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目的食管裂孔疝的加速康复护理围手术期的护理措施的优化。 方法回顾分析在接受腹腔镜下食管裂孔疝修补+胃底折叠术治疗的食管裂孔疝的32例患者围手术期的系统性护理措施,总结食管裂孔疝围手术期的快速康复护理要点。 结果32例患者均顺利完成手术,术后胃管留置(22.4±3.5)h、腹腔引流管(30.2±4.6)h、1例出现气胸的胸腔闭式引流69 h;恢复排气时间(21.3±2.4)h、排便时间(37.6±3.2)h、进食时间为(23.5±2.6)h;并发症发生率方面出现吞咽困难2例、气胸1例。 结论围手术期的优化护理措施,一定程度上加快了食管裂孔疝患者术后康复。 相似文献
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Yunpeng Zhang Yufang Xin Daqing Cheng Ming Xu Ji Chen 《Scandinavian journal of gastroenterology》2013,48(9):1124-1131
AbstractBackground: The Enhanced Recovery After Surgery (ERAS) pathway is widely applied in the perioperative period of stomach and colorectal surgery, and can decrease the length of hospital stay of the patients without compromising the safety of the patients. However, some patients are removed from this pathway for various reasons. Here we found some factors that taking the patients out from the procedures.Methods: A retrospective analysis of collected data of 550 patients over a 3-year period was conducted, with 292 in the ERAS group and 258 in the conventional care group. Then various basic elements were analyzed to explore the reasons for the failure to complete the ERAS program.Results: Total length of hospital stay after surgery was significantly shorter in the ERAS group, and a similar incidence of complication rates were observed in the two groups. In this study, the significant factors that associated with complications were advanced age (OR 2.18; p?=?.031), history of abdominal surgery (OR 2.03; p?=?.04), incomplete gastrointestinal obstruction (OR 3.42; p?.001), laparoscopic surgery (OR 0.39; p?=?.004) and intraoperative neostomy (OR 2.37; p?=?.006).Conclusions: We found that advanced age (>80?years old), history of abdominal surgery, gastrointestinal obstruction and stoma formation were the risk factors. We anticipated to design a risk assessment system upon the high-risk patients from the present ERAS pathway, and make a modified ERAS pathway for those patients. 相似文献
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Anderson da Costa Armstrong Lucas Gomes Santos Thiago Cavalcanti Leal Joo Paulo Silva de Paiva Leonardo Feitosa da Silva Gibson Barros de Almeida Santana Carlos Alberto de Oliveira Rocha Thiala Alves Feitosa Sara Larissa de Melo Araújo Mrcio Bezerra-Santos Carlos Dornels Freire de Souza Rodrigo Feliciano do Carmo 《Arquivos brasileiros de cardiologia》2022,119(1):37
Background:The COVID-19 pandemic has had an impact on mortality from several diseases worldwide, especially cardiovascular diseases (CVD). Brazil is a continent-sized country with significant differences in the health care structure between its federative units.Objective:Analyze in-hospital mortality from CVDs in the Brazilian public health system during the first year of the COVID-19 pandemic (2020).Methods:This is an ecological study analyzing the absolute number of in-hospital deaths and the rate of in-hospital mortality in Brazil, its macro-regions, and federative units. Data were obtained from the Hospital Information System of the Brazilian Ministry of Health. To analyze excess mortality, the P-score was used. It compares the events observed with those expected for a given place and period. The P-score was corrected by the joinpoint regression model, with a 95% confidence interval and 5% significance level.Results:There were 93,104 in-hospital deaths due to CVD in Brazil in 2020, representing 1,495 fewer deaths (P score: −1.58) than expected. The central-west region had a positive P-score, with a 15.1% increase in the number of deaths. Ten federative units showed a greater number of deaths in 2020. There was also a 13.3% excess in-hospital mortality at the country level, and an excess in-hospital mortality in all macro-regions.Conclusions:There was a decrease in the absolute number of in-hospital deaths, as well as an increase in in-hospital mortality from CVD in Brazil, in 2020, after the COVID-19 pandemic onset. 相似文献
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《Nutrition, metabolism, and cardiovascular diseases : NMCD》2020,30(7):1061-1067
