摘要
Objective To analyze the current situation of unplanned reoperation in cardiac surgery and to discuss the management measures of unplanned reoperation.Methods The information of patients undergoing cardiac surgery in a class A tertiary comprehensive hospital during 2018-2022 was collected to analyze the incidence of unplanned reoperation,major ca uses,disease types,surgica l moda lities and Complications.Results A tota l of 3902 patients underwent surgery,of whom 73(1.87%)underwent unplanned reoperation.The main cause of unplanned reoperation was bleeding(50%).The disease types with the highest unplanned reoperation composition ratio were coronary heart disease(38.4%),and the disease types with the highest incidence were dilated cardiomyopathy(11.1%).The average hospitalization cost,the average length of hospitalization,mortality rate and medical dispute rate of patients who had unplanned reoperation were significantly higher than those who did not have unplanned reoperation,the difference was statistically significant(P=0.001).Conclusion The hospital should strengthen the perioperative management of cardiac surgery,focus on supervising disease types and surgical modalities with high incidence of unplanned reoperation,and strictly implement the system of operation classification and the system of reporting unplanned reoperation to ensure the quality of patient surgery.
摘要
Objective To evaluate the safety and efficacy of the modified subclavian vein cathetrization (SVC) in Neurosurgical Intensive Care Unit (NICU).Methods The clinical data of 292 patients experienced SVC in NICU over a 3-year-and-9-month periodwere retrospectively analyzed,and they were divided into groups by the method of SVC,in which 227 patients underwent modified SVC were identified and compared with 65 patients who underwent routine SVC during the same period.Medical charts of the patients were reviewed to collect demographic information,such as age,sex,rate of success at first-puncture and complications.Statistical comparisons between the two groups were made using Chi-square analysis for the variables and were considered to be statistically significant if P ＜ 0.05.Data were analyzed using SPSS 19.0 (Armonk,NY:IBM Corp,USA).Results In the SVC group,the total success was achieved in 61 patients (93.8％),and the incidence rate of complications related to puncture and cathetrization was 29.5％.In the mSVC group,the total successful rate was 99.1％,and the incidence rate of complications related to puncture and cathetrization was 7.1％.The mSVC was better than traditional SVC in successful rate and incidence rate of complications related to puncture and cathetrization (x2 =4.61,7.32,all P ＜ 0.05).Conclusion mSVC for the patients in NICU is a safe and effective technique with low morbidity and mortality.
摘要
Objective To discuss the features of the alcoholic liver disease complicated with chronic subdural hemetoma and the use of neuroendoscopy in the disease’s treatment.Methods Clearing the hemetome by neuroendoscopic operation,hemostatic was injected through vein during the operation,the treatment of hemostasis and the liver’s protection were implied in postoperation.Results All of the patients were cured without death and complications correlated the liver disease and hemetoma.Conclusion Neuroendoscopy has a unique advantage in the treatment of the alcoholic liver disease complicated with chronic subdural hemetoma,it is worth promoting.