ObjectiveTo investigate the influencing factor of intraoperative hypothermia during laparotomy.MethodsA total of 81 patients underwent laparotomy in our hospital from October 1, 2018 to January 1, 2019 were enrolled. The difference of preoperative baseline data and surgical data between the hypothermia and non-hypothermia groups was compared, and the influencing factor of intraoperative hypothermia during laparotomy was explored.ResultsOf the 81 patients, 32 patients occurred hypothermia during operation. There were no significant differences in gender, age, BMI, HGB, WBC count, PLT count, TB, AST, ALT, ALB, PT, operation time, postoperative hospital stay, and Clavien-Dindo grade between the hypothermia group and the non-hypothermia group (P>0.05), but there were significant differences in intraoperative infusion volume, intraoperative blood loss, and surgical mode (P<0.05). The intraoperative infusion volume and intraoperative blood loss in the hypothermia group were higher than those in the non-hypothermia operation group, and the proportion of hepatectomy was higher than that in the non-hypothermia group. The multivariate analysis show that the intraoperative blood loss, intraoperative infusion volume, and kind of operation were the risk factors for the hypothermia during laparotomy (P<0.05).ConclusionsIntraoperative hypothermia is related to intraoperative bleeding volume, intraoperative fluid infusion volume, and the kind of operation. Therefore, for patients with less bleeding, the intraoperative hypothermia can be reduced by limiting the volume of intraoperative fluid infusion. For those patients with more intraoperative bleeding, warming fluid infusion may reduce the incidence of intraoperative hypothermia.
Objective To explore the effect of different nutrition on the immune function of patients with colorectal cancer. Methods A total of 640 colorectal cancer patients were randomized into the enteral nutrition and peripheral nutrition groups. The peripheral venous blood was sampled before operation and on the postoperative days 1 and 7 to determine the serum levels of IgG, IgA, IgM, the percentage of T lymph cell subgroups CD3, CD4, CD4/CD8 and CRP, PGE, α- antitrypsin etc. The patient’s general condition, side-effects, and complications were observed intimately after surgery. Results Compared with the control group, the IgG, IgA, IgM, CD3, CD4,CD4/CD8 levels of the trial group on postoperative day 7 were higher. But the levels of CRP, PGE, α- antitrypsin were decreased. Hospitalization time and anal exsufflation time were shorter as well. There was no significant difference in either the general conditions or complications between the two groups. Conclusion Application of enteral nutrition after colorectal cancer surgery is safe, ,effective, and can improve the patient’s immune function and prognosis.
ObjectiveTo review the application of omega-3 polyunsaturated fatty acids (Ω-3PUFAs) in patients with gastric cancer.MethodThe related literatures about the application of Ω-3PUFAs in patients with gastric cancer were reviewed by searching domestic and international databases.ResultsΩ-3PUFAs didn’t only improve the perioperative immune function and inflammatory response in patients with gastric cancer, but also prevent the occurrence of gastric cancer, inhibit the proliferation and promote the apoptosis of gastric cancer cells, increase the sensitivity of chemotherapy, and reduce the occurrence of chemotherapy-related adverse events.ConclusionsΩ-3PUFAsis an immunological nutrition, which can provide energy and also has functions of anti-inflammatory, anti-cancer, immunity regulation. It has been widely used in patients with gastric cancer, but the relevant mechanism needs further to be investigated.
Objective To study the relationship between autonomic nerve preservation and sexual and urinary functions after total mesorectal excision in patients with cancer of the lower rectum, and to explore improved nursing methods for these patients. Methods Eligible patients with cancer of the lower rectum were non-randomly assigned to either a control group (n=278)or an autonomic nerve-preserving group （n=263）. The recovery time of micturition desire, catherization time, lower urinary tract infection rate, residual urine, severity of urinary disorders and sexual disorders were observed. Results The recovery time of micturition desire, catherization time, lower urinary tract infection rate, residual urine, severity of urinary disorders and sexual disorders were lower in the autonomic nerve-preserving group than in the control group. (Plt;0.05) . Conclusion Autonomic nerve preservation radical resection leads to better maintenance of urinary and sexual functions for patients with cancer of the lower rectum. Nursing should be focused on the prevention of urinary tract complications and the rehabilitation of sexual and urinary functions.
