ObjectiveTo evaluate the quality of life of residents in stricken area five years after Wenchuan earthquake, so as to explore the main influential factors such as gender, age, ethnic group, marriage status and the extent affected by the earthquake. MethodsUsing WHOQOL-BREF, 500 residents from Hanyuan county in Sichuan province were assessed in order to analyze their life quality and related factors. ResultsThe score on the overall WHOQOL-BREF and the level of each factor were significantly lower than the score on the normal people (P < 0.001). Male score in the factor of social relations significantly higher than female (t=3.963, P < 0.001). The overall score and the score of social factor were significantly lower in the minor than in the adults (t=-2.667, P < 0.01; t=-19.287, P < 0.001). And the quality score of social relationship was significantly lower in the single than in the married and cohabiting couples (P < 0.001; P < 0.01). ConclusionThe quality of life of residents in stricken area five years after Wenchuan earthquake was significantly lower than the national norm. There are significant differences in terms of gender, age, marriage status and earthquake damage on social relations. Steady intimate relationships with others help improve the quality of life of residents in stricken area. Besides, compared those with average damage or no damage, the residents with serious damage are relatively worse in the overall quality of life as well as environmental conditions.
ObjectiveTo evaluate the effect of postoperative no indwelling urethral catheters in lung operation. MethodsIn this prospective cohort study, we recruited 100 patients who were scheduled for pulmonary lobectomy under general anesthesia in a single institution of Thoracic Surgery Department in West China Hospital between April and December 2014. These patients were divided into two groups including a no indwelled urethral catheter group (NIUC, 50 patients) and an indwelled urethral catheter group (IUC, 50 patients). The clinical effect was compared between the two groups. ResultsThere was no statistical difference in incidence of postoperative urinary retention or urinary tract infection between the two groups (P=0.433, 0.050). However, the comfort degrees(0 degree) of patients in the NICU group was significantly higher than that of the ICU group with a statistical difference (P=0.002). While postoperative hospitalization time in the NICU group (P=0.023) was shorter than that in the ICU group (P=0.004). Prostatic hyperplasia was the high risk factor for the lung postoperative urinary retention (P=0.056). ConclusionPostoperative no indwelling urethral catheters in lung operation has the benefit of improving the comfort degrees of inpatients and increasing the postoperation urinary retention.
ObjectiveTo evaluate the feasibility and efficacy of laparoscopic paravaginal repair (LPVR) for anterior vaginal prolapse in women of child-bearing age. MethodsTotally, 21 patients with anterior vaginal prolapse underwent laparoscopic extraperitoneal vaginal vault suspension between January 2012 and May 2013. Among the 21 patients, 5 were in grade Ⅲ, 15 in grade Ⅱ, and 1 in grade Ⅰ. Under laparoscope, the bilateral white lines and ischial spines were exposed, and then the angle of vaginal fornix was sutured to the ipsilateral ischial spine and the vaginal wall was sutured to the ipsilateral white line. Laparoscopic sacrocolpopexy or Burch or posterior vaginal wall repair was performed as well if necessary. The patients without any subjective symptom were defined as subjective cure and those whose pelvic organ prolapse quantification of anterior vaginal was zero degree were defined as objective cure. ResultsLaparoscopic sacrocolpopexy was performed in 5 patients, Burch in 3, and posterior vaginal wall repair alone in 6. The operation time ranged from 110 to 225 minutes with an average of 155 minutes, and the intraoperative blood loss ranged from 30 to 100 mL with an average of 60 mL. No intraoperative complication occurred. The marking point of pelvic organ prolapse quantitation Aa before and after operation was (1.0±0.4) cm and (-3.0±0.8) cm, and Ba was (1.5±0.4) cm and (-3.0±0.5) cm, and there were significant differences (P<0.01). The patients were discharged from hospital within 5 to 10 days averaging 7 days. The cost of hospitalization was 7 000 to 11 000 yuan, with an average of 8 500 yuan. One patient who felt obstruction of urethra and diffcult urination was improved by keeping indwelling urinary catheter for 7 days. Follow-up was achieved in 21 patients for 10 to 18 months with a mean of 15 months, and 19 of them had subjective cure and 20 of them objective cure. ConclusionLPVR can be successfully completed in anterior vaginal prolapse patients with paravaginal defect with less injury and shorter recovery time.
