaine and sufentanil anesthesia during the surgery can achieve good anesthesia eff ects, shorten anesthesia movement and block time, improve postoperative anal contraction recovery rate, and have a low incidence of adverse reactions compared to simple ropivacaine anesthesia.
Objective To analyze the eff ect of personalized nursing during the perioperative period on patients undergoing gallstones surgery. Method Sixty patients with gallstones who received treatment at Leliu Hospital affi liated to Shunde Hospital of Guangzhou University of Traditional Chinese Medicine from March 2020 to March 2022 were selected and randomly divided into an observation group (personalized nursing) and a control group (routine nursing), with 30 patients in each group. The nursing satisfaction, incidence of complications, and quality of life scores of the two groups were compared after nursing care. Result Before nursing, there was no signifi cant difference in the quality-of-life scores between the two groups of patients (P ＞ 0.05). After nursing, the nursing satisfaction and quality of life scores of the observation group patients were signifi cantly higher than those of thecontrol group, but the total incidence of complications was signifi cantly lower than that of the control group, and the differences were significant (P ＜ 0.05). Conclusion The application of personalized nursing interventions in patients undergoing gallstones surgery can significantly improve their nursing satisfaction. Compared with conventional nursing measures, it can help patients reduce the incidence of postoperative complications, improve their quality of life, and promote physical recovery.
Objective To explore the effect of evidence-based nursing intervention on discharge readiness in postoperative enterostomy patients with rectal cancer. Method 80 patients with postoperative enterostomy for rectal cancer were selected from the patients admitted to Hezhou Guangji Hospital from September 2022 to August 2023, and were randomly divided into 2 groups with 40 cases in each group. The control group received traditional intervention, and the observation group received nursing mode intervention based on evidence-based concept. Discharge readiness score, self-care ability and self-esteem were compared between the two groups. Result The discharge readiness scores of the observation group patients, including physical and mental status (7.98±1.35) points, disease knowledge (7.68±1.12) points, social support (8.98±0.5) points, and coping ability (8.34±1.02) points, were signifi cantly higher than those of the control group (P ＜ 0.05). There was no signifi cant diff erence in self-care ability scores between the two groups before intervention (P ＞ 0.05); After intervention, the self-care ability scores of the observation group, including self responsibility (28.65±3.52), self-concept (30.62±4.35), self-care ability (31.45±4.69), and health knowledge (30.26±4.36), were signifi cantly higher than those of the control group (P ＜ 0.05). There was no signifi cant diff erence in self-esteem scores between the two groups before intervention (P ＞ 0.05), but after intervention, the self-esteem scores of the observation group were signifi cantly higher than those of the control group (P ＜ 0.05). Conclusion The intervention effect of nursing mode based on evidence-based concept in postoperative enterostomy patients with rectal cancer is obvious, patients are well prepared for discharge, improve their self-care ability, and make patients satisfi ed with self-esteem, which can be used for reference and promotion in clinical practice.
Objective To investigate the eff ects of laparoscopic cholecystectomy on the levels of infl ammatory factors, pain scores, and incidence of complications in patients with acute cholecystitis caused by stones. Method Eighty patients with acute calculous cholecystitis who visited Shantou Chaonan Minsheng Hospital from June 2023 to June 2024 were randomly divided into a control group (small incision cholecystectomy) and a study group (laparoscopic cholecystectomy) using a random number table, with 40 patients in each group. Compare the levels of infl ammatory factors, pain scores, oxidative stress indicators, and incidence of complications between two groups. Result Before surgery, there was no signifi cant diff erence in the levels of interleukin-6, interleukin-8, C-reactive protein, tumor necrosis factor - α, as well as serum malondialdehyde (MDA) and superoxide dismutase (SOD) levels between the two groups of patients (P ＞ 0.05). After surgery, the levels of interleukin-6, interleukin-8, C-reactive protein, tumor necrosis factor - α, and serum MDA in the study group were lower than those in the control group, but the level of SOD was higher than that in the control group, and the diff erences were signifi cant (P ＜ 0.05). At 12 hours, 1 day, and 3 days after surgery, the pain scores of patients in the study group were signifi cantly lower than those in the control group (P ＜ 0.05). The total incidence of postoperative complications in the study group (3.33%) was lower than that in the control group (13.33%), and the diff erence was signifi cant (P ＜ 0.05). Conclusion Laparoscopic cholecystectomy for the treatment of acute calculous cholecystitis can inhibit the body's inflammatory response and postoperative pain, reduce surgical stress response, and lower the risk of complications.
