Background Total knee arthroplasty （TKA） is an important therapy for the treatment of various late-stage knee diseases. However, it has been observed that patients have lower hemoglobin （HB） counts postoperatively...Background Total knee arthroplasty （TKA） is an important therapy for the treatment of various late-stage knee diseases. However, it has been observed that patients have lower hemoglobin （HB） counts postoperatively, which are significantly inconsistent with the measured blood loss. Although the concept of hidden blood loss has been presented in 2000, very little clinical attention has been paid since then. In this study, we investigated the characteristics and influential factor of hidden blood loss after TKA in treating knee osteoarthritis.展开更多
Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or anas-tomosis.Providing enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challengi...Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or anas-tomosis.Providing enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challenging,especially for those with discontinuity of the bowel.Here,we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3.Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed.Postoperatively,the patient was transferred to our trauma center for septic shock and hyperbilirubinemia.Following salvage resuscitation,damage control lapa-rotomy with open abdomen was performed for abdominal sepsis,and a temporary double enterostomy(TDE)was created where the anastomosis was ruptured.Given the TDE and high risk of malnutrition,multiple portions EN were performed,including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube.Besides,chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube.Hyperbilirubinemia was alleviated with the increase in chyme reinfusion.After 6 months of home EN and chyme reinfusion,the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet.For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen,the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.展开更多
目的检索并总结儿童造血干细胞回输护理的最佳证据。方法检索BMJ Best Practice、英国国家卫生与临床优化研究所、美国国立指南网、国际指南协作网、苏格兰校际指南网、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、UpToDate、...目的检索并总结儿童造血干细胞回输护理的最佳证据。方法检索BMJ Best Practice、英国国家卫生与临床优化研究所、美国国立指南网、国际指南协作网、苏格兰校际指南网、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、UpToDate、CINAHL、Embase、PubMed、中国知网、万方数据库、维普网等中英文数据库及相关网站中关于儿童造血干细胞回输护理的临床决策、指南、推荐实践、证据总结、系统评价、专家共识等,检索时限为建库至2023年3月。由2名研究者独立进行文献质量评价、确定纳入文献,逐条提取证据内容并对证据进行翻译、整理与汇总。结果共纳入文献9篇,其中临床决策2篇,专家共识2篇,指南4篇,证据总结1篇。从患儿准备、干细胞准备、物品准备、回输中护理、回输后护理、评估与教育6个方面,最终纳入24条证据。结论儿童造血干细胞回输护理的最佳证据总结涉及面广,管理者及临床医护人员应结合具体医疗情境进行证据的应用,以期安全合理地进行造血干细胞回输。展开更多
Purpose: The aim of the study was to evaluate the feasibility of a new venous-thrombus aspiration and autologous blood(auto-blood) reinfusion system.Materials and methods: We constructed the venous model from polyviny...Purpose: The aim of the study was to evaluate the feasibility of a new venous-thrombus aspiration and autologous blood(auto-blood) reinfusion system.Materials and methods: We constructed the venous model from polyvinyl chloride(PVC) tubes and three-way unions using a fresh clot of chicken blood as the venous thrombus. Eight French and 12 F aspiration catheters were used to aspirate the thrombus in the right–pulmonary-artery model, 8 French and 14 F aspiration catheters were used in the inferior–vena cava model, and 8 French and 10 F aspiration catheters were used in the left-–iliofemoral-vein model. A thrombus filtration and auto-blood reinfusion bottle was used to filter the thrombus and re-infuse auto-blood. We evaluated the thrombus aspiration capability of each catheter by comparing preaspirated with the post-aspirated thrombus volume, and we evaluated the difference in aspiration capability between the two catheters in each model by comparing their thrombus aspiration rates. We used Student’s t-test for statistical analysis.Results: Differences between pre-aspirated and post-aspirated thrombus volumes for each catheter were insignificant, as were those between the thrombus aspiration rates of the two catheters in each venous model. Using the thrombus aspiration and auto-blood reinfusion system, each aspiration catheter could fluently aspirate the thrombus out of the venous model.Conclusion: In this study, we designed a new venous-thrombus aspiration system. This system could be used to aspirate acute venous thrombi and re-infuse autologous blood.展开更多
<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>...<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.展开更多
文摘Background Total knee arthroplasty （TKA） is an important therapy for the treatment of various late-stage knee diseases. However, it has been observed that patients have lower hemoglobin （HB） counts postoperatively, which are significantly inconsistent with the measured blood loss. Although the concept of hidden blood loss has been presented in 2000, very little clinical attention has been paid since then. In this study, we investigated the characteristics and influential factor of hidden blood loss after TKA in treating knee osteoarthritis.
