ObjectiveTo assess postoperative analgesia and early rehabilitation of continuous incision infiltration with ropivacaine in open gastrectomy. MethodsFrom June 2011 to October 2014, 50 patients underwent open gastrectomy were divided into two groups:standard analgesic therapy group (Abbreviation:standard group, n=25) and continuous incision infiltration with ropivacaine group (Abbreviation:ropivacaine group, n=25). All the patients were also given patient controlled intravenous analgesia (PCIA). Points of visual analog scale (VAS), Bruggrmann comfort scale (BCS), and nausea and vomiting were assessed at different time during the first 48 hours postoperatively. Total sufentanil dosage, the first postoperative ambulation time, bowel recovery time, postoperative hospital stay, and incision infection rate were compared between two groups. ResultsAt 4 h, 8 h, 16 h, 24 h, 48 h postoperatively, the points of VAS in the ropivacaine group were significantly lower than those in the standard group (P < 0.05), the points of BCS in the ropivacaine group were significantly higher than those in the standard group (P < 0.05). Compared with the standard group, the dosage of sufentanil was significantly less (P < 0.05), the bowel recovery time, the first postoperative ambulation time, and the postoperative hospital stay were significantly shorter (P < 0.05), the point of nausea and vomiting was significantly lower (P < 0.05) at 48 h postoperatively in the ropivacaine group. There was no difference of the incision infection rate between the two groups (P > 0.05). ConclusionContinuous incision infiltration with ropivacaine is effective and safe to relief postoperative pain and accelerate patient's recovery after open gastrectomy.
ObjectiveTo investigate whether the recombinant human growth hormone (rhGH) can promote endothelialization, inhibit vascular intimal hyperplasia, and improve long-term patency rate by the treatment of rhGH after vascular prostheses bypass. MethodsBetween August 2007 and January 2009, 94 patients with lower extremity arteriosclerotic occlusive disease were treated. Among them, 32 patients (34 limbs) who met the selection criteria were enrolled in this study. All cases were randomly divided into study group (16 cases, 18 limbs) and control group (16 cases, 16 limbs). There was no significant difference (P>0.05) in gender, age, disease time, location of lesions, the Trans-Atlantic Inter-Society Consensus (TASC) grade, and basic diseases between 2 groups. The patients with superficial femoral artery disease received above-knee femoro-popliteal prostheses bypass. The patients who had combined abdominal-iliac artery disease received concurrent abdominal-femoral and femoro-popliteal prostheses bypass. Subcutaneous injection of 9 U rhGH was given every night for 7 days in study group, and saline was applied in control group. Ultrasonography was taken after 2 weeks and 3 months of operation to observe the patency and measure the wall thickness of vascular prostheses. ResultsAfter operation, 1 patient of control group died of renal failure caused by acute thrombosis. After 2 weeks, ultrasonography showed no obvious intimal hyperplasia in 2 groups; the wall thickness was (0.13±0.02) cm in study group and (0.15±0.03) cm in control group, showing no significant difference (t=-1.720, P=0.108). After 3 months, the wall thickness was (0.17±0.06) cm in study group and was (0.26±0.09) cm in control group, showing significant difference (t=-2.240, P=0.045). All cases were followed up 36-60 months (mean, 56.4 months). The 5-year primary patency rate was 52.5% in study group and 35.7% in control group, showing no significant difference (χ2=1.470, P=0.225). ConclusionThe rhGH can improve endothelialization in vascular prostheses and can inhibit postoperative vascular intimal hyperplasia in clinical application.
ObjectiveTo compare the risk factors of angina pectoris and atherosclerotic thrombotic cerebral infarction, and to study the possible risk factors of angina pectoris complicated with atherosclerotic thrombotic cerebral infarction (XNHB abbr. in Chinese) and provide the basis for the prevention of XNHB. MethodsClinical epidemiological cross-sectional survey methods were used. Information of angina pectoris patients, atherosclerotic thrombotic cerebral infarction patients and XNHB patients were collected. The statistical software SPSS 17.0 was used to analyze the single risk factors, and then logistic regression analysis was used to filter the independent risk factors of XNHB. Results1 002 cases of angina pectoris, 963 cases of atherosclerotic thormbotic cerebral infaction and 982 cases of XNHB were included. There were significant differences among the three diseases in the following index:age (P=0.000 0), gender (P < 0.000 1), resting lifestyle (P=0.000 0), body mass index (BMI) (P=0.000 0), diabetes (P=0.001 9), hypertension (P < 0.000 1), diabetes complicated with hypertension (P < 0.000 1), smoking (P < 0.000 1), alcohol consumption (P < 0.000 1), and the combination of more than 3 risk factors (P=0.000 0). Age (OR=1.690, 95%CI 1.420 to 2.012), hypertension (OR=1.558, 95%CI 1.312 to 1.850), abnormal BMI (OR=1.356, 95%CI 1.158 to 1.587) and resting lifestyle (OR=1.319, 95%CI 1.107 to 1.572) were shown as the independent risk factors of XNHB filtering by logistic multiple regression analysis. ConclusionThe elderly with hypertension, abnormal BMI or live a resting way of life are more likely to have XNHB, so positive control of risk factors should be needed.