合并糖尿病食管癌患者的围手术期综合护理分析

目的 分析合并糖尿病食管癌患者围手术期综合护理的应用效果.方法 选取郑州大学第一附属医院2019年11月至2020年11月收治的64例糖尿病食管癌患者,随机将其均分为对照组32例和观察组32例,分别给予常规护理和综合护理,比较2组护理效果.结果 观察组的糖化血红蛋白值和空腹血糖分别为(5.28±0.50)％和(4.82...     

食管癌合并糖尿病患者的围手术期处理

目的：探讨食管癌合并糖尿病的围手术期治疗措施。方法：对外科治疗的48例食管癌合并糖尿病患进行回顾性分析。结果：48例患均行手术治疗，术后并发症12例，无死亡病例。结论：食管癌合并糖尿病只要围手术期严格控制血糖，仍然是安全的。     

34例食管癌合并糖尿病患者围手术期的治疗体会

回顾性总结了食管癌合并糖尿病围手术期的治疗经验，其要点包括：术前常规查血糖，术后用末梢血糖检测仪监测血糖，尿糖试纸监测尿糖，应用胰岛素调整血糖，给予充足的热量，预防酸碱平衡失调及电解质紊乱，采取妥善的处理方法可减少食管癌的术后并发症。     

食管癌贲门癌合并糖尿病的围手术期处理

目的探讨食管癌贲门癌合并糖尿病的外科治疗和围手术期处理。方法对2004年1月至2009年5月手术治疗的41例食管癌贲门癌合并糖尿病患者进行回顾性分析。术前对患者行全面检查,做好血糖、尿糖的检测记录,并根据这些指标调整血糖。术中尽可能选择对糖代谢影响较小的麻醉药品,尽量不输含糖液体。术后采用肠外营养（PN）和肠内营养（EN）相结合的方法给机体提供热卡并维持水电解质平衡,总热卡为25～30kcal／kg／d。结果手术切除率为100％,无手术死亡,术后并发症6例,但无1例发生酮症酸中毒、非酮症高渗性昏迷及低血糖性休克。结论对食管癌贲门癌合并糖尿病患者的手术治疗应采取积极态度,只要重视围手术期的处理,合并糖尿病并不增加手术死亡率和并发症的发生率。     

高龄食管癌患者围手术期的护理

随着人们生活水平的不断提高、寿命的延长以及人口老龄化,老年食管癌发病率相对增加,且多为晚期,术后并发症和病死率均较高.     

食管癌合并糖尿病的围手术期处理

回顾性总结 2 3例食管癌合并糖尿病的处理经验。术前、术中、术后均应用普通胰岛素 (RI)控制糖尿病 ,不限制糖的摄入 ,按比例应用RI ,并根据尿糖的测定追加RI ,使血糖略高于正常水平 ,尿糖控制在 (± )～ ( )为安全措施。研究提示 ,术前常规检查血糖 ,针对糖尿病采取妥善的围手术期处理明显减少食管癌合并糖尿病患者的术后并发症 ,RI的合理应用是治疗成功的关键 ,治疗过程中应重点加强对糖尿病的处理。     

老年妇科恶性肿瘤合并糖尿病患者的围手术期护理

目的探讨老年妇科恶性肿瘤合并糖尿病患者的临床特点及围手术期护理的方法。方法对2007年1月至2012年1月间收治的54例老年妇科恶性肿瘤合并糖尿病患者的临床资料及护理方法进行回顾性分析。结果 54例患者中,50例患者手术后恢复良好,无护理相关并发症,3例患者经二次重缝愈合,1例患者合并高血压发生下肢深静脉血栓。结论对患有老年妇科恶性肿瘤合并糖尿病患者通过围手术期护理可获得良好效果。     

高龄食管癌患者围手术期的处理

食管癌是一种常见的恶性肿瘤，而我国太行山系又是世界上食管癌的高发地区，手术为食管癌首选的治疗方法。2000年12月-2006年6月我院共行食管癌手术396例，现将其中62例高龄食管癌患围手术期处理情况进行回顾性分析，报告如下。[第一段]     

食管贲门癌合并糖尿病93例围手术期治疗

[目的]探讨食管癌和贲门癌合并糖尿病围手术期处理方法。[方法]分析93例食管癌和贲门癌合并糖尿病的临床资料.[结果]食管癌和贲门癌外科治疗合并糖尿着占l.7％，术前、采中控制血糖在略高于正常水平。术后并发症发生率2l.5％。[结论]胰岛素的合理应用是食管癌和贲门癌合并糖尿病治疗成功的关键之一。     

34例食管癌合并糖尿病患者围手术期的治疗体会

回顾性总结了食管癌合并糖尿病围手术期的治疗经验。其要点包括 :术前常规查血糖 ,术后用末梢血糖检测仪监测血糖 ,尿糖试纸监测尿糖 ,应用胰岛素调整血糖 ,给予充足的热量 ,预防酸碱平衡失调及电解质紊乱。采取妥善的处理方法可减少食管癌的术后并发症     

围手术期序贯处理对食管癌及贲门癌患者的术后影响

目的探讨围手术期序贯处理对食管癌及贲门癌患者的术后影响。方法217例食管癌及贲门癌患者分为两组：对照组112例，全部患者行常规的围手术期治疗。实验组105例，术前1天全胃肠道灌洗，术后第1天开始肠内营养支持，维持5～7d。麻醉前1／2h静脉点滴抗生素1个单位，术后48h内停用抗生素。术前及术后第7天清晨测量体重，采血检测总蛋白（TP）、白蛋白（Alb），观察其手术前后的变化。术中观察肠道清洁状况，术后观察肛门排气恢复时间、术后并发症发生率及住院天数等。结果术后肛门排气恢复时间及术后住院天数，两组比较有显著性差异（P〈0.05）。术后并发症发生实验组较对照组少，且未发生吻合口瘘者。血清总蛋白、白蛋白及体重手术前后比较．对照组下降有显著性差异（P〈0．05），术后两组比较也有显著性差异（P〈0．05）。结论序贯的医疗措施，可使食管癌和贲门癌患者术后肠道功能恢复早，体重减轻、血清蛋白下降更少，减少术后并发症的发生，提高手术成功率。     

