Plasmapheresis in combined measures to prevent postoperative thromboembolic complications in cancer patients

Plasmapheresis with exfusion of 30-60% circulating plasma volume has been first used in combination with conventional drug therapy for the prevention of postoperative thromboembolic complications in cancer patients at risk of thrombosis (II-III stage lung cancer). The use of plasmapheresis made it possible to reduce the incidence of postoperative thromboembolic complications by 40.6% and to decrease postoperative lethality.     

Interventions to prevent loss of bone mineral density in women receiving chemotherapy for breast cancer

Loss of bone mineral density (BMD) is a significant problem for women receiving breast cancer treatment. The purpose of this article is to present the state of the knowledge on BMD loss and analyze interventions to prevent BMD loss in women receiving breast cancer treatment. The data sources include primary research reports, review articles, and book chapters. With increased numbers of breast cancer survivors, BMD loss experienced with treatment is a significanthealth concern because of risks of osteoporosis and bone fractures. These long-term treatment effects may significantly impact patients' long-term morbitity and mortality. BMD screening as well as an assessment of physical activity and dietary history should be conducted with women undergoing breast cancer treatment. Bisphosphonates are effective in preventing BMD loss, and other interventions such as physical activity and dietary interventions need further testing. Oncology nurses are ideal candidates for implementing interventions to prevent BMD loss because of their understanding of cancer treatments, knowledge of health-related behaviors, and ability to teach patients about the positive health benefits of lifestyle changes.     

A systematic review of intraoperative warming to prevent postoperative complications

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THIS SYSTEMATIC REVIEW examines whether preventing hypothermia during surgery prevents postoperative complications and thereby improves outcomes for patients. Twenty-six randomized controlled trials were identified, and data extraction and assessment of study quality were carried out by two researchers independently. The results of studies with similar patients, surgical procedures, and outcomes were pooled.

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OUTCOMES MEASURED included postoperative pain levels, thermal comfort, and treatment costs. Postoperative complications identified were shivering, cardiac events, need for blood transfusion, wound infections, and pressure ulcers. The majority of studies favored treatment. AORN J 83 (May 2006) 1090-1113.

     

Intracuff alkalinized lidocaine to prevent postoperative airway complications: A meta-analysis

BACKGROUNDPost-extubation cough is a common phenomenon in surgical patients undergoing general anesthesia, which can lead to potentially dangerous complications. In this meta-analysis, we evaluated the efficacy and safety of intracuff alkalinized lidocaine in patients with tracheal intubation to prevent cough and other airway complications during the perioperative period.AIMTo perform a systematic review and meta-analysis of intracuff alkalinized lidocaine for the prevention of postoperative airway complications.METHODSPubMed, Embase, Cochrane, and Web of Science were searched for randomized controlled trials (RCTs) that compared intracuff alkalinized lidocaine to placebo. We used risk-of-bias assessment to assess the RCTs, and the quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluations.RESULTSTwelve randomized trials (1175 patients) were analyzed. Meta-analysis showed that intracuff alkalinized lidocaine was associated with less cough compared to that produced by placebo [risk ratio (RR): 0.38; 95% confidence interval (CI): 0.23-0.63]. Similarly, intracuff alkalinized lidocaine was more effective than the control in reducing postoperative sore throat at 24 h (RR: 0.19; 95%CI: 0.09-0.41) and postoperative hoarseness (RR: 0.38; 95%CI: 0.21-0.69). CONCLUSIONIntracuff alkalinized lidocaine is an effective adjuvant that can decrease airway complications, such as coughing, hoarseness, and sore throat.     

Symptom concerns of women with ovarian cancer

This study describes the symptom experience of women with ovarian cancer. A body of data consisting of 21,806 letters, cards, and e-mails written by ovarian cancer patients was donated to the City of Hope investigators by the founder and editor of Conversations!: The International Newsletter for Those Fighting Ovarian Cancer. Using ethnographic qualitative research procedures, meaningful comments in the data were bracketed and coded within physical, psychological, social, and spiritual domains according to the City of Hope QOL–Ovarian Cancer instrument. Six hundred seventy-seven (677) comments were identified as pertaining to pre- and post-diagnostic symptomatology. Findings, based on major themes derived from the analysis, included distress over delayed diagnoses given the presence of pre-diagnosis symptoms. Frequently described post-diagnosis symptoms included pain, fatigue, gastrointestinal effects, and menstrual and fertility changes. Women demonstrated resourcefulness and optimism by sharing innovative ideas for coping with varied symptoms. Significant attention was dedicated to complementary and alternative therapies, both for symptom management and with curative intent. Findings demonstrate the need to improve diagnostic tests, symptom management, and patient education.     

Care of elderly women with ovarian cancer

The goal of this article is to educate nurses about ovarian cancer in older women, its treatment options, and related nursing interventions. This information will enable readers to identify risk factors for ovarian cancer, standard treatment approaches, nursing interventions, and patient care.     

Preadmission interventions to prevent postoperative complications in older cardiac surgery patients: A systematic review

Objective(s)

The literature on postoperative complications in cardiac surgery patients shows high incidences of postoperative complications such as delirium, depression, pressure ulcer, infection, pulmonary complications and atrial fibrillation. These complications are associated with functional and cognitive decline and a decrease in the quality of life after discharge. Several studies attempted to prevent one or more postoperative complications by preoperative interventions. Here we provide a comprehensive overview of both single and multiple component preadmission interventions designed to prevent postoperative complications.

Methods

We systematically reviewed the literature following the PRISMA statement guidelines.