基金Grants from the National Natural Science Foundation of China(Grant No.82270587)the Jinling Hospital Scientific Research Project(Grant No.YYZD2021011).
文摘Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or anas-tomosis.Providing enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challenging,especially for those with discontinuity of the bowel.Here,we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3.Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed.Postoperatively,the patient was transferred to our trauma center for septic shock and hyperbilirubinemia.Following salvage resuscitation,damage control lapa-rotomy with open abdomen was performed for abdominal sepsis,and a temporary double enterostomy(TDE)was created where the anastomosis was ruptured.Given the TDE and high risk of malnutrition,multiple portions EN were performed,including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube.Besides,chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube.Hyperbilirubinemia was alleviated with the increase in chyme reinfusion.After 6 months of home EN and chyme reinfusion,the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet.For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen,the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.
文摘目的检索并总结儿童造血干细胞回输护理的最佳证据。方法检索BMJ Best Practice、英国国家卫生与临床优化研究所、美国国立指南网、国际指南协作网、苏格兰校际指南网、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、UpToDate、CINAHL、Embase、PubMed、中国知网、万方数据库、维普网等中英文数据库及相关网站中关于儿童造血干细胞回输护理的临床决策、指南、推荐实践、证据总结、系统评价、专家共识等,检索时限为建库至2023年3月。由2名研究者独立进行文献质量评价、确定纳入文献,逐条提取证据内容并对证据进行翻译、整理与汇总。结果共纳入文献9篇,其中临床决策2篇,专家共识2篇,指南4篇,证据总结1篇。从患儿准备、干细胞准备、物品准备、回输中护理、回输后护理、评估与教育6个方面,最终纳入24条证据。结论儿童造血干细胞回输护理的最佳证据总结涉及面广,管理者及临床医护人员应结合具体医疗情境进行证据的应用,以期安全合理地进行造血干细胞回输。
文摘Purpose: The aim of the study was to evaluate the feasibility of a new venous-thrombus aspiration and autologous blood(auto-blood) reinfusion system.Materials and methods: We constructed the venous model from polyvinyl chloride(PVC) tubes and three-way unions using a fresh clot of chicken blood as the venous thrombus. Eight French and 12 F aspiration catheters were used to aspirate the thrombus in the right–pulmonary-artery model, 8 French and 14 F aspiration catheters were used in the inferior–vena cava model, and 8 French and 10 F aspiration catheters were used in the left-–iliofemoral-vein model. A thrombus filtration and auto-blood reinfusion bottle was used to filter the thrombus and re-infuse auto-blood. We evaluated the thrombus aspiration capability of each catheter by comparing preaspirated with the post-aspirated thrombus volume, and we evaluated the difference in aspiration capability between the two catheters in each model by comparing their thrombus aspiration rates. We used Student’s t-test for statistical analysis.Results: Differences between pre-aspirated and post-aspirated thrombus volumes for each catheter were insignificant, as were those between the thrombus aspiration rates of the two catheters in each venous model. Using the thrombus aspiration and auto-blood reinfusion system, each aspiration catheter could fluently aspirate the thrombus out of the venous model.Conclusion: In this study, we designed a new venous-thrombus aspiration system. This system could be used to aspirate acute venous thrombi and re-infuse autologous blood.
文摘<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.
