Objective To explore the application effect of the clinical pathway for perianal day surgery based on enhanced recovery after surgery (ERAS) concept. Methods The case data of patients who underwent perianal surgery in the Department of Anorectal Surgery of Gansu Provincial Hospital between January and October 2023 and patients who underwent perianal day surgery based on the ERAS clinical pathway in the Ambulatory Surgery & Chemotherapy Centre of Gansu Provincial Hospital were retrospectively collected. The patients in the Department of Anorectal Surgery were defined as the control group, while the patients in the Ambulatory Surgery & Chemotherapy Centre were defined as the pathway group. The differences in indicators such as hospitalization cost, average hospitalization time, preoperative hospitalization time, surgical time, intraoperative bleeding, patient satisfaction, and postoperative follow-up between the two groups of patients were analyzed. Results A total of 400 patients were included, with 200 in each group. The differences between the two groups in gender and age were not statistically significant (P>0.05), the Visual Analogue Scale of the pathway group was lower than that of the control group (P<0.05), and the Kolcaba Comfort Scale score was higher than that of the control group (P<0.05). The hospitalization cost, average hospitalization time, preoperative hospitalization time, and surgical time of the pathway group were all lower than those of the control group (P<0.05), and there was no statistically significant difference in intraoperative bleeding between the two groups (P>0.05). The satisfaction rates of the pathway group and the control group were 90.5% and 86.0%, respectively, and there was no statistically significant difference between the two groups (P>0.05). The follow-up results showed that perianal day surgery did not increase the discomfort of patients after discharge. Conclusions The clinical pathway for day surgery based on ERAS concept is more conducive to the postoperative recovery of patients undergoing day surgery, reducing medical costs, improving medical quality, and increasing patient satisfaction. It is worthy of clinical promotion and application.
ObjectiveTo compare the recommended medicines of cardiovascular and cerebrovascular diseases guidelines, expert consensus, or diagnosis and treatment specifications with essential medicines from the 2023 World Health Organization Model List of Essential Medicines (WHO-EML) and the 2018 National Essential Medicine List (NEML) in differences and similarities. MethodsSix guideline websites and one association website including Guidelines International Network and National Guideline Clearinghouse, etc. were searched until July 2023. The latest cardiovascular and cerebrovascular diseases guidelines, expert consensus, diagnosis and treatment specifications involving medicine treatment were included, and we extracted the data (year, title, target disease, authors and recommended medicines), and the statistical analysis of recommended medicines included in the WHO-EML and NEML was performed by Excel 2016. ResultsA total of 83 guidelines, expert consensus, and diagnosis and treatment specifications were included, covering cerebrovascular diseases, ischemic heart diseases, hypertensive diseases, chronic rheumatic heart diseases, diseases of arteries, arterioles and capillaries and other unspecified circulatory system disorders. They were issued from 2002 to 2023. 55 (66.3%) were published in the past 5 years. For the 246 recommended medicines, they were divided into 14 categories according to the pharmacological effect. 27.2% (67/246) were included in WHO-EML and 32.9% (81/246) were included in NEML, among which 41 medicines were included both in WHO-EML and NEML, 40 in NEML only, 26 in WHO-EML only, and 139 in neither. The number of excluded medicines in antihypertensive medicines, lipid-regulating medicines and antiatherosclerotic medicines and anticoagulants exceeded 10. ConclusionThe number of cardiovascular and cerebrovascular disease guidelines, expert consensus, and diagnosis and treatment specifications recommended for WHO-EML and NEML is lower than 50%, and the coverage rate of NEML for cardiovascular and cerebrovascular disease guidelines recommended treatment medicines is higher than that of WHO-EML.
To prevent and control 2019 novel coronavirus pneumonia diseases (COVID-19), hundreds of medical teams and tens of thousands of medical professionals throughout the nation were transferred to Hubei to assist COVID-19 control efforts. Medical professionals were at high risk of novel coronavirus pneumonia infections. To ensure the prevention and control of infection in medical teams and prevent cross-infection among medical staff at the medical station, this management standard includes routine management standards, resident disinfection, personnel entry and exit process, and logistics support management, so as to provide reference for medical teams combating COVID-19 in the future.