胃肠肿瘤病人术后两种促进胃肠功能恢复方法的效果观察

[目的]探讨胃肠肿瘤术后恢复胃肠功能的方法,促进胃肠肿瘤术后胃肠功能的恢复。[方法]按随机数字表法将80例胃肠肿瘤病人随机分为干预组和对照组各40例;对照组术前1d对病人及其家属作手术前后一般护理常规宣教,于术后第1天起采用维生素B1100mg行双侧足三里穴位注射每天1次及足三里、内庭升白仪穴位电疗每天2次;干预组在对照组基础上增加针对性护理干预;观察两组病人首次肛门排气时间及排便时间。[结果]干预组术后首次肛门排气时间及排便时间均较对照组提前,差异有统计学意义(P0.05)。[结论]穴位治疗联合针对性护理干预能有效促进胃肠肿瘤病人术后胃肠功能的恢复。     

护理干预对胃肠肿瘤术后患者肠功能恢复的影响

目的：探讨穴位治疗联合针对性护理干预对胃肠肿瘤患者术后肠功能恢复的影响。方法按随机数字表法将80例胃肠肿瘤患者随机分为干预组和对照组各40例。对照组术前1 d对患者及其家属做手术前后一般护理常规宣教,于术后第1天起采用维生素B1100 mg行双侧足三里穴位注射每天1次,及足三里、内庭升白仪穴位电疗每天2次;干预组在对照组基础上增加针对性护理干预。比较两组患者术后首次肛门排气、排便时间、术后留置胃管时间及腹胀发生率。结果干预组患者术后首次肛门排气、排便时间、术后留置胃管时间分别为（47．90±6．16）,（58．90±10．68）,（24．52±8．45）h;均短于对照组的（52．62±9．46）,（65．46±13．56）,（31．38±9．50）h,两组比较差异有统计学意义（t值分别为2．64,2．40,3．41;P＜0．05）;干预组腹胀发生率为5．0％低于对照组20．0％,两组比较差异有统计学意义（χ2＝4．11,P＜0．05）。结论穴位治疗联合针对性护理干预能有效促进胃肠肿瘤患者术后胃肠功能早日恢复。     

术后护理干预对胃肠手术病人早期胃肠功能恢复的影响

[目的]观察术后护理干预对胃肠手术病人早期胃肠功能恢复的影响。[方法]将45例行胃肠手术病人随机分为对照组22例和观察组23例,对照组病人实施常规的胃肠手术护理。观察组病人在常规护理基础上实施术后护理干预。比较病人术后肠鸣音恢复时间、肛门排气时间、排便时间、进食时间、住院时间以及不良反应发生情况。[结果]观察组病人肠鸣音恢复时间、肛门排气时间、排便时间、进食时间、住院时间均少于对照组(P<0.05);观察组病人术后并发症发生率低于对照组(P<0.05)。[结论]术后护理干预可促进胃肠手术病人早期胃肠功能的恢复、减少并发症的发生。     

护理干预联合穴位治疗对胃肠肿瘤术后胃肠功能的影响

[目的]探讨护理干预联合穴位治疗对胃肠肿瘤术后胃肠功能的影响。[方法]137例行手术治疗的胃肠肿瘤病人随机分为观察组(n=71)和对照组(n=66),对照组采取胃肠肿瘤围术期常规护理措施,观察组则在对照组基础上进行术前及术后心理干预、术后早期主动运动及特殊功能运动、穴位注射和穴位电疗等措施,记录两组病人手术一般情况,记录两组病人术后首次排气时间、首次排便时间、胃管留置时间、术后住院时间及住院费用、出院时对护理过程满意度,比较两组病人术后胃肠道并发症发生情况。[结果]观察组病人首次排气时间、首次排便时间和胃管留置时间均短于对照组,差异均有统计学意义(P0.05);观察组病人术后住院时间和术后住院费用均少于对照组,而病人对护理过程满意度则高于对照组,差异均有统计学意义(P0.05);观察组病人术后腹胀及胃肠道总并发症发生率均低于对照组,差异均有统计学意义(P0.05)。[结论]护理干预联合穴位治疗有助于胃肠肿瘤病人术后胃肠功能早期恢复,减少腹胀及胃肠道并发症的发生,提高病人对护理过程满意度。     

