1.Quality of life in patients with obstructive hypertrophic cardiomyopathy after percutaneous transluminal septal tunnel myocardial ablation and its influencing factors in a short time
He WANG ; Huaimin GUAN ; Jinhong XIE ; Yushan CHEN ; Minghua LUO ; Shuangshuang CHAI
The Journal of Practical Medicine 2014;(9):1398-1400
Objective To observe the short-term quality of life in patients with obstructive hypertrophic cardiomyopathy (OHCM) after percutaneous transluminal septal tunnel myocardial ablation (PTSTMA). Methods The quality of life in patients with OHCM were assessed by the SF-36 before and three months after PTSTMA. Results Three months after the procedure , quality of life was markedly improved at different variances in patients with OHCM as compared with the baseline. The linear regression analysis showed the factors influencing quality of life were character, coexistence with other diseases, and 6-minute walk test. Conclusions Percutaneous transluminal septal tunnel myocardial ablation can improve the short-term quality of life in patients with OHCM. Postoperative psychological counseling and rehabilitation guidance can practically enhance quality of life.
2.Correlation between blood glucose variability index and postoperative delirium in elderly patients undergoing knee arthroplasty
Xin PAN ; Ning CAI ; Huihui LI ; Shuangshuang GUAN ; Chenyu WANG
The Journal of Clinical Anesthesiology 2024;40(10):1058-1062
Objective To investigate the correlation between blood glucose variability index(GLUCV)and postoperative delirium(POD)in elderly patients undergoing knee arthroplasty.Methods A total of 112 elderly patients undergoing elective knee arthroplasty were analyzed retrospectively,16 males and 96 females,aged 65-80 years,BMI 22.0-28.0 kg/m2,ASA physical status Ⅰ or Ⅱ.They were di-vided into two groups according to whether they had POD within 5 days after operation:POD group and non-POD group.The score of the last preoperative mini-mental state examination(MMSE),operation time,the duration of the intraoperative regional cerebral oxygen saturation(rScO2)value decreased by more than 13%of the rScO2 basic value(△rScO2>13%),the preoperative hemoglobin(Hb)and C-reactive protein(CRP)concentration,the fingertip blood glucose concentration before entry,before anesthesia induction,5 minutes after anesthesia induction,1 minute after skin incision,and before leaving the chamber were col-lected,and the GLUCV was calculated.The risk factors of POD in elderly patients undergoing knee arthro-plasty were analyzed by univariate and multivariate logistic regression,and the odds ratio(OR)and 95%confidence interval(CI)were calculated.The receiver operating characteristic(ROC)curve was drawn to calculate the area under the curve(AUC)and analyze the predictive value of GLUCV.Results Thirty patients(26.8%)showed POD symptoms within 5 days after surgery.Compared with the non-POD group,the operation time and duration of intraoperative △rScO2>13%in the POD group were significantly prolonged(P<0.05),the CRP concentration and GLUCV were significantly increased(P<0.05).Multi-variate logistic regression analysis showed that prolonged time of △rScO2>13%(OR=3.542,95%CI 1.380-9.093,P=0.011),elevated CRP concentration(OR=1.984,95%CI 1.078-3.650.P=0.015),and elevated GLUCV(OR=5.257,95%CI 1.690-16.353,P=0.008)were risk factors of POD in elderly patients undergoing knee arthroplasty.ROC curve analysis showed that the area under the AUC of GLUCV in predicting POD in elderly patients undergoing knee arthroplasty was 0.747(95%CI 0.650-0.844,P<0.001),while the optimal cutoff value was 23.4%,the sensitivity was 71.4%,and the specificity was 63.3%.Conclusion GLUCV is closely related to POD,and GLUCV level has a good pre-dictive effect on POD in elderly patients undergoing knee arthroplasty.
3.Effects of optimizing project in nursing quality management on patients with ST-segment elevation myocardial infarction in chest pain center
Yanping LIU ; Honglei YANG ; Yanli DING ; Shu LIU ; Shuangshuang CHAI ; Xuhong HU ; Shuangna WANG ; Huaimin GUAN
Chinese Journal of Modern Nursing 2019;25(17):2204-2206
Objective? To investigate the effects of nursing quality improvement in chest pain center on patients with ST-segment elevation myocardial infarction (STEMI). Methods? A total of 93 patients with STEMI who received routine nursing care from July to December 2016 (n=30) and optimized quality nursing care from January to July 2017 (n=63) in the First Affiliated Hospital of He'nan University of Traditional Chinese Medicine were enrolled to the study. The patients' gender, age, and 18-lead ECG completion time, Door-To-Balloon time (D2B), myocardial injury marker report time, and their hospitalization days (d), were compared between the two groups. Results? The differences in the indicators including sex,age and 18-leads ECG completion time were not statistically different (P>0.05). However, the differences in hospitalization time, D2B time, and myocardial injury marker report time had statistical significance (P< 0.05). Conclusions? The optimizing project of nursing quality management, including the optimization of nursing document writing, specialized instrument operation process and ward management index, can reduce patients' hospital stay, D2B time, and myocardial injury marker report time, hence improve the overall treatment quality for the patients.