1.Safety and feasibility of day surgery management model under ERAS concept for gynecologic laparoscopic surgery
Huaying LIU ; Ling LI ; Yuanxiang SHI ; Xin RONG ; Xiaolong LIANG ; Yanzhou WANG ; Zhimin WU
Journal of Army Medical University 2024;46(14):1658-1665
Objective To explore the safety and feasibility of the application of day surgery management model under enhanced recovery after surgery(ERAS)concept in patients undergoing gynecologic laparoscopic surgery.Methods A non-randomized concurrent control trial was conducted on the patients who underwent laparoscopic surgery in our department from January to August 2021.A total of 92 patients admitted on odd date were assigned into Ward B of our department and served as the control group,and another 96 patients hospitalized on even date were subjected into Ward A and served as the observation group.The control group was given the routine treatment schedule,including the relevant examinations after admission and general operation procedure during hospitalization.The observation group was under a day surgery management model based on the concept of ERAS,with aid of a day surgery team and optimized perioperative management measures,including pre-hospital rehabilitation,shortening water fasting before surgery,multi-mode analgesia,preventive antiemesis,intraoperative warmth,prevention of deep vein thrombosis,immediate postoperative eating and activity,and follow-up after discharge.Postoperative subjective comfort,intestinal function recovery,social and economic benefits,postoperative complications and inflammatory indicators were compared between the 2 groups.Results In 0~6,7~12 and 13~24 h after operation,the scores of thirst,hunger,nausea,pain,abdominal distension and pharyngeal discomfort were significantly lower in the observation group than the control group(P<0.01).The observation group had obviously shorter length of hospital stay and ealier bowel sound recovery and first anal exhaust than the control group(P<0.01).No postoperative complication,such as fall,unplanned secondary operation or wound infection was observed in both groups.The postoperative inflammatory indicators,including procalcitonin(PCT),neutrophil percentage(Neu%)and white blood cell count(WBC)were all in the normal ranges in the 2 groups at 24 h and 3 and 7 d after surgery.Statistical differences were found in firstly postoperative mobilization,length of hospital stay,hospitalization cost and patient satisfaction between the 2 groups(P<0.01).Conclusion ERAS-based day surgery management model has the advantages of shortening hospital stay,reducing medical costs,promoting postoperative rehabilitation,and improving the comfort and satisfaction in patients undergoing gynecologic laparoscopic surgery.
2.Formulation of Criterion for Clinical Application of Shuxuetong Injection by Clinical Pharmacists in Our Hospital Based on Evidence Quality Evaluation Method
Ziwei DENG ; Ye DENG ; Yuanxiang JIN ; Chengfeng QIU ; Hongqiang WANG ; Liming TAN ; Zhihua SHI
China Pharmacy 2019;30(11):1551-1554
OBJECTIVE: To provide reference for strengthening clinical application of key monitoring drugs and promoting rational drug use in clinic. METHODS: Based on evidence-based medicine, taking key monitoring drugs Shuxuetong injection as example, clinical evidence of domestic and foreign clinical studies were collected. The included literatures were graded according to the quality of GRADE evidence and recommended strength system. Evidence-based medicine evidence for the indications of Shuxuetong injection were evaluated, and criterion for clinical use of Shuxuetong injection was formulated in Huaihua First People’s Hospital (our hospital). RESULTS: The main content of criterion for clinical application of Shuxuetong injection formulated by our hospital was that there was A-level evidence support for acute ischemic cerebral infarction, but it was weakly recommended and only used for adjuvant therapy; there was B-level evidence support for anticoagulation (for preventing DVT), diabetic peripheral nerve lesion, but it was weakly recommended; there was only C-level or D-level evidence support for other indications, it was strongly recommendation against use. CONCLUSIONS: Clinical pharmacists formulate the criterion for clinical application of Shuxuetong injection by evidence quality evaluation method, provide reference for clinical application management of key monitoring drug and play an important effect on rational drug use in clinic.