ObjectiveTo summarize and share the surgical nursing experiences for hybrid procedures in the treatment of congenital heart disease with diminished pulmonary blood flow and aortopulmonary collateral arteries (APCA). MethodWe retrospectively analyzed the clinical data, including nursing problems, interventions and outcomes, of 15 patients with congenital heart disease with diminished pulmonary blood flow and APCA treated between May 2011 and February 2012. ResultsAll operations were completed successfully with effective nursing interventions. No complications like low cardiac output syndrome, lung over-perfusion, vital organ dysfunction, neuropsychological disorder, or systemic infection were noticed. ConclusionsHybrid procedure in the treatment of congenital heart disease with diminished pulmonary blood flow and APCA with complex surgical procedures, intraoperative variables and high surgical risks requires multi-disciplinary collaboration. Effective surgical nursing intervention is important to ensure the successful completion of surgery, and reduce possible complications.
ObjectiveTo assess the effect of polyurethane gelatum grommet positioning and Mayfield head holder positioning under suboccipital retrosigmoid approach in acoustic neuroma resection on patients' facial crushing. MethodsRetrospective analysis of the clinical and nursing data of 90 patients treated by microsurgical surgery under the lateral prone position in our hospital from January 2013 to January 2014 was carried out. Patients in group A (n=28) were given grommet positioning, while those in group B (n=62) were given Mayfield head holder positioning, and then we compared the situation of facial crushing between the two groups. ResultsIn group A, 5 patients showed abnormality including 2 cases of skin injury in lower frontozygomatic and mandibular area, 2 cases of lower conjunctival edema and 1 of co-existing skin injury in lower zygomatic area and lower conjunctival edema, and the crushing rate was 17.86% in group A. In group B, the crushing rate was 1.61% with one case of mandibular skin injury. There was a significant difference between the two groups (χ2=5.778, P=0.016). ConclusionUnder suboccipital retrosigmoid approach for acoustic neuroma resection, Mayfield head holder positioning is better to avoid facial crushing.
Objective To explore the emergence agitation resulting from postoperative indwelling urethral catheters in patients of thoracic surgery. Methods In this prospective cohort study, we recruited 140 patients who were scheduled for thoracic surgery under general anesthesia in West China Hospital from January through April 2014. These patients were divided into two groups including a control group and a trial group with 70 patients in each group. The patients in the control group had indwelled urethral catheter routinely. The catheter removed after the surgery at operation room in the trial group. Intraoperative urinary volume, emergence agitation (EA) occurrence, postoperative urinary retention, and urethral irritation were recorded. Results There was no statistical difference in postoperative urinary retention rate between the control group and the trial group (1.43% vs. 2.86%, P=0.230). However, the urethral irritation rate in the control group was significantly higher than that in the trial group (12.86% vs. 0.00%, P=0.012) . And there was a statistical difference in adverse event rate (2.86% vs. 0.00%, P=0.039) between the two groups. There was a significantly higher incidence of urethral irritation in male patients (20.51%, 8/39) than female patients (3.23%, 1/31, P=0.033).The rate of EA in the control group was significantly higher than that in the trial group (28.57% vs. 12.86%, P=0.010). There was a significantly higher EA rate in the patients who had urethral irritation by postoperative indwelling catheters compared with those without indwelling catheters (45.00% vs. 12.86%, P=0.043). Conclusion This study suggests that postoperative EA is a result from urethral irritation than local pain, and the EA rate can be decreased by removal of catheter before anaesthetic recovery.