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1.
目的:比较高聚焦超声睫状体成形术(UCP)和睫状体冷冻术治疗难治性青光眼的疗效。方法:回顾性研究。收集2017-01/2020-12本院收治的难治性青光眼患者45例81眼,依据患者治疗方法不同分为睫状体冷冻术组22例40眼,高聚焦超声睫状体成形术组23例41眼。观察两组患者术前,术后1d,1wk,1、3mo眼压变化情况,采用疼痛数字等级评定量表(NRS)评估眼球疼痛程度,比较两组患者手术效果和并发症发生情况。结果:高聚焦超声睫状体成形术组手术总有效率明显高于睫状体冷冻术组(P<0.05),两组患者术后1d,1wk,1、3mo眼压和眼球疼痛程度均低于术前(均P<0.05),两组间患者术后各时间点眼压和眼球疼痛程度比较均有差异(均P<0.05)。高聚焦超声睫状体成形术组患者结膜充血、角膜水肿、前房炎性渗出、反应性高眼压和前房积血并发症发生率低于睫状体冷冻术组(P<0.05)。结论:高聚焦超声睫状体成形术治疗难治性青光眼疗效明确,在降低患者眼压、减少眼球疼痛和并发症发生方面较睫状体冷冻术有明显优势。  相似文献   
2.
ObjectiveNew-onset postoperative atrial fibrillation (POAF) after cardiac surgery is common, with rates up to 60%. POAF has been associated with early and late stroke, but its association with other cardiovascular outcomes is less known. The objective was to perform a meta-analysis of the studies reporting the association of POAF with perioperative and long-term outcomes in patients with cardiac surgery.MethodsWe performed a systematic review and a meta-analysis of studies that presented outcomes for cardiac surgery on the basis of the presence or absence of POAF. MEDLINE, EMBASE, and the Cochrane Library were assessed; 57 studies (246,340 patients) were selected. Perioperative mortality was the primary outcome. Inverse variance method and random model were performed. Leave-one-out analysis, subgroup analyses, and metaregression were conducted.ResultsPOAF was associated with perioperative mortality (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.58-2.33), perioperative stroke (OR, 2.17; 95% CI, 1.90-2.49), perioperative myocardial infarction (OR, 1.28; 95% CI, 1.06-1.54), perioperative acute renal failure (OR, 2.74; 95% CI, 2.42-3.11), hospital (standardized mean difference, 0.80; 95% CI, 0.53-1.07) and intensive care unit stay (standardized mean difference, 0.55; 95% CI, 0.24-0.86), long-term mortality (incidence rate ratio [IRR], 1.54; 95% CI, 1.40-1.69), long-term stroke (IRR, 1.33; 95% CI, 1.21-1.46), and longstanding persistent atrial fibrillation (IRR, 4.73; 95% CI, 3.36-6.66).ConclusionsThe results suggest that POAF after cardiac surgery is associated with an increased occurrence of most short- and long-term cardiovascular adverse events. However, the causality of this association remains to be established.  相似文献   
3.
目的研究系统营养联合节律运动对糖尿病合并心血管疾病风险人群干预的效果。方法选取60名有糖尿病史(≥3年)的受试者,每天进行系统营养联合节律运动的干预,连续干预60d。干预前、干预后分别采用生物电全身扫描、动脉硬化检测、糖尿病风险评估等技术对60名受试者进行检测。结果与干预前比较,干预后绝大部分受试者血糖、血脂水平,心血管系统相关脏器活性及心血管并发症发病风险相关指标均显著改善。结论节律运动联合系统营养可显著改善糖代谢异常人群的糖代谢水平,并可显著降低心血管并发症发病风险。  相似文献   
4.
林小红 《中国校医》2022,36(1):47-49
目的 探讨基于加速康复外科(ERAS)理念护理干预对老年腹股沟疝手术患者应用效果。方法 选取2017年11月—2020年11月收治于我院的84例老年腹股沟疝日间手术患者,按随机数字表法分为两组,各42例。对照组给予常规护理,观察组采用基于ERAS理念的护理干预。对比两组术后机体康复情况与并发症发生率。结果 观察组术后首次肛门排气、排便、下床活动、进食及住院时间为(4.28±1.23)h、(15.24±2.16)h、(15.39±2.17)h、(5.69±1.41)h、(3.83±1.03)d,短于对照组的(5.48±1.08)h、(16.54±2.37)h、(16.43±2.11)h、(6.38±1.52)h、(4.38±1.14)d,差异有统计学意义(t=4.751、2.627、2.227、2.157、2.320,P=<0.001、0.010、0.029、0.034、0.023);观察组并发症发生率4.76%,低于对照组的19.05%,差异有统计学意义(χ2=4.087,P=0.043)。结论 基于ERAS理念护理干预能够加快老年腹股沟疝手术患者术后肛门排气、排便等时间,预防并发症,促进术后康复。  相似文献   
5.