Objective To compare the clinical outcomes of laparoscopic cholecystectomy through the posterior triangle approach and the gallbladder plate approach. Method 96 patients with gallstones and chronic cholecystitis who were scheduled to undergo laparoscopic cholecystectomy treatment at the Huishan District Second People’s Hospital in Wuxi City from January 2020 to October 2023 were selected and divided into Group A and Group B using the odd even method, with 48 patients in each group. Group A underwent laparoscopic cholecystectomy via the posterior triangle approach, while Group B underwent laparoscopic cholecystectomy via the gallbladder plate approach. Observe and compare the surgical time, gastrointestinal function recovery time, hospitalization time, intraoperative blood loss, postoperative pain at 12 hours and 24 hours between two groups of patients, and also compare the incidence of postoperative complications between the two groups of patients. Result The surgical time, gastrointestinal function recovery time, and hospitalization time of patients in group A were shorter than those in group B. The intraoperative blood loss and visual pain simulation score at 12 and 24 hours after surgery were lower than those in group B, and the diff erences were signifi cant (P ＜ 0.05). The incidence of postoperative complications in Group A was lower than that in Group B, and the difference was significant (P ＜ 0.05). Conclusion Compared with the gallbladder plate approach, laparoscopic cholecystectomy through the posterior triangle approach can shorten the patient’s surgery, hospitalization time, and gastrointestinal function recovery time, reduce intraoperative bleeding, lower patient pain, and lower the risk of postoperative complications.
Objective To observe the application eff ect of the mini-nutritional assessment short-form (MNA-SF) in elderly patients during the perioperative period. Method 100 patients who underwent radical gastrectomy for gastric cancer at Yangjiang People's Hospital from July 2022 to October 2023 were selected. The selected patients were randomly divided into a control group and an experimental group, with 50 patients in each group. All patients in the experimental group underwent MNA-SF nutritional risk screening within 24 hours of admission, and patients at risk of malnutrition were given enteral and parenteral nutrition interventions before surgery. All patients in the control group were screened for nutritional risks using the nutritional risk screening 2002(NRS2002) within 24 hours of admission. Patients at risk of malnutrition were given enteral and parenteral nutrition interventions before surgery. Compare the positive rate of nutritional risk screening and postoperative recovery status between two groups of patients. Result The positive detection rate of nutritional risk screening in the experimental group of elderly patients was higher than that in the control group, and the diff erence was signifi cant (P ＜ 0.05). The experimental group had a shorter postoperative time to get out of bed, wound healing time, and hospitalization time compared to the control group, and a lower incidence of postoperative complications, with signifi cant diff erences (P ＜ 0.05). Conclusion MNA-SF provides a simple and comprehensive assessment framework, which helps to detect nutritional problems in elderly patients early and intervene early, promoting patient recovery.
Objective To investigate the efficacy of regorafenib combined with microwave ablation and percutaneous transhepatic arterial chemoembolization (TACE) in the treatment of primary liver cancer. Method Seventy four patients with primary liver cancer admitted to the Tianjin Second People's Hospital from October 2023 to April 2024 were selected and divided into an observation group and a control group using the medical record number envelope drawing method, with 37 patients in each group. The control group received microwave ablation combined with TACE treatment, while the observation group received regorafenib combined with microwave ablation and TACE treatment. The short-term efficacy, tumor markers, biomarkers, liver function, and adverse reactions of the two groups were compared. Result The disease control rate of the observation group patients was signifi cantly higher than that of the control group, and the diff erence was signifi cant (P ＜ 0.05). After treatment, the levels of cytokeratin 19, alpha fetoprotein, carcinoembryonic antigen, as well as alanine aminotransferase and alanine aminotransferase in the observation group were significantly lower than those in the control group. The levels of fragile histidine triad, P16 protein, and albumin were higher than those in the control group, and the diff erences were signifi cant (P ＜ 0.05). Nine patients in the observation group experienced adverse reactions, while ten patients in the control group experienced adverse reactions. There was no signifi cant diff erence in the incidence of adverse reactions between the two groups of patients (P ＞ 0.05). Conclusion Primary liver cancer treated with regorafenib combined with microwave ablation and TACE can improve short-term effi cacy, alleviate liver function damage, and with high safety.
