柳氮磺吡啶结合地塞米松保留灌肠对中轻度溃疡性直乙状结肠炎疗效的影响

目的 评价柳氮磺吡啶结合地塞米松保留灌肠对中轻度溃疡性直乙状结肠炎疗效的影响。方法 选择2014年10月至2016年11月唐山市中医医院治疗的溃疡性直乙状结肠炎病人100例,按随机数字表法分为两组,灌肠组50例病人采用柳氮磺吡啶结合地塞米松保留灌肠治疗,对照组50例病人采用口服柳氮磺吡啶治疗,比较两组病人治疗前后及治疗后2个月的疾病活动度(DAI)评分,比较两组治疗疗效及不良反应发生情况。结果 两组治疗后及治疗后2个月的DAI水平较治疗前有较大幅度的下降,灌肠组在治疗后[(5.83±1.24) 分]及治疗后2个月[(2.48±0.98) 分]的DAI水平显著优于对照组[(4.71±1.12)、(3.86±1.04) 分],差异有统计学意义(F组间=3.39,P=0.031;F时间点=10.23,P=0.000;F交互作用=3.43,P=0.034);经过8周的治疗,灌肠组病人治疗有效率为96%,显著高于对照组84%的有效率(χ²=4.000,P=0.046);灌肠组不良反应发生率为10%,显著低于对照组的28%(χ²=5.263,P=0.022)。结论 柳氮磺吡啶结合地塞米松保留灌肠治疗中轻度溃疡性直乙状结肠炎起效快,效果好,不良反应少,值得临床推广。     

穴位艾灸后中药保留灌肠对药液在肠道内保留时间的影响

为探讨穴位艾灸后中药保留灌肠对药液在肠道内保留时间的影响,将拟采用愈肠灵灌肠液保留灌肠治疗的80例脾虚兼湿热型泄泻患者随机分为治疗组和对照组,各40例,治疗组穴位艾灸治疗后30min保留灌肠,对照组直接行保留灌肠,每天1次,l0d为一疗程。对比观察两组患者治疗第3、7、10天保留灌肠时药液在肠道内保留时间,以及患者临床疗效。结果显示,治疗组治疗第3、7、10天药液在肠道内保留时间明显长于对照组,P〈0．05。治疗组临床疗效明显优于对照组,P〈0．05。结果表明,穴位艾灸后中药保留灌肠可明显延长药液在肠道内保留时间,有利于药液的吸收,从而提高疗效。     

辨证用药保留灌肠联合大肠水疗治疗慢性功能性便秘的临床疗效

为探讨辨证用药保留灌肠联合大肠水疗治疗慢性功能性便秘（CFC）的临床疗效,将160例CFC患者随机分为4组,即单纯辨证用药保留灌肠组（A组）、单纯大肠水疗组（B组）、辨证用药保留灌肠联合大肠水疗组（C组）、辨证用药口服组（D组）,各40例,均治疗2周,对比观察4组患者疗效。结果显示,c组总有效率明显高于其他3组,P〈0．05;C组治疗后便秘症状积分明显低于其他3组,P〈0．05;C组治疗后不透x线标志物残留数明显少于其他3组,P〈0．05。结果表明,辨证用药保留灌肠联合大肠水疗治疗CFC疗效满意,值得临床推广应用。     

An integrative review of Enrolled Nurse recruitment and retention

BackgroundAustralia is facing a severe shortage of Enrolled Nurses. Jurisdictions have introduced strategies in attempts to recruit and retain Enrolled Nurses in the health workforce.AimTo explore factors impacting recruitment and retention of Enrolled Nurses.MethodsA systematic search of literature published in the English language from 2000 to 2018 that addressed the recruitment or retention of aspiring and current Enrolled Nurses (or global equivalents). The search yielded 6955 publications; 20 articles were retained for full-text review and eleven articles were included in the final review.FindingsThree major themes (Nursing work and the EN role, Educational structure and support, and Personal attributes) were identified that covered enablers and barriers to the recruitment of Diploma of Nursing students and Enrolled Nurses. Evidence of the efficacy of programs designed to integrate and retain Enrolled Nurses in the health workforce is scant. Enrolled Nurses viewed participation in a Transition to Practice Program as an integral step in the pathway to becoming a registered nurse.DiscussionContinued debate around scope of practice is contributing to organisational and collegial confusion and discriminatory practices with negative consequences for the recruitment and retention of Enrolled Nurses.ConclusionThe value of Enrolled Nurse Transition to Practice Programs for recruitment and retention is questionable. Greater recognition of Enrolled Nurses’ contributions to patient care is essential and could provide Assistants in Nursing with a career opportunity.     

