1.
Clinical efficacy of comprehensive nursing in patients with cerebral hemorrhagic hemiplegia
Wang Z, Pan J, Wang L, Chen P
American journal of translational research. 2021;13(5):5526-5532
Abstract
OBJECTIVE To explore the clinical efficacy of comprehensive rehabilitation nursing (CRN) intervention in patients with cerebral hemorrhagic hemiplegia (CHH). METHODS A total of 102 patients with CHH admitted to our hospital were selected for the prospective study. The patients were randomly divided into the control group (n=51) and the observation group (n=51) according to the random number table method. Routine nursing was performed in the control group, while CRN was conducted in the observation group. Fugl-Meyer motor function assessment scale, activity of daily living scale (Barthel index), self-rating anxiety scale (SAS), complications and muscle strength improvement (Brunnstrom assessment) were compared between the two groups. RESULTS Compared with those before nursing, Fugl-Meyer score, Barthel index and SAS score in the two groups after nursing were significantly improved (P<0.01). Fugl-Meyer score and Barthel index of the observation group were significantly higher than those of the control group after nursing, while SAS score showed the opposite change (P<0.001). The incidence of complications in the control group was 49.02%, and that in the observation group was 29.41% (P<0.05). The rate of muscle strength improvement in the observation group was 80.39% after nursing, which was significantly higher than that in the control group (60.78%; P<0.05). CONCLUSION CRN intervention has a positive clinical efficacy in patients with CHH. It can enhance motor ability, improve the ability of daily life, amend psychological mood and reduce the incidence of complications.
2.
Better Treatment Values in Local Application of Tranexamic Acid (TXA) than Intravenous Application with the Same Dose in Total Hip Arthroplasty
Zhang X, Ma D, Wen L, Pan J
Advances in therapy. 2020
Abstract
INTRODUCTION The aim of our study was to investigate the hemostatic effect of local and intravenously administered tranexamic acid (TXA) at the same dose in total hip arthroplasty. METHODS The prospective study included 72 patients who underwent total hip arthroplasty in our hospital between March 2018 and March 2019. The patients enrolled in the study were randomly divided into two groups: the observation group (36 patients were injected with 2.0 g TXA in 10 mL 0.9% NaCl using the joint cavity drainage tube after suturing the joint capsule) and the control group (36 patients were given an intravenous infusion of 2 g TXA in 200 mL 0.9% NaCl 30 min before the operation). In each patient, apparent blood loss, hidden blood loss, average blood transfusion, and the number of cases receiving blood transfusion were compared between the two groups after treatment. Hematocrit (Hct) and hemoglobin (Hb) levels were recorded at postoperative day (POD) 1, 2, 3, 7, and 10. We also recorded the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) before the operation and 12 h postoperative and POD 1, 3, 7, and 10. The incidence of deep venous thrombosis and pulmonary embolism was also taken into account. RESULTS In the observation group, apparent blood loss, hidden blood loss, average blood transfusion volume, and the number of patients receiving blood transfusion were lower compared than the control group (P < 0.001). The levels of Hct and Hb were compared between the two groups at POD 1, 2, 3, 7, and 10, and the observation group reported higher levels of Hct and Hb (P < 0.001). The levels of CRP and IL-6 were compared between the two groups at POD 1, 3, 7, and 10, and the observation group reported lower levels of CRP and IL-6 than the control group (P < 0.001). On POD 7, there was no pulmonary embolism in both groups, and no significant difference was observed in the incidence of deep venous thrombosis between the two groups (P > 0.05). CONCLUSIONS Local and intravenous applications of TXA at the same dose are effective approaches in terms of reducing bleeding and inflammatory reaction with a good safety profile; however, the effect of local application had superior therapeutic values.
3.
Effects of Different Applications of Tranexamic Acid on Perioperative Blood Transfusion Rate and Postoperative Pain in Unilateral Total Knee Arthroplasty
Zhang X, Ma D, Pan J, Wen L
Advances in therapy. 2020
Abstract
INTRODUCTION The current study was conducted to evaluate the effect of different applications of tranexamic acid (TXA) on perioperative blood transfusion rate and postoperative pain in unilateral total knee arthroplasty. METHODS This prospective study included a total of 102 patients undergoing unilateral total knee arthroplasty in our hospital from November 2017 to October 2019. On the basis of different TXA administration methods, these patients were randomly assigned to a surface treatment group (50 cases were treated with intraoperative spraying and drug-soaked gauze to cover the wound combined with local injection into the articular cavity) and control group (52 cases were given TXA by intravenous drip combined with local injection into the articular cavity) by random number table method. Clinical data were recorded and evaluated in the two groups. A total of five surgeons participated in the study. RESULTS In the surface treatment group, the operation time, hospital stay, tourniquet time, and blood transfusion rate were significant lower compared with the control group, and there was no significant difference in the incision length between the two groups. Our results showed that intraoperative blood loss, postoperative drainage, postoperative blood loss, total blood loss, and the incidence of deep venous thrombosis in the surface treatment group were significantly lower than those in the control group. Our results demonstrated that the surface treatment group reported significantly lower degree of pain compared with the control group at 1 day and 3 days after the operation. However, 7 days after the operation, the degree of pain in the surface treatment group did not differ significantly from that in the control group. In addition, the results of blood coagulation indexes showed that the values of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer (D-D), and hemoglobin (HGB) in the surface treatment group did not differ significantly from those in the control group before the operation (P > 0.05). CONCLUSION In terms of applications of TXA, the method of intraoperative spraying and drug-soaked gauze covering the wound combined with local injection into the articular cavity can reduce the amount of bleeding and the rate of blood transfusion, and alleviate the degree of pain with high safety profile.