神经内科便秘患者应用甘油灌肠剂的护理探讨

目的：探讨神经内科便秘患者应用甘油灌肠剂的护理措施。方法选取该院神经内科2012年1月—2013年5月收治的120例有便秘症状的患者,对照组60例不应用甘油灌肠剂,观察组60例应用甘油灌肠剂进行护理,观察患者12 h排便情况。结果观察组12 h排便总有效率为100%,对照组12 h排便总有效率为7%,两组比较差异有统计学意义(P<0.01)。结论对神经内科便秘患者应用甘油灌肠剂进行护理,可有效提高便秘的治愈率,促进疾病康复,减轻了护理工作负担,提升了护理质量。     

Validation of the self-confidence scale of nursing care in urinary retention

Objective:

to validate an instrument to measure self-confidence of nursing care in urinary retention.

Methods:

methodological research study, carried out after ethical approval. A Likert-like scale of 32 items related to nursing care in urinary retention was applied to students of the graduate nursing course. For instrument validation, analysis of the sample adequacy and main components, Varimax orthogonal rotation and internal consistency analyses were developed.

Results:

in a sample of 305 students, there was high correlation of all items with the total scale and Cronbach''s alpha of 0.949. The scale items were divided into five factors with internal consistency: Factor 1 (0.890), Factor 2 (0.874), Factor 3 (0.868), Factor 4 (0.814) and Factor 5 (0.773), respectively.

Conclusion:

the scale meets the validity requirements, demonstrating potential for use in evaluation and research.     

中药灌肠治疗胃肠术后腹胀疗效观察

目的观察中药灌肠治疗胃肠术后腹胀的临床疗效。方法 90例胃肠术后腹胀患者随机两组。治疗组采用中药灌肠治疗,对照组口服西沙比利,连续治疗5d后评定疗效。结果治疗组总有效率明显优于对照组(P0.01)。结论中药灌肠治疗胃肠术后腹胀疗效可靠。     

药物保留灌肠治疗溃疡性结肠炎的临床护理方法及效果

目的：探讨药物保留灌肠治疗溃疡性结肠炎的疗效观察及护理措施。方法：回顾性分析2012年3月－2014年4月我院62例溃疡性结肠炎采取利多卡因、地塞米松、锡类散加入生理盐水保留灌肠治疗患者的临床病历,分析临床疗效和护理措施。结果：62例灌肠过程中出现便急3例,灌肠后出现轻度腹痛1例,所有患者未影响正常治疗和护理干预;治愈34例,有效24例,无效4例,总有效率93.55％。结论：护理干预能够明显提高药物灌肠治疗溃疡性结肠炎的临床疗效,在改善溃疡性结肠炎患者的临床疗效和促进患者早期康复方面具有非常重要的意义。     

中医综合疗法治疗输卵管阻塞性不孕症

目的 探讨输卵管阻塞性不孕症患者术后给予中药方剂灌肠及口服的治疗效果及机制.方法 将就诊的输卵管阻塞术后再通患者88例,随机分为2组,治疗组50例给予中药灌肠并予中药自拟助孕汤(红藤、败酱草、蒲公英、路路通等)口服;对照组38例仅给予中药灌肠,治疗6个月经周期后观察怀孕情况及输卵管再通情况.结果 宫内妊娠率治疗组为32.00％,对照组为13.16％,2组比较,差异有统计学意义(P＜0.05).结论 中药灌肠联合汤剂口服可帮助输卵管阻塞性不孕术后患者疏通输卵管,减少输卵管再次阻塞的发生,增加受孕概率.     

自拟中药方保留灌肠治疗慢性盆腔炎的疗效观察

目的：观察自拟中药方保留灌肠治疗慢性盆腔炎的效果。方法将60例慢性盆腔炎患者随机分为治疗组30例、对照组30例。对照组口服中成药,治疗组在口服中成药的基础上,予自拟中药方保留灌肠。比较2组的临床疗效。结果治疗组30例中,显效18例（60．0％）,有效11例（36．7％）,无效1例（3．3％）,总有效率为96．7％;对照组30例中,显效8例（26．7％）,有效15例（50．0％）,无效7例（23．3％）,总有效率为76.7％。经秩和检验,Z＝－3．873,P＜0．05,说明治疗组临床疗效优于对照组。结论在口服中成药的基础上予自拟中药方保留灌肠治疗慢性盆腔炎具有较好的疗效。     

