Objective To investigate the effects of cryoanalgesia for post-thoracotomy pain on the intercostal nerves. Methods Two hundred and eight patients suffering from thoracotomy were divided into three groups, according to different analgesia received respectively. Cryoanalgesia group （n = 80）： cryoanalgesia on the intercostal nerves, intercostals nerves was freezed at -55 ℃ for 90 seconds ; patient controlled analgesia by vein （PCA group, n= 80）： patient controlled analgesia was practiced intravenously, and control group （n = 48）： Dolantin given irregularly intra-muscularly and/or tramadol orally. Severity of pain was graded by visual analogue scale. Forced expiratory volume in one second（FEV1.0） was measured and pulmonary complication after operation was compared. Results There was a statistically significant improvement in postoperative pain scores and an improvement in respiratory function tests for patients in cryoanalgesia group（X2 = 74.93,15.04,P〈0. 05）. FEV1.0 in cryoanalgesia group was significantly higher than that in control group（1. 97±0.27L vs. 1. 39±0. 14 L,P〈0. 05）. Pulmonary complication in cryoanalgesia group after operation was lower than that in control group （6. 25% vs. 31. 25%, P〈0. 05 ）, Conclusion Cryoanalgesia on post-thoracotomy pain is very effective and may improve the respiratory function after operation.
Objective To investigate the suicide related factors of the teenagers after trauma and further discuss the prevalence and related factors of suicide idea plan and behavior. Methods Using the general information questionnaire and the Youth Risk Behavior Survey (YRBS) to investigate the primary and secondary students in the nine worst-hit areas in Wenchuan earthquake of 2008, with cluster random sampling and the class as a sampling unit, to extract random 110 primary and middle schools and gather their general information, disaster-related cases and scores of suicide in YRBS. According to the different types of data, we used descriptive statistics,t test,Chi square test and Logistic regression analysis and respectively use single factor analysis and multivariate logistic regression analysis for suicide idea, plan and behavior. Results A total of 7 833 questionnaires were sent out and a total of 7 521 questionnaires were collected and the recovery rate was 96. 02%. Among them, there were 6 875 valid questionnaires (91.41%) and 636 invalid questionnaires. According to the investigation, the prevalence of the primary and secondary students which had seriously considered suicide was 6. 90%, which had a plan to commit suicide was 4.00% and which tried to take over the action of suicide was 2.70%. With general information for the independent variable, logistic regression analysis showed that whether there had seriously considered suicide as the dependent variable: age (OR=1.178, 95%CI 1.098 to 1.178) and changed in family structure after the earthquake (OR=1.360, 95%CI 1.360 to 1.085) were risk factors for post disaster the teenagers with suicide idea; whether there had been plan to commit suicide as the dependent variable: age (OR=1.099, 95%CI 1.050 to 1.150), the history of being buried in ruin (OR=2.155, 95%CI to 1.104 to 4.205) and changed in family structure after the earthquake (OR=1.495, 95%CI 1.128 to 1.981) were risk factors for post disaster the teenagers with suicide plan; whether took over the action of suicide as the dependent variable: male (OR=1.513, 95%CI 1.122 to 2.039) and changed in family structure after the earthquake (OR=1.555, 95%CI 1.112 to 2.175) were risk factors for post disaster the teenagers with suicide behavior. Conclusion Age and changed in family structure after the earthquake were the risk factors for suicide idea and age was positively correlated with suicidal idea. Age, had the history of being buried in ruin and changed in family structure after the earthquake were the risk factors for suicide plan and age was positively associated with suicide plan. Male and changed in family structure after the earthquake were the risk factors for suicide behavior. Among them, changed in family structure after the earthquake was the common risk factor. So there should be targeted psychological assessment and psychological rehabilitation intervention to avoid the risk of suicide among the teenagers after the disaster.
Objective To evaluate the mental status of survivors after Wenchuan earthquake, so as to provide relevant information for psychological and medical intervention. Methods Demographic data was recorded and the post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C) was evaluated. The acute stress disorder (ASD) were assessed with the DSM-IV criteria in the survivors from the central earthquake area who are now living in two shelters in Chengdu. Results Among the 780 retrieved questionnaires, 729 baseline registration forms and 450 PCL-C were valid. In the 729 baseline registration forms, male to female ratio was 1:1.31 and the mean age was 36.73±20.82. 9.5% of subjects suffered from physical diseases, 9.7% needed assistance in daily activities, 70.7% were passive and didn’t participate in community activities, 9.1% suffered from severe psychological problems. In the present study, 30.9% of subjects were found to meet the DSM-IV criteria for ASD. 41.3%, 22.2% and 18.4% of subjects had a PCL-C score ≥ 38, ≥ 45 and ≥50, respectively. Consistency check showed there was no significant difference between the screening result of PCL-C score ≥45 and clinical diagnosis (Kappa=0.780, P=0.033). There was significant difference in the age of subjects between ASD and non-ASD groups (Plt;0.05). Conclusion The earthquake survivors suffered from psychological problems after the disaster in the early stage. Thus, in addition to life rescue, we should pay more attention to psychological intervention.
Objective To explore the clinical effect of ventricular septal defect repair and lung allograft (simply as "heart repair and lung transplant") in the treatment of ventricular septal defect complicated with severe pulmonary hypertension. Methods A 21-year-old female patient with ventricular septal defect and severe pulmonary hypertension was treated with cardiopulmonary bypass (CPB) under general anesthesia, and then right lung transplantation was performed, and then left lung transplantation was performed after changing body position. Results The operation was conducted successively. The intraoperative CPB support time was 90 minutes, and the blood loss was 2000 mL. Extracorporeal membrane oxygenation was removed on the second day after operation, the ventilator was evacuated on the third day, and the patient recovered and discharged on the 38th day. Postoperative echocardiography showed significant improvement in pulmonary artery pressure. Conclusion For patients with simple congenital heart disease complicated with severe pulmonary hypertension, "heart repair and lung transplant" can improve their quality of life.