PDCA护理模式在治疗腋臭围术期中的应用

目的探讨PDCA护理模式在微创耕耙剥离搔刮法治疗腋臭围术期的应用效果。方法选择2012年1月-2012年12月本院收治的腋臭患者共80例，将其随机分为观察组和对照组各40例。观察组采用PDCA护理模式贯穿于整个围术期，对照组行常规护理。采用Zung焦虑与抑郁自评量表（SAS、SDS）、疼痛指数、创面愈合率和创面愈合时间等指标综合评价护理效果。结果观察组与对照组手术前SAS、SDS评分比较，差异无统计学意义（P〉0．05）；而两组术中疼痛指数比较，差异有统计学意义（P〈0．05）；术后两组创面愈合率和创面愈合时间比较，差异有统计学意义（P〈0．05）。结论PDCA护理模式可有效降低患者疼痛敏感度，促进患者术后康复，有利于临床护理工作的开展。     

预见性护理在糖尿病性白内障患者围术期护理中的应用

目的探究预见性护理在糖尿病性白内障患者围术期护理中的应用效果。方法从2018年5~11月聊城市第三人民医院收治的糖尿病性白内障手术患者中选出92例,随机分成两组,对照组采取常规护理,观察组采取“常规护理+预见性护理”,各46例。比较两组患者的并发症发生率、生活质量。结果观察组患者的并发症发生率显著低于对照组,生活质量评分显著高于对照组,差异均有统计学意义(均P<0.05)。结论预见性护理可显著降低糖尿病性白内障患者并发症发生率,提高患者生活质量。     

新型冠状病毒肺炎疫情期间外科患者围术期防控策略

目前新型冠状病毒肺炎疫情防控形势严峻,各级医疗机构在做好新型冠状病毒肺炎防控的同时,还需提供优质安全的常规医疗服务。笔者旨在通过严格患者分类管理以及围术期标准预防,为需行外科治疗的患者,尤其是需行急诊外科治疗的患者提供优质安全的医疗服务,减少院内感染,为新型冠状病毒肺炎防控贡献一份力量。     

优质护理服务模式在股骨颈骨折围手术期护理中的作用效果分析

目的分析优质护理服务模式在股骨颈骨折围手术期护理中的效果。方法资料选自2013年1月~2014年1月我院收治的股骨颈骨折患者68例,均分为研究组和对照组,给予对照组常规护理,研究组实施优质护理服务模式,对比两组护理效果。结果护理后,研究组护理满意度97.06%,高于对照组79.41%,比较差异有统计学意义(P0.05)。结论给予股骨颈骨折患者围手术期优质护理服务,对改善护患关系有积极意义。     

Multidisciplinary treatment strategy for locally advanced gastric cancer: A systematic review

BackgroundMultidisciplinary management of patients with locally advanced gastric cancer (LAGC) remains unstandardized worldwide. We performed a systemic review to summarize the advancements, regional differences, and current recommended multidisciplinary treatment strategies for LAGC.MethodsEligible studies were identified through a comprehensive search of PubMed, Web of Science, Cochrane Library databases and Embase. Phase 3 randomized controlled trials which investigated survival of patients with LAGC who underwent gastrectomy with pre-/perioperative, postoperative chemotherapy, or chemoradiotherapy were included.ResultsIn total, we identified 11 studies of pre-/perioperative chemotherapy, 38 of postoperative chemotherapy, and 14 of chemoradiotherapy. In Europe and the USA, the current standard of care is perioperative chemotherapy for patients with LAGC using the regimen of 5-FU, folinic acid, oxaliplatin and docetaxel (FLOT). In Eastern Asia, upfront gastrectomy and postoperative chemotherapy is commonly used. The S-1 monotherapy or a regimen of capecitabine and oxaliplatin (CapOx) are used for patients with stage II disease, and the CapOx regimen or the S-1 plus docetaxel regimen are recommended for those with stage III Gastric cancer (GC). The addition of postoperative radiotherapy to peri- or postoperative chemotherapy is currently not recommended. Additionally, clinical trials testing targeted therapy and immunotherapy are increasingly performed worldwide.ConclusionsRecent clinical trials showed a survival benefit of peri-over postoperative chemotherapy and chemoradiotherapy. As such, this strategy may have a potential as a global standard for patients with LAGC. Outcome of the ongoing clinical trials is expected to establish the global standard of multidisciplinary treatment strategy in patients with LAGC.     

A nationwide surveillance of surgical site infection after mid-urethral slings in Japan

We performed a questionnaire-based, retrospective, nationwide survey on perioperative management and antimicrobial prophylaxis for mid-urethral sling surgery for stress urinary incontinence in Japan to realize the clinical practice and risk factors for SSI.Records of women receiving transobturator tape (TOT) and tension-free vaginal tape (TVT) surgeries from 2010 to 2012 were obtained from hospitals belonging to the Japanese Society of Pelvic Organ Prolapse Surgery. The questionnaire addressed hospital volume, perioperative management, and SSI. Risk factors for SSI were investigated by comparing cases with and without SSI.The data from 97 hospitals and a total 1627 TOT and 1045 TVT surgeries were analyzed. Mean case volumes of TOT and TVT surgeries were 7.3 ± 14.9 and 7.1 ± 17.8 cases per year, respectively. Preoperative hair removal, bowel preparation, and urine culture were routinely performed at 44 (45.3%), 31 (32.0%), and 22 (22.7%) hospitals, respectively. First-generation (51.5%) or second-generation (34.0%) cephalosporin was mostly used for antimicrobial prophylaxis. SSI was reported only in 6 patients (0.22%) and none of them developed abscesses. None of the factors we could evaluate from the questionnaire were found to be significantly associated with SSI.SSI after mid-urethral slings rarely occurred in Japan (0.22%) and no parameters about perioperative managements significantly increased SSI. However, further studies with more detail information of each patient and operation are required to confirm their appropriate perioperative managements for mid-urethral slings.     

改良纤维板剥脱术对慢性结核性脓胸患者围手术期临床指标、肺功能及术后并发症的影响

目的探讨改良纤维板剥脱术对慢性结核性脓胸患者围手术期临床指标、肺功能及术后并发症的影响。方法选取慢性结核性脓胸患者140例,采用随机数字表法分为对照组(70例)和试验组(70例),分别常规纤维板剥脱术和改良纤维板剥脱术治疗。比较两组患者围手术期临床指标,术后肺活量(VC)和最大通气量(MVV)增加量及术后胸腔再次感染率等。结果两组患者手术时间、术中出血量、术后24 h引流量、引流管放置时间及住院时间等围手术期临床指标比较差异无统计学意义(P0.05);试验组患者治疗后VC和MVV增加量均高于对照组,差异有统计学意义(P0.05);两组患者术后胸腔再次感染率比较差异无统计学意义(P0.05)。结论改良纤维板剥脱术治疗慢性结核性脓胸患者可有效改善肺功能,且未对围手术期临床指标及术后并发症产生明显影响,具有临床应用价值。