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Objective:To formulate a ladder type early activity program in order to provide a theoretical and practical basis for improving the current activity status of tumor patients with pulmonary embolism.Methods:This research was conducted experimentally. A total of 92 tumor patients diagnosed as pulmonary embolism from January 1, 2021 to March 31, 2022 in Sichuan Cancer Hospital were divided into control group and experimental group with 46 cases each by random number table method. In the control group, a routine activity program was carried out, and the patients were confined to bed for 7 days. The experimental group obtained the best evidence of early pulmonary embolism activity plan through evidence-based nursing, formed a nurse-led ladder type early pulmonary embolism activity team, and finally constructed and implemented the ladder type early activity plan. The mortality rate, new thrombosis in ICU for 3 days and 7 days, length of stay in ICU and patients′ comfort were compared between the two groups.Results:The mortality rates within 30 days after the diagnosis of pulmonary embolism were 4.35% (2/46) and 2.17% (1/46) respectively in the control group and the experimental group, with no significant difference between the two groups ( χ2=0.35, P>0.05). The rates of new thrombosis were 15.22% (7/46) and 26.09% (12/46) in the control group, and 4.35% (2/46) and 4.35% (2/46) in the experimental group, respectively at 3 and 7 days after ICU admission, with a significant difference between the two groups at 7 days after ICU admission ( χ2=8.43, P<0.05). The length of stay in ICU and the score of General Comfort Questionnaire (GCQ) were (15.74 ± 11.11) days and (64.30 ± 15.54) points in the experimental group, respectively, while those in the control group were (11.07 ± 5.63)days and (73.84 ± 11.73) points, respectively. The difference between the two groups was statistically significant ( t=-2.55, -3.32, both P<0.05). Conclusions:The evidence-based ladder type early activity program for patients with pulmonary embolism caused by tumor will not increase the mortality of patients, but can ensure the safety of patients, reduce the incidence of new thrombosis and the length of ICU stay, improve the comfort of patients during the treatment of pulmonary embolism. It is worthy of clinical application.
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Objective@#To discuss the application of bedside ultrasound monitoring of gastric residual volume in ICU patients complicated with enteral nutrition support via nasogastric tube.@*Methods@#November 2017 to May 2018, 120 patients with enteral nutrition support via nasogastric tube who admitted in ICU of our hospital were randomly divided into the observation group and the control group. The observation group used bedside ultrasound monitoring to determine the gastric residual volume, while the control group was estimated by withdrawn with 50 ml syringe. Reflux, pulmonary aspiration and the time of enteral nutrition were observed in both groups.@*Results@#Reflux and pulmonary aspiration were present in 2, 3 in the observation group and 10, 11 in the control group, with significant difference between them (χ2=4.53, 3.96, P<0.05). The time of enteral nutrition in the observation group was (13.98±3.20) h, and (15.54±3.54) h in the control group, which had a statistically difference (t=-10.49, P<0.05).@*Conclusion@#The application of bedside ultrasound monitoring of gastric residual volume in ICU patients complicated with enteral nutrition support via nasogastric tube can significantly reduce the risk of reflux and pulmonary aspiration which can ensure the safety of enteral nutrition, and decrease time of enteral nutrition.
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Objective To discuss the application of bedside ultrasound monitoring of gastric residual volume in ICU patients complicated with enteral nutrition support via nasogastric tube. Methods November 2017 to May 2018, 120 patients with enteral nutrition support via nasogastric tube who admitted in ICU of our hospital were randomly divided into the observation group and the control group. The observation group used bedside ultrasound monitoring to determine the gastric residual volume, while the control group was estimated by withdrawn with 50 ml syringe. Reflux, pulmonary aspiration and the time of enteral nutrition were observed in both groups. Results Reflux and pulmonary aspiration were present in 2, 3 in the observation group and 10, 11 in the control group, with significant difference between them (χ2=4.53, 3.96, P<0.05). The time of enteral nutrition in the observation group was (13.98±3.20) h, and (15.54 ± 3.54) h in the control group, which had a statistically difference (t =-10.49, P<0.05). Conclusion The application of bedside ultrasound monitoring of gastric residual volume in ICU patients complicated with enteral nutrition support via nasogastric tube can significantly reduce the risk of reflux and pulmonary aspiration which can ensure the safety of enteral nutrition, and decrease time of enteral nutrition.
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[Objective]The purpose of this study was to investigate the effect of severe aortic valve incompetence on the pharmacodynamics of cisatracurium.[Methods]Thirty patients were enrolled in this study:15 patients with severe aortic valve incompetence scheduled for aortic valve replacement were included in the study group(AI-group)and 15 patients without heart disease undergoing general surgical operations were allocated into the control group(C-group).Anesthesia was induced with fentanyl 5 μg/kg.propofol 1.5～2 mg/kg and cisatracurium 0.1 mg/kg and maintained by total intravenous anesthesia with propofol-remifentanil infusion.Degree of neuromuscular block was measured by train-of-four ratio using TOF-WATCH acceleragraph monitor.Onset time(from administration of cisatracurium to T1=0),total twitch suppression time,the time for spontaneous recovery of T1 to 25%and 75%.and the recovery index were recorded respectively.[Results]The onset time of cisatracurium was significantly longer in the AI group compared to the control group(5.6±0.8 min vs 3.4 ±0.4 min.P＜0.001.However.there was no difference in the recovery time between the two groups.[Conclusion]We demonstrated that the onset of cisatracurium was delayed in the patients with severe aortic regurgitation in comparison to those without heart disease.
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Objective To observe the psychological stress reactions of 238 patients injured in earthquake in our hospital and explore their interventions to such reaction. Methods A total of 238 patients wounded in earthquake were recruited. Along with the active treatment of primary physical trauma, wide range of preventative psychological interventions for crisis was carried out individually or in group. The psychological emergency measures included communication and exchange of ideas, mental health education, and psychological support and a relaxing environment to the patients. All the patients were evaluated by using depression and anxiety assessment scales before and after the intervention. Results Various psychological stress responses were found in 238 patients after injury, in which sleep disorders, memory decline, tension and fear, wabble and emotional instability ranked the top 5. Some patients' psychological status recovered after one-week's hospitalization, while most recovered after two-week's hospitalization. Three patients were transferred to other professional psychiatric hospitals for professional psychological treatment and intervention because of serious psychological obstacle. Conclusion The wounded caused by earthquake manifested various psychological stress reactions. Immediate psychological intervention can effectively help the patients to recover psychologically, promote their physical rehabilitation, and prevent posttraumatic stress disorder.