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。     

Surgical treatment of peri‐implantitis: Prognostic indicators of short‐term results

Aim

To evaluate the clinical and radiographic short‐term (6 months) effect of surgical treatment of peri‐implantitis, and to identify prognostic indicators affecting the outcome using a multilevel statistical model.

Materials & Methods

A total of 143 implants (45 patients) with a diagnosis of progressive peri‐implantitis (progressive bone loss (PBL) ≥2.0 mm and bleeding on probing (BoP)/suppuration) received surgical treatment. Clinical and radiographic parameters were assessed 6 months postoperatively. Potential prognostic indicators on subject, implant and site level prior to surgery were analysed to evaluate the effect on individual and composite outcomes using multilevel logistic regression analysis.

Results

At the 6‐month evaluation, none of the implants demonstrated PBL and 14% of the implants were registered with the absence of bleeding and no pocket probing depth ≥6 mm. Multilevel regression analysis identified, among others, suppuration, pocket probing depth >8 mm, bone loss >7 mm and the presence of plaque as criteria associated with the outcome.

Conclusion

Resective peri‐implantitis surgery seemed to reduce the amount of peri‐implant inflammation. However, most of the sites continued to have BoP/suppuration. Thus, long‐term maintenance and evaluation is warranted. The effect of treatment was reduced by some prognostic indicators such as the presence of suppuration prior to interception and peri‐implant bone loss exceeding 7 mm.     

Postoperative pain assessment in hospitalised patients: National survey and secondary data analysis

BackgroundMeasuring pain is important for the adequate pain management of postoperative patients. The actual compliance with pain assessment in postoperative patients after implementation of a national safety program is unknown.ObjectivesThe aim of this study is to examine the compliance with pain assessment in postoperative patients after implementation of a national safety program, according to the national quality indicators for pain assessment in postoperative patients. Furthermore, organisational factors associated with this compliance were determined.Study designIn this study, two data sources were used: 1) data from an evaluation study of the Dutch Hospital Patient Safety Program; and 2) data from a questionnaire survey.MethodsThe compliance with two different pain process indicators was determined: 1) 3 pain measurements a day, all three full days after surgery; and 2) ≥1 pain measurement a day, all three full days after surgery. Multilevel logistic regression analysis was used to investigate the association between organisational factors in hospitals and compliance with pain process indicators.ResultsData of 3895 patient records from 16 hospitals was included in this study. In 12% of the postoperative patients, pain was measured 3 times a day, all three full days after surgery. In 53% of the postoperative patients, pain was measured ≥1 time a day, all three full days after surgery. Compliance was highest in general hospitals compared to tertiary teaching and academic hospitals, and was statistically significantly higher at the surgery and surgical oncology department compared to the other departments.ConclusionsLow compliance was shown with pain assessment in postoperative patients, according to the process indicator pain after surgery in Dutch hospitals. This suggests that the implementation of measuring pain in hospitals is still insufficient.     

腹腔镜下卵巢囊肿剥除术的疗效观察及安全性分析

目的:探讨腹腔镜下卵巢囊肿剥除术的疗效观察及安全性。方法:以2017年1月~2018年12月期间108例卵巢囊肿的患者为研究对象,按照患者入院治疗的先后顺序,将其分为观察组与对照组各54例,对照组实施传统开腹手术,观察组实施腹腔镜卵巢囊肿剥除术,观察两组患者的临床指标及不良反应率。结果:观察组患者手术用时及肛门首次排气时间明显短于对照组,术中出血量明显少于对照组(P<0.05);观察组5.56%的不良反应率明显低于对照组20.37%的不良反应率(P<0.05)。结论:针对卵巢囊肿患者,行腹腔镜下卵巢囊肿剥除术能缩短手术用时及肛门首次排气时间,减少术中出血量,使得不良反应发生率得以减少,对患者预后有着积极的作用。     

专科护理质量指标在呼吸内科使用吸入剂患者管理中的应用

目的探讨专科质量指标在呼吸内科使用吸入剂患者管理中的应用。方法以专科疾病特点及循证为基础,建立吸入剂使用前评估、吸入剂使用方法、吸入剂使用宣教及交接班四个方面的护理质量标准与细则,运用这四个方面的专科指标对呼吸内科使用吸入剂患者进行护理质量管理。比较专科护理指标实施前(2015年3月)与实施半年后(2015年9月),吸入剂使用护理质量中评估正确率、操作使用方法正确率、患者及家属对吸入剂相关知识的掌握率和交接班的合格率的情况。结果专科质量指标实施后,吸入剂使用护理质量中评估正确率、操作使用方法正确率、患者及家属对吸入剂相关知识的掌握率和交接班的合格率均高于实施前,差异有统计学意义(P0.05)。结论吸入剂专科质量指标的实施,能有效的提高呼吸专科优质护理质量,进一步提高专科护士的业务素质,且该指标的数据易于收集,指标和标准基于科学文献于临床实践,是有效和可靠的,具有科学性和可行性。     

Cross-sectional study involving healthcare professionals in a Vaccinia virus endemic area

Orthopoxviruses (OPV) are emerging viruses with great importance in human and veterinary medicine, such as Vaccinia virus (VACV), which causes outbreaks of bovine vaccinia (BV) in South America. The clinical aspects of BV are similar to other vesicular infections, complicating the clinical diagnosis. This cross-sectional study evaluated the knowledge of Healthcare Professionals about BV and revealed their unpreparedness about BV in a VACV hyper-endemic area in Brazil, highlighting the public health issues associated with VACV infections. This study presents an opportunity to discuss the importance of vaccination for healthcare professionals who work in areas of VACV circulation and brings an educational measure on VACV infections for health professionals around the world.