中药保留灌肠治疗溃疡性结肠炎临床研究

目的：观察中药保留灌肠治疗溃疡性结肠炎的疗效以及对血清炎症因子水平的影响。方法：102例溃疡性结肠炎患者随机分为对照组和观察组,每组各51例。对照组给予口服柳氮磺吡啶治疗,每次1．5～2．0 g,每日3次;观察组给予中药保留灌肠治疗,15 d为1个疗程。治疗4个疗程后采用ELISA法检测血清肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）和白介素-6（interleukin-6,IL-6）的浓度,同时观察两组患者腹痛、腹泻、黏液脓血便、里急后重等症状体征改善情况并结合肠镜检查比较两组患者临床疗效。结果：两组患者治疗后血清TNF-α和IL-6水平较治疗前相比均明显下降（P＜0．05）,但观察组患者下降程度甚于对照组（P＜0．05）。观察组患者各种症状改善率明显优于对照组（P＜0．05）。对照组有效率为84．31％,观察组有效率为96．08％,两组比较,差异有统计学意义（P＜0．05）。结论：中药保留灌肠治疗溃疡性结肠炎能够显著抑制患者体内炎症因子水平,临床疗效显著。     

益气利湿降浊汤联合中药灌肠治疗早期糖尿病肾病临床研究

目的:观察益气利湿降浊汤联合中药灌肠治疗早期糖尿病肾病的疗效及对肾功能的影响。方法:100例早期糖尿病肾病患者随机平均分为观察组和对照组。对照组在使用胰岛素控制血糖的基础上,给予低蛋白饮食,水肿严重患者给予利尿剂,血压高患者加降血压药;观察组在对照组治疗的基础上给予益气利湿降浊汤联合中药灌肠治疗,比较两组患者治疗后的临床有效率,肾功能改善情况以及各项指标变化,包括红细胞比容、血胆固醇、血白蛋白、三酰甘油和蛋白尿。结果:1观察组患者的有效率为90.00%,明显高于对照组的有效率66.00%(χ2=8.31,P<0.05);2观察组患者的功能改善情况明显优于对照组(P<0.05);3观察组各项指标改善情况明显优于对照组(P<0.05)。结论:益气利湿降浊联合中药灌肠治疗早期糖尿病肾病显著疗效,能够降低血黏度和血脂,减少蛋白尿,且安全可靠。     

Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa

Background

‘Dual practice’, or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. This form of the practice is purported to help retain public health care workers in low and middle-income countries’ public sectors through additional wage incentives. There has been little conceptual or empirical development of the relationship between dual practice and retention.

Methods

This article helps begin to fill this gap, drawing on empirical evidence from a qualitative study focusing on South African specialists. Fifty-one repeat, in-depth interviews were carried out with 28 doctors (predominantly specialists) with more than one job, in one public and one private urban hospital.

Results

Findings suggest dual practice can impact both positively and negatively on specialists’ intention to stay in the public sector. This is through multiple conceptual channels including those previously identified in the literature such as dual practice acting as a ‘stepping stone’ to private practice by reducing migration costs. Dual practice can also lead specialists to re-evaluate how they compare public and private jobs, and to overworking which can expedite decisions on whether to stay in the public sector or leave. Numerous respondents undertook dual practice without official permission.

Conclusions

The idea that dual practice helps retain public specialists in South Africa may be overstated. Yet banning the practice may be ineffective, given many undertake it without permission in any case. Regulation should be better enforced to ensure dual practice is not abused. The conceptual framework developed in this article could form a basis for further qualitative and quantitative inquiry.

Electronic supplementary material

The online version of this article (doi:10.1186/1478-4491-13-3) contains supplementary material, which is available to authorized users.     

药物灌肠前行清洁灌肠治疗溃疡性结肠炎的疗效观察

目的：分析药物灌肠前行清洁灌肠治疗溃疡性结肠炎的效果。方法64例溃疡性结肠炎患者随机分为对照组与实验组,各32例。对照组的患者采用传统的药物保留灌肠法,实验组的患者采用先行清洁灌肠之后再对其进行药物保留灌肠的方法。比较两组疗效。结果实验组的治疗效果明显优于对照组患者,差异有统计学意义(P<0.05),实验组不良反应率比较低(P<0.05)。结论药物灌肠前行清洁灌肠治疗溃疡性结肠炎可以提高疗效,减少不良反应,值得推广。