Relief of anxiety in patients wtih choledocholithiasis receiving ERCP and EST: footbath with Chinese herbs, acupoint message and aromatherapy

目的 探讨中西医综合干预对内镜下ERCP及EST术患者焦虑的影响.方法 将86例胆管结石行内镜下ERCP及EST术患者按随机数字表法分为观察组和对照组各43例,术前术中对照组给予常规护理,观察组在此基础上增加中药沐足联合穴位按摩疗及芳香疗法.结果 术后观察组焦虑评分显著低于对照组,术中血压、心率波动显著低于对照组(均P＜0.01).结论 中药沐足联合穴位按摩疗及芳香疗法的应用,可降低患者术中焦虑程度,有利于治疗顺利完成.     

芳香疗法联合穴位按摩缓解乳腺癌术后化疗患者疲乏与睡眠障碍

目的 探讨芳香疗法联合穴位按摩对乳腺癌术后化疗患者疲乏及睡眠的影响。 方法 以抛硬币法将2个病区随机分为试验组和对照组，各纳入38例乳腺癌术后化疗患者。对照组给予常规护理，试验组在此基础上给予芳香疗法联合穴位按摩。干预前及干预21 d后，采用Piper疲乏修订量表、匹兹堡睡眠质量指数比较两组患者疲乏与睡眠状况。 结果 干预后，试验组患者疲乏总分及4个维度得分显著低于对照组，睡眠质量、入睡时间、睡眠障碍、日间功能障碍得分及睡眠总分显著低于对照组（均P＜0.05）。 结论 芳香疗法联合穴位按摩可改善乳腺癌术后化疗患者癌因性疲乏程度，提高睡眠质量。     

穴位按摩联合艾灸防治妇科腹腔镜术后腹胀

目的探讨穴位按摩联合艾灸防治妇科腹腔镜术后腹胀的效果。方法将120例妇科腹腔镜手术患者随机分为观察组和对照组各60例。两组均给予术后常规护理,观察组在此基础上予以穴位按摩联合艾炙治疗护理,取双内关穴、足三里穴、中脘穴行穴位按摩和艾灸,比较两组患者腹胀的防治效果。结果两组术后腹胀程度和排气时间比较,观察组显著低于和早于对照组（均P〈0.01）。结论穴位按摩联合艾灸,能有效缓解妇科腹腔镜患者术后腹胀,且安全无痛苦。     

穴位按摩联合艾灸防治妇科腹腔镜术后腹胀

目的 探讨穴位按摩联合艾灸防治妇科腹腔镜术后腹胀的效果.方法 将120例妇科腹腔镜手术患者随机分为观察组和对照组各60例.两组均给予术后常规护理,观察组在此基础上予以穴位按摩联合艾炙治疗护理,取双内关穴、足三里穴、中脘穴行穴位按摩和艾灸,比较两组患者腹胀的防治效果.结果 两组术后腹胀程度和排气时间比较,观察组显著低于和早于对照组(均P＜0.01).结论 穴位按摩联合艾灸,能有效缓解妇科腹腔镜患者术后腹胀,且安全无痛苦.     

穴位按摩及抚触对局麻拇外翻术患者生命体征及焦虑情绪的影响

目的改善局部浸润麻醉下拇外翻手术患者术中生命体征及焦虑情绪。方法将60例拇外翻局麻手术患者随机分为两组各30例。对照组实施常规护理,观察组在常规护理的基础上行穴位按摩及抚触干预。结果观察组术中舒张压、收缩压、心率及术后焦虑得分显著低于对照组(均P0.01)。结论对局麻下拇外翻手术患者实施穴位按摩及抚触可以降低由手术引发的应激反应,缓解焦虑状态。     

