护理干预影响手术患者焦虑心理的效果研究

目的探讨术前护理干预对减少手术患者焦虑、恐惧心理的效果。方法 72例择期手术患者随机分为干预组和非干预组 ,干预组术前实施访视 ,讲解麻醉和手术相关知识 ,给予心理辅导和卫生宣教等护理干预措施。非干预组按常规护理。结果比较分析显示两组患者在担心手术疼痛 ,手术不成功 ,术前失眠、恐惧 ,术后遗留疤痕等 5项观察指标之间存在显著的差异 (P <0 .0 5 )。结论术前护理干预对减轻手术患者焦虑心理具有重要的辅助作用     

胃肠减压管置管长度的临床研究

目的:研究胃肠减压管置管长度,提高治疗效果和减少术后并发症。方法:以随机对照研究的方法,将普外科胃肠减压 病人240例分二组,实验组120例置管55～70 cm,对照组120例置管45～55 cm。比较二组临床效果。结果:二组的引流效果、术后 腹胀及肠蠕动恢复时间、胃管留置时间经统计学处理,差异有显著性意义。结论:胃肠减压管的留置长度应以55-70 cm为妥。     

The effect of the mammalian neuropeptide, gastrin-releasing peptide (GRP), on gastrointestinal and pancreatic hormone secretion in man

Gastrin-releasing peptide, a newly isolated mammalian peptide similar in its structure and actions to the amphibian peptide, bombesin, has recently been localized to nerves in the brain, gut and pancreas. The present study investigates its effects on gut and pancreatic peptides in man. Intravenous infusion of 0.7 and 2.9 pmol min-1 kg-1 produced significant elevation of plasma gastrin, cholecystokinin-like immunoreactivity and neurotensin. It was found also to potentiate glucose-dependent insulin secretion. Its specific location in nerve fibres in the proximal gut and pancreas and its selective effect on gastroenteropancreatic peptides may favour its role as a physiological regulatory neuropeptide.     

对精神科门诊家庭护理指导内容和方式的探讨

[目的 ]探讨精神科家庭护理指导的内容和方式。 [方法 ]对精神科家庭护理咨询门诊 2 61例病人及家属咨询的问题及效果进行分析。 [结果 ] 2 2 4例认为效果满意 ,2例不满意 ,3 5例未作评价。 [结论 ]护理咨询门诊是病人和家属接受的护理服务新方式 ,护理咨询内容应体现病人及家属对精神卫生知识的需求。     

消化道出血的诊断程序探讨

目的：通过对消化道出血患者进行诊断线索分析及误诊、漏诊分析,探讨消化道出血诊断的基本程序。方法：对１８年来住院的１７２９例消化道出血患者的临床资料进行回顾性分析。结果：黑便、呕血、持续进行胃管引流和黏液血便及滴血性血便对消化道出血的部位诊断有一定的价值。结论：为避免误诊漏诊,笔者提出诊断消化道出血应遵循的诊断和验证诊断的程序。     

Video capsule endoscopy for investigation of obscure gastrointestinal bleeding: feasibility, results, and interobserver agreement

BACKGROUND AND STUDY AIMS: The aim of the study was to assess the feasibility, diagnostic yield, and interobserver agreement of capsule endoscopy in the investigation of patients with obscure or occult gastrointestinal bleeding. PATIENTS AND METHODS: A total of 64 consecutive patients with occult bleeding (31 %) or overt bleeding (69 %) were assessed using capsule endoscopy after negative upper and lower endoscopy and small-bowel radiology. The quality of visualization of the small-bowel mucosa was scored from 1 (poor) to 4 (excellent). Thirty video capsule recordings with normal or abnormal findings were blindly assessed by four independent endoscopists. Interobserver agreement was evaluated using the kappa index. RESULTS: The small bowel was completely visualized in 57/64 patients (89 %). Incomplete small-bowel transit was most commonly due to prolonged gastric retention (five patients). The mucosa visualization scores (means) for the proximal, middle, and distal thirds of the small bowel were 3.7, 3.3, and 2.2 respectively. Visualization of the distal ileum was good (> or = 3) in 38 % and a bleeding site was found in 45 % of patients. Push-enteroscopy was also performed in 56 patients. The results of the two techniques were similar in 37 patients, capsule endoscopy was superior in 12 patients, and push-enteroscopy was superior in seven patients. Interobserver agreement was good for bleeding and for angiodysplasia, but poor for ulcers and tumors. Mean interobserver agreement was better among experienced endoscopists than among junior endoscopists. CONCLUSIONS: Capsule endoscopy allowed the whole small intestine to be explored in 89 % of patients, with good visualization of the mucosa, except distally. Interobserver agreement was better among the experienced endoscopists and was better for red-colored abnormalities (bleeding and angiodysplasia) than for ulcers and tumors.