Objective:To explore the anesthesia effect of dexmedetomidine combined with general anesthesia and superficial cervical plexus block in subtotal parathyroidectomy.Methods:A retrospective analysis was conducted on the medical records of 63 patients with secondary hyperparathyroidism (SHPT) in the anesthesia department of the People′s Hospital of Wuzhou from January 2021 to September 2022. According to different surgical anesthesia methods, the patients were divided into an observation group (dexmedetomidine combined with general anesthesia and superficial cervical plexus block, n=32) and a control group (general anesthesia and superficial cervical plexus block, n=31). Two groups of patients were compared in terms of perioperative hemodynamic indicators [heart rate (HR), diastolic blood pressure (SBP), systolic blood pressure (DBP), mean arterial pressure (MAP)], wake-up time and Stewards score of 5 points, total anesthetic dosage, blood glucose (BG) and norepinephrine (NE), and incidence of postoperative adverse reactions. Results:The HR, SBP, DBP, and MAP of the control group patients were significantly higher than those before anesthesia after tracheal intubation and tracheal extubation (all P<0.05), while there was no statistically significant difference in HR, SBP, DBP, and MAP between the observation group and before anesthesia after tracheal intubation and tracheal extubation (all P>0.05). The HR, SBP, DBP, and MAP of the observation group were significantly lower than those of the control group after tracheal intubation, during tracheal extubation, and at room departure (all P<0.05). The wake-up time and Stewards score of 5 points in the observation group were significantly shorter than those in the control group (all P<0.05). The dosage of propofol and remifentanil in the observation group was significantly lower than that in the control group ( P<0.05), and there was no statistically significant difference in the dosage of cisatracurium between the two groups ( P>0.05). The serum BG and NE levels in the observation group were significantly lower than those in the control group after tracheal intubation, during skin cutting, tracheal extubation, and during extubation (all P<0.05). The incidence of nausea, vomiting, and chills in the observation group was significantly lower than that in the control group (all P<0.05). Conclusions:The combination of dexmedetomidine with general anesthesia and superficial cervical plexus block is beneficial for stabilizing hemodynamics, inhibiting intraoperative stress response, reducing postoperative adverse reactions, and improving the quality of general anesthesia in patients with subtotal parathyroidectomy.

Objective:To study the value hyperthermic intraperitoneal chemoperfusion after ruptured and hemorrhage of hepatocellular carcinoma.Methods:A retrospective study was conducted on 53 patients with ruptured hepatocellular carcinoma treated in Zhongshan Hospital Affiliated to Sun Yat-sen University from January 1, 2009 to January 1, 2019.Patients who underwent surgical resection combined with hyperthermic intraperitoneal chemoperfusion were included into the experimental group. Those who underwent surgical treatment only were included into the control group. The clinical data, postoperative hospital stay, complications, long-term tumor-free survival and overall survival were analyzed. Independent risk factors affecting prognosis were also determined.Results:Of the 33 patients in the experimental group, there were 27 males and 6 females, with a mean age ± s. d. being 50.49±11.59 years. There were 20 patients in the control group, including 17 males and 3 females, with a mean ± s. d. of 53.70±13.89 years. There were no significant differences in the length of postoperative hospital stay and complication rates between the two groups ( P>0.05). The tumor-free survival rate of the experimental group was significantly higher than that of the control group ( P<0.05). There was no significant difference in overall survival rates between the two groups ( P>0.05). Cox multivariate analysis showed that histological classification [ HR(95% CI): 27.700(1.695-452.794); 42.754(2.091-874.034)] and hyperthermic intraperitoneal chemoperfusion [ HR(95% CI): 0.238(0.086-0.661); 0.205(0.069-0.611)] were independent risk factors affecting tumor-free survival and overall survival (all P<0.05). Conclusion:Hyperthermic intraperitoneal chemoperfusion after surgical resection for ruptured hepatocellular carcinoma is a safe and effective treatment.