Perioperative Comprehensive Supportive Care Interventions for Chinese Patients with Esophageal Carcinoma: a Prospective Study

Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcomeof Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophagealcarcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chineseversion of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions,including health education, psychological support, stress management, coping strategies and behavior training,were carried out in 3 phases (preoperative, postoperative Ⅰ and postoperative Ⅱ), and psychological effects werethereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costswere estimated at discharge. Survival of patients was estimated each year post-surgery. General health statusand satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All thesubjects demonstrated higher scores in the preoperative phase than the normal range of Chinese populationconcerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility,phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groupsat admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CGat weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less thanthose of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-yearsurvival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportivecare interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, toreduce health care costs and to promote satisfaction of patients and their families with hospital.     

Radiological Imaging in Patients with Esophageal Carcinoma

Diagnostic imaging is carried out in patients with esophageal carcinoma in order to decide on thetherapeutical procedure,to control therapy,to document complications and to assess concomitant diseases.Chest X-rays and esophagograms give a 2-dimensional view of the X-ray absorption in a-dimensionalexamination volumes,the diagnostic accuracy thus being limited by overshadowing.Because of the robustexamination technique,the broad availability and the low costs chest X-rays are usually used for short-termcontrols under therapy and follow-up.Esophagography is carried out in order to asses the exact locationand length of a known esophageal carcinoma prior to therapy and in order to assess peristaltic disturbancesand fistulas.CT and MRI provide tomographic images with a spatial resolution of up to 1 mm allowingthe reconstruction of high-resolution images not only in the transversal but also in any other plain.Thediagnostic accuracy of esophagography is comparatively high in T1-T3 stages (80%-90%).T1 and T2tumors cannot be diagnosed by CT and MRI,because both methods do not visualize the mucosa (unlikeesophagography and endoscopy) and the esophageal wall layers (unlike EUS).Infiltration depth tends tobe overestimated in T1 and T2 carcinomas and to be underestimated in T3 and T4 cancers.CT andMRI cannot detect metastases in normally sized lymph nodes and cannot accurately differentiate betweenbenign and malignant lymphadenopathy in enlarged nodes with a reported sensitivities and specifities of60% and 74%,respectively.However,further prospective studies using up to date CT and MR technologyare needed to assess the present diagnostic situation.CT and MRI do not only visualize the mediastinum,but also the lungs,the pleura and the skeleton as well as the neck and the abdomen thus providing acomprehensive overview of the TNM stage in 3 body regions.     

食管癌的影像学表现

Diagnostic imaging is carried out in patients with esophageal carcinoma in order to decide on the therapeutical procedure, to control therapy, to document complications and to assess concomitant diseases.Chest X-rays and esophagograms give a 2-dimensional view of the X-ray absorption ill 3-dimensional examination volumes, the diagnostic accuracy thus being limited by overshadowing. Because of the robust examination technique, the broad availability and the low costs chest X-rays are usually used for short-term controls under therapy and follow-up. Esophagography is carried out in order to asses the exact location and length of a known esophageal carcinoma prior to therapy and in order to assess peristaltic disturbances and fistulas. CT and MRI provide tomographic images with a spatial resolution of up to 1mm^3 allowing the reconstruction of high-resolution images not only in the transversal but also in any other plain. The diagnostic accuracy of esophagography is comparatively high in T1 T3 stages (80%-90%). T1 and T2 tumors cannot be diagnosed by CT and MRI, because both methods do not visualize the mucosa(unlike esophagography and endoscopy) and the esophageal wall layers (unlike EUS). Infiltration depth tends to be overestimated in T1 and T2 carcinomas and to be underestimated in T3 and T4 cancers. CT and MRI cannot detect metastases in normally sized lymph nodes and cannot accurately differelltiate between benign and malignant lymphadenopathy in enlarged nodes with a reported sensitivities and spccifities of 60% and 74%, respectively. However, further prospective studies using up to date CT and NIR technology are needed to assess the present diagnostic situation. CT and MRI do not only visualize the inediastinum,but also the lungs, the pleura and the skeleton as well as the neck and the abdomen thus providing a comprehensive overview of the TNM stage in 3 body regions.     

左旋精氨酸在食管癌治疗中的作用

目的：探讨左旋精氨酸在食管癌治疗中的作用。方法：８６例患者随机分为两组，实验组术前１５天静脉输注左旋精氨酸０．５ｋｇ／ｋｇ天，然后手术。标本行细胞凋亡检查，与对照组对比。结果：实验组肿瘤细胞凋亡阳经明显高于对照组。结论：左旋中引起食管癌细胞的凋亡，在管癌治疗中的有一定作用。     

乳腺癌保乳术患者的围手术期心理护理和康复指导

目的：探讨乳腺癌保乳手术围手术期心理护理和康复指导的意义。方法：对2006年7月-2008年6月我院收治的57例乳腺癌保乳术患者,施以围手术期心理护理和指导患侧上肢功能锻炼,使其精神和身体得到尽快康复。结果：57例患者出院时心理状态良好,患侧上肢功能完全恢复到术前水平者52例,基本恢复到术前水平者5例。结论：对乳腺癌保乳手术患者进行及时的围手术期心理护理和康复指导,有助于患者及早手术恢复,保持良好心理状态并积极配合后续治疗。