腹式全子宫切除病人围术期的护理

腹式全子宫切除术是妇科最常见的手术方式之一，占腹部手术的第3位，是根治子宫肌瘤、子宫恶性肿瘤、严重功血等疾病的主要手段，为使患者顺利度过手术关，护理工作者做好围术期护理至关重要，现将护理体会总结如下：     

腹腔镜辅助阴式子宫切除围手术期护理

目的探讨腹腔镜辅助阴式子宫切除术围手术期护理措施。方法回顾87例腹腔镜辅助阴式子宫切除术病情观察及护理资料。结果 87例患者通过术前及术后严密的观察及护理,1例实施中转为开腹手术,1例阴道残端感染,余85例无并发症出现,均痊愈出院。结论良好的术前准备、术后仔细的观察及有效的护理是减少并发症,保证手术成功的关键。     

子宫切除术围术期患者的心理护理

目的探讨子宫切除术前、术后患者的心理状态,有针对性地实施心理护理,促进产妇身心健康的恢复。方法通过60例产妇子宫切除术患者围术期进行心理问卷调查,随机分为A、B两组,开展心理疏导护理及对比研究,并进行统计学处理。结果A、B两组在术前两组比较差异无统计学意义(P>0.01),术后10 d两组比较差异有统计学意义(P<0.01)。结论早期心理干预护理能促进患者身心康复。     

腹腔镜下子宫切除术的围术期护理

目的探讨腹腔镜下子宫切除术患者的围术期的护理方法。方法回顾性分析2005年至2007年收治的80例经腹腔镜行子宫切除患者的临床资料,针对护理要点进行归纳总结。结果本组80例患者经精心、细致的护理,均治愈出院。护理要点包括:心理护理,加强对引流管的护理及并发症的预防。结论在围术期给予正确的指导和护理有利于患者加深对疾病和手术的认识,有利于患者的康复。     

异丙酚对子宫切除术病人围术期炎症细胞因子平衡的影响

手术创伤和麻醉引起的促炎症因子和抗炎症因子间平衡的改变是影响机体炎症反应和免疫功能变化的重要因素。异丙酚对炎症细胞因子的影响的报道较多,但结果不尽一致。本研究拟观察小剂量异丙酚对硬膜外麻醉下子宫切除术病人围术期炎症细胞因子平衡的影响。     

腹腔镜全子宫切除术围手术期的护理

1997年 1月至 2 0 0 3年 1月我院行腹腔镜全子宫切除术(CISH) 30例 ,现将护理体会报道如下。1　临床资料以CISH 30例为研究组 ,以同期行开腹全子宫切除术 30例为对照组。两组患者 36～ 5 5岁 ,平均 4 5岁。2　护　理2 1　术前护理　CISH作为新技术尚未被患者认可。术前须向患者及家属讲述此手术的优点 ,此术式的可靠性及临床开展情况 ,详细说明手术过程、时间、麻醉方式等 ,取得患者信任 ,主动配合治疗。并按腹部及外阴手术常规备皮 ,特别注意清洁脐部 ,用松节油棉棒去除脐孔内污垢 ,防止术后切口局部感染。术前 1d常规试机 ,保证性能…     

腹腔镜肾切除病人围手术期护理

对 2 3例采用腹腔镜手术的肾肿瘤病人进行针对性的护理 ,并与 19例开放性手术病人进行比较 ,观察两组术中出血量、术后肠功能恢复时间、术后下床活动时间、拔除引流管时间、术后输液天数、术后住院天数、住院总天数。结果腹腔镜手术组各项指标均优于开放性手术组 (P <0 .0 5 ,P <0 .0 1)。应用腹腔镜行肾切除手术 ,病人创伤小、恢复快 ,有效减少了护理工作量。     

肺癌病人围手术期的护理

<正>肺癌系指支气管源性恶性肿瘤,外科手术仍是治疗肺癌的重要手段。我院自2002年6月~2004年6月对84例肺癌病人行手术治疗,术后进行严密监护。从护理实践中我们体会到,全面、认真地进行手术前后的护理,将减少术后并发症的发     