优化保留灌肠方法在标准化病人中的临床研究

目的观察优化保留灌肠方法在标准化病人中的临床效果。方法招募30名护士作为标准化病人,将其随机编号为1至30号,单号先实施传统保留灌肠方法,5 d后实施优化保留灌肠方法,双号先实施优化保留灌肠方法,5 d后实施传统保留灌肠方法。比较两种保留灌肠方法插肛管时的疼痛程度、便意感、黏膜出血情况及灌肠后药液保留时间。结果优化保留灌肠组插肛管时无痛14例、轻度疼痛16例,传统保留灌肠组无痛4例、轻度疼痛9例、中度疼痛17例,两组疼痛程度比较,差异有统计学意义(P<0.05)。优化保留灌肠组插管时便意感评分为(2.76±0.71)分,传统保留灌肠组为(3.46±0.90)分,两组便意感比较,差异有统计学意义(P<0.05)。优化保留灌肠组药液保留时间为(70.43±19.34)min,传统保留灌肠组为(37.34±16.53)min,两组药液保留时间比较,差异有统计学意义(P<0.05)。优化保留灌肠组肠黏膜出血2例次,传统保留灌肠组肠黏膜出血8例次,两组肠黏膜出血比较,差异无统计学意义(P>0.05)。结论优化保留灌肠方法可减轻患者插肛管时的疼痛程度和便意感,延长药液保留时间。     

Mucosal colonic tube fistula with antireflux wrap for antegrade colonic enema

Antegrade enemas can provide children with excellent faecal continence in situations where adequate control has been compromised because of underlying congential anomaly or poor surgical outcome in their treatment. The enema is often delivered through an appendicostomy. If the appendix is absent or utilized for another purpose, then placement of a chait tube or caecostomy button can provide access to the colon for the enema. However, these devices may be associated with breakages, accidental removal and leakage and replacement may require another operative procedure under a general anaesthetic. Full thickness colonic tubes can also be constructed at any point along the colon but in the author’s experience, they can be associated with significant leakage of both gas and faecal material. The construction of a mucosal colonic tube with anti-reflux wrap is a technique that avoids the above problems and offers a distinctive advantage in selected situations. The technique relies on tabularising mucosa alone to create a continent fistula. Six children with severe soiling underwent the technique. The outcomes were evaluated using a modified quality of life score (QOLI) [1, 2]. The score included assessment of soiling, staining, odour, self-esteem and socialization measure. Technical evaluation included analysis of the ease of catheterization and continence of the mucosal fistula site. All six patients had dramatic improvement in their faecal continence with complete resolution of soiling in all six. Follow up median is 42 months and the range is 6–48 months. QOLI scores improved from a total of 4.75 to 18.5. Possible range is 0–21. All the six fistula sites catheterize easily and no stenosis or faecal leakage has occurred. Two patients required treatment of minor granulations at the entry site of the fistula during the early healing phase.     

中药灌肠并针灸佐治小儿病毒性肠炎60例疗效观察

目的：观察中药灌肠并针灸对小儿病毒性肠炎的疗效。方法：临床上将110例病儿随机分为治疗组和对照组,对照组不用抗生素,纠正水电解质及酸碱平衡紊乱,并常规口服思密达12包-1包;治疗组：在对照组相同治疗的基础上加用中药30m l-50m l灌肠2次/d,针灸1次/d,观察患儿治疗后症状缓解情况。结果：治疗后,治疗组总有效率96.7%,对照组总有效率68.0%,疗效明显优于对照组,且减少了不良反应。结论：中药灌肠并针灸治疗小儿病毒性肠炎操作简单,使用方便,不良反应少的优点,可明显提高治愈率。     

Predictors of retention among undergraduate students attending associate-degree nursing programs in Illinois

The purpose of the study was to determine what the relationship is between emotional intelligence, motivation, demographic variables, and retention. The Motivated Strategies for Learning Questionnaire and the Assessing Emotions Scale garnered data submitted from 390 first-year students attending nine associate-degree nursing schools in Illinois. Statistically significant differences in the mean scores for several motivation subscales were noted. Age, race/ethnic background, and school were predictors with retention. Emotional intelligence was not predictive with retention.