通幽丸治疗功能性便秘57例

[目的]观察通幽丸治疗功能性便秘(FC)的临床疗效和安全性.[方法]159例FC患者,随机抽样分为3组.治疗组服用通幽丸;对照1组服用芪蓉润肠口服液;对照2组服用麻仁胶囊,均为饭后服用.7d为一疗程.[结果]治疗组总有效率为85.59％,对照1、2组总有效率分别为61.54％,64.00％;治疗组与对照1组、对照2组比较均差异有统计学意义(均P＜0.05,).[结论]通幽丸治疗FC优于芪蓉润肠口服液与麻仁胶囊,临床效果较为显著.     

老年良性前列腺增生合并混合痔患者术后尿潴留的影响因素分析

目的 分析老年良性前列腺增生(BPH)合并混合痔患者术后尿潴留的影响因素。方法 选取2020年1月—2023年5月安庆市中医医院收治的194例老年BPH合并混合痔患者。根据患者外剥内扎术术后是否发生尿潴留分为尿潴留组(n=72)和非尿潴留组(n=122)。比较2组的临床资料、术后24 h视觉模拟评分法(VAS)及术后24 h焦虑自评量表(SAS)评分。分析患者术后尿潴留的影响因素，构建术后尿潴留的人工神经网络模型，并对模型的效能进行验证。结果 与非尿潴留组比较，尿潴留组便秘者和镇痛泵使用者较多，术前空腹血糖(FBG)水平较高，手术时间较长，静脉补液量较大，术后24 h VAS和SAS评分较高(P<0.05)。多因素分析结果显示，便秘、术前FBG升高、手术时间长、静脉补液量大、术后使用镇痛泵、术后24 h VAS和术后24 h SAS评分升高均为老年BPH合并混合痔患者术后尿潴留的独立危险因素(P<0.05)。人工神经网络预测模型的区分度良好，该模型的曲线下面积为0.733(95%CI:0.663～0.804,P<0.001);灵敏度为83.33%(60/72),特异度...     

天灸疗法治疗老年功能性便秘的随机对照研究

目的探讨中药天灸疗法对改善老年功能性便秘的近远期疗效。方法将72例老年功能性便秘患者随机分为试验组和对照组,每组各36例,试验组按老年人特点选穴选药进行天灸治疗;对照组采用果导片口服,治疗4周后停药并随访6月,每周采用便秘评分量表(CCS)评估便秘情况并观察2组试验后每周及结束后第1月、3月及6月自主排便次数及用药后的不良反应。结果试验组在试验第1、2周CCS评分与对照组差异无统计学意义(P0.5),第3周以后CCS评分明显降低(P0.05);试验期和随访期试验组排便次数显著多于对照组(P0.05);2组患者用药后均无不良反应。结论中药天灸能改善老年人的便秘状况,远期疗效较好,而且用药安全,无不良反应。     

老年便秘患者出院后便秘原因分析及健康指导

便秘是排便次数在7天内少于2～3次，粪便量少，干硬并伴排出困难。便秘是许多慢性病的诱因，严重影响着老年患者的生活质量。诱发便秘的原因很多，但进食量过少、水分不足、缺乏体力活动、饮食中缺乏膳食纤维是老年人便秘的主要因素。便秘患者如果长期依赖服用药物排便，会引发相应的不良反应，为预防和减少出院后便秘的发生，现将2006年8至12月20例老年便秘患者出院后便秘原因分析及护理报告如下。     

便通胶囊联合莫沙必利治疗老年痔患者术后便秘的临床疗效

目的:探讨便通胶囊联合莫沙必利治疗老年痔患者术后便秘患者的临床疗效,为临床治疗老年痔患者术后便秘提供参考.方法:收集河南省南阳市中心医院肛肠科收治的78例老年痔术后便秘患者,随机分为观察组和对照组,各39例,观察组采用便通胶囊+莫沙必利治疗,对照组采用莫沙必利治疗,比较两组患者临床治疗效果.观察组2例大便不成形,坚持服用药物治疗后患者的临床症状缓解;对照组6例腹痛胀,经过排便灌肠之后缓解.两组的对象均无肝肾功能异常的情况.结果:观察组患者治疗痊愈26例(66.7%),显效7例(17.9%),有效4例(10.3%),无效2例(5.1%),总有效率94.9%;对照组患者痊愈17例(43.6%),显效4例(10.3%),有效10例(25.9%),无效8例(20.5%),总有效率为79.5%,差异具有统计学意义(P<0.05).结论:通便胶囊具有健脾益肾、润肠通便的作用,莫沙必利能促进胃肠蠕动,将两者联合用于治疗老年痔术后便秘取得良好的效果,值得临床推广应用.     