腹腔镜子宫切除术的围手术期护理

<正> 2000年1月始我院开展了腹腔镜子宫切除术,现已成功地施术29例,现将护理体会报告如下:1 临床资料29例中子宫肌瘤26例,子宫腺肌病3例,26～52岁,平均38岁,手术时间60～150min,平均90min,术中出血20-80ml,平均30ml,患者均行全麻,手术经过顺利,术后5-7d出院。2 术前护理2.1 心理护理 腹腔镜下子宫切除术了解甚少,有害怕、     

腹腔镜全子宫切除术围术期护理

将60例行子宫全切除的病人随机分为观察组和对照组各30例,对照组采用常规腹式手术;观察组采用腹腔镜下全子宫切除术,术前予心理支持,术中保持良好体位、默契配合术者,术后动态观察病情。结果观察组术中出血量,术后疼痛发生率、发热时间、抗生素应用时间及术后住院时间均显著低于对照组(P<0.05)。提示观察组术式及护理模式具有安全、高效优势。     

急危重症病人营养支持的临床研究

目的探讨营养支持在急危重症病人中的合理应用 ,以提高急危重症病人的抢救成功率。方法将 16 9例收住ICU的急危重症病人随机分为对照组 (82例 )和观察组 (87例 ) ,对照组实施肠外营养支持 ,观察组实施肠内加肠外营养支持 ,观察两组并发症发生率。结果两组均达到营养支持效果 ,但对照组胃肠道出血、二重感染、肠麻痹、肝功能异常以及腹胀、高血糖的发生率明显高于观察组 (P <0 .0 1,P <0 .0 5 )。结论对急危重症病人实施肠外加肠内营养支持 ,可减少并发症发生 ,促进病人康复。     

Food Intake and Nutritional Status in Stable Hemodialysis Patients

This is a cross-sectional, multicenter, controlled study aiming to evaluate changes of actual dietary nutrient intake in 94 stable hemodialysis patients in respect to 52 normal subjects and guideline recommendations, and to assess the prevalence of signs of malnutrition. Energy and nutrients intake assessment was obtained by a three-day period food recall. Anthropometric and biochemical parameters of nutrition, bioelectric impedance vector analysis, and subjective global assessment (SGA) have been performed to assess nutritional status. SGA-B was scored in 5% of the patients. Body mass index < 20 Kg/m², serum albumin <35 g/L, nPNA < 1.0 g/Kg, and phase angle <4.0° were detected in 16.3%, 16%, 23%, and 8.0 % of patients, respectively. HD patients showed a lower energy and protein intake in respect to controls, but no difference occurred when normalized per ideal body weight (29.3 ± 8.4 vs. 29.5 ± 8.4 Kcal/Kg i.b.w./d and 1.08 ± 0.35 vs. 1.12 ± 0.32 Kcal/Kg i.b.w. /d, respectively). Age was the only parameter that inversely correlates with energy (r = ?0.35, p < 0.001) and protein intake (r = ?0.34, p < 0.001). This study shows that in stable dialysis patients, abnormalities of nutritional parameters are less prevalent than expected by analysis of dietary food intake. Age is the best predictor of energy and protein intake in the dialysis patients who ate less than normal people, but no difference emerged when energy and protein intakes were normalized for body weight. These results recall the attention for individual dietetic counseling in HD patients, and also for a critical re-evaluation of their dietary protein and energy requirements.     

早期肠内营养护理对烧伤患者营养状况、胃肠道耐受性的影响

目的 探究早期肠内营养护理对烧伤患者营养状况、胃肠道耐受性的影响。方法 选取2017年1月-2022年12月盐城市第一人民医院烧伤整形科收治的70例烧伤患者作为研究对象,应用随机数字表法分为早期组和常规组,每组35例。早期组给予早期肠内营养护理（即入院12 h后行肠内营养护理）,常规组给予常规肠内营养护理（即入院48 h后行肠内营养护理）,比较两组营养状况、胃肠道耐受性及并发症发生情况。结果 早期组实施后血清白蛋白、血清转铁蛋白和淋巴细胞计数均高于常规组,差异有统计学意义（P ＜0.05）;早期组腹痛、腹胀、腹泻及恶心呕吐症状积分均低于常规组,差异有统计学意义（P ＜0.05）;早期组并发症总发生率为5.71%,低于常规组的22.86%,差异有统计学意义（P ＜0.05）。结论 早期肠内营养护理可帮助烧伤患者营养状况恢复至正常水平,且有助于提升胃肠道耐受性,减少各种相关并发症的发生风险,促进患者康复。     

