Objective To observe the effects of intravenous injection of fentanyl and tramadol on postoperative analgesia in laparoscopic cholecystectomy of clinical efficacy.Methods 80 cases treated with laparoscopic cholecystectomy were randomly divided into the fentanyl group (group F) and tramadol group (group Q).VAS score,adverse reaction incidence and patient satisfaction,were observed after the administration of 0.5,1,2,4,8,12h.Results In group F after administration of 0.5,1,2h,VAS score was better than that of group Q; group F after administration of the drug 4,8 h VAS score was inferior to group Q;two groups of patients in postoperative 12h VAS scores showed no significant difference in group F;the overall incidence of adverse reactions was higher than that of group Q,patients' satisfaction was higher than that of group Q.Conclusion Intravenous fentanyl in laparoscopic cholecystectomy operation postoperative overall are superior to the analgesic effect of tramadol,with high patient's satisfaction.

Objective:To explore the status quo of exercise rehabilitation attitudes and compliance in patients undergoing coronary artery bypass grafting (CABG), and analyze the influencing factors, so as to provide evidence for improving the compliance of rehabilitation exercise in CABG patients.Methods:From January to August 2022, convenience sampling was used to select 228 patients with CABG in three ClassⅢ Grade A hospitals in Urumqi City as the survey subject. One month after surgery, a questionnaire survey was conducted using the General Information and Disease Information Questionnaire, the Questionnaire of Rehabilitation Exercises (QRE), the Chinese version of the Tampa Scale of Kinesiophobia for the Heart (TSK Heart), and the Chinese version of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF-C). This study conducted a latent category analysis of rehabilitation exercise attitudes and compliance among CABG patients, and identified the influencing factors of their latent categories through Logistic regression. A total of 220 valid questionnaires were collected, with an effective recovery rate of 96.49% (220/228) .Results:The fitting results of latent category analysis showed that the rehabilitation exercise attitudes and compliance of 220 CABG patients could be divided into 4 latent categories, which were respectively named as: excellent attitude-excellent compliance group, good attitude-single exercise group, moderate attitude-poor compliance group, poor attitude-poor compliance group. Logistic regression showed that education level, nationality, pain, exercise fear and fatigue were independent influencing factors for the latent categories of exercise rehabilitation attitudes and compliance in CABG patients ( P<0.05) . Conclusions:Postoperative exercise rehabilitation attitudes and compliance in CABG patients have 4 latent categories, and patient education level, nationality, pain, exercise fear and fatigue are all factors that affect compliance. Medical and nursing workers should formulate targeted interventions based on influencing factors to improve the compliance of exercise rehabilitation in patients with CABG.

Objective:To explore the effects of refined nursing for critical pulmonary disease patients treated by fibrobronchoscopy.Methods:From May 2018 to September 2019, we selected 126 critical pulmonary disease patients admitted to Wuhan Pulmonary hospital by convenient sampling. All patients were divided into control group and observation group with the method of random number table, 63 cases in each group. Patients of two groups were all treated with conventional treatment combined with fibrobronchoscopy. On this basis, patients in control group received routine nursing intervention, and patients in observation group were given refined nursing intervention on the basis of the control group. The scores of mental state, sleep quality, were compared with the Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) and Pittsburgh Sleep Quality Index (PSQI) of patients between two groups before and after intervention, and the incidence of postoperative complications and nursing satisfaction of patients between two groups before and after intervention were compared too.Results:There was no statistical difference in the scores of SAS, SDS and sleep quality of patients between two groups before nursing ( P>0.05) . After nursing, the scores of SAS and SDS of patients in observation group were lower than those in control group with statistical differences ( P<0.05) ; the dimension scores and total score of PSQI of observation group were lower than those of control group also with statistical differences ( P<0.05) ; the incidence of complications of observation group was 3.2% (2/63) , which was lower than 12.7% (8/63) of control group with a statistical difference ( P<0.05) ; the nursing satisfaction of observation group was 95.2% (60/63) higher than that [84.1% (53/63) ] of control group, the difference was statistically significant ( P<0.05) . Conclusions:Refined nursing can effectively correct the negative emotions of patients with critical pulmonary disease treated by fibrobronchoscopy, improve the sleep quality of patients, reduce the incidence of postoperative complications and improve nursing satisfaction, which is worthy of clinical application.