1.Effect evaluation on application of mobile internet in continuing nursing care in premature infants
Juan SUN ; Jun JIANG ; Zhengxin WANG ; Ping YU ; Wenqing PAN ; Yonglan RUAN ; Hongwen XIE
Chinese Journal of Practical Nursing 2017;33(33):2589-2593
Objective To explore the effect of mobile internet management in continuing nursing care of premature infants. Methods The convenience sampling method was adopted to divide the premature infants from January to December in the year 2015 into 2 groups according to the time order, the control group (n = 56), and the observation group (n = 57). The control group received continuing nursing care for the whole course from admission to discharge. Based on the nursing care of the control group, the observation group were given an extra continuing nursing care by using the mobile internet. Both group's continuing nursing care were lasted from the birth till 12 month.Comparisons of two groups were made from the following aspects: of preterm infants born at 12 months in the length, weight, head circumference of the preterm infants at 12 months old and 40 weeks corrected gestational age Neonatal Behavioral Neurological Assessment,breastfeeding confidence;parents care knowledge scores at the time of admission, discharge and 1month after discharge; referral rate; parents satisfaction at the time of discharge and the end of extended care). Results In the observation group,the length,weight and head circumference of the preterm infants at birth were(74.10 ± 2.66)cm,(8.70 ± 1.43)kg,(45.40 ± 1.38)cm, Neonatal Behavioral Neurological Assessment at 40 weeks of gestation,self-confidence in breastfeeding,1 post-discharge and 1 post-discharge parents care knowledge score of the month, parents of preterm children satisfaction scores, respectively(37.30 ± 3.22),(120.31 ± 13.65),(82.28 ± 3.99, 96.70 ± 2.28), (93.55±2.91,96.61±2.37),the control group were(73.20±2.80)cm,(8.44±1.02)kg,(44.2±1.40)cm, (36.00±2.87),(114.54±12.21),(80.66±3.51, 95.02±3.87),(92.57±2.41, 95.72±2.02). The difference between the two groups was statistically significant(t=-5.244~-2.014,all P<0.05). Conclusions The mobile internet application of continuing nursing care in premature infants can improve the growth and development of premature infants and maternal breastfeeding confidence,promote parents care knowledge, referral rate and satisfaction,thus guarantee the he living quality of the preterm infants.
2.Application of hypotension prediction index in intraoperative hemodynamic management of robot-assisted laparoscopic cystectomy:A case report and literature review
Wenqing RUAN ; Zerun FU ; Yi HUANG ; Longyun LI ; Yao SUN ; Kai LI
Journal of Jilin University(Medicine Edition) 2024;50(4):1130-1136
Objective:To analyze the intraoperative hemodynamic management by hypotension prediction index(HPI)in one patient underwent robot-assisted laparoscopic cystectomy,and to provide the reference for anesthesia monitoring and hemodynamic management in the similar major surgery.Methods:The clinical data,intraoperative hemodynamic data,usage and dosage of vasoactive drugs,and clinical outcomes of one patient underwent robot-assisted laparoscopic cystectomy with HPI-guided intraoperative hemodynamic management were retrospectively analyzed,and the relevant literatures were reviewed.Results:The patient,a 72-year-old female,was admitted due to macroscopic hematuria for 5 months accompanied by dysuria for 3 months.The cystoscope results showed a 7 cm× 7 cm× 5 cm mass on the right side of the bladder trigone and a 4 cm × 3 cm × 3 cm mass near the bladder neck.The positron emission tomography/computed tomography(PET/CT)results showed thickening of the right posterior bladder wall with high metabolism,and the preliminary diagnosis was bladder malignancy.After preoperative anesthesia evaluation,the robot-assisted laparoscopic cystectomy was planned.After entering the operating room,the routine monitoring was conducted,and the monitor equipped with HPI software was used to guide intraoperative hemodynamic management.After routine anesthesia induction,the tracheal intubation was performed by video laryngoscope.The patient experienced intraoperative hypotension(IOH)for six times,the cumulative time of mean arterial pressure(MAP)<65 mmHg was 13.7 min,accounting for 4.40%of the anesthesia duration,and the time-weighted average of MAP<65 mmHg was 0.28 mmHg.The time range with HPI≥85 roughly overlapped with and included the period of MAP<65 mmHg.At 146 time points with HPI≥85,the MAP remained greater than 65 mmHg at 68.5%(100/146)of the points.At 47 time points with MAP<65 mmHg,HPI≥85 occurred at 97.9%(46/47)of the points.On the first postoperative day,the patient's hypersensitive cardiac troponin I was<0.01 μg·L-1,and no perioperative adverse events occurred.The patient was discharged on the eighth day.Conclusion:HPI can promptly and accurately predict the occurrence of IOH in the patients undergoing robot-assisted laparoscopic cystectomy.The use of HPI-based hypotension correction strategies during surgery can maintain the time-weighted average of MAP<65 mmHg at a lower level.