莫沙必利与普芦卡必利治疗老年慢性便秘的疗效比较

目的:比较莫沙必利与普芦卡必利治疗老年慢性便秘的疗效,为老年慢性便秘的治疗提供依据.方法:将青海大学附属医院2013-02/2014-09收治的123例老年慢性便秘患者随机分为对照组(61例)和观察组(62例),分别接受莫沙必利和普芦卡必利口服治疗,比较两组的疗效,首次排便时间及排便困难、排便不尽的改善时间和常见症状(排便频度、粪便性质、排便困难程度和排便时间)的评分,记录治疗期间的不良反应.结果:观察组的总有效率为95.16%(59/62),高于对照组的83.61%(51/61)(P0.05);与对照组比较,观察组的首次排便时间及排便困难、排便不尽的时间均缩短,常见症状评分均降低(P0.05);两组的主要不良反应为腹泻、恶心及腹痛,多为轻中度,持续时间较短,且不良反应发生率的差异无统计学意义(P0.05).结论:普芦卡必利治疗老年慢性便秘的疗效优于莫沙必利,可改善便秘症状,不良反应较低,患者可耐受.     

中西医结合治疗慢性功能性便秘的临床研究

目的观察枯草杆菌二联活菌肠溶胶囊联合柏子滋阴润肠汤治疗慢性功能性便秘的疗效。方法将入院治疗的慢性功能性便秘患者259例分为治疗组130例和对照组129例。对照组给予枯草杆菌二联活菌肠溶胶囊治疗,治疗组在此基础上给予柏子滋阴润肠汤治疗,所有患者均治疗1个疗程并对比两组患者的疗效。结果治疗组患者的总有效率为93.85%与对照组患者的77.52%相比具有显著的优势,差异具有统计学意义(P0.05)。结论枯草杆菌二联活菌肠溶胶囊联合柏子滋阴润肠汤治疗慢性功能性便秘,可有效的减少患者每次排便所需的时间,及缓解排便难度,临床不良反应少,且长期服药不易产生耐药性,值得临床推广应用。     

不同手术方式对老年阑尾炎患者凝血和纤溶系统的影响

目的探讨腹腔镜及开腹阑尾切除手术对老年阑尾炎患者凝血和纤溶系统的影响及术后下肢深静脉血栓(DVT)发生情况。方法选择老年阑尾炎患者80例,按照随机数字表法分为腔镜组40例,开腹组40例。腔镜组患者行腹腔镜下阑尾切除术(LA),开腹组患者行开腹阑尾切除术(OA)。比较两组术前半小时、术后24 h和72 h血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板(PLT)变化情况,以及术后72 h DVT的发生情况。结果两组患者术前各项凝血指标及两组术后24 h、72 h PT与术前半小时比较差异无统计学意义(P0.05);两组患者术后24 h APTT均较术前半小时明显降低(P0.05),两组相比,术后24 h、72 h APTT差异无统计学意义(P0.05);两组术后24 h、72 h FIB、D-D均较术前半小时升高,腹腔镜组术后24 h、72 h FIB、D-D均低于开腹组,差异均有统计学意义(P0.05);两组术后24 h、72 h PLT均较术前半小时显著降低(P0.0 5),两组相比,术后24 h、72 h PLT差异无统计学意义(P0.05)。腔镜组和开腹组术后72 h DVT发生率分别为10.0%和7.5%,组间比较差异无统计学意义(P0.05)。结论两种手术方式均对老年患者凝血和纤溶系统产生明显影响,术后高凝状态,血栓风险增高,腹腔镜手术对凝血功能和纤溶系统的影响低于开腹手术,但由于腔镜手术术中气腹及体位等因素影响,患者术后DVT发生率高。老年患者是血栓疾病的高危人群,应重视术前、术后的监测与防治。     