《Pancreatology》2022,22(2):270-276
Backgroundand purpose: Zinc is an essential element for human health and plays an important role in metabolic, immunological and other biological processes. The present study was conducted to investigate the association between zinc deficiency (ZD) and the perioperative clinical course in patients with pancreatic ductal adenocarcinoma (PDAC).MethodsOf 216 patients with PDAC who underwent elective pancreatectomy between 2013 and 2017 at our institution, 206 patients with sufficient clinical data were retrospectively reviewed. The perioperative variables were compared and the risk factors associated with infectious complications were identified.ResultsZD was preoperatively present in 36 (17.5%) of 206 patients with PDAC. In the patients of the ZD group, a higher proportion of males, higher preoperative modified Glasgow prognostic scores, a higher neutrophil-to-lymphocyte ratio, and a higher occurrence of postoperative infectious complications after pancreatectomy were observed, compared to the non-ZD group. By a univariate analysis, three risk factors were significantly associated with infectious complications after pancreatectomy: ZD (vs non-ZD: p = 0.002), serum albumin <3.5 g/dl (vs ≥ 3.5 g/dl: p = 0.005), and the procedure of pancreaticoduodenectomy (vs others: p = 0.013). By multivariate logistic regression analysis, the occurrence of infectious complications was significantly associated with ZD (OR 3.430, 95%CI 1.570 to 7.490, p = 0.002) and the procedure of pancreaticoduodenectomy (OR 2.030, 95%CI 1.090 to 3.770, p = 0.025).ConclusionsThe current study newly demonstrated that ZD could serve as a preoperative predictor of infectious complications after pancreatectomies in the patients with PDAC.  相似文献   
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8.
目的:通过对接受腹腔镜直肠癌根治(total mesorectal excision,TME)手术患者的术后随访,探究保留左半结肠血管对术后便秘及相关并发症的影响。方法:我院普外科2015年05月至2017年05月共收治的93例直肠肠癌根治手术患者进行回顾性分析。结果:对于病人的年龄、性别、BMI、术前CEA、术中出血量、吻合口瘘、术后肿瘤复发率,是否保留左半结肠血管方面无差异(P>0.05)。低位结扎组在术后肠道功能恢复、吻合口炎症以及术后便秘发生率中明显优于高位结扎组(P<0.05);高位结扎组在手术时间上优于低位结扎组(P<0.05)。结论:保留左半结肠的TME手术可以完成同样的淋巴结清扫,虽然术中用时较长但一定程度上保护了肠道的血运及神经,降低了术后便秘的发生率,值得临床进一步研究与推广。  相似文献   
9.
贾春萌 《全科护理》2022,20(1):105-107
目的:分析腹腔镜直肠癌根治术病人术后动力性肠梗阻的相关因素,并探讨对应的护理干预措施。方法:纳入2017年1月—2020年2月在医院行腹腔镜直肠癌根治术的400例直肠癌病人为研究对象,采用单因素、多因素Logistic回归分析法对腹腔镜直肠癌根治术病人术后动力性肠梗阻的相关危险因素进行分析。结果:400例腹腔镜直肠癌根治术病人中38例(9.50%)术后出现动力性肠梗阻。多因素Logistic回归分析结果显示,有术前肠梗阻史、合并低蛋白血症、手术时间>3 h、吻合口瘘均为影响腹腔镜直肠癌根治术病人术后发生动力性肠梗阻的独立因素(P<0.05)。结论:有术前肠梗阻史、合并低蛋白血症、手术时间>3 h和吻合口瘘等因素使腹腔镜直肠癌根治术病人术后发生动力性肠梗阻的风险增大,临床护理工作者应积极实施对应护理干预,以期降低术后动力性肠梗阻的发生率。  相似文献   
10.
Most surgical and anaesthetic mortality and morbidity occurs postoperatively, disproportionately affecting low- and middle-income countries. Various short courses have been developed to improve patient outcomes in low- and middle-income countries, but none specifically to address postoperative care and complications. We aimed to identify key features of a proposed short-course addressing this topic using a Delphi process with low- and middle-income country anaesthesia providers trained as short-course facilitators. An initial questionnaire was co-developed from literature review and exploratory workshops to include 108 potential course features. Features included content; teaching method; appropriate participants; and appropriate faculty. Over three Delphi rounds (panellists numbered 86, 64 and 35 in successive cycles), panellists indicated which features they considered most important. Responses were analysed by geographical regions: Africa, the Americas, south-east Asia and Western Pacific. Ultimately, panellists identified 60, 40 and 54 core features for the proposed course in each region, respectively. There were high levels of consensus within regions on what constituted core course content, but not between regions. All panellists preferred the small group workshop teaching method irrespective of region. All regions considered anaesthetists to be key facilitators, while all agreed that both anaesthetists and operating theatre nurses were key participants. The African and Americas regional panels recommended more multidisciplinary healthcare professionals for participant roles. Faculty from high-income countries were not considered high priority. Our study highlights variability between geographical regions as to which course features were perceived as most locally relevant, supporting regional adaptation of short-course design rather than a one-size-fits-all model.  相似文献   
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