Results

Of 1335 initial citations, 31 were subjected to critical appraisal. Finally, 23 studies were included, of which we derived a list of interventions that can be applied in the preadmission period to effectively reduce postoperative depression, infection, pulmonary complications, atrial fibrillation, prolonged intensive care unit stay and hospital stay in older elective cardiac surgery patients. No high quality studies were found describing effective interventions to prevent postoperative delirium. We did not find studies specifically targeting the prevention of pressure ulcers in this patient population.

Conclusions

Multi-component approaches that include different single interventions have the strongest effect in preventing postoperative depression, pulmonary complications, prolonged intensive care unit stay and hospital stay. Postoperative infection can be best prevented by disinfection with chlorhexidine combined with immune-enhancing nutritional supplements. Atrial fibrillation might be prevented by ingestion of N-3 polyunsaturated fatty acids. High quality studies are urgently needed to evaluate preadmission preventive strategies to reduce postoperative delirium or pressure ulcers in older elective cardiac surgery patients.     

胃癌患者术后早期并发症的护理与体会

目的探讨胃癌术后早期并发症的护理措施。方法回顾分析220例胃癌患者中发生术后早期并发症的护理资料并予以总结。结果 220例患者发生术后早期并发症75例,经过正确有效的护理后,其中58例患者症状完全缓解,13例患者症状缓解明显,4例患者症状有缓解。结论正确的护理措施能有效提高患者生活质量,改善并发症症状,临床效果明显。     

沐舒坦在预防老年手术病人肺部并发症中的应用

通常,老年病人腹部手术后容易并发上呼吸道感染及肺部感染,当合并有慢性支气管炎、慢性阻塞性肺部病变(COPD)时病情更难处理。我们采用静脉注射沐舒坦,收到了满意的效果,现报告如下。1　临床资料　　收集2 0 0 1年8月—2 0 0 3年8月在我院普外科行各类上腹部手术的老年病人共15     

肌酐/胱抑素C对晚期上皮性卵巢癌术后并发症的预测价值

目的研究肌酐/胱抑素C(CCR)对晚期上皮性卵巢癌(EOC)术后并发症的预测价值。 方法对2017年1月1日至2020年10月30日于济宁医学院附属医院妇科行手术治疗的106例晚期EOC患者进行回顾性队列研究。单因素回归分析确定术后并发症的潜在危险因素。Logistic回归分析确定术后并发症的独立影响因素。受试者工作特征(ROC)曲线确定CCR的最佳临界值。根据临界值将患者分为高CCR组及低CCR组,分析CCR与术后并发症的关系。 结果76例(71.70%)患者发生术后并发症。调整相关混杂因素后,Logistic回归分析结果显示,术中出血量>300 ml(OR＝8.53,95%CI 2.04~35.74)是术后并发症的独立危险因素(P<0.01);而CCR是术后并发症的独立保护因素,CCR每升高1个单位,术后并发症降低40.00%(OR＝0.60,95%CI 0.37~0.97,P<0.05)。术前CCR的最佳截断值为8.165。低CCR组术后总体并发症的发生率(72/91,79.12%)明显高于高CCR组(4/15,26.67%)(χ²＝14.46,P<0.01);低CCR组术后轻度并发症的发生率(62/91,68.13%)明显高于高CCR组(3/15,20.00%)(χ²＝12.58,P<0.01)。 结论术前CCR能有效预测晚期EOC患者术后并发症的发生。     

老年妇科恶性肿瘤术后并发症相关因素分析——附114例报告

目的:探讨65岁以上老年妇科恶性肿瘤患者术后并发症的相关因素.方法:对114例65岁以上妇科恶性肿瘤患者的临床资料进行数理分析.对术后并发症发生率与年龄、术前合并症、FIGO分期及手术方法的关系进行Logistic 回归分析.结果:114例患者中,35例(31%)术后出现并发症,共63例次,其中严重并发症(包括脑梗死、下肢静脉栓塞、肺动脉栓塞、酮症酸中毒、不完全肠梗阻、手术切口裂开)12例(11%).经Logistic 回归分析,结果显示术前有合并症与术后出现并发症有关(优势比为3.89,P＜0.01),而与年龄、FIGO分期、手术方式无关.对术后出现合并症的患者,均予相应的处理.除1例并发肺动脉栓塞患者(有高血压史10年)于术后第2日猝死外,其余患者均安全渡过围手术期.结论:术前有合并症的老年妇科恶性肿瘤患者易发生术后并发症.对老年妇科恶性肿瘤患者应做好充分的术前评估、积极处理术前并发症,术中严密监护并及时处理有助于降低术后并发症的发生率,使其安全渡过围手术期.     

老年胃癌患者术后并发症的影响因素分析

目的：探讨老年胃癌患者术后并发症的影响因素。方法选择2009年1月至2012年12月在普外科接受手术治疗的老年胃癌患者（年龄≥65岁）115例,根据术后是否发生并发症分为两组,术后发生并发症63例,其余52例术后未发生并发症,回顾性分析两组患者的一般资料,包括年龄、胃癌分期、是否行根治手术、是否联合脏器切除和手术时间等,总结术后发生并发症的相关因素。结果术后并发症影响因素中,有无并发症组患者年龄分布、胃癌分期、是否行根治手术、是否联合脏器切除等差异均无统计学意义（χ^2=3.113、P =0.078,χ^2=0.465、P =0.495,χ^2=0.518、P =0.472,χ^2=0.303、P=0.582）,术后未发生并发症组与发生并发症组手术时间≤3 h 者分别为30例（57.9％）和51例（81.0％）,＞3 h 者分别为22例（42.3％）和12例（19.1％）,两组手术时间比较差异有统计学意义（χ^2=6.326,P =0.012）。结论手术时间是老年胃癌患者术后并发症的主要影响因素,因此,在保证手术质量的前提下,尽可能缩短手术时间是降低老年胃癌患者术后并发症发生率最有效的方法。