ObjectiveTo investige the effects of multidisciplinary perioperative nutrition management on nutrition and postoperative complications of patients with esophageal cancer.MethodsA total of 239 patients with esophageal cancer who received elective surgical treatment were included in the study. They were divided into a trial group (120 patients) and a control group (119 patients) according to the random number table method. There were 97 males and 23 females in the trial group with an average age of 63.78±9.13 years, and 94 males and 25 females in the control group with an average age of 64.12±7.91 years. The control group received routine diet management, and the trial group received multidisciplinary perioperative nutrition management. The differences of nutrition and postoperative complications between the two groups were compared.ResultsThe total protein and albumin levels on postoperative days 3 and 7 in the trial group were higher than those in the control group (P<0.05), patients' postoperative anal exhaust time was shorter than that in the control group (P<0.05), the incidence of postoperative gastrointestinal adverse reactions, lung infection, postoperative anastomotic fistula, hypoproteinemia on postoperative days 3 and 7 was lower than that in the control group (P<0.05), and hospitalization cost was lower than that in the control group (P<0.05).ConclusionMultidisciplinary nutrition management can effectively improve the nutrition of patients, promote the rapid recovery of postoperative gastrointestinal function, reduce postoperative complications, and reduce hospitalization costs. It has high clinical reference and promotion value.
ObjectiveTo investigate the current status of work readiness and its influencing factors among postoperative lung cancer patients returning to work. MethodsA retrospective study was conducted on young and middle-aged postoperative lung cancer patients who were treated at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to September 2023 and returned to their jobs. Data were collected through a general information questionnaire, readiness for return-to-work scale (RRTW), general self-efficacy scale (GSES), and simplified coping style questionnaire (SCSQ). Univariate and multivariate logistic regression analyses were used to explore the factors affecting the work adaptation of returning patients. ResultsA total of 219 patients were included, with 59 males and 160 females aged 18-60 years. Among the postoperative lung cancer patients returning to work, 73.1% were in the active maintenance stage of return-to-work readiness with a RRTW score of (17.59±1.48) points, and 26.9% were in the uncertain maintenance stage with a RRTW score of (16.22±1.50) points. Bivariate logistic regression analysis showed that patients aged≤30 years (OR=52.381), employees of enterprises and institutions (OR=7.682), agricultural, pastoral, fishery, forestry laborers (OR=15.665), and those with higher self-efficacy (OR=1.157) had higher return-to-work readiness, while patients with≥2 children (OR=0.055), positive coping (OR=0.022), and out-of-pocket expenses (OR=0.044) had lower return-to-work readiness. ConclusionThe return-to-work readiness of young and middle-aged postoperative lung cancer patients needs to be improved, and occupation, job nature, main coping styles, and general self-efficacy are associated with return-to-work readiness.
Objective To investigate whether the new oxygenation index [ PaO2 /( FiO2 ×Paw ) ]which including mean airway pressure ( Paw ) for assessing intrapulmonary shunting of acute respiratory distress syndrome( ARDS) could be more accurate than the conventional oxygenation ratio ( PaO2 /FiO2 ) .Methods Twelve patients with ARDS were recruited. All patients received mechanical ventilation under lung ventilation protective strategy ( VT 6 mL/kg, f 16 bpm, FiO2 60% ) , and had a Swan-Ganz catheter inserted. Then, pressure/ volume curves were determined by low-flow method and the lower inflection point pressure was surveyed. Subsequently, parameters of respiratory mechanics and haemodynamics were recorded while periphery and pulmonary artery blood gas analysis were performed when positive end expiratory pressure ( PEEP) were changed. PaO2 /FiO2 and Qsp/Qt were calculated through special formula respectively. Results The progressive PEEP could not change Cst, PaO2 /FiO2 , and PaO2 / ( FiO2 ×Paw) in patients with ARDS significantly ( P gt; 0. 05) . The progressive PEEP did not change Qsp/Qt significantly ( P gt;0. 05) . The Δz which was used to test the difference between the correlation coefficient of Qsp/Qt and PaO2 / ( FiO2 ×Paw) and the correlation coefficient of Qsp/Qt and PaO2 /FiO2 was 0. 571, and there was no difference between the two correlation coefficients ( P gt; 0. 05) . It was not Paw but Cst which impacted on Qsp/Qt and PaO2 /FiO2 . Conclusion PaO2 / ( FiO2 × Paw ) is equal to PaO2 /FiO2 in assessing intrapulmonary shunting of ARDS.