Background and aimA novel coronavirus severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) caused pneumonia, Coronavirus Disease 2019 (COVID-19), broke out in Wuhan, China in December 2019, and spread all over the world. Patients with COVID-19 showed huge differences in the hospital stay, progression, and prognosis. As reported, the comorbidities may play an important role in COVID-19. Here, we aim to address the role of cardiovascular disease (CVD) in the progression and prognosis of COVID-19.Methods and resultsEighty-three confirmed COVID-19 patients were divided into CVD (n = 42) and non-CVD (n = 41) group according to their medical history. Medical records including demographic data, medical history, clinical characteristics, laboratory examinations, chest computed tomography (CT), and treatment measures were collected, analyzed, and compared between the two groups. COVID-19 patients with CVD showed (1) more severe pathological changes in the lungs, (2) elevated injury-related enzymes including α-hydroxybutyrate dehydrogenase (HDBH), lactic dehydrogenase (LDH), γ-glutamyltransferase (GGT), creatine kinase (CK), and alanine aminotransferase (ALT), (3) significantly increased uncontrolled inflammation related markers, such as c-reactive protein (CRP), interleukin (IL)-6, serum ferritin, erythrocyte sedimentation rate (ESR), and serum amyloid A (SAA), (4) serious hypercoagulable status reflected by increased D-dimer and serum fibrinogen (FIB), and (5) higher mortality, compared to COVID-19 patients without CVD.ConclusionsOur data indicated that CVD is a strong risk factor for rapid progression and bad prognosis of COVID-19. More intensive medical care should be applied to patients with CVD to prevent rapid deterioration of the disease. 相似文献
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《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2022,16(6):102513
Background and aimsRecent media reports of myocarditis after receiving COVID-19 vaccines, particularly the messenger RNA (mRNA) vaccines, are causing public concern. This review summarizes information from published case series and case reports, emphasizing patient and disease characteristics, investigation, and clinical outcomes, to provide a comprehensive picture of the condition.MethodsA systematic literature search of PubMed and Google scholar was conducted from inception to April 27, 2022. Individuals who develop myocarditis after receiving the COVID-19 vaccine, regardless of the type of vaccine and dose, were included in the study.ResultsSixty-two studies, including 218 cases, participated in the current systematic review. The median age was 29.2 years; 92.2% were male and 7.8% were female. 72.4% of patients received the Pfizer-BioNTech (BNT162b2) vaccine, 23.8% of patients received the Moderna COVID-19 Vaccine (mRNA-1273), and the rest of the 3.5% received other types of COVID-19 vaccine. Furthermore, most myocarditis cases (82.1%) occurred after the second vaccine dose, after a median time interval of 3.5 days. The most frequently reported symptoms were chest pain, myalgia/body aches and fever. Troponin levels were consistently elevated in 98.6% of patients. The admission ECG was abnormal in 88.5% of cases, and the left LVEF was lower than 50% in 21.5% of cases. Most patients (92.6%) resolved symptoms and recovered, and only three patients died.ConclusionThese findings may help public health policy to consider myocarditis in the context of the benefits of COVID-19 vaccination. 相似文献
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《Nutrition, metabolism, and cardiovascular diseases : NMCD》2020,30(7):1057-1060
AimsTo analyze the potential mechanism of cardiovascular dysfunctions induced by Coronavirus Disease 2019 (COVID-19) and to evaluate more effective therapeutic pathways for patients with cardiovascular diseases.Data synthesisCOVID-19 mainly invades the lungs, causing its serious damage. Studies found that COVID-19 induced the renin–angiotensin system imbalance, inflammatory storm, hypoxemia, stress response, and so on; all contributed to hypertension and serious myocardial damage in the process of virus pathogenesis, even increasing mortality in COVID-19 patients.ConclusionIn the process of management of COVID-19 infections, close attention should be paid on both lung and cardiovascular damage, especially on those with only symptoms of cardiovascular diseases. Early identification, timely and effective treatments, and maintenance of hemodynamics and electrophysiological stability are of great significance on effective treatment and long-term prognosis. 相似文献
