Postoperative gastrointestinal disorder (POGD) was a common complication after surgery under anesthesia. Strategies in combination with Traditional Chinese Medicine and Western medicine showed some distinct effects but standardized clinical practice guidelines were not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center/Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University, was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients' preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations included disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.
目的 探讨复方苦参注射液联合六味补气方对肿瘤患者癌因性疲乏(cancer-related fatigue,CRF)的临床疗效.方法 选取2022年1-8月安徽中医药大学第一附属医院气虚型恶性肿瘤伴CRF患者60例,随机分为对照组和观察组,每组30例.对照组采用常规治疗,观察组采用常规治疗联合复方苦参注射液和六味补气方治疗,治疗1个疗程(7d),比较治疗前后两组生活状况、疲乏状况和中医证候评分.结果 60例患者中男32例,女28例,年龄28～83岁,平均(62.9±1.5)岁.与治疗前相比,治疗后观察组生活状况评分较高[(71.00±7.59)分比(60.00±7.88)分]、疲乏状况评分[(2.73±0.69)分比(5.73±0.98)分]和中医证候评分[(5.03±1.21)分比(16.80±1.18)分]较低,差异均有统计学意义(P＜0.05).治疗后与对照组相比,观察组生活状况评分较高[(71.00±7.59)分比(62.00±6.64)分]、疲乏状况评分[(2.73± 0.69)分比(5.53±0.94)分]和中医证候评分[(5.03±1.21)分比(15.40±1.37)分]较低,差异均有统计学意义(P＜0.05).结论 复方苦参注射液联合六味补气方可以有效减轻肿瘤患者的CRF程度,改善患者身体状况,提高生活质量.
Objective To explore the status and influencing factors of postoperative anxiety in patients undergoing non-cardiac surgery.Methods A total of 299 non-cardiac surgery patients from Beijing Chaoyang Hospital,Capital Medical University from August 2019 to January 2020 were selected,the perioperative data were collected,and multivariate logistic regression equation was used to analyze the influencing factors of postoperative anxiety in patients undergoing non-cardiac surgery.Results Among the 299 patients,there were 134 males and 165 females,aged from 20 to 85 years,with an average age of(55.2±14.0)years.The incidence of postoperative anxiety was 12.70％(38/299).Multivariate logistic regression analysis showed that preoperative anxiety(OR=5.512,95％CI:2.206-13.776,P=0.001),preoperative depressive symptoms(OR=3.523,95％CI:1.436-8.644,P=0.006)and first day postoperative pain(OR=1.405,95％CI:1.125-1.756,P=0.003)were risk factors for postoperative anxiety in patients undergoing non-cardiac surgery.Conclusions In non-cardiac surgery,pre-screening and intervention for patients with preoperative anxiety and depression,and actively relieving postoperative pain can significantly reduce the incidence of postoperative anxiety.
Objective To explore the clinical observation of multi-frequency vestibular function examination for rehabilitation evaluation of vestibular neuritis(VN).Methods A total of 25 atients with unilateral acute VN in the Second Affiliated Hospital of Henan University of Science and Technology from July 2021 to February 2022 were selected.Temperature test(CT),velocity step test(VST),video head impulse test(video impulse test,vHIT)and dizziness handicap inventory(DHI)were used to evaluate the vestibular function of patients at admission,one month and three months after medications and vestibular rehabilitation training.Results There were 20 males and five females among the 25 patients,aged from 18 to 76 years,with an average age of(46.9±4.9)years.The highest abnormal rate was DHI(100.00％),followed by vHIT(96.00％)and CT(96.00％),and VST(84.00％)was the lowest before treatment.The effective rates of CT(52.00％,88.00％)and VST(48.00％,80.00％)were higher than those of vHIT(16.00％,56.00％)and DHI(20.00％,60.00％)after rehabilitation treatment for one month and three months,and the differences were statistically significant(P＜0.05).Conclusions CT,VST,vHIT and DHI are of great significance in the clinical evaluation of VN patients during the rehabilitation period,among which CT and VST are more effective in evaluating long term rehabilitation of VN vestibula function.The different vestibular rehabilitationin results of the process of the four tests can be used as a complement.
Objective To explore the status and influencing factors of complications after cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)for pseudomyxoma peritonei(PMP).Methods A total of 344 patients who were transferred to intensive care unit(ICU)after CRS combined with HIPEC in Peking University Aerospace Center Hospital from May 2015 to December 2022 were selected.The grading situation of postoperative complications were analyzed according to the Clavien-Dindo classification system,and the influencing factors of postoperative complications were analyzed by multivariate logistic regression equation.Results Among the 344 patients,there were 110 males and 234 females,aged from 32 to 85,with a median age of 61(54,68)years old.A total of 133 patients(38.7％)developed at least one complication during hospitalization,including 42 cases of pulmonary infection(12.2％),41 cases of abdominal infection(11.9％)and 31 cases of intestinal fistula(9.0％).There were 209 complications in 133 patients,including 3.8％(8/209)of grade Ⅰ,53.1％(111/209)of grade Ⅱ,43.1％(90/209)of serious complication(≥ Ⅲ a).Logistic regression analysis showed that patients with history of chronic lung disease(OR=6.410,95％CI:2.037-20.408,P=0.001)and CRS history(OR=3.425,95％CI:2.004-5.848,P＜0.001),and high-grade tumor pathologic classification(OR=1.704,95％CI:1.007-2.882,P=0.047)had higher risk of postoperative complications after CRS and HIPEC.Conclusions PMP patients with CRS+HIPEC has a higher incidence of postoperative serious complications which should be alert to the occurrence of postoperative complications in PMP patients with chronic lung diseases,CRS history and high-level pathological classification of tumors.