针灸配合中药足浴对胃肠手术后肛门排气时间影响的研究

[目的]探讨针灸配合中药足浴对促进胃肠手术后病人肠蠕动恢复的作用。[方法]将120例胃肠术后病人随机分为实验组和对照组,实验组术后采用针刺穴位配合中药足浴治疗,对照组术后按常规护理。观察两组病人术后排气、排便时间。[结果]实验组病人术后肛门排气时间较对照组病人明显提前。[结论]采用针刺穴位配合中药足浴有助于促进胃肠手术后病人胃肠功能的恢复。     

针灸配合中药足浴对胃肠手术后肛门排气时间影响的研究

[目的]探讨针灸配合中药足浴对促进胃肠手术后病人肠蠕动恢复的作用.[方法]将120例胃肠术后病人随机分为实验组和对照组,实验组术后采用针刺穴位配合中药足浴治疗,对照组术后按常规护理.观察两组病人术后排气、排便时间.[结果]实验组病人术后肛门排气时间较对照组病人明显提前.[结论]采用针刺穴位配合中药足浴有助于促进胃肠手术后病人胃肠功能的恢复.     

维生素B_1足三里注射联合多潘立酮鼻饲对腹部手术后胃肠功能恢复的影响

[目的]探讨腹部手术后维生素B1足三里穴位注射联合多潘立酮鼻饲对胃肠功能恢复的影响。[方法]将120例腹部手术病人随机分为实验组和对照组,每组60例。实验组于术后第1天起采用维生素B1行双侧足三里注射及多潘立酮鼻饲,对照组则使用传统的护理方法。从两组病人的肠鸣音恢复时间、肛门排气时间、腹胀程度来评价其胃肠功能恢复情况。[结果]实验组肠鸣音恢复时间、肛门排气时间明显早于对照组,两组比较差异有统计学意义（P〈0.05）。[结论]维生素B1行双侧足三里穴位注射联合多潘立酮鼻饲可促进腹部术后病人胃肠功能恢复。     

维生素B1足三里注射联合多潘立酮鼻饲对腹部手术后胃肠功能恢复的影响

[目的]探讨腹部手术后维生素B1足三里穴位注射联合多潘立酮鼻饲对胃肠功能恢复的影响。[方法]将120例腹部手术病人随机分为实验组和对照组,每组60例。实验组于术后第1天起采用维生素B1行双侧足三里注射及多潘立酮鼻饲,对照组则使用传统的护理方法。从两组病人的肠鸣音恢复时间、肛门排气时间、腹胀程度来评价其胃肠功能恢复情况。[结果]实验组肠鸣音恢复时间、肛门排气时间明显早于对照组,两组比较差异有统计学意义(P<0.05)。[结论]维生素B1行双侧足三里穴位注射联合多潘立酮鼻饲可促进腹部术后病人胃肠功能恢复。     

穴位贴敷结合艾灸促进腹部术后胃肠功能恢复的护理研究

[目的]探讨穴位贴敷结合艾灸对腹部术后病人胃肠功能恢复的效果。[方法]将80例行胃大部切除术病人随机分为实验组和对照组各40例,对照组病人采用常规护理,实验组病人在常规护理的基础上于术后即刻用硝黄贴贴敷神阙穴,并且在术后第1天开始艾灸中脘、关元、足三里,观察两组病人肠鸣音恢复时间、首次排气排便时间、腹胀等情况。[结果]实验组病人术后肠鸣音恢复时间、首次排气排便时间明显缩短,与对照组比较差异均有统计学意义(P<0.05);实验组病人胃肠功能恢复情况优于对照组、腹胀程度轻于对照组,差异有统计学意义(P<0.05)。[结论]穴位贴敷结合艾灸能促进腹部手术病人胃肠功能恢复、减少腹胀等并发症的发生。     