Objective To investigate the effects of different pneumoperitoneum pressures on patients undergoing laparoscopic colorectal cancer surgery (LCS) and their impact on the quality of postoperative recovery period. Method 70 patients with LCS admitted to Gaozhou Traditional Chinese Medicine Hospital from October 2022 to October 2023 were selected and divided into a control group (controlled at 13 ～ 15mmHg) and an observation group (controlled at 8 ～ 12mmHg) based on diff erent levels of artifi cial pneumoperitoneum pressure, with 35 patients in each group. Result Compare the quality of recovery, cognitive function, stress response indicators, and gastrointestinal function recovery between two groups of patients. There was no significant diff erence in extubation time and anesthesia recovery time between the two groups of patients (P ＞ 0.05). The incidence of agitation during the awakening period in the observation group was lower than that in the control group, and the recovery of bowel sounds, anal exhaust, and postoperative fasting time were shorter than those in the control group, with signifi cant diff erences (P ＜ 0.05). The scores of the simple mental state examination scale for both groups of patients on postoperative day 1, 3, and 7 were lower than those on preoperative day 1, and the scores of the observation group were higher than those of the control group, with signifi cant diff erences (P ＜ 0.05). Compared with T0, the levels of cortisol and C-reactive protein in both groups increased from T1 to T3, and the levels of cortisol and C-reactive protein in the observation group were lower than those in the control group at the same time, with signifi cant diff erences (P ＜ 0.05). Conclusion Compared with high pneumoperitoneum pressure, adopting low pneumoperitoneum pressure in LCS treatment has less impact on patients' cognitive function, gastrointestinal function, and stress response, and can reduce the risk of agitation during the recovery period.
Objective To explore the clinical effi cacy of laparoscopic plain tension-free hernia repair and hernia ring filling tension-free hernia repair in the treatment of inguinal hernia. Method Ninety patients with inguinal hernia admitted to Qingyang Hospital in Jiangyin City from January 2021 to December 2023 were selected and divided into a study group and a routine group, with 45 patients in each group, based on diff erent surgical methods. The conventional group underwent tension-free hernia repair with hernia ring filling, while the study group underwent laparoscopic plain mesh tension-free hernia repair. The surgical related indicators, treatment outcomes,and complications of the two groups were compared. Result The overall treatment effi cacy rate of the study group patients (97.78%) was significantly higher than that of the conventional group (75.56%). The surgical duration and postoperative time to get out of bed of the study group patients were shorter than those of the conventional group, and the intraoperative blood loss was less than that of the conventional group, with signifi cant diff erences (P ＜ 0.05). The incidence of complications in the study group was 2.22% (1/45), signifi cantly lower than that in the conventional group [6.67% (3/45)], and the difference was significant (χ2=4.406, P=0.036). Conclusion Laparoscopic plain fi lm tension-free hernia repair is safe and eff ective in the treatment of inguinal hernia, with a lower risk of complications.
Objective To explore the anesthetic effect of ketamine combined with remifentanil on appendectomy and its impact on postoperative pain and adverse reactions in patients. Method 102 patients who underwent appendectomy at the Huai'an First People's Hospital Branch from January 2023 to March 2024 were selected and randomly divided into an observation group (n=51) and a control group (n=51) according to the principle of random number table. Both groups adopted the same anesthesia induction protocol, with the control group receiving remifentanil anesthesia during surgery and the observation group receiving a combination of ketamine and remifentanil anesthesia during surgery. Result Compare the perioperative vital signs, postoperative pain, and incidence of adverse reactions between two groups of patients. There was no signifi cant diff erence in heart rate and mean arterial pressure between the two groups of patients when they entered the operating room (P ＞ 0.05); The heart rate and mean arterial pressure at 1 minute and 5 minutes of anesthesia were lower than those at the time of entering the operating room (P ＜ 0.05), while there was no signifi cant diff erence at the end of the operation compared to entering the operating room (P ＞ 0.05). The heart rate and mean arterial pressure of the observation group patients were signifi cantly higher than those of the control group at 1 minute and 5 minutes of anesthesia (P ＜ 0.05). The VAS scores of the observation group were signifi cantly lower than those of the control group at 4, 8, and 12 hours after surgery (P ＜ 0.05), while there was no signifi cant diff erence in VAS scores between the two groups at 24 hours after surgery (P ＞ 0.05). There was no signifi cant diff erence in the occurrence of adverse reactions between the two groups of patients (P ＞ 0.05). Conclusion For patients undergoing appendectomy, the anesthesia eff ect of using ketamine combined with remifentanil is satisfactory, with mild postoperative pain and a lower incidence of adverse reactions.
Objective To explore the eff ect of nursing mode in the day surgery ward on patients undergoing laparoscopic tension-free inguinal hernia repair. Method A retrospective analysis was conducted on 117 patients who underwent laparoscopic tension-free inguinal hernia repair surgery at Lufeng People's Hospital from January 2022 to January 2024. The patients were divided into an inpatient surgery group (59 cases, intervened with conventional nursing methods) and a daytime surgery group (58 cases, intervened with nursing mode in the daytime surgery ward) according to diff erent surgical times. Result The diff erences in intraoperative bleeding, hospitalization time, daytime mobilization time, and incidence of complications between the two groups were compared. The results showed that the postoperative hospitalization time, surgery time, and postoperative mobilization time of patients in the daytime surgery group were shorter than those in the inpatient surgery group, and the intraoperative bleeding and total consumption were both less than those in the inpatient surgery group, with signifi cant diff erences (P ＜ 0.05). The total incidence of complications in the daytime surgery group (22.41%) was signifi cantly lower than that in the inpatient surgery group (47.46%), and the diff erence was signifi cant (P ＜ 0.05). Conclusion The intervention of nursing mode in the daytime surgical ward can signifi cantly improve the clinical treatment eff ect of patients undergoing laparoscopic lower abdominal inguinal hernia repair, with lower complications.