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Clinicians' Perspectives on Patient Satisfaction in Adult Congenital Heart Disease Clinics—A Dimension of Health Care Quality Whose Time Has Come
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Ronen Rozenblum PhD MPH Ann Gianola MA Raluca Ionescu‐Ittu PhD Amy Verstappen MEd Michael Landzberg MD Michelle Gurvitz MD MS Kathy Jenkins MD MPH David W. Bates MD MSc Ariane J. Marelli MD MPH 《Congenital heart disease》2015,10(2):128-136
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《Hellenic Journal of Cardiology》2020,61(6):381-395
The novel coronavirus disease 2019 (COVID-19) pandemic has already caused more than 300,000 deaths worldwide. Several studies have elucidated the central role of cardiovascular complications in the disease course. Herein, we provide a concise review of current knowledge regarding the involvement of cardiovascular system in the pathogenesis and prognosis of COVID-19. We summarize data from 21 studies involving in total more than 21,000 patients from Asia, Europe, and the USA indicating that severe disease is associated with the presence of myocardial injury, heart failure, and arrhythmias. Additionally, we present the clinical and laboratory differences between recovered and deceased patients highlighting the importance of cardiac manifestations. For the infected patients, underlying cardiovascular comorbidities and particularly existing cardiovascular disease seem to predispose to the development of cardiovascular complications, which are in turn associated with higher mortality rates. We provide mechanistic insights into the underlying mechanisms including direct myocardial damage by the virus and the consequences of the hyperinflammatory syndrome developed later in the disease course. Finally, we summarize current knowledge on therapeutic modalities and recommendations by scientific societies and experts regarding the cardiovascular management of patients with COVID-19. 相似文献
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《Nutrition, metabolism, and cardiovascular diseases : NMCD》2023,33(7):1415-1419
Background and aimTo contain the spread of COVID-19, many countries imposed several restrictive measures, leading to radical changes in daily life behaviors. Healthcare workers experienced additional stress due to the increased risk of contagion, possibly causing an increase in unhealthy habits. We investigated changes in cardiovascular (CV) risk assessed by the SCORE-2 in a healthy population of healthcare workers during the COVID-19 pandemic; an analysis by subgroups was also conducted (sportspeople vs sedentary subjects).Methods and resultsWe compared medical examination and blood tests in a population of 264 workers aged over 40, performed yearly before (T0) and during the pandemic (T1, T2). We found a significant increase in the average CV risk, according to SCORE-2, during the follow-up in our healthy population, with a shift from a mean low-moderate risk profile at T0 (2.35%) to a mean high-risk profile at T2 (2.80%). Furthermore, in sedentary subjects was observed a greater and early increase in SCORE-2 compared to sportspeople.ConclusionsSince 2019, we observed an increase in CV risk profile in a healthy population of healthcare workers, particularly in sedentary subjects, highlighting the need to reassess SCORE-2 every year to promptly treat high-risk subjects, according to the latest Guidelines. 相似文献
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本文探讨了新型冠状病毒肺炎疫情期间及防控常态化下太钢总医院消化内科和新安国际消化内科实施日间手术的情况,旨在为在特殊时期的临床工作提供安全及有效性的依据.我们医院消化内镜中心按照卫生行政部门及医院防控要求,结合科室工作特点,制定了一系列防控管理措施并准确落实,使临床工作在安全防护的基础上取得良好的效果.2020-2021消化内镜中心共完成日间手术2000余例,无疑似手术感染和新型冠状病毒肺炎病例.严格的疫情防控及高质量的管理为该中心日间手术的积极开展发挥了积极有效作用;安全优化的诊疗流程,让患者及家属安心;医务人员严格执行防护措施,保证了手术的安全和工作效率的流畅高效. 相似文献