早期肠内营养对老年结肠癌患者术后营养状况及免疫功能的影响

目的 探讨早期肠内营养对老年结肠癌患者术后营养状况及免疫功能的影响.方法 将116倒老年结肠癌患者随机分为观察纽和对照组各58例.观察组术中置穿刺式空肠造口管,术后20～24 h开始进行肠内营养}对照组术后行常规静脉液体输入治疗和普外科术后常规护理.两组患者分别于术前和术后第1天、第7天测定营养指标、免疫指标和生化检查,并观察术后并发症发生情况.结果 观察组术后第1天、第7天营养指标、生化指标、免疫指标(CD3+、CD4+、CD8+、CD4+/CD8+及NK细胞)与对照组比较,差异有统计学意义(均P<0.05);且术后并发症发生率显著低于对照组(P<0.05).结论 早期肠内营养可改善老年结肠癌患者术后营养状况和免疫功能,降低术后并发症的发生.     

The Effect of Roux-en-Y Gastric Bypass on Zinc Nutritional Status

Background Researchers have found that zinc nutritional status in obese and diabetic subjects is altered: low zinc concentrations in plasma and erythrocytes, with high urinary zinc excretion, were observed. This study evaluated the effect of Roux-en-Y gastric bypass (RYGBP) on plasma, erythrocyte and urinary zinc concentration. Methods 22 morbidly obese patients were studied before and 6 months after RYGBP. Fasting blood sample and 24-hour urine were collected in the pre- and postoperative phases. A software analyzed the diet information from 3-day food records after RYGBP. Zinc nutritional status was evaluated by determination of the concentration of this mineral in plasma and erythrocytes, and the urinary excretion of zinc / 24 hours by atomic absorption spectrophotometry. Results The diets consumed by the patients had adequate average concentrations of zinc. Zinc concentration in plasma, erythrocytes and urine were within the values of normality before RYGBP, with mean values of 93.25 ± 19.34 μg/dL, 43.85 ± 7.76 μg Zn/gHb and 583.05 ± 359.30 μg Zn/24 hours, respectively. At 6 months after RYGBP, there was a change in these parameters to 69.82 ± 10.95 μg/dL, 51.80 ± 6.92 μg Zn/gHb, 535.29 ± 216.40 μg Zn/24 hours in the concentration of plasma, erythrocyte and urinary zinc. Conclusion These results suggest that RYGBP promoted, besides change in body composition, an alteration in the zinc plasma and erythrocytes concentrations which in the medium and long term, could cause problems for these patients.     

Effect of comestibles on symptoms of interstitial cystitis

PURPOSE: Anecdotal evidence suggests that patients with painful bladder syndrome/interstitial cystitis report symptom exacerbation after consuming particular foods, beverages and/or supplements. We determined the prevalence of the effect of comestibles on painful bladder syndrome/interstitial cystitis symptoms and identified particular comestible items more likely to affect such symptoms. MATERIALS AND METHODS: A validated questionnaire designed to detect whether food, beverages and/or supplements have an effect on bladder symptoms was administered to 104 patients meeting National Institute for Diabetes and Digestive and Kidney Diseases criteria for interstitial cystitis. In addition to answering general questions about the effect of comestibles on painful bladder syndrome/interstitial cystitis symptoms, subjects were asked to indicate whether each of 175 individual items worsened, improved or had no effect on symptoms. Each response was numerically scored on a scale of -2 to 2 and mean values were generated for each comestible item. RESULTS: Of the surveyed patients with painful bladder syndrome/interstitial cystitis 90.2% indicated that the consumption of certain foods or beverages caused symptom exacerbation. There was no correlation between allergies and the effect of comestibles on symptoms. Patients who reported that specific foods worsened symptoms tended to have higher O'Leary-Sant interstitial cystitis symptom index and problem index, and/or pelvic pain and urgency/frequency patient symptom scale scores. A total of 35 comestible items had a mean score of lower than -1.0, including caffeinated, carbonated and alcoholic beverages, certain fruits and juices, artificial sweeteners and spicy foods. CONCLUSIONS: There is a large cohort of patients with painful bladder syndrome/interstitial cystitis in whom symptoms are exacerbated by the ingestion of specific comestibles. The most frequently reported and most bothersome comestibles were coffee, tea, soda, alcoholic beverages, citrus fruits and juices, artificial sweeteners and hot pepper.     

