Objective:To investigate the risk factors for delirium after free flap reconstruction surgery in elderly patients with head and neck cancer.Methods:This study retrospectively collected clinical data from 309 elderly patients with head and neck cancer who underwent radical resection and free flap reconstruction surgery in the Department of Operation & Anesthesiology, College & Hospital of Stomatology, Guangxi Medical University from January 2018 to December 2022. Among them, there were 197 males (63.8%) and 112 females (36.2%), with an average age of (66.8±5.5) years old. Based on the delirium diagnostic criteria outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, patients were evaluated for postoperative delirium within one week after surgery. They were then divided into a delirium group ( n=75) and a non-delirium group ( n=234). Perioperative indicators potentially related to postoperative delirium, including age, gender, past medical history, tumor characteristics, hematological tests, perioperative sleep disturbances, surgical procedures, intraoperative fluid intake and output, anesthetic dosage, postoperative pain, etc, were collected from the relevant medical record system.Variables with P<0.05 were included in a multivariate Logistic regression model to screen for independent risk factors for delirium. Results:The incidence of delirium after free flap reconstruction surgery for head and neck cancer in elderly patients was 24.3% (75/309). Multivariate Logistic regression analysis showed that male gender ( OR=2.802, P=0.005), perioperative sleep disturbances ( OR=7.104, P<0.001), and moderate-to-severe postoperative pain ( OR=6.903, P<0.001) were risk factors for postoperative delirium. Conclusions:Male gender, perioperative sleep disturbances, and moderate-to-severe postoperative pain are independent risk factors for delirium in these patients.

Objective:To investigate the risk factors for delirium after free flap reconstruction surgery in elderly patients with head and neck cancer.Methods:This study retrospectively collected clinical data from 309 elderly patients with head and neck cancer who underwent radical resection and free flap reconstruction surgery in the Department of Operation & Anesthesiology, College & Hospital of Stomatology, Guangxi Medical University from January 2018 to December 2022. Among them, there were 197 males (63.8%) and 112 females (36.2%), with an average age of (66.8±5.5) years old. Based on the delirium diagnostic criteria outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, patients were evaluated for postoperative delirium within one week after surgery. They were then divided into a delirium group ( n=75) and a non-delirium group ( n=234). Perioperative indicators potentially related to postoperative delirium, including age, gender, past medical history, tumor characteristics, hematological tests, perioperative sleep disturbances, surgical procedures, intraoperative fluid intake and output, anesthetic dosage, postoperative pain, etc, were collected from the relevant medical record system.Variables with P<0.05 were included in a multivariate Logistic regression model to screen for independent risk factors for delirium. Results:The incidence of delirium after free flap reconstruction surgery for head and neck cancer in elderly patients was 24.3% (75/309). Multivariate Logistic regression analysis showed that male gender ( OR=2.802, P=0.005), perioperative sleep disturbances ( OR=7.104, P<0.001), and moderate-to-severe postoperative pain ( OR=6.903, P<0.001) were risk factors for postoperative delirium. Conclusions:Male gender, perioperative sleep disturbances, and moderate-to-severe postoperative pain are independent risk factors for delirium in these patients.

Objective To explore and compare the clinical effects of pregnant women with liver cirrhosis after hepatitis in cesarean section between general anesthesia and single spinal anesthesia.Methods Clinical data of pregnant women of 35,including compensated cirrhosis 26 cases,decompensated cirrhosis 9 cases,aged 24-45 years,weighing 55-98 kg,falling into ASA Ⅱ or Ⅲ,were divided into group A (general anesthesia group,n=15) and B (single spinal group,n=20).In patients of group A,propofol were infused at 1.5 mg/kg till the time for fetal delivery,after intubation,followed by infusion of remifentanil at a rate of 0.2 μg·kg-1·min-1 TCL combined with propofol until the end of operation.In group B,the puncture was performed at L3-4 interspace,following by intrathecal injection of ropivacaine 10~15 mg and within 10 seconds.With liver cirrhosis after hepatitis were collected and analyzed,retrospectively.Preoperative general status,blood loss and time of operation,Apgar score of neonates compared and analyzed in groups A and B.And the changes of hepatic function and coagulation function of the body under different anesthesia methods were also studied.The influential factors of postoperative elevation of hepatic function were analyzed by non-conditional logistic regression models.Results Blood loss and time of operation,Apgar score of neonates and postoperative hospital stay had no significant differences between the two groups.Postoperative albumin of group A was higher than that of preoperative,with a statistical significance (P<0.05).Alanine aminotransferase,aspartate aminotransferase of postoperative of group B were increased,with a statistical significance (P<0.01).Logistic analysis showed that the type of anesthesia was the possible influencing factor of postoperative elevation of total bilirubin (OR=12.04,95%CI 1.14-127.45).Conclusion The negative effect of single spinal anesthesia on hepatic function more than that of general anesthesia in pregnant women with liver cirrhosis in cesarean section.

Objective To understand the current situation of the learning motivation of continuing nursing education in the clinical nurses in order to provide the reference for improving the quality of continuing nursing education .Methods Three hundred and seventy-eight nurses were surveyed by the questionnaire about Chinese Education Participation Scale in one grade a tertiary general hospital in Changchun .Results The average score of the learning motivation in nurses was (3.08 ±0.69), and the score of professional development dimension was highest (3.58 ±0.77), and the score of escape/stimulation dimension was lowest (2.44 ± 0.80).The differences in the learning motivation were found in the different age , degree, title, position, marriage, working time ( t =2.946, 5.515, 6.918, 2.025, 3.548, 5.797, respectively;P <0.05 ). Conclusions The learning motivation of continuing nursing education in the clinical nurses is at medium level . The management should carry out the targeted continuing nursing education according to the different nurses ’ characteristic , and stimulate the enthusiasm of learning so as to improve the quality of continuing nursing education .