腹腔镜疝修补技术治疗老年腹股沟疝的临床效果及对生活质量的影响

目的探讨腹腔镜疝修补技术治疗老年腹股沟疝的临床效果及对生活质量的影响。方法选择老年腹股沟疝患者126作为研究对象,按照随机数字表法分为对照组63例与观察组63例。对照组采用开放腹股沟疝修补术治疗,观察组采用腹腔镜疝修补术治疗。比较两组治疗效果,术后并发症,术后3 h、12 h和24 h疼痛视觉模拟评分(VAS)变化,术后随访6个月生活质量改善情况。结果观察组术中出血量显著少于对照组,下床活动时间显著快于对照组,住院时间和手术时间显著短于对照组(P0. 05)。观察组术后并发症发生率(7. 94%)显著低于对照组(25. 40%,P0. 05)。观察组术后3 h、12 h和24 h VAS显著低于同期对照组(P0. 05)。观察组术后随访6个月健康状况调查问卷(SF-36)评分显著高于对照组(P0. 05)。结论腹腔镜疝修补技术在老年腹股沟疝患者中临床效果显著,且可明显改善生活质量,减轻疼痛并降低术后并发症发生。     

老年心血管病患者白内障围手术期心律失常的变化及对策

目的应用动态心电图(DCG)观察老年心血管病患者行白内障摘除术围手术期心律失常发生情况,为制定干预措施提供依据。方法对66例(72只眼)年龄≥60岁伴有心血管病史的白内障手术摘除患者,在围手术期间进行24 h DCG监测,观察术前2 h、术中以及术后2 h的心律失常变化,所得DCC数据用统计学方法进行对比分析研究。结果 66例患者在围手术期间心律失常的总发生率为87.9%,以房性心律失常最高(86.2%),室性心律失常次之(72.4%);短暂房性心动过速和短暂室性心动过速分别为24.1%和3.4%。术中和术后2 h房性心律失常发生率明显高于术前2 h(P=0.000);而术中和术后2 h室性心律失常明显低于术前2 h(P=0.000)。23例(34.8%)有眼心反射的发生。术后出院视力脱残率为86.1%,脱盲率为93.1%。手术中无严重全身并发症发生。结论老年心血管病患者白内障围手术期心律失常发生率较高,术前应予全面综合分析和评估,针对其变化特点采取相应措施,尽可能减少心律失常的发生,使手术风险降至最低。     

腹腔镜腹膜前疝修补术与Lichtenstein疝修补术对腹股沟疝患者凝血功能的影响

目的比较腹腔镜腹膜前疝修补术(TAPP)与Lichtenstein疝修补术治疗腹股沟疝对患者凝血功能的影响。方法选取2017-06~2019-06收治的70例腹股沟疝患者作为研究对象,随机分为研究组和对照组,各35例。研究组采用TAPP治疗;对照组采取Lichtenstein疝修补术治疗。观察比较两组患者手术情况及围术期凝血功能指标的变化。结果两组术前凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、D二聚体(D-D)比较差异无统计学意义(P>0.05);术后0 h、术后24 h与术前比较,两组PT和APTT显著下降,Fbg和D-D水平显著上升(P<0.05);术后0 h与术后24 h比较,两组PT、APTT、Fbg比较差异无统计学意义(P>0.05),术后两组的D-D水平比较差异有统计学意义(P<0.05),但术后24 h两组D-D水平比较差异无统计学意义(P>0.05)。研究组术后D-D水平波动更大,术后上升更高,术后24 h下降更多(P<0.05)。结论TAPP与Lichtenstein疝修补术均使腹股沟疝患者凝血功能增强,血液处于高凝状态。TAPP可能给患者带来更严重的高凝状态,但因术后康复快,下床活动早,避免了血液瘀滞,并没有增加术后深静脉血栓风险,故TAPP值得临床推广应用。     

