经皮肝动脉插管化疗栓塞术后并发症的原因分析及护理

目的探讨肝癌患者经皮肝动脉化疗栓塞术后并发症的原因及护理对策,以提高护理观察能力,促进患者术后康复。方法回顾性分析肝动脉插管化疗栓塞术后180例患者的临床资料,总结术后并发症原因及采取的护理措施。结果本组80例患者术后发生并发症,并发症包括穿刺部位出血及血肿、迷走神经反射、股动脉栓塞、栓塞性胆囊炎、化疗栓塞术后综合征、上消化道出血、尿潴留等;经过周密观察、对症治疗与护理,患者均恢复良好。结论严密细致地观察术后病情变化,正确认识和处理并发症,是预防和减少术后并发症的关键,对于提高并发症治愈率、促进患者康复有着重要意义。     

腭裂患儿术后并发症发生的危险因素分析及干预措施

目的探讨腭裂患儿术后并发症发生的危险因素及干预措施。方法选取2017年7月至2019年3月我院收治的85例腭裂患儿作为研究对象,收集患儿基本资料、围手术期相关指标及术后并发症发生情况。采用单因素分析和多因素logistic回归分析腭裂患儿术后并发症发生的影响因素,并制定相应的干预措施。结果本组发生术后并发症患儿16例(18.82%)。单因素分析显示,年龄、术前血红蛋白、术前白蛋白、手术次数、单次手术时间、住院时间、术后疼痛及使用抗生素是影响腭裂患儿术后并发症发生的相关因素(P<0.05);多因素logistic回归分析显示,年龄、术前白蛋白、术后疼痛是影响腭裂患儿术后发生并发症的独立危险因素(P<0.05)。结论腭裂患儿术后发生并发症受年龄、术前白蛋白及术后疼痛的影响,需要通过加强术前评估、给予充足营养、提高凝血功能、缓解术后疼痛降低术后并发症发生。     

小儿腹腔镜手术相关并发症分析与护理

总结了69例小儿腹腔镜手术后相关并发症及护理干预措施,包括术后窒息、脐部切口网膜脱出、术后呕吐、出血及疝气和积水等并发症及相应护理措施,认为小儿腹腔镜手术术后并发症通过术前术后适当的护理干预可得到有效的预防和治疗。     

胰腺头颈部严重损伤行胰腺空肠吻合术后的护理

总结了16例胰腺头颈部严重损伤患者术后并发症的预防及护理,包括术后加强并发症的预防及护理、营养支持、心理护理等。认为术后严密的病情观察和有效的护理措施是减少并发症,提高术后患者治愈率的关键。     

晚期肿瘤患者热疗术后的监护及并发症的诊治

目的:总结晚期肿瘤患者热疗术后的监护及并发症的诊治经验。方法:对15例晚期肿瘤患者施行热疗术,术后于重症监护室监护,对并发症给予治疗。结果:术后主要并发症有肺水肿、急性肺损伤、急性呼吸窘迫综合征、心肌损伤、心律失常、血电解质紊乱、血糖异常、烫伤等。经监护及治疗后,病情稳定,无一例死亡,转归各科继续康复治疗。结论:晚期肿瘤患者热疗术后并发症较多,术后严密监护及对并发症及时有效的治疗,是热疗术获得较好疗效的关键。     