理气通腑散穴位贴敷对肠道术后病人胃肠功能恢复的影响

[目的]探讨理气通腑散穴位贴敷对肠道手术后病人胃肠功能恢复的影响。[方法]选取我科2014年1月1日—6月30日腹部手术病人64例,随机分为研究组34例和对照组30例,两组术后均予常规护理,研究组在常规护理基础上给予理气通腑散穴位贴敷脐部,对两组病人的肠鸣音恢复时间、肛门排气时间、排便时间进行统计。[结果]两组病人的肠鸣音恢复时间、肛门排气时间、排便时间比较差异有统计学意义(P0.05),研究组胃肠功能恢复时间较对照组明显缩短。[结论]理气通腑散穴位贴敷能促进胃肠道手术病人术后胃肠功能恢复。     

体表胃肠起搏治疗功能性胃肠道疾病的研究

目的:分析评估胃肠起搏器治疗功能性胃肠道疾病的疗效。方法:收集97例功能性消化不良及胃下垂患者,分为治疗组(73例)和对照组(24例),治疗组用胃肠起搏器进行治疗,对照组不给予刺激,通过临床症状、EGG、X线钡餐造影和胃排空试验综合判断疗效。结果:功能性消化不良患者经胃肠起搏器治疗后,临床症状总有效率超过85%,而对照组总有效率远低于治疗组(P<0.01);治疗组EGG明显改善(P<0.05 vs治疗前),部分患者行胃排空试验,结果明显改善,而对照组EGG与治疗前相比差异无统计学意义;胃下垂患者经胃肠起搏器治疗后,胃的体位显著上升。结论:胃肠起搏能有效改善功能性消化不良和胃下垂患者的临床症状。     

Intraoperative gastrointestinal endoscopy in the management of occult gastrointestinal bleeding.

Intraoperative gastrointestinal endoscopy has become an increasingly valuable diagnostic and therapeutic adjunct in the management of a variety of complicated problems in surgical patients. At the Medical College of Georgia, intraoperative gastrointestinal endoscopic technics have been successfully used to locate the site and cause of occult gastrointestinal bleeding; to diagnose, biopsy, and, when appropriate, resect lesions during operations conducted for other pathologic processes; to gain endoscopic access for resection of lesions otherwise inaccessible (endoscopically) by virtue of intestinal distortion caused by adhesions; to guide the operating surgeon to an area of resectable disease through dense adhesions secondary to multiple previous laparotomies; and to enhance diagnosis at laparotomy. The value of intraoperative gastrointestinal endoscopy in lesions resulting in occult gastrointestinal hemorrhage and the value of combined radiographic and intraoperative endoscopic technics in diagnosing and managing occult GI bleeding are discussed.     

胃、结肠黑腔MR水造影在肿瘤诊断中的应用

为满足病人对影像学检查高质量的要求,笔者本着简便、快捷、实用的原则,对黑腔MR胃肠水造影（DLMRGIH）技术的临床应用作了初步尝试。     

Pathogenesis of gastrointestinal infection

The last 30 years has seen the recognition of many intestinal pathogens, through a combination of microscopy, tissue availability and open minds. In the developing world the challenge to eradicate such infections continues, especially in infancy and early childhood. In developed communities, however, the challenge is shifting to pathogens ('super bugs') arising from our own interventions and lifestyles which will occupy many future careers.     