复方碳酸氢钠栓治疗功能性便秘的多中心、随机、双盲、安慰剂对照临床试验

背景：功能性便秘是一种常见慢性肠道功能性疾病，目前其治疗药物虽较多，但疗效不尽如人意。目的：观察复方碳酸氢钠栓治疗功能性便秘的临床疗效和安全性。方法：2006年5月-2007年5月由6家医院进行多中心、随机、双盲、安慰剂对照临床试验。1周筛选期后，218例功能性便秘患者随机分为试验组和对照组，每组109例，分别给予复方碳酸氢钠栓和安慰剂纳肛，1粒／d，连续7d。治疗第1d，用药1次后若无排便，可重复用药1次。治疗第2d起每日用药1次。受试者每日记录排便次数、大便性状以及排便费力、排便不尽感、服用缓泻剂天数和药物用量。结果：治疗1周后，与治疗前和对照组相比，试验组周排便次数、周大便性状、周排便不尽感天数均显著改善（P〈0．05），但两组周排便费力天数、周服用缓泻剂天数和周药物用量相比差异均无统计学意义。两组均未出现严重不良事件。结论：复方碳酸氢钠栓治疗功能性便秘有效而安全。     

PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial

BACKGROUND: Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. AIMS: To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects. PATIENTS: One hundred patients (aged 6 months-15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial. METHODS: After faecal disimpaction, patients <6 years of age received PEG 3350 (2.95 g/sachet) or lactulose (6 g/sachet) while children > or =6 years started with 2 sachets/day. Primary outcome measures were: defecation and encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency > or =3/week and encopresis < or =1 every two weeks. Secondary outcome measures were side effects after eight weeks of treatment. RESULTS: A total of 91 patients (49 male) completed the study. A significant increase in defecation frequency (PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group. CONCLUSIONS: PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation.     

一次性根治术与切开挂线术对腺源性肛瘘患者的疗效对比

目的分析比较一次性根治术与切开挂线术对腺源性肛瘘患者的疗效。方法将重庆医科大学附属第一医院收治的88例腺源性肛瘘患者随机分为一次性根治术组(DRO组)和切开挂线术组(ITD组),各44例,DRO组给予一次性根治术治疗,ITD组给予切开挂线术治疗。对比两组患者住院时间,应用视觉模拟评分法(VAS)评估术后6 h、12 h、24 h、48 h患者的疼痛程度,并比较伤口愈合时间、术后2周时的排便功能恢复情况,另统计并对比两组患者手术治愈率及术后并发症及复发情况。结果DRO组住院时间及伤口愈合时间均明显长于ITD组(P<0.05)。经重复测量方差分析,VAS评分差异有统计学意义(P<0.05);两组组内术后48 h VAS评分<术后24 h<术后12 h<术后6 h,差异均有统计学意义(P<0.05);DRO组术后6 h、12 h、24 h、48 h VAS评分均显著低于ITD组(P<0.05)。术后2周时两组排便功能恢复情况等级分布差异显著(P<0.05)。两组治愈情况等级分布差异不显著(P>0.05)。术后两组总并发症发生率无显著差异(P>0.05)。随访1年,DRO组复发率为2.27%,显著低于ITD组的18.18%(P<0.05)。结论在腺源性肛瘘患者的治疗中,一次性根治术与切开挂线术的治愈率相当,术后并发症少,一次性根治术能够减轻患者术后疼痛,促进排便功能恢复,降低复发率,切开挂线术能够缩短住院时间,加快伤口愈合。     

