1.Clinical research in humidifying methods of artificial airway
Chinese Journal of Practical Nursing 2011;27(36):3-4
Objective To explore the best humidifying methods of artificial airway by comparison of different humidifying approaches.Methods 124 patients were divided into the control group (60 cases) and the treatment group (64 cases).Two methods,continuous airway humidifying by the trace injection pump and continuous airway humidifying by oxygen atomization were adopted.The humidifying effect,tolerance rate of patients,the airway complications and nursing cost were compared between the two groups.Results The method of continuous airway humidifying by oxygen atomization had better effect,was easy to be tolerated,less complications and less cost.Conclusions Continuous airway humidifying by oxygen atomization is a safe,effective,low-cost method,it is easy to be tolerated by patients and is worthy of being popularized.
2.Research in effect of cerebrospinal fluid replacement in treatment of subarachnoid hemorrhage and its nursing countermeasures
Lihuan WANG ; Yongqing WANG ; Chunxia WANG
Chinese Journal of Practical Nursing 2009;25(12):24-25
Objectives To investigate the effect of cerebrespinal fluid replacement using three- way pipe on subarachnoid hemorrhage and the nursing points were summarized. Methods 80 subarachnoid hemorrthage patients were divided into the treatment group and the control group with 40 patients in each group. The control group received traditional medical treatment and routine nursing. The treatment group received cerebrospinal fluid replacement.The incidence of complication,death and clinical effect were com-pared between the two groups and the data under χ2 test and t test. Results Each index in the treatment group was better than that of the control group. Conclusions Intensified nursing after cerebrospinal fluid replacement can improve treatment effect, alleviate prognosis and supply reference for future nursing work for this disease.
3.Observation on sterile effect of sterile adhesive tape on opened infusion bottle mouth
Lihuan WANG ; Xiaohui WANG ; Jiantao YU
Chinese Journal of Practical Nursing 2010;26(20):37-38
Objective To discuss the sterile effect of sterile adhesive tape on opened infusion bottle mouth. Methods From February to May, 2009, 400 infusion bottles were chosen and divided into the observation group and the control group with 200 bottles in each. The bottle mouth in the observation group was covered with sterile adhesive tape, while the control group used iodophor. The incidence of infusion reaction, disposable materials and time consuming of nurses were compared. Results No infusion reaction occurred in both groups. But disposable materials and time consuming was less in the observation group compared with the control group. Conclusions Application of sterile adhesive tape in sterilization of opened infusion bottle mouth is safe, reliable, simple and economic, it can save time and increase work efficiency of nurses.
4.Comparison between Fast Track Cardiac Anesthesia and Regular Anesthesia for Pediatric Patients with Congenital Heart Disease
Rong WANG ; Weipeng WANG ; Lihuan LI
Chinese Journal of Minimally Invasive Surgery 2001;0(05):-
Objective To retrospectively compare the postoperative recovery and medical cost of pediatric patients underwent fast track cardiac anesthesia(FTCA,extubated in operating room)or regular anesthesia(extubated out of operating room).Methods From January 2005 to January 2006,108 children with congenital heart disease were operated under FTCA,108 patients who received regular anesthesia were set as a control group.The general characteristics,anesthetic method,postoperative treatments,recovery,and medical cost of the two groups were compared.Results The mean body weight of FTCA group was significantly higher than that in the control [(13.8?4.2)kg vs(10.9?3.8)kg,t=5.321,P=0.000].The patients received sevoflurane for anesthesia induction in the FTCA group were more than those in the control(58 vs 16,?2=36.260,P=0.000).The mean dosage of fentanyl used during operation in FTCA group was significantly lower than that in the control [(10.9?7.3)?g/kg vs(18.0?5.7)?g/kg,t=-7.697,P=0.000].In addition,fewer patients in FTCA group used more than one kind of sedative after the operation(7 vs 19,?2=6.296,P=0.012).95 patients in FTCA group returned to their ward without extubation-related complications.No significant difference in length of hospital stay was found between the two groups,however,the medical cost of FTCA group was significantly lower than that in the control(P
5.Investigation and analysis of influence of social support and coping style on depression mood of infertile patients
Shuzhen LIU ; Haiyan QIAO ; Lihuan WANG
Chinese Journal of Practical Nursing 2014;30(3):59-61
Objective This study aims to explore the social support,coping style on depressive mood of infertile patients.Methods 165 infertility patients were collected as the research object,and they were investigated with the self-rating depression scale,social support scale and coping style questionnaire.Results 34.55%,48.48% of the patients with education background of junior middle school,high school appeared depression.Subjective support and positive coping had significant positive correlation.The availability of support and positive coping had significant positive correlation.Positive coping and depression had significant negative correlation,negative coping and depression had significant positive correlation.Educational level and depression demonstrated inverted U shape relationship; coping style had direct effect and indirect effect on infertile female patients with depression.Conclusions Use of active coping without negative coping can reduce depressive mood,improve patients' social support in order to reduce mental stress level.
