Effectiveness,Patient Satisfaction,and Cost Reduction of Virtual Joint Replacement Clinic Follow-Up of Hip and Knee Arthroplasty

BackgroundTotal hip and knee arthroplasties are increasingly performed operations, and routine follow-up places huge demands on orthopedic services. This study investigates the effectiveness, patients’ satisfaction, and cost reduction of Virtual Joint Replacement Clinic (VJRC) follow-up of total hip arthroplasty and total knee arthroplasty patients in a university hospital. VJRC is especially valuable when in-person appointments are not advised or feasible such as during the COVID-19 pandemic.MethodsA total of 1749 patients who were invited for VJRC follow-up for knee or hip arthroplasty from January 2017 to December 2018 were included in this retrospective study. Patients were referred to VJRC after their 6-week postoperative review. Routine VJRC postoperative review was undertaken at 1 and 7 years and then 3-yearly thereafter. We evaluated the VJRC patient response rate, acceptability, and outcome. Patient satisfaction was measured in a subgroup of patients using a satisfaction survey. VJRC costs were calculated compared to face-to-face follow-up.ResultsThe VJRC had a 92.05% overall response rate. Only 7.22% required further in-person appointments with only 3% being reviewed by an orthopedic consultant. VJRC resulted in an estimated saving of £42,644 per year at our institution. The patients’ satisfaction survey showed that 89.29% of the patients were either satisfied or very satisfied with VJRC follow-up.ConclusionVJRC follow-up for hip and knee arthroplasty patients is an effective alternative to in-person clinic assessment which is accepted by patients, has high patient satisfaction, and can reduce the cost to both health services and patients.     

支撑喉镜下射频加囊肿揭盖术治疗会厌囊肿的临床研究

目的探讨囊肿揭盖术、囊肿揭盖术＋射频、射频＋囊肿揭盖术治疗会厌囊肿3种术式的疗效及其优劣。方法57例随机分为3组：单纯囊肿揭盖术组、囊肿揭盖术＋射频治疗组及射频＋囊肿揭盖术组。3组均采用表面麻醉＋强化麻醉经支撑喉镜下手术。随访6-12个月，比较3组总有效率、术中出血量及手术时间。结果3种术式总有效率均为100％，差异无显著性。囊肿揭盖术＋射频治疗组、射频＋囊肿揭盖术组与对照组比较，术中出血量、手术时间的差异均有显著性；囊肿揭盖术＋射频治疗组、射频＋囊肿揭盖术组术中出血量、手术时间相比较，差异均有显著性。结论3种术式均是治疗会厌囊肿的有效方法。射频＋囊肿揭盖术具有出血更少、手术时间更短、病人痛苦更小等优点，值得临床推广应用。     

基于虚拟仪器技术的高频电刀波峰因子检测与验证

提出了一种有效易行的高频电刀波峰因子检测系统的软、硬件设计方案。利用电磁感应原理接收电刀输出波形,由普通的数字示波器完成数据采集与数字化,基于虚拟仪器技术的PC端软件根据数据计算波峰因子。通过对高频电刀波峰因子的检测,最终验证波峰因子对电刀性能以及临床使用效果的重要性。     

视场角设置对虚拟环境中目标判断的影响

目的探讨不同视场角参数对虚拟环境中目标判断的影响规律 ,找出最佳视场角参数。方法利用自行研制基于PC平台的虚拟现实 (VR)实验系统 ,选定 45名年龄在 2 3～ 5 8岁被试者并完成大小与角度判断的实验设计。首先进行 30 0人次的预实验 ,确定引起虚拟环境中目标判断差错的视场角及相应观察任务的差别等级 ,然后开始单因素、4水平的完全随机正式实验。结果方差分析表明 ,不同的虚拟环境视场角对目标判断的真实性有显著性影响 ,当视场角为 60°时 ,目标判断的正确率最大。结论利用VR技术进行载人航天器工效设计、操作训练或其它任务的研究时 ,应考虑视场角的作用 ,适合目标大小判断的视场角参数值宜取 60°,以便获得最大的工效     

Effect of fentanyl on the circulatory responses to orotracheal fibreoptic intubation

The effectiveness of fentanyl in attenuating the pressor and heart rate response to orotracheal fibreoptic intubation under general anaesthesia was assessed in 60 healthy patients undergoing elective surgery. Patients were randomly assigned to receive either fibreoptic intubation with or without fentanyl 6 micrograms.kg-1 or traditional Macintosh intubation with fentanyl 6 micrograms.kg-1. A standardised general anaesthetic was administered which included temazepam premedication, thiopentone, atracurium, oxygen, nitrous oxide and isoflurane. The pressor response to fibreoptic intubation was suppressed in those patients who received fentanyl and was similar to that seen in the Macintosh-fentanyl group of patients. The heart rate response to fibreoptic intubation was also significantly reduced in the patients who received fentanyl, but, in contrast, was still significantly greater than that in the Macintosh-fentanyl group. Fentanyl 6 micrograms.kg-1 appears to have a useful place in attenuating the cardiovascular effects of fibreoptic intubation under general anaesthesia.     

A Comparative Study on the Close Reduction of Arytenoid Dislocation under Indirect and Direct Laryngoscope

To assess the curative effects of different reduction techniques on the dislocation of cricoarytenoid joint caused by intubation,indirect laryngoscope (IL) and direct laryngoscope (DL) were utilized for the closed reduction of the displaced arytenoid under local anesthesia.23 patients who underwent the reduction for dislocated arytenoid under IL or DL from January 1991 to June 2001 were reviewed.The data were collected on the duration of the laryngeal injury,times of receiving reduction,side-effects after the treatment and the period for voice to returen to normal.The relationship between the duration of the laryngeal lesion and the period of the voice rehabilitation was examined.13 patients received the reduction under IL and 10 patients under DL,Except the times of the reduction,which showed significant difference,no differences were found between IL group and DL group in the course and the period of voice rehabilitation,as well as sore throat after the manipulation.The patients‘ voice recovery was positively related to their course of disease in both IL and DL group.It is coucluded that the recovery of normal voice is obviously affected by the duration of arytenoid dislocation.The reduction under Il is as effective as under DL in the treatment of arytenoid dislocation.Reduction by DL is better suit the patients with long time course of disease.     

支撑喉镜手术治疗声带息肉小结

目的:观察支撑喉镜下手术治疗声带息肉/小结的疗效.方法:对100例声带息肉/小结的患者在全麻下行支撑喉镜手术.结果:100例中,术后3d发音恢复正常31例,术后6d发音恢复正常34例,好转35例,随访3mo无复发.结论:支撑喉镜下手术治疗声带息肉/小结疗效好、创伤小、精确度较高,但同时要注意并发症的预防和处理.