腹横平面联合髂腹下-髂腹股沟神经阻滞麻醉在老年高危患者腹股沟疝修补术中的应用

目的探讨腹横平面（transversus abdominis plane block, TAP）神经阻滞联合髂腹下-髂腹股沟（Ilioinguinal-iliohypogastric, IIIH）神经阻滞作为主要麻醉方法,在老年高危患者腹股沟疝修补术中应用的安全性和有效性。 方法选择新疆维吾尔自治区人民医院2017年4月至2018年4月收治的择期行单侧腹股沟疝修补术的68例老年高危患者。其中35例采用TAP联合IIIH神经阻滞（TAP-IIIH组）,33例采用局部麻醉浸润（local anesthesia infiltration, LAI）（LAI组）。术前两组患者均给予咪哒唑仑2 mg+舒芬太尼5μg镇静。术中观察记录两组患者T1（切皮时）、T2（打开腹外斜肌腱膜时）、T3（游离疝囊时）、T4（分离腹膜前间隙置入补片时）、T5（缝合腹横筋膜时）、T6（缝合腹外斜肌筋膜）、T7（皮肤切口闭合时）时点的视觉模拟评分（visual analogue scale, VAS）;术后观察记录2、12、24 h时患者休息和运动（咳嗽）状态下的VAS;记录术中舒芬太尼追加使用量、术后患者对麻醉的满意度评分、麻醉费用、手术时间、术后恢复活动时间和住院时间。随访麻醉并发症至手术后4周。 结果TAP-IIIH组患者6个时点（T2～T7）的VAS均较LAI组低（t=-4.635、-7.309、-5.994、-8.888、-4.499、-8.132,均P<0.01）。术后2、12 h时,休息或活动状态下TAP组的VAS均明显低于LAI组（t=-7.295、77.283,-6.606、-3.034;P<0.05或0.01）;术后24 h时,无论休息或运动状态下,两组患者VAS的差异均无统计学意义（t=-2.293、-1.365,均P>0.05）。与LAI组患者比较,TAP-IIIH组患者舒芬太尼的追加量更少、患者满意度评分更高、手术时间更短、术后恢复活动时间更短,但麻醉费用更高,差异均有统计学意义（t=-6.433、3.639、-4.238、-2.518、21.645,P<0.05或0.01）;两组患者住院时间的差异无统计学意义（t=1.797,P>0.05）,均未发生明显的麻醉相关并发症。 结论TAP-IIIH神经阻滞作为主要的麻醉方式在老年高危患者腹股沟疝修补术中的应用是安全有效的。     

Polyglactine/Polypropylene Mesh vs. Propylene Mesh: Is There a Need for Newer Prosthesis in Inguinal Hernia?

Background/Aim:

To compare outcomes of light and heavy weight mesh for repair of inguinal hernia.

Materials and Methods:

This study was conducted at the Department of Surgery; Lady Reading Hospital, Peshawar from January 1, 2007 to December 31, 2008. Patients were divided into two groups based on the type of mesh implanted for inguinal hernia repair. Group 1 included patients in whom light weight composite (VyproII^®) mesh is implanted: Group 2 included patients in whom polypropylene (Prolene^R) mesh is implanted. Data concerning the complications and post operative pain in the perioperative and postoperative period were collected and analyzed. Categorical data were presented as percentages with 95% confidence intervals and compared using a χ²test and P<0.05 were considered significant.

Results:

Following allocation and exclusion of violating cases, 111 patients in group 1 and 138 patients in group 2 were analyzed. The mean age in group 1 was 38.20 ± 13.34 years and in group 2 was 39.55 ± 13.70 (P = 0.434). In group 1, hematoma formation was observed in four cases (3.6%), while it was observed in six cases (4.2%) in group 2 (P = 0.766). During the entire study, ten patients in all developed urinary retention, three of which required transient catheterization. One year post operation, there was a recurrence in only five cases overall, while only two patients complained of pain (P = 0.826).

Conclusion:

The frequency of postoperative pain and complications in patients was similar in both groups.     

Is colorectal cancer screening necessary in the preoperative assessment of inguinal herniorrhaphy? a case-control study

OBJECTIVES: The question of whether patients presenting for inguinal hernia repair require pre-operative assessment for colon cancer has remained unanswered. A case-control study is necessary to assess whether the prevalence of premalignant or malignant colonic lesions is higher in patients presenting with inguinal hernia compared to the general population. METHODS: Between 1990-2000, 614 inguinal herniorrhaphies were performed at the Veterans Affairs Palo Alto Health Care System (VAPAHCS). We retrospectively studied the 149 (24%) patients from this group with no prior history of colonic polyps, malignancy, or gastrointestinal bleeding who had flexible sigmoidoscopy or colonoscopy performed during the peri-operative period. Comparison was made to 149 controls undergoing colonoscopy or sigmoidoscopy during the same time period for colon cancer (CRC) screening. RESULTS: The mean (+/-SEM) patient age was 67 +/- 0.7 (range 31-92) yr in the hernia patients and 66 +/- 0.8 (range 46-93) in the control group (p = 0.7). Eighty-two of the inguinal hernia patients had screening procedures performed preoperatively with a mean time (+/-SEM) of 1.4 +/- 0.14 yr, while endoscopy was performed in the post-operative period for the remaining 67 patients (average time 2.7 +/- 0.2 yr, p < 0.001). More patients underwent colonoscopy in the control group compared to the hernia cohort (p = 0.004). Seven (5%) patients in the hernia group were found to have colorectal cancer compared to six (4%) in the control group (p = 0.8). CONCLUSIONS: This study does not support previously published findings that patients with inguinal hernias are more likely to have premalignant colonic lesions. Patients with inguinal hernias should undergo screening for colon cancer at the same rate as the general population.     