中药外敷联合穴位按摩预防下肢骨折患者内固定术后膝关节僵硬

目的预防下肢骨折手术患者内固定术后膝关节僵硬。方法将100例下肢骨折行内固定术患者随机分为干预组和对照组各50例。对照组采用传统骨科护理;干预组住院后至术前应用中药九号膏外敷患侧膝关节,术后对膝关节进行穴位按摩。结果干预组患者膝关节HSS评分等级显著优于对照组,膝关节僵硬发生率显著低于对照组,患者对护理工作的满意率显著高于对照组(均P<0.01)。结论中药外敷联合穴位按摩可有效预防下肢骨折患者内固定术后膝关节僵硬,提升患者对护理工作的满意度。     

抚触联合穴位按摩对新生儿黄疸的影响研究

目的:探讨抚触联合穴位按摩对新生儿黄疸的影响.方法:选取新生儿黄疸600例,随机分成对照组、抚触组、穴位按摩组和穴位按摩抚触联合组各150例.对照组予以新生儿常规护理,抚触组在常规护理基础上给予传统正规的标准抚触方法;穴位按摩组给予中医穴位按摩;穴位按摩抚触联合组将穴位按摩手法融入标准抚触方法中进行按摩,观察并记录新生儿的经皮胆红素变化及高胆红素血症发生率等指标.结果:高胆血红素症发生率联合组低于其他三组(P＜0.05);抚触组与穴位按摩组低于对照组,但高于联合组(P＜0.05).指数正常时间联合组低于其他三组(P＜0.05):抚触组与穴位按摩组低于对照组,但高于联合组(P＜0.05).胆红素下降幅度联合组高于其他三组(P＜0.05);抚触组与穴位按摩组高于对照组,但低于联合组(P＜0.05).每天排便次数联合组高于其他三组(P＜0.05);抚触组与穴位按摩组高于对照组,但低于联合组(P＜0.05).胎便转黄时间联合组低于其他三组(P＜0.05);抚触组与穴位按摩组低于对照组,但高于联合组(P＜0.05).结论:抚触与穴位按摩有降低新生儿黄疸指数和新生儿高胆红素血症的作用,抚触联合穴位按摩效果更优于单纯抚触法与单纯穴位按摩法.     

臭氧水冲洗联合穴位按摩治疗糖尿病足患者的护理

目的探讨臭氧水联合穴位按摩治疗糖尿病足患者的护理效果。方法将40例糖尿病足患者随机分为观察组和对照组各20例;两组均对创面进行间断冲洗引流,对照组采用生理盐水冲洗,观察组采用臭氧水冲洗联合穴位按摩;观察两组创面愈合的效果。结果观察组治愈例数多于对照组;治疗显效时间显著短于对照组(P0.05)。结论臭氧水冲洗联合穴位按摩,能够促进糖尿病足患者创面愈合,改善患者的生活质量。     

穴位按摩在乳腺癌改良根治术后术肢功能康复中的应用

目的探讨穴位按摩对乳腺癌改良根治术后术肢功能的效果,寻找能有效促进术肢功能恢复的方法。方法将60例患者按手术先后顺序按照随机数字表法分为对照组和观察组各30例。对照组患者乳腺癌术后按照常规进行患肢功能锻炼,观察组在患肢常规功能锻炼基础上实施穴位按摩。比较两组肩关节功能及上肢肿胀程度。结果肩关节功能评分比较,观察组术后第3、7、10天显著高于对照组,差异有统计学意义(P0.05);术肢容积比较,观察组术后第3、7、10天低于对照组,差异有统计学意义(P0.05)。结论穴位按摩可有效改善乳腺癌改良根治术患肢功能障碍,促进水肿消退,加快术肢功能康复。     

微波联合腹部按摩预防骨科术后便秘

目的观察微波联合腹部按摩预防骨科术后便秘的效果。方法将60例骨科术后患者随机分为对照组和观察组各30例,两组均予以常规护理,包括饮食指导、康复护理等,观察组在此基础上予以微波联合腹部按摩治疗。结果观察组便秘发生率显著低于对照组（P〈0.01）。结论微波联合腹部按摩可有效预防骨科术后患者便秘,促进术后康复。     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.