6.Postoperative analgesia with flurbiprofen axetil combined with sufentanil in patients underwent cardiac surgery
The Journal of Clinical Anesthesiology 2009;25(12):1051-1052
Objective To access the analgesia effect and side effect of flurbiprofen axetilcombined with sufentanil.Methods Thirty-eight patients underwent cardiac surgery were randomlydivided into two groups with nineteen cases each.Group S was given sufentanil 250μg diluted to 125ml via PCIA after surgery.Group F was given sufentanil 125 gg plus flurbiprofen axetil 150 mgdiluted to 125 ml via PCIA after surgery.The PCIA pump was set at a rate of 0.2 ml/h,bellus dosewas 0.8 ml.lockout time interval was 10 min. Analgesia grade was accessed,vital sign and sideeffects were recorded.Results 'Fhere was no significant difference in analgesia grade between tWOgroups.The side effects were lower in group F than those in group S.Conclusion Flurbiprofen axetilcombined with sufentanil can obtain similar analgesia effects to sufentanil alone,but can reduce sideeffects and fever temperature.
7.Anesthesia for video-assisted thoracoscopic coronary artery bypass surgery
Weipeng WANG ; Lihuan LI ; Mingzheng LIU
Chinese Journal of Minimally Invasive Surgery 2001;0(04):-
Ojective To study the anesthesia technique for video-assisted thoracoscopic coronary artery bypass surgery (VATCABS). Methods The anesthesia of 14 VATCABS were reviewed retrospectively. Results The average dose of Fentanyl was (13.3?7 3)?g/kg Six (42.9%) of 14 cases were extubated at the operating room, while other 8 cases (57.9%) were extubated (4.71?2.21) hours after operation. The time of ICU stay was (45.2?35.5) hours. No anesthesia related complications were found perioperatively. Conclusions "Fast track" anesthesia technique is suitable for VATCABS.
8.Risk factors for development of SIRS in patients after off-pump coronary artery bypass grafting
Yuefu WANG ; Guyan WANG ; Fang CHEN ; Lihuan LI
Chinese Journal of Anesthesiology 2009;29(3):230-232
Objective To determine the risk factom for the development of systemic inflammatory response syndrome(SIRS)in patmnts after off-pump coronary artery bypass grafting(OPCABG).Methods Sixty NYHA Ⅰ or Ⅱ patients,aged 46-73 yr,weighing 54-110 kg,undergoing OPCABG,were studied.Blood samples from intemal iugular vein were taken for determination of the plasma concentrations of IL-6 and IL-10 at 4 h after the surgery by ELISA.SIRS 8COre W88 performed during 24 h after the surgery.The patients were divided into 2 groups:SIRS group(S,SIRS 8core≥2)and non-SIRS group(U,SIRS score<2).Factors including age,sex,weight,percentage of mononuclear cells,concentration of hemoglobin,time of operation,left ventricular ejection firction,whether using proteinase inhibitor or not during surgery and plasma concentrations of IL-6 and IL-10 at 4 h after surgery were reccorded.The risk factors were identified by logistic regression analysis.Results Logistic analysis indicated that percentage of mononuclear cells,concentration of hemoglobin,the plasma concentrations of IL-6 and IL-10 were closely related with the development of SIRS in patients after 0PCABG(P<0.05),Y=0.155+0.52 X1+0.39 X2+0.76X1-0.79X,Conclusion The percentage of mononuclear cells,concentration of hemoglobin,and plasma concentrations of IL-6 and IL-10 after surgery Call be the risk factors for the development of SIRS in patients after OPCABG.