Long term efficacy, safety, and tolerabilitity of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation

AIMS: To assess the long term therapeutic effectiveness, safety, and tolerability of low daily doses of isosmotic PEG electrolyte solutions (PMF-100) administered for a six month period for the treatment of functional constipation, in a double blind, placebo controlled, parallel group study. METHODS: After an initial four week run in period with PMF-100 (250 ml twice daily; PEG 14.6 g twice daily), 70 patients suffering from chronic constipation (58 females, aged 42 (15) years) with normalised bowel frequency (>3 bowel movements (bm)/week) were randomly allocated to receive either PMF-100 or placebo, contained in sachets (one sachet in 250 ml of water twice daily) for 20 weeks. Patients were assessed at four week intervals, and reported frequency and modality of evacuation, laxative use, and relevant symptoms on a diary card. At weeks 1, 12, and 24, a physical examination and laboratory tests were performed. RESULTS: Complete remission of constipation was reported by a significantly (p<0.01) higher number of patients treated with PMF-100 compared with placebo at each four week visit. At the end of the study, 77% of the PMF-100 group and 20% of the placebo group were asymptomatic. Compared with placebo, patients treated with PMF-100 reported hard/pellety stools and straining at defecation less frequently, a significantly higher bowel frequency (week 12: 7. 4 (3.1) v 4.3 (2.5) bm/week, 95% CI 1.64, 4.42; week 24: 7.4 (3.2) v 5.4 (2.1) bm/week, 95% CI 0.13,3.93), reduced consumption of laxative/four weeks (week 12: 0.7 (2.7) v 2.2 (3.3), 95% CI -2.29, 0. 03; week 24: 0.2 (0.8) v 1.4 (2), 95% CI -2.07, -0.023), reduced mean number of sachets used (week 12: 33 (13) v 43 (12), 95% CI -17. 24, 4.56; week 24: 33 (13) v 44 (12), 95% CI -19.68, -2.24), and reduced number of drop outs for therapy failure (16 v 3; p<0.005). Adverse events, physical findings, laboratory values, palatability, and overall tolerance of the solutions did not differ between groups. CONCLUSIONS: Administration of small daily doses of isosmotic PEG electrolyte balanced solutions was effective over a six month period for the treatment of functional constipation. A mean daily dose of approximately 300 ml of PEG solution (PEG 17.52 g) appeared to be safe, well tolerated, and devoid of significant side effects.     

不同穴位按摩对老年患者腹腔镜胆囊切除术后胃肠功能影响

目的 观察老年患者腹腔镜胆囊切除术后单穴与多穴位按摩对改善胃肠功能的效果.方法 选择2014年12月-2017年2月在上海市中医医院住院行腹腔镜胆囊切除术及胆囊切除加胆管探查术的老年患者72例,采用随机数字分组法分为3组,单穴位按摩为A组、多穴位按摩为B组、常规护理为C组,每组24例.3组患者均采用腹腔镜胆囊手术常规治...     

Determination of total and segmental colonic transit time in constipated patients

Ninety-one patients with idiopathic constipation had segmental colonic transit studied with radiopaque markers using a new simplified technique to determine frequency and type of colonic transit time (CTT) abnormalities and to determine the utility of this test in planning therapy. Colonic transit studies defined four groups: normal CTT(N=49), right colonic stasis (N=16), outlet obstruction (N=12), and isolated left colonic stasis (N=14). Right colonic stasis and outlet obstruction were associated with frequent use of digital pressure to assist defecation. Right colonic stasis was characterized by a low stool frequency (<3 per week) in 93% of cases and failure to respond to bran therapy. Outlet obstruction also showed a poor response to bran therapy but weekly stool frequency was higher than 3 in 46% of cases. Normal colonic transit time and isolated left colonic stasis were characterized by a normal stool frequency (5.8±0.05 and 4.2±0.1, respectively) and clinical help with the use of bran treatment (72 and 64%, respectively). Our study suggested that patients who complain of idiopathic constipation represent a heterogenous group of disorders. Segmental CTT determination is a simple, useful, and noninvasive test of patients with constipation.