内镜黏膜下剥离术治疗结直肠肿物患者并发症发生的危险因素

目的探究内镜黏膜下剥离术治疗结直肠肿物患者并发症发生的危险因素。方法选取2015年6月至2019年3月徐州市第一人民医院行内镜黏膜下剥离术(ESD)未发生术后并发症的结直肠肿物患者82例为对照组,另选取同时期在该院行ESD发生术后并发症的结直肠肿物患者23例为研究组。统计ESD术后并发症发生情况,通过单因素分析ESD术后并发症发生的相关危险因素,通过多因素Logistic回归分析ESD术后并发症发生的独立危险因素。结果23例发生术后并发症的患者中,ESD术后出血为9例,占39.13%;术后腹痛为6例,占26.09%;术后腹胀为5例,占21.74%;术后穿孔为3例,占13.04%。其中术中出血患者给予止血药及输血治疗好转;腹痛、腹胀患者给予止痛及对症治疗好转;穿孔患者给予内镜下钛夹夹闭治疗好转。年龄、高血压、糖尿病、肿物大小、手术时间、是否完整切除及术后疼痛为ESD术后并发症发生的相关危险因素(P<0.05)。糖尿病、肿物大小及手术时间为ESD术后是否发生并发症的独立危险因素(OR>1,P<0.05)。结论ESD治疗结直肠肿物患者发生术后并发症的危险因素为糖尿病、肿物大小及手术时间,通过加强术前准备,提高患者营养状态及帮助患者控制血压水平可以有效降低患者出现术后并发症的发生风险。     

胆道闭锁患儿肝移植术后并发症的观察及护理

目的总结胆道闭锁患儿肝移植术后并发症的观察及护理要点,并推广护理经验。方法对4例胆道闭锁患儿行肝脏原位植入术术后血管并发症、感染的预防及控制、消化道瘘及术后营养支持、胆道并发症等的观察和针对性护理措施进行分析,总结护理经验。结果 1例患儿术后出现感染症状,给予动态调整抗感染方案,落实保护性隔离措施,顺利出院。1例患儿术后出现了消化道瘘,经过手术及营养支持,严密观察治疗后消化道功能逐渐恢复,经过积极治疗护理,顺利康复出院。4例患者出院后随防至术后1年,无其他严重并发症。结论胆道闭锁患儿肝移植术后在做好常规围手术期管理的基础上,重视患儿术后血管并发症、感染、消化道瘘等并发症的观察护理,同时根据患儿术中情况,个体差异等特例,预警可能出现并发症,改善肝移植患儿预后,促进患儿康复。     

75岁及以上患者非体外循环冠状动脉旁路术后呼吸系统并发症的护理

目的探讨75岁及以上患者非体外循环冠状动脉旁路术（OPCABG）术后呼吸系统的护理特点。方法 回顾性分析135例75岁及以上OPCABG患者的临床资料,对呼吸系统术后常见并发症的原因及护理进行分析探讨。结果呼吸系统并发症是高龄患者OPCABG术后常见病、多发病,135例高龄患者术后呼吸系统并发症发生率高达81.5%, 院内死亡6例均为呼吸系统严重并发症,病死率4.4%。结论 高龄患者OPCABG术后呼吸系统并发症的护理是术后护理的重点,对于患者顺利康复起着关键性的作用。     

原位肝移植联合胰十二指肠根治性切除术治疗肝门部胆管癌患者并发症的观察及护理

目的 探讨原位肝移植联合胰十二指肠根治性切除(HPLT)术后患者早期并发症的观察及护理要点.方法 回顾性总结1例肝门部胆管癌患者行HPLT术后早期并发症的发生情况及处理方法.结果 患者术后出现一过性消化道出血、盆腔脓肿形成、中肝静脉不完全堵塞、肝动脉栓塞、腹腔积液、输入袢抑制综合征等并发症,经积极有效的处理后痊愈,于术后3个月出院.至今无瘤生存28个月,移植肝功能及消化功能良好.结论 HPLT术后并发症发生风险极高,加强术后出血、感染、移植肝血管并发症、胃肠吻合口漏、胃肠功能紊乱等并发症的观察及护理,能充分预防并减少并发症的发生.     

肝移植术后神经精神并发症原因分析及护理

目的:探讨肝移植术后患者神经精神并发症发生原因及护理方法.方法:对162例肝部疾病患者行肝移植术,术后出现神经精神并发症38例,分析其发生原因并提出针对性护理对策.结果:本组术后发生神经精神并发症38例,给予积极处理,死亡2例,其余症状均缓解.肝移植术后神经精神并发症的发生与心理、药物、疾病、手术及是否快速纠正低钠血症等因素有关.结论:肝移植术患者术后易出现神经精神并发症,分析其发生原因,加强针对性护理干预可减少肝移植术后患者神经精神并发症发生,提高手术成功率,促进患者康复.     

