Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · Aug 2020
Randomized Controlled Trial[Effects of desflurane and sevoflurane anesthesia on postoperative recovery after long-term tumor surgery].
Objective: To analyze the effects of desflurane and sevoflurane anesthesia on postoperative recovery after long lasting tumor surgery. Methods: One hundred and sixty patients undergoing endoscopic radical esophagectomy and gastrectomy (80 cases of each surgical type) from November 2019 to March 2020 at Henan Cancer Hospital, were randomized into 4 groups(n=40): group CS (esophageal cancer+sevoflurane anesthesia), group DS (esophageal cancer+desflurane anesthesia),group CW (stomach cancer+sevoflurane anesthesia) and group DW (gastric cancer+desflurane anesthesia). General anesthesia was induced by intravenous agents in all four groups, which were maintained by inhaled anesthetic during the operation. ⋯ Compared with group CS and group CW, group DS and group DW required significantly shorter time for spontaneous breathing recovery, eye opening,extubation, and directional force recovery after operation (all P<0.05). Conclusions: Both desflurane and sevoflurane anesthesia can achieve satisfactory anesthesia depth during long lasting tumor surgery. Desflurane can shorten the recovery time and early extubation, and improve the quality of recovery.
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Zhonghua yi xue za zhi · Jul 2020
Randomized Controlled Trial[Application value of non-invasive ventilation combined with high flow nasal cannula oxygen therapy in sequential treatment of patients with chronic obstructive pulmonary disease after mechanical ventilation].
Objective: To investigate the value of non-invasive ventilation (NIV) combined with high flow nasal cannula oxygen therapy (HFNCO) in sequential treatment of patients with chronic obstructive pulmonary disease after mechanical ventilation. Methods: Chronic obstructive pulmonary disease with acute exacerbation (AECOPD) patients with invasive mechanical ventilation (MV) and successful withdrawal admitted into Huxi Affiliated Hospital of Jining Medical College from January 2018 to December 2019 were enrolled for perspective study. The patients were divided into treatment group (n=40) and control group (n=33) by random number table method. ⋯ The average duration of NIV treatment time [(7.5±1.2) vs (9.3±2.6) h] in the treatment group was significantly shorter than that in the control group (P<0.01). There were no statistically significant differences in PaO(2), PCO(2), re-tracheal intubation rate and the mortality rate of 28 days. Conclusion: NIV combined with HFNCO sequential therapy can effectively relieve diaphragm fatigue and promote recovery of respiratory muscle strength, and it's better than NIV alone.
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Zhonghua yi xue za zhi · Jan 2020
Randomized Controlled Trial[Analysis of sugammadex for antagonistic neuromuscular block in patients with radical resection of lung cancer under thoracoscope].
Objective: To investigate the efficacy and safety of sugammadex for antagonistic neuromuscular block in patients with radical resection of lung cancer under thoracoscope. Methods: One hundred patients undergoing radical resection of lung cancer under thoracoscope in Affiliated Cancer Hospital of Zhengzhou University from March to September in 2019, were randomly divided into control group (group C) and sugammadex group (group S). All patients were anaesthetized (induced and maintained) with intravenous target-controlled infusion of propofol and remifentanil, and intermittent intravenous injection of the neuromuscular block of rocuronium. ⋯ There were no significant difference of the incidence of postoperative nausea and vomiting between these two groups. There were 5 patients with respiratory depression in group C and no respiratory depression patient in group S, the difference was statistically significant between these two groups (χ(2)=5.263, P<0.05). Conclusion: Sugammadex is effective for antagonizing the neuromuscular blockade of rocuronium in patients with radical resection of lung cancer under thoracoscope, and can shorten the time of tracheal tube extubation after surgery.
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Zhonghua yi xue za zhi · Dec 2019
Randomized Controlled Trial[Safety of del Nido cardioplegia in coronary artery bypass grafting combined with heart valve replacement in adults].
Objective: To investigate the safety and myocardial protective effect of del Nido cardioplegia in coronary artery bypass grafting combined with heart valve replacement in adults. Methods: From April 2018 to April 2019, 84 patients undergoing coronary artery bypass grafting combined with heart valve replacement under cardiopulmonary bypass (CPB) in the Second Affiliated Hospital of Nantong University and Shanghai Chest Hospital were selected, and divided into del Nido cardioplegia (n=44) group and Thomas cardioplegia (n=40) group using a random number table. The concentration of troponin was measured before anesthesia induction and 2, 12 and 24 hours after the termination of CPB, respectively. ⋯ No statistically significant differences were found in the postoperative recovery of cardiac autonomic rhythm (P=0.887), cardiac defibrillation (P=0.880), positive inotropic drugs (P=0.163) and left ventricular ejection fraction (P=0.338) between the two groups. Conclusions: It is safe to use del Nido cardioplegia in coronary artery bypass grafting combined with heart valve replacement in adults, which can reduce the frequency of cardioplegia infusion and simplify the surgical procedure. The trend of troponin concentration suggests that del Nido cardioplegia has a better myocardial protective effect.
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Zhonghua yi xue za zhi · Sep 2019
Randomized Controlled Trial[Effect of intravenous granisetron combined and acupuncture point injection at PC6(Neiguan) with 0.9% sodium chlorideon postoperative nausea and vomiting after gynecological laparoscopy].
Objective: To observe the effects of intravenous granisetron and acupuncture point injection at PC6(Neiguan) with 0.9% sodium chloride on postoperative nausea and vomiting (PONV) after gynecological laparoscopic surgery. Methods: Qualified cases were collected according to prospective randomized controlled clinical trial design. 94 cases patients undergoing gynecological laparoscopic surgery without postoperative intravenous analgesia were selected from February 2017 to November 2018 in Beijing Aerospace General Hospital and The Affiliated Hangzhou Hospital of Nanjing Medical University. The patients were randomly divided into three groups: bilateral PC6 sham injection of 0.9% sodium chloride+ intravenous granisetron(group A, n=31); bilateral acupuncture point injection at PC6 of 0.9% sodium chloride+ intravenous 0.9% sodium chloride(group B, n=33); bilateral acupuncture point injection at PC6 of 0.9% sodium chloride+ intravenous granisetron(group C, n=30). ⋯ The time for the first anal exsufflation in group C was earlier than group A and B. Conclusion: Either intravenous granisetron or acupuncture point injection at PC6 of 0.9% sodium chloride can effectively reduce the incidence of postoperative nausea and vomiting after gynecological laparoscopic surgery. Intravenous granisetron combined with acupuncture point injection at PC6 of 0.9% sodium chloride has better effect and promotes the first anal exsufflation time, which is conducive to the rapid postoperative recovery of patients.