Objective To compare the clinical effect between alginate calcium dressing and radix yarn dressing after anal fistula surgery. Methods A survey of 128 patients with anal fistula from April to October 2008 were studied. Patients were divided into two groups using a simple random method: 64 cases in therapy group which were treated with alginate calcium dressing and 64 cases in control group which were treated with traditional radix yarn dressing. The difference of the wound recovery indexes between two groups was compared.Results With regard to age, gender, anal fistula type, the proportion of preoperative diabetes and the diameter of wound, there was no statistical significance between therapy group and control group (Pgt;0.05). The proportion of slight pain during dressing change in therapy group (45.32%, 29/64) was more than control group (25.00%, 16/64), which had statistical significance (Pgt;0.05). The incidence of skin allergy was significantly different between two groups (29.69% vs. 60.94%, P＜0.05). Also, the rotten tissue and the soakage disappears with a shorter period, which both had statistical significance 〔(8.60±2.37) d vs. (12.22±3.29) d， (16.96±5.83) d vs. (22.02±5.90) d〕， Plt;0.05.Conclusion With the shorten of inflammatory and increment stage of the wound recovery, alginate calcium dressing is an ideal material for the postoperative duration of surgery of anal fistula.
ObjectiveTo review the association of gut microbiota and postoperative gastrointestinal dysfunction (GID) in patients after abdominal surgery and to provide a new idea for the pathogenesis, prevention, and treatment of postoperative GID in patients after abdominal surgery.MethodThe related and latest literatures were reviewed by searching the literatures on “intestinal flora” “gut microbiota” “intestinal microbial population” “brain-gut axis” “gastrointestinal function” “gastric paralysis” “intestinal paralysis” and “ileus” from January 1, 2000 to April 2, 2021 in Chinese and English databases.ResultsGut microbiota diversity was closely related to postoperative GID symptoms in patients after abdominal surgery. Gut microbiota regulated gastrointestinal motility and mucosal barrier function by metabolizing food to produce metabolites such as 5-hydroxytryptamine, melatonin, short-chain fatty acid, succinic acid, lactic acid, and so on.ConclusionsThe imbalance of gut microbiota is closely related to postoperative GID in patients after abdominal surgery. However, the relevant bacterial metabolites that have been found are limited at present, and the relevant mechanism needs to be further investigated.
Objective To analyze the research status of immunonutrition in China based on Chinese databases, and to provide a reference for clinical practice and future research. Methods Literatures about the application of immunonutrition in nutrition support were searched in China National Knowledge Infrastructure, SinoMed, Chongqing VIP and Wanfang databases using bibliometrics methods. The retrieval time was up to August 2022, and the document characteristics such as the number of publications, the institutions and the citation frequency and other features were analyzed. Results A total of 725 literatures were included, with the highest number of literatures issued in 2015 and 2020, both 62. The areas with the most published literatures were Jiangsu (10.6%) and Guangdong (8.4%). The institutions with the most published literatures were General Hospital of Eastern Theater Command (4.8%) and West China Hospital of Sichuan University (3.9%). There were 78 dissertations and 647 journal articles in total. The most published journal was Parenteral & Enteral Nutrition (6.5%). The top three citations were all reviews. The degree of cooperation was 2.7, and the co-authorship rate was 70.1%. A total of 121 articles reported the supporting funds and projects. The research types included 499 original studies (68.8%) and 226 secondary studies (31.2%). The analysis of the subjects showed that immunonutrition was mostly applied to gastrointestinal diseases, especially gastrointestinal cancer patients, accounting for 42.5%. Nutritional support was divided into enteral nutrition and parenteral nutrition. Enteral nutrition was adopted in most literatures, accounting for 88.4%. Conclusions The research content of immunonutrition in Chinese database in China is relatively simple. Most of them focus on the comparison between immunonutrition and general nutrition support. The selection of immune nutrients and the application of immunonutrition in critically ill patients such as sepsis need further research.