Treatment of gastrointestinal hemorrhage

Background We assessed the value of selective arteriography in the diagnosis and management of acute gastrointestinal hemorrhage. Methods We reviewed the records of 107 consecutive patients who had gastrointestinal hemorrhage and underwent selective arteriography between January 1992 and October 2003: 10 had upper gastrointestinal bleeding, 79 had lower gastrointestinal bleeding, and 18 had varicose bleeding with portal hypertension. Selective embolization was attempted in 15 patients to obtain hemostasis. Angiographic findings were reviewed and prospective reports were compared with the final diagnosis and outcome. Results Of 129 angiographic studies, 36 correctly revealed the bleeding site and 93 were negative. Extravasation was seen in 24 cases at the level of stomach (n = 2), duodenum (n = 1), small bowel (n = 5), or colon (n = 16). Indirect signs of bleeding sources were identified in 12 patients (stomach in one, small bowel in four, large bowel in four, liver in three). Transcatheter embolization induced definitive hemostasis in 11 of 15 patients (73%), namely in the stomach (n = 2), small bowel (n = 3), colon (n = 7), and liver (n = 3). Three patients required surgery after embolization. Conclusion Abdominal arteriography may localize gastrointestinal bleeding sources in approximately one-third of cases. Selective embolization may provide definitive hemostasis in most instances. P. Charbonnet and J. Toman contributed equally to this work.     

Utility of gastrointestinal ultrasound in functional gastrointestinal disorders: A narrative review

Gastrointestinal (GI) ultrasound (GIUS) is valuable in the evaluation of GI diseases such as inflammatory bowel disease, but its use in functional GI disorders (FGIDs) is largely unknown although promising. In order to review the current knowledge on current and potential uses of GIUS in FGIDs, information was obtained via a structured literature search through PubMed, EMBASE and Google Scholar databases with a combination of MESH and keyword search terms: “ultrasound”, “functional GI disorders”, “irritable bowel syndrome”, “functional dyspepsia”, “intestinal ultrasound”, “point of care ultrasonography”, “transabdominal sonography”, “motility”, “faecal loading”, “constipation”. GIUS is currently used for various settings involving upper and lower GI tracts, including excluding organic diseases, evaluating physiology, guiding treatment options and building rapport with patients. GIUS can be potentially used to correlate mechanisms with symptoms, evaluate mechanisms behind treatment efficacy, and investigate further the origin of symptoms in real-time. In conclusion, GIUS is unique in its real-time, interactive and non-invasive nature, with the ability of evaluating several physiological mechanisms with one test, thus making it attractive in the evaluation and management of FGIDs. However, there are still limitations and concerns of operator dependence and lack of validation data for widespread implementation of GIUS in FGIDs.     

上消化道胃肠道间质瘤的内镜及临床分析

目的探讨上消化道胃肠道间质瘤(GIST)的内镜、病理及免疫组化特征,以提高内镜医生对该疾病的认识和诊断,减少误诊和漏诊。方法检索我院2007年1月至2010年4月所有经手术治疗的GIST,选择病变部位在食管、胃、十二指肠的病例,分析其临床表现、胃镜表现,辅助检查、手术病理及免疫组化结果。结果 30例患者中,以消化道出血为主要症状的患者11例(36.7%),腹痛的患者6例(20%),腹部不适的4例(13.3%),查体发现的3例(10%)。GIST部位:胃底12例(40%),胃体7例(23.3%)。胃镜下表现:(1)黏膜下隆起,表面光整,12例;(2)黏膜下隆起伴顶端溃疡7例;(3)溃疡型肿物4例;(4)黏膜下隆起顶端凹陷3例;(5)黏膜下隆起表面增殖糜烂1例;(6)黏膜下隆起伴糜烂2例;(7)胃镜阴性:1例。其中14例行超声内镜检查,多数病变来源于固有肌层。29例病理为梭形细胞肿瘤,免疫组化:CD117阳性29例(96.7%),CD34阳性27例(90%)。结论上消化道GIST临床表现多样,症状以消化道出血和腹痛、腹部不适为多。胃镜下表现不一,表现为黏膜隆起性病变,40%的病例黏膜表面光整,56.7%的病例呈溃疡表现或糜烂,少数病例肿物表面增殖,与胃癌不易鉴别。超声胃镜的诊断率高。