9.Effects of intravenous ulinastatin on perioperative lung function in patients undergoing off-pump coronary artery bypass grafting
Yuefu WANG ; Tong YAO ; Guyan WANG ; Lihuan LI
Chinese Journal of Anesthesiology 2009;29(1):37-40
Objective To investigate the effects of intraoperative intravenous ulinastatin infusion on perioperative lung function in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods Twenty-four NYHA class Ⅰor Ⅱ patients aged 65-75 y undergoing elective OPCABG were randomly divided into 2 groups(n=12 each): control group (C) and ulinastatin group (U). In group U, after tracheal intubation the patients received iv injection of ulinastatin 6 000 U/kg over 30 min followed by iv ulinastatin infusion at 1 000 U·kg-·h-1 until the end of surgery. In group C equal vohtme of normal saline was administered iv instead of ulinastatin. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring and blood sampling. The patients were premeditated with intramuscular morphine 10 mg. Anesthesia was induced with midazolam 0.1 mg/kg, fentanyl 10 μg/kg and pipecuronium 0.1 mg/kg and maintained with 1%-2% sevoflurane in 70% O2 and intermittent iv boluses of fentanyl and pipecuronium. Blood samples were taken before (T1) and at the end of operation (T2) and at 4, 8, 20 h after operation (T3.5) for determination of plasma CD11/CD18 expression, plasma IL-6 and serum NO concentrations, and blood gases. P(A-a) O2 and respiratory index (RI) (RI=P(A-a)O2/PaO2) were calculated. Mechamcal ventilation time in ICU was recorded. Results The two groups were comparable with respect to age, sex, body weight, duration of anesthesia and surgery, and the number of bypass grafts. The plasma level of IL-6, and expression of CD11 b/CDI8 were significantly increased while serum NO level was significantly decreased after operation as compared to the baseline values before operation (T1) in group C. There was no significant change in the plasma levels of IL-6, CD11b/CDI8 expression and serum levels of NO after operation in group U. P(A-a)O2 and RI were significantly increased after operation in both groups and were significandy lower in group U than in group C. The mechanical ventilation time in ICU was significantly shorter in group U than in group C. Conclusion Intravenous ulinastatin inihsion can significantly protect lung function during OPCABG by inhibiting inflammatory response.
10.Effects of different doses of ulinastatin on platelets during normothermic cardiopulmonary bypass in rabbits
Keqin CHANG ; Daxuan YANG ; Guyan WANG ; Qinghua XUE ; Lihuan LI
Chinese Journal of Anesthesiology 2009;29(12):1079-1082
Objective To investigate the effects of different doses of ulinastatin on platelet counts and function after normothermic cardiopulmonary bypass (CPB) in rabbits. Methods Fifty lung-ear white rabbits aged 5-6 months weighing 2.3-3.0 kg were randomly assigned to one of 5 groups (n = 10 each) : control group (group C) and4 ulinastatin groups (group U~1, U_2,U_3,U_4). The rabbits received ulinastatin 1×10~4, 3×10~4, 5×10~4 and 10×10~4 U/kg before CPB in group U~1, U_2, U_3 and U_4 respectively while equal volume of normal saline was given instead of ulinastatin in group C. All rabbits underwent CPB for 30 min at perfusion flow of 72-120 ml·kg~(-1) ·min~(-1). The rectal temperature was maintained at 36.5-37.5℃. Hemodynamic parameters were recorded and blood platelet count, platelet adhesion rate and platelet membrane glycopretein Gp Ⅰ b, Gp Ⅱ b, Gp Ⅲ a receptors were determined before CPB (baseline), at termination of CPB and at 1, 2 and 3 h after CPB. Results The platelet counts were significantly decreased after CPB in all 5 groups (P< 0.05), but there was no significant difference among the 5 groups. The platelet adhesion rates were significantly decreased after CPB as compared with the baseline value before CPB in all 5 groups but the platelet adhesion rates were significantly higher after CPB in group U_4 than in group C. The number of molecules of Gp Ⅰ b, Gp Ⅱ b and Gp Ⅲ a receptors was significantly decreased after CPB in all 5 groups. The number of molecules of Gp Ⅰ b, Gp Ⅱ b and Gp Ⅲ a receptors after CPB was significantly higher in group U_2, U_3 and U_4 than in group C, and there was no significant difference between group U_3 and U_4 . ConclusionUlinastatin 3×10~4-5×10~4 U/kg administered before CPB can inhibit breakdown of platelet membrane glycoprotein receptors. Ulinastatin 10×10~4 U/kg can preserve the platelet adhesion function.