ObjectiveTo systematically review the efficacy of enteral nutrition combined with parenteral nutrition (EN+PN) and enteral nutrition alone (EN) in gastric cancer patients undergoing gastrectomy. MethodsPubMed, EMbase, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of EN+PN and EN in gastric cancer patients undergoing gastrectomy from inception to September 25th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 23 RCTs were included. The results of meta-analysis showed that compared to EN group, EN+PN group had a shorter hospital stay (MD=−1.75, 95%CI −2.45 to −1.05, P<0.000 1) and a lower risk of postoperative complications (RR=0.55, 95%CI 0.46 to 0.66, P<0.000 1). However, there was no statistical difference in the first exhaust time between the two groups. ConclusionThe current evidence shows that EN+PN may contribute to reducing the incidence of postoperative complications and shortening the length of hospital stay in gastric cancer patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
目的 了解局部麻醉下腹股沟疝无张力修补术后患者排便变化的相关影响因素。 方法 采用自行设计的问卷调查表，对2010年5月－6月行无张力修补术的腹股沟疝患者术后排便情况及变化进行调查，并就相关影响因素采用logistic回归方法进行统计分析。 结果 腹股沟疝无张力修补术后患者进食量减少、活动量减少、饮食成分变化、担心排便引起复发是术后排便变化的影响因素。 结论 加强该病症术后健康宣传，指导患者正常进食、多活动，消除患者对腹股沟疝复发的焦虑，可促进其早期排便。Objective To research on the risk factors for change of defecation after inguinal hernia mesh-repairs under local anesthesia. Methods Self-made questionnaires were used to investigate the defecation change among patients having undergone inguinal hernia mesh-repairs from May to June 2010, and the correlated factors for change of defecation were analyzed by logistic regression analysis. Results Reduction of activity and food, changes of food ingredients, and worries about recurrence were risk factors for change of defecation. Conclusion In order to facilitate the recovery of the patients, nurses should promote patients’ knowledge on the surgery, guide them to eat as usual and do more exercises, and eliminate their anxiety on recurrence of the disease.
Objective To evaluate anal function in patients with rectal carcinoma after low anastomosis operation. Methods Five hundred and forty-one patients with low rectal carcinoma were followed up for 1-3 years to assess anal function after low or ultra-low Dixon anastomosis. The evaluation was based on Xu Zhong-fa Assessment Criteria of Anal Function, anastomotic position and time-to-operation. Defecation function training and rehabilitation instructions were administered after the operation. Results The evaluation of defecation function showed that in the low Dixon operation group, 75.8%(211/278) scored “excellent”, 11.8%(33/278) scored “good”, 10.1%(28/278) scored “fair” and 2.2%(6/278) scored “poor”. In the ultra-low Dixon operation group, 70.7%(186/263) scored “excellent”, 13.3%(35/263) scored “good”, 10.6% (28/263) scored “fair”, and 5.3%(14/263) scored “poor”. No statistical difference was found between the low and ultra-low Dixon groups in this evaluation (Z= –1.429,P=0.136). However, there was statistical difference in the “awareness of defecation”(Z= –4.610,P=0.000) and “sense of defecation” (Z= –5.252, P=0.000) domains between the two groups. The defecation functions were similar between the low and the ultra-low Dixon operation groups after 6-month post-operation training(Z= –0.550, P=0.582). Conclusions There is no difference in defecation function between low and ultra-low Dixon anastomotic operation patients with rectal carcinoma by nursing.