Objective To observe the effect of Tonglin Gushen Moxibustion combined with traditional Chinese medicine comprehensive nursing on the risk of urinary retention in patients with mixed hemorrhoids after operation. Method 102 patients with mixed hemorrhoids who underwent external stripping and internal ligation surgery at Sanshui Hospital of Foshan Traditional Chinese Medicine Hospital from July 2022 to October 2023 were selected and randomly divided into a control group and an experimental group, with 51 patients in each group, using a random number table method. The control group of patients received comprehensive traditional Chinese medicine nursing, while the experimental group of patients received a combination of Tonglin Gushen Moxibustion and comprehensive traditional Chinese medicine nursing. The incidence of urinary retention, perioperative related indicators, and urination status of the two groups were compared, and the abdominal distension of the patients was evaluated with the self-made abdominal distension scale. Result The fi rst spontaneous urination time of the experimental group patients after surgery was shorter than that of the control group, and the residual urine volume in the bladder was less than that of the control group, but the urine volume was greater than that of the control group, with signifi cant diff erences (P ＜ 0.05). The incidence of urinary retention in the test group was 3.92% (2/51), signifi cantly lower than 19.6% (10/51) in the control group, and the score of urination status and abdominal distention in the patients were signifi cantly lower than those in the control group (P ＜ 0.05). Conclusion Tonglin Gushen moxibustion combined with comprehensive nursing of traditional Chinese medicine can significantly reduce the incidence of urinary retention in patients with mixed hemorrhoids after operation, shorten the time of first urination, increase the amount of urination, reduce the amount of residual urine in the bladder, promote the smooth discharge of urine, and improve the abdominal distension of patients.
Objective To explore the implementation effect of integrated medical and nursing accelerated rehabilitation surgical nursing based on postoperative rehabilitation indicators, incidence of complications, and hospital satisfaction evaluation in the perioperative period of colorectal cancer patients. Method 66 patients with colorectal cancer admitted to the Second Affiliated Hospital of Shantou University School of Medicine from January 2021 to January 2024 were selected and divided into a control group (January 2021 to June 2022, n=33) and an experimental group (July 2022 to January 2024, n=33) according to the filing time. The control group received routine nursing during the perioperative period, while the experimental group received integrated medical
and accelerated rehabilitation surgical nursing. Statistics on postoperative rehabilitation indicators, incidence of complications during implementation, and satisfaction with hospitalization the day after implementation for two groups. Result The infusion treatment, fi rst anal exhaust, and hospitalization time of the experimental group patients were significantly shorter than those of the control group (P ＜ 0.05). The incidence of postoperative complications in the experimental group (9.09%) was lower than that in the control group (33.33%), and the hospital satisfaction rate (93.94%) was higher than that in the control group (72.73%), with signifi cant diff erences (P ＜ 0.05). Conclusion Implementing integrated accelerated rehabilitation surgical nursing for colorectal cancer patients during the perioperative period can promote postoperative recovery, reduce the incidence of complications, and improve hospital satisfaction.
Objective To explore the value of implementing operating room nursing in reducing the incidence of surgical pressure injuries. Method Sixty surgical patients admitted to Guangzhou University of Traditional Chinese Medicine Meizhou Hospital from March 2022 to November 2023 were collected and randomly divided into a control group and an observation group, with 30 patients in each group, using a random number table method. The control group received routine operating room care, while the observation group received preventive care in the operating room. The incidence of pressure ulcers, pressure ulcer risk assessment, and patient satisfaction were evaluated in both groups. Result The incidence of pressure ulcers in the observation group was lower than that in the control group, the area of pressure ulcers was smaller than that in the control group, and the patient satisfaction was higher than that in the control group, with signifi cant diff erences (P ＜ 0.05). The Braden scores of the observation group patients before and after nursing were (13.36±2.66) and (19.27±2.47) points, respectively, while the Braden scores of the control group patients before and after nursing were (13.28±2.56) and (16.23±2.25) points, respectively. After nursing, the Braden scores of both groups increased compared to before nursing, and the Braden scores of patients in the observation group were higher than those in the control group, with a signifi cant difference (t=4.984, P ＜ 0.001). Conclusion Scientific evaluation of pressure injuries and the development of corresponding operating room nursing plans based on the actual situation of elderly patients can help reduce the risk of pressure ulcers and improve patient satisfaction.