Objective To investigate the risk factors of postoperative urinary retention of non-small cell lung cancer patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy without indwelling urinary catheterization. Methods In this prospective trial, we recruited 148 patients who were scheduled for lung cancer lobectomy under general anesthesia by VATS in Department of Thoracic Surgery in West China Hospital from July through December 2015. These patients were divided into two groups including a trial group and a control group. There was no indwelled urethral catheter in the trial group. And the patients in the control group were indwelled urethral catheter routinely. Postoperative urinary retention, urinary tract infection, the postoperative hospitalization duration and the clinical data were recorded. Results There was no significant difference between the trial group and the control group in postoperative urinary retention (9.46% vs. 6.76%, P=0.087). However, the ratios of the male patients and the patients with history of abdomen operation, and international prostate symptom score (IPSS) of the urinary retention patients (83.33%, 33.33%, 26.55±7.00) were statistically higher than those of the patients without urinary retention (56.62%, 0.00%, 15.31±8.31, P=0.017, P=0.000, P=0.031). Postoperative urinary tract infection rates in the trial group and the patients with urinary retention (4.05%，25%) were statistically higher than those in the control group and the patients without urinary retention (1.35%, 0.74%, P=0.049, P=0.048). Conclusion The risk factors of postoperative urinary retention patients with non-small cell lung cancer undergoing VATS lobectomy are male patients, history of abdomen operation, and moderate to severe hyperplasia of prostate.
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.
ObjectiveTo determine if comfort level was associated with chest tube size(16F or 28F) among lung cancer patients with video-assisted thoracoscopic surgery (VATS) lobectomy. MethodsWe performed VATS lobectomy for 163 patients with lung cancer in our hospital between February and May 2014. There were 70 males 93 females. The patients were allocated into two groups including a 28F group and a 16F group. There were 75 patients at age of 53.18±14.73 years with insertion of one chest drain of 28F in the 28F group. And there were 88 patients at age of 56.62±12.62 years with insertion of one chest drain of 16F in the 16F group. Heart rate and variation of pulse, breathing rate and variation of breathing rate, pain scores, comfort level, and activities daily living (ADL) of the two groups were compared. ResultsThere was no significant difference in the patient characteristics and operation data between the two groups. There were statistical differences in variation of heart rates on the 1st day, 2nd day, and 3rd day after operation between the 16Fgroup and the 28F group (9.67±3.33 times/min vs.18.54±5.33 times/min, P=0.037; 7.89±2.88 times/min vs. 19.01±4.67 times/min, P=0.045; 7.67±3.01 times/min vs. 20.88±5.34 times/min, P=0.021). The percentage patients of mild pain in the 16F group (77.65%) was higher than that in the 28F group (49.78%, P=0.023) with a statistical difference. The independent ambulation and comfort level in the 16F group(67.05%, 67.05%) were significant higher than those in the 28F group (45.78%,55.11%, P=0.023, P=0.026). ConclusionOur findings suggest that drainage via a small-bore chest tube provides meaningful postoperative comfort level in the patients with VATS lobectomy.
