ObjectiveTo compare the outcome between two nutrition support methods, total enteral nutrition (TEN) and enteral nutrition combined with parenteral nutrition, in infants after ventricular septal defect (VSD) repair operation. MethodsWe retrospectively analyzed the clinical data of 76 infants who underwent VSD repair operation in Xinhua Hospital in 2012 year. There were 46 males and 35 females aged 1.6-11.9 (5.5±2.5) months. Nutrition support was started from the first day after operation. There were 35 patients in the group A with TEN 60 kcal/(kg·d), and 41 patients in the group B with both enteral nutrition at 30 kcal/(kg·d) and parenteral nutrition at 30 kcal/(kg·d). ResultsThere was no statistical difference between two groups in demography data and preoperative clinical indicators. The number of patients suffered abdominal distension and gastric retention was more in the group A (22.9% vs. 4.9%, 68.6% vs. 2.4%, P<0.05). There was no difference in diarrhea. The completion of nutrition support in the group A was worse than that in the group B. In the group A, only 40% of the goal calorie was finished on the first and the second day after operation. It was improved until the third day, and the goal calorie could be finished on the seventh day. In the group B, the nutrition support method could be finished on the first day. The prealbumin level in the group B was significantly higher on the third, fifth and seventh day (P<0.05). The blood urea nitrogen (BUN) level in the two groups on the first day after operation was higher than that before operation (P<0.05), and persisted in the group A, while decreased to the normal level gradually in the group B. Following up to discharge, the weight was higher and the length of stay was shorter in the group B (P<0.05). There was no statistical difference in the cost of hospitalization between the two groups (P>0.05). ConclusionThe nutrition support method, enteral nutrition combined with parenteral nutrition, is better than TEN for infants after VSD repair operation.
ObjectiveTo summarize the clinical characteristics and mid-long term efficacy of children under 15 years with mechanical valve replacement. Methods We retrospectively analyzed the clinical data of 51 children aged 1 to 15 years underwent mechanical valve replacement in Xinhua Hospital between January 2006 and January 2014. There were 32 males and 19 females with mean age of 9.6±4.0 years (ranged 1-15 years). ResultsThe average cardiopulmonary bypass time was 120.50±61.02 minutes, and average aortic cross-clamping time was 68.35±42.68 minutes. One patient died in hospital. There were 6 patients (11.8%) with complications including mitral paravalvular leakage in 1 patient, malignant ventricular arrhythmia in 1 patient, respiratory failure in 1 patient, acute renal failure in 2 patients, and delayed thoracic close in 1 patient. All the children cured and were followed up for 1-96 months. One patient died during the follow-up time. No other redo-valve replacement or complications correlated to anticoagulant occurred. ConclusionsMechanical valve replacement may be necessary in children with extremely dysplastic valves and severe hemodynamic impairment or after failed repair. With appropriate selection of the prosthetic valve and intensive care therapy during the peroperative period, the mid to long term efficacy is optimistic.
ObjectiveTo investigate the prevalence of chronic obstructive pulmonary disease (COPD) and related risk factors in two districts and five counties in Jiaxing city of Zhejiang province. MethodsWe randomly selected people over the age of 40 in 10 communities of two districts and five counties in Jiaxing city by cluster sampling and random sampling to investigate the prevalence of COPD from January 2013 to December 2013. All included patients received pulmonary function test at the same time. ResultsA total of 1 256 cases of adults over the age of 40 were included, among which, 1 056 cases with complete data and qualified for pulmonary function test. There were 410 males with mean age of 58.74±11.62, and 646 females with mean age of 59.45±11.72. The overall prevalence of COPD was 13.60%. Male and female prevalence rates were 13.90% and 13.41%, respectively. Divided by age, the prevalence of the age of 40 to 50 was 3.38%, the age of 51 to 60 was 9.57%, the age of 61 to 70 was 19.15%, and the age of above 70 was 29.35%. The results of multivariate logistic regression analysis showed that the main risk factors of COPD were smoking, passive smoking, history of dust exposure, chronic respiratory disease history and age. ConclusionThe total prevalence of COPD in Jiaxing area is high, and the female prevalence rate is especially higher than the national average level, which is the epidemiological characteristic of this area. Because the risk factors of COPD are complex, an integrated control strategy should be adopted.