Interventions to prevent postoperative complications in women with ovarian cancer

Women with ovarian cancer often undergo multimodal treatment, which may cause physical complications and decrease quality of life. As a result, this article describes postoperative complications in women with suspected primary ovarian cancer, explains factors related to developing postoperative complications, and discusses the clinical implications of postoperative complication management. The researchers used self-report questionnaires completed by women who were within one month after surgery for suspected ovarian cancer (N = 142) to identify postoperative complications. Demographic characteristics also were examined to determine factors that may predict postoperative complications. The most common complications reported were wound infection, fever, and sepsis, followed by ileus, nausea, and vomiting. Women diagnosed with new or late-stage cancer were equally likely to develop a postoperative complication. Healthcare providers should carefully assess women diagnosed with ovarian cancer before surgery to determine their individual risk of developing postoperative complications. All women should be monitored for complications; however, women who are at higher risk because of multiple modalities, late-stage cancer, or the presence of comorbidities warrant particular attention after surgery and discharge.     

Correlation of serum albumin and prognostic nutritional index with outcomes following pancreaticoduodenectomy

BACKGROUND Pancreaticoduodenectomy(PD) is a complex surgical procedure with a high morbidity rate. The serious complications are major risk factors for poor longterm surgical outcome. Studies have reported an association between early postoperative prognostic nutritional index(PNI) and prediction of severe complications after abdominal surgery. However, there have been no studies on the use of early postoperative PNI for predicting serious complications following PD.AIM To analyze the risk factors and early postoperative PNI for predicting severe complications following PD.METHODS We retrospectively analyzed 238 patients who underwent PD at our hospital between January 2007 and December 2017. The postoperative complications were classified according to the Dindo-Clavien classification. Grade Ⅲ-Ⅴ postoperative complications were classified as serious. The risk factors for serious complications were analyzed by univariate analysis and multivariate logistic regression analysis.RESULTS Overall complications were detected in 157 of 238 patients(65.9%) who underwent PD. The grade Ⅲ-Ⅴ complication rate was 26.47%(63/238 patients).The mortality rate was 3.7%(9/238 patients). Multivariate logistic regression analysis revealed that preoperative serum albumin [odds ratio(OR): 0.883, 95%confidence interval(CI): 0.80-0.96; P < 0.01] and PNI on postoperative day 3 <40.5(OR: 2.77, 95%CI: 1.21-6.38, P < 0.05) were independent factors associated with grade Ⅲ-Ⅴ postoperative complications.CONCLUSION Perioperative albumin is an important factor associated with serious complications following PD. Low early postoperative PNI(< 40.5) is a predictor for serious complications.     

食管癌术后并发症的危险因素分析

【目的】探讨食管癌术后发生并发症的危险因素。【方法】采用病例对照研究的方法回顾胸外科食管癌根治术后患者,将其中出现并发症的120例患者与同期行食管癌手术未出现并发症的患者进行各个危险因素对比,并将各种危险因素进一步行Logistic回归分析。【结果】单因素分析发现下列因素与食管癌术后并发症的发生有显著相关：年龄60岁以上,术前全身情况,基础疾病,术前病理分级,入信ICU时间,手术时间,输血量,激素使用,意识障碍,抗酸制剂的使用,术后纤支镜使用,术后循环情况,液体出入量,术后氧合情况。Logistic回归分析食管癌术后并发症的高度相关的危险因素为：年龄,术前全身情况,术后循环情况,术后氧合情况。【结论】年龄,术前全身情况,术后循环情况,术后氧合情况这些因素可能为食管癌术后出现并发症的高危因素。     

Preoperative nutritional status and other factors that influence surgical outcome in patients with Crohn's disease

