Intelligent Algorithm-Based Ultrasound for Evaluating the Anesthesia and Nursing Intervention for Elderly Patients with Femoral Intertrochanteric Fractures.

This study was aimed to explore the anesthesia, analgesia, and nursing intervention scheme for elderly patients undergoing the operation of intertrochanteric fracture of femur under the guidance of ultrasound optimized by blind deblurring algorithm. Fifty elderly patients undergoing intertrochanteric femoral surgery were randomly enrolled into control group (tracheal intubation intravenous anesthesia + routine nursing) and experimental group (ultrasound-guided nerve block anesthesia + comprehensive nursing based on blind deblurring algorithm), with 25 patients in each group. The effects of anesthesia and recovery were evaluated in the two groups. The results showed that the image evaluation index of blind deblurring algorithm was superior to other algorithms (BM3D, DnCNN, and Red-Net), which improved the quality of ultrasound imaging and was more conducive to intraoperative anesthesia guidance. At the beginning and end of intubation and operation, the fluctuation range of mean arterial pressure (MAP) and heart rate (HR) in the experimental group was lower than that in the control group. The maintenance time of sensory and motor anesthesia block (7.53 ± 1.47 h, 5.45 ± 1.36 h) was longer than that of control group (3.38 ± 1.26 h, 3.02 ± 1.31 h). Visual Analogue Scale/Score (VAS) scores at 6 h, 12 h, and 24 h after surgery were lower than those in the control group. The effective rate of nursing and the incidence of complications (92% and 8%) were better than the control group (80% and 16%), and the difference was statistically significant (P < 0.05). In summary, the optimization effect of blind deblurring algorithm was good, which can improve the quality of ultrasound-guided surgery and help in the smooth implementation of surgery. Moreover, nerve block anesthesia and comprehensive nursing were of great value in postoperative analgesia and recovery of patients.

[Study on 31 cases with cesarean scar pregnancy treated by transvaginal surgery].

OBJECTIVE: To study clinical efficacy on cesarean scar pregnancy (CSP) treated by transvaginal surgery. METHODS: From Jan. 2008 to Mar. 2011, 31 cases with CSP were managed by transvaginal surgery in Anshan Women and Children Hospital. Based on ultrasonograpy examination and intraoperative exposure of lesion, variable surgical options were executed. Fifteen cases in group A were treated by debridement resection and vaginal repair of uterine wall, 7 cases in group B were treated by transvaginal uterine artery ligation and curettage, 9 cases were treated by cutting the anterior wall in the lower uterine segment and repairing uterine. The intraoperative blood loss, operation time, hospital stay, hCG fluctuation at postoperative period and complications were analyzed among those groups. RESULTS: All cases in 3 groups were cured well in one time. (1) The intraoperative blood loss were (41 ± 21) ml in group A, (27 ± 7) ml in group B and (148 ± 132) ml in group C. There was no statistically different blood loss between group A and group B (P > 0.05), however, the amount blood loss in group C was significantly more than those in group A and group B (P < 0.05). (2) The average surgical time, the mean hospital stay, postoperative recovery time of blood hCG were (40 ± 11) minutes, (4.7 ± 0.8) days and (2.7 ± 1.0) weeks in group A, (44 ± 5) minutes, (4.0 ± 0.8) days and (2.9 ± 1.0) weeks in group B, (40 ± 12) minutes, (4.9 ± 1.0) days and (2.8 ± 0.9) weeks in group C. Those clinical index were no statistically different among those 3 groups (P > 0.05). (3) No bladder injury and other complications were observed in those groups. CONCLUSIONS: Transvaginal surgery is efficacy, easy to operate, to keep the uterus, safe and economy in treatment of CSP. Surgery in group A is suitable to treat early and exogenous lesions; surgery in group B is suitable to treat endogenous lesions; surgery in group C is suitable to treat failure cases in group A and B, however, the injury is greater than those in group A and B.