Successful abdominal operation without replacement therapy in a patient with combined factor V (FV) and FVIII deficiency due to novel homozygous mutation in LMAN1

Effect of Comprehensive Nursing on the Recovery of Gastrointestinal Function in Patients Undergoing Abdominal Operation

Objective

The objective is to explore the effect of comprehensive nursing on the recovery of gastrointestinal function in patients undergoing an abdominal operation.

Methods

Sixty patients undergoing abdominal surgery in our hospital from January 2019 to April 2021 were enrolled. The patients were arbitrarily assigned into control group and research group. The former group received routine nursing and the latter group received comprehensive nursing. Nursing satisfaction, gastrointestinal function, POMS-SF score, nutrition risk score, incidence of adverse reactions, and quality of life scores were compared.

Results

The nursing satisfaction of the research group was higher than that of the control group, and the difference between the groups was statistically significant (P < 0.05). In terms of gastrointestinal function, the anal exhaust time eating time defecation time and bowel sound recovery time in the research group were significantly lower than those in the control group, and the difference between the groups was statistically significant (P < 0.05). In terms of POMS-SF score, the scores of tension–anxiety, depression–depression, fatigue–dullness, anger–hostility, and confusion–confusion in the research group were lower than those in the control group, while the energy-vitality score was higher than that in the control group, and the difference between the groups was statistically significant (P < 0.05). There was no significant difference in nutritional risk score among patients before nursing (P > 0.05); after nursing, the nutritional risk score decreased. Compared between the two groups, the nutritional risk score of the research group was lower when compared to the control group at 3 days, 5 days, and 7 days after nursing, and the difference between the groups was statistically significant (P < 0.05). In terms of the incidence of adverse reactions, the incidence of adverse reactions such as incision effusion, incision infection, incision dehiscence, and anastomotic leakage in the research group was lower when compared to the control group, and the difference between the groups was statistically significant (P < 0.05). Regarding quality of life scores, before nursing, there exhibited no significant difference of patients (P > 0.05); after nursing, the quality of life scores of patients decreased. Compared with the two groups, the physical function, psychological function, social function, and healthy self-cognition scores of the research group were all lower compared to the control group, and the difference between the groups was statistically significant (P < 0.05).

Conclusion

Abdominal surgery patients received comprehensive care, which improved their mental health, reduced anxiety and depression levels, relieved fatigue and dullness, improved energy and vitality, and enhanced their overall mood. Meanwhile, it can also promote the recovery of gastrointestinal function in patients and reduce the incidence of adverse reactions.

The use of prophylaxis in the treatment of rare bleeding disorders

Rare bleeding disorders (RBDs) are a heterogeneous group of coagulation factor deficiencies that include fibrinogen, prothrombin, α₂-antiplasmin, plasminogen activator inhibitor-1, and factors II, V, V/VIII, VII, X, XI and XIII. The incidence varies based upon the disorder and typically ranges from 1 in 500,000 to 1 per million population. Symptoms vary with the disorder and residual level of the clotting factor, and can range from relatively minor such as epistaxis, to life threatening, such as intracranial hemorrhage. Rapid treatment of bleeding episodes in individuals with severe bleeding phenotypes is essential to preserve life or limb and to prevent long-term sequelae; therapeutic options depend on the deficiency and range from plasma-derived (eg, fresh frozen plasma, prothrombin complex concentrates, factor X concentrate) to highly purified and recombinant single factor concentrates. The rarity of these disorders limits the feasibility of conventional prospective clinical trials; instead, clinicians rely upon registries, published case reports/series and experience to guide treatment. In some disorders, long-term prophylactic therapy is administered in response to the bleeding phenotype in an individual patient or based on the known natural history and severity of the deficiency. Intermittent prophylaxis, surrounding surgery, pregnancy, labor, and menstruation may be required to prevent or control excessive bleeding. This review summarizes therapeutic options, guidelines, recommendations and observations from the published literature for long-term, surgical, gynecological, and obstetric prophylaxis in deficiencies of fibrinogen; prothrombin; factors II, V, V/VIII, VII, X, XI and XIII; combined vitamin-K dependent factors; α2-antiplasmin; and plasminogen activator inhibitor 1. Platelet disorders including Glanzmann's thrombasthenia and Bernard-Soulier syndrome are also addressed.