Among 124 patients who underwent an elective surgical procedure for Crohn's disease during 1 year at our institution, 16(13%) had postoperative complications, including one death. The risk of developing postoperative complications was inversely related to the concentrations of serum albumin and total iron-binding capacity. The complication rate was 29% among patients with low (less than 3.1 g/dl) serum albumin levels but only 6% among patients with normal albumin levels. Patients were also more likely to experience postoperative complications if they had previously undergone an operation for Crohn's disease, received sulfasalazine, or required an ileostomy. No correlations were noted between postoperative complications and preoperative weight loss or preponderance of Crohn's disease of the colon. The median duration of postoperative hospitalization was 24.5 days for the 16 patients with complications in comparison with only 10 days for patients without complications.     

老年恶性胃肠肿瘤临床病理特征及术后并发症相关因素分析

[目的]分析老年恶性胃肠肿瘤患者临床病理特征及术后并发症发生情况.[方法]本院进行手术治疗的80例老年(年龄＞65岁)恶性胃肠肿瘤患者按术后有无并发症分为并发症组(n =26)与无并发症组(n=54),比较分析患者临床病理特点及术后并发症相关影响因素.[结果]①80患者中,26例术后出现并发症,并发症发生率为32.50％(26/80),以切口感染、肺部感染、心血管病发生率最高,其次为肝肾功能异常、吻合口瘘;②术后发生并发症组男性所占病例高于无并发症组,且其手术时间、年龄均大于无并发症组,两组合并症、TNM分期、病理分化程度、淋巴结清扫情况、淋巴结转移发生率等相比较差异均有显著性(P＜0.05);③多因素回归分析显示:年龄、手术时间、术前合并症、淋巴结清扫类型、病理分化程度是影响胃肠道恶性肿瘤患者术后并发症发生的独立危险因素(P＜0.05).[结论]年龄、性别、病理分化程度、淋巴结清扫、术前合并症均为影响老年胃肠道恶性肿瘤患者术后并发症发生率的独立危险因素,临床应积极控制相关危险因素.     

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.     

非肿瘤性成人脑积水脑室-腹腔分流术后并发症分析

目的提高脑室-腹腔分流术的治疗水平,减少并发症的发生。方法报告非肿瘤性成人脑积水V-P术后15例并发症,并结合文献进行讨论。结果主要并发症是分流管梗阻和感染,其它可出现颅内出血、癫痫、腹部症状等。结论脑室-腹腔分流术的并发症率较高,需重视手术适应证的选择、手术操作技巧和术后处理。     

盆底重建术后并发症的预防与护理

目的探讨盆底重建手术患者术后并发症的预防与护理措施。方法对住院手术治疗的39例盆腔器官脱垂患者提供规范化术后并发症的预防与护理措施:网片侵蚀及感染的预防和护理,静脉血栓栓塞的预防和护理,尿潴留的预防和护理,泌尿系感染的预防和护理,脏器损伤的预防和护理。结果所有患者术后无严重并发症发生,均康复出院,经1~24个月随访,39例患者均未出现器官脱垂、压力性尿失禁。结论对盆底重建手术患者提供围术期规范化术后并发症的预防与护理措施,可缩短术后恢复时间,减少术后并发症的发生。     

循证护理在减少肝癌TACE术后并发症中的应用研究

目的分析采用TACE治疗肝癌患者时应用循证护理对术后并发症减少的作用。方法选择本院收治的肝癌患者116例,均给予TACE治疗,随机抽取其中58例作为实验组,给予循证护理,另58例作为对照组,实施常规护理,观察2组患者术后并发症发生情况,对比2组患者护理满意度评分。结果实验组患者术后并发症发生率低于对照组,护理满意度评分高于对照组,差异具有统计学意义(P0.05)。结论采用TACE治疗肝癌患者时,围术期给予患者循证护理可减少术后并发症发生率,促进患者康复,提高患者对护理满意程度。