Objective To explore the advantages of postoperative chest drainage with 16F urinary catheter for video- assisted thoracoscopic surgery (VATS) lobectomy. Methods Data of 102 patients (October to December 2015) who under- went VATS lobectomy of lung disease with insertion of catheter (16 F urinary catheter or 28 F chest tube) were analyzed. The patients were divided into two groups including a 16F group (49 patients, with 16 F urinary catheter) and a 18F group (53 patients, with 18F chest drainage tube).The following post-operative data were evaluated: primary healing of tube inci- sion, chest X ray abnormalities (pneumothorax, pleural effusion, subcutaneous emphysema, and hematoma), drainage time, re-insert the drainage tube, and wound healing at the site of insertion. Results Both groups were similar in age, gender, co-morbidity and pathological evaluation of resected specimens. After adjustment, no statistically significant difference was found between the two groups in pulmonary complications (30.6% vs. 28.3%, P=0.102), subcutaneous emphysema (60.0% vs. 6.7%, P=0.011), required intervention (2.0% vs. 5.7%, P=0.048). The average total drainage volume in the 16F group (587.3±323.7 ml) was less than that of the 28 F group (824.1±444.3 ml, P=0.000). The rate of primary healing at the site of insertion in the 16 F group (100.0%) was higher than that in the 28F group (58.5%, P=0.014). A significant difference was found in the drainage time and post-operative length of stay between the two groups (54.2±28.6 h vs. 95.6±65.5 h，4.2±1.4 d vs. 6.5±3.0 d). Conclusion Since 16F urinary catheter has advantage in fast track rehabilitation and low risk of pulmonary complications, the use of 16F urinary catheter is appropriate after VATS pulmonary lobectomy.
Objective To evaluate the advantages of perioperative painless indwelling urethral catheters in lobectomy of lung cancer. Methods We recruited 133 patients who were scheduled for lung cancer lobectomy under general anesthesia in Department of Thoracic Surgery in West China Hospital from April through December 2014. These patients were divided into two groups including a control group (68 patients) and a trial group (65 patients). The trial group was painless indwelled urethral catheter, and the control group was indwelled urethral catheter routinely. The clinical effectiveness between the two groups was compared. Results The rates of emergence agitation (EA) occurrence and urinary tract infection in the trial group (10.77%, 9.23%) were reduced than those in the control group (26.47%, 26.47%) with statistical differences (P=0.022, P=0.047). And the rate of comfort level (0 degree) of the patients in the trial group (87.69%) was significantly increased than that in the control group (48.53%, P=0.001). And postoperative hospitalization duration in the trial group (5.00±1.60 d) was shorter than that in the control group (6.48±3.14 d, P=0.004). Conclusion Perioperative painless indwelling urethral catheters in lobectomy of lung cancer has benefit of improving the comfort level of the patients and promoting fast-track rehabilitation in the patients with lung cancer.
Objective To investigate the present situation and effect of public health education based on WeChat platform in a first class of the third grade hospital in Sichuan province. Methods We designed the patient/relative health education questionnaire by literature reading and analysis, and expert consultancy. Then according to the inclusion and exclusion criteria, from April to December 2015, the questionnaire was used to investigate inpatients and their relatives in departments within the WeChat platform including the Department of Endocrinology, International Health Care Center, Department of Gastrointestinal Surgery, Department of Thoracic Surgery, and Department of Dermatovenereology. Results There were 5 WeChat public accounts in the hospital, and the average running days was 177.2, the average number of subscription was 2 974, and the average number of pushed messages was 30. A total of 289 patients/relatives were surveyed, among whom 137 subscribed to the WeChat public account. The investigation results showed that 54.02% of the responders were university or college graduates, most of whom had stable jobs (civil servants: 12.41%, factory workers: 13.87%, medical staff: 9.49%, teachers: 7.30%, IT workers: 6.57%), and had a longer disease course averaging 4.5 years. Among the respondents, 87.59% came to know the WeChat public account through the publicity work by the hospital departments where they stayed, 30.66% thought it was very helpful and 63.50% considered it to be useful, and 47.45% read WeChat messages every day. They admitted that it was convenient and could be found at any time (63.50%, 66.42%), but the drawback was online communication with health educators was not integrated in the platform (54.74%). Conclusions Health education WeChat platform is effective to give health education to the patients and their relatives, but there are also some shortcomings. More functions should be integrated in order to provide comprehensive health education knowledge to the patients.