Although the incidence of gastrointestinal hemorrhage after cardiac surgery is low, the mortality rate is high. Early detection and diagnosis of gastrointestinal hemorrhage are difficult. The high risk phases including preoperation, intraoperation and postoperation. Preoperative high risk comorbidities include gastrointestinal ulcer, hypertension, coronary heart disease and chronic renal failure. Intraoperative high risk factors include decreased gastrointestinal blood perfusion due to cardiopulmonary bypass, inflammatory factors releasing, coagulation disorders, and thrombosis. Postoperative high risk factors include hypotension, low cardiac output, prolonged mechanical ventilation, etc. This article retrospectively summarized high-risk factors and pathogenesis of gastrointestinal hemorrhage after cardiac surgery, in order to improve prevention and treatment of gastrointestinal hemorrhage.
Objective
To explore how to integrate the various sources of information in designing an evidence-based nursing care plan for preventing gastrointestinal hemorrhage (GIH) after pancreaticoduodenectomy (PD).
Method
Papers and references about prevention of GIH after PD were searched between September and October 2015, and an evidence-based nursing care plan was drawn up and implemented from November 2015 to January 2016.
Results
A total of 79 papers were found and of which 17 were aviliable. Thirty-nine patients were cared on the basis of the effective project, of whom one was dignosed with GIH on the 3rd postoperative day and the rate of post-PD hemorrhage was 2.6%. All patients were diacharged on the 6th or 7th postoperative day.
Conclusion
Exploring evidences under the guidance of scientific method and applying them to clinical nursing can prevent post-PD hemorrhage and improve life quality of patients.
ObjectiveTo investigate the relationship between chronic obstructive pulmonary disease (COPD) and respiratory failure in patients with upper gastrointestinal bleeding and recent prognosis.
MethodsWe retrospectively analyzed the clinical data of 73 patients with COPD and respiratory failure treated from February 2009 to May 2011. The patients were assigned to the observing group (n=33) and control group (n=40). General characteristics, improvement rates, mortality rates, lengths of hospital stay, endotracheal tube rates and arrhythmia rates were compared between the two groups.
ResultsAge, sex, and medical history of the patients were similar in both groups (P>0.05). Compared with the control group, the improvement rate was lower (P<0.001), the mortality rate (P<0.001), length of hospital stay (P<0.001), endotracheal tube rate (P<0.05) and arrhythmia rate (P<0.05) were all higher in the observing group after treatment.
ConclusionUpper gastrointestinal bleeding is a high risk factor for short-term prognosis patients with COPD and respiratory failure.