围术期综合护理对于唇腭裂手术患儿的应用效果

目的 探究围术期采用综合护理对于唇腭裂手术患儿的护理效果。方法 选取2022年2月-2023年 2月本院收治的60例唇腭裂手术患儿作为研究对象,随机分为对照组和观察组,各30例。对照组采用常规 护理,观察组采用围术期综合护理,比较两组疼痛程度、并发症发生情况、满意度、生活质量及心理状 况。结果 观察组疼痛评分为（1.53±0.87）分,低于对照组的（2.01±0.92）分（P ＜0.05）;观察组并 发症发生率为10.00%,低于对照组的36.67%（P ＜0.05）;观察组满意度为96.67%,高于对照组的73.33% （P ＜0.05）;观察组生活质量评分均高于对照组（P ＜0.05）;观察组心理健康率为93.33%,高于对照组 的73.33%（P ＜0.05）。结论 围术期综合护理的实施能够有效提升唇腭裂患儿的术后恢复情况,减少并发 症,提高满意度,同时能够更好的满足患儿的心理需求,值得应用。     

腔镜资源整合管理对手术室护理质量的影响

目的 探讨医院腔镜资源整合管理对手术室护理质量的影响。方法 成立腔镜整合管理小组，采取统一购置、统一编号、合理调配使用的科学化、规范化、程序化管理模式，实行专人清洗消毒，专人进行感染控制监测的操作规程。实施6个月后，与非整合管理组（管理前）进行比较，观察两组连台手术衔接时间、器械护士腔镜器械准备的准确率、手术医生对两组器械护士的满意度及手术切口愈合情况。结果 整合管理组连台手术衔接时间显著短于非整合管理组（P〈0．01），腔镜器械准备准确率、手术医生的满意度及手术切口的愈合率显著高于非整合管理组（均P〈0．01）。结论 医院腔镑资源罄合，充分发挥了腔镜设备的使用效能，提高了腔镜专科护士工作效益，提升了手术室护理质量。     

阴道再造术围手术期的护理

目的：探讨阴道再造术的护理方法,降低并发症的发生率,提高患者生活质量。方法：对我院收治的12例先天性无阴道、阴道闭锁无子宫的患者,8例异性癖患者进行阴道再造术的术前准备、术后护理、出院指导等进行回顾性分析。结果：20例阴道再造术患者,平均住院8～16天,均痊愈出院,1例易性癖患者术后20天发生阴道回缩,经换药、植皮后痊愈。随访1个月～1年,1例发生阴道粘连挛缩、狭窄,其余效果满意。结论：针对不同患者的心理状况,做好耐心细致的心理护理及手术前后的综合性护理,特别是术前肠道准备、术后人工阴道的护理及指导患者出院后正确的健康指导是降低阴道再造术的并发症,提高手术的成功率的重要措施。     

颌骨骨折内固定术后患者的饮食干预

目的 探讨颌骨骨折钛板内固定术后患者安全、有效的营养支持方法,为该类患者的营养护理提供依据.方法 将40例颌骨骨折切开复位微型钛板内固定术患者随机分为对照组和观察组各20例.根据患者营养需求,对照组给予匀浆膳,观察组按照患者饮食习惯、口味给予营养膳并辅助康全饮肠内营养液.结果 术后1周、2周两组患者体重、白蛋白、外周血淋巴细胞计数与术前比较,差异无显著性意义(均P＞0.05);对照组胃肠道不良反应发生率高于观察组(P＜0.05,P＜0.01);观察组对营养饮食的外观、口味满意率及饮食依从性显著高于对照组(均P＜0.01).结论 颌骨骨折内固定术后根据患者饮食习惯给予营养膳食并辅助康全饮,可有效改善患者营养状况,减少胃肠道不良反应,提高其饮食依从性.