大肠息肉患者电子结肠内镜下行电切除术41例强化护理干预

目的:探讨大肠息肉患者电子结肠内镜下行电切除术的强化护理干预效果。方法:将82例结肠内镜下行大肠息肉切除术患者随机分为观察组与对照组各41例,对照组给予常规护理,观察组在对照组基础上给予强化护理干预。比较两组患者住院费用、住院时间、心理状态、对护理工作满意度及并发症发生情况。结果:观察组平均住院费用、并发症发生率低于对照组,平均住院时间短于对照组,心理状态良好率,病房巡视、基础护理、健康教育、技术操作、服务态度的满意度明显高于对照组,两组比较差异均有统计学意义(P0.05,P0.01)。结论:大肠息肉患者应用电切除术强化护理干预,可进一步巩固治疗效果,促进患者预后,有效缩短住院时间,提高患者满意度,值得临床推广。     

内镜下大肠息肉摘除术60例临床护理

目的:探讨内镜下大肠息肉摘除术的护理方法。方法:选取我院收治的60例大肠息肉患者作为研究对象,均行内镜下大肠息肉高频电摘除术,对患者的临床资料及其系统护理情况进行回顾性分析。结果:经治疗及系统护理,60例患者中仅有1例出现术中出血,并发症发生率为1.7%;余59例均无并发症发生,患者行大肠息肉摘除术的成功率为100%。结论:在大肠息肉患者中应用内镜下大肠息肉高频电摘除术治疗的同时,给予系统护理干预,不但能够有效缩短患者治疗的时间,减轻痛苦,还有助于提高手术成功率,值得临床推广应用。     

临床护理路径在内镜下大肠息肉摘除术中的应用

目的:探讨临床护理路径在内镜下大肠息肉摘除术患者中的应用效果。方法:将50例内镜下大肠息肉摘除术患者随机分为实验组和对照组各25例。对照组给予常规护理,实验组在此基础上制定临床护理路径表并实施,比较两组护理效果及患者满意度。结果:实验组平均住院日、平均住院费用及并发症发生率低于对照组(P<0.05),患者满意度高于对照组(P<0.05)。结论:应用临床护理路径表可缩短内镜下大肠息肉摘除术患者住院时间和术后卧床天数,降低术后并发症发生率,提高患者满意度。     

幼儿大肠息肉高频电凝摘除术的护理15例

1998年 7月～ 2 0 0 1年 12月 ,我科在内镜下行小儿大肠息肉摘除术 (ＰＳＤ)共 48例 ,其中幼儿 15例。针对幼儿不合作 ,手术需要在全麻下进行的特点 ,我们注重术前的心理护理、肠道准备及急救物品准备 ;加强术后的病情观察、并发症预防及康复指导 ,取得显著的效果 ,无 1例发生并发症。1　临床资料本组 15例患儿中 ,男 6例 ,女 9例 ,年龄 16个月～ 4岁。均有反复无痛性便血 ,病程 1～ 18个月。结肠镜检查为“大肠息肉” ,息肉病变在直肠 5枚 ,乙状结肠 9枚 ,升结肠 2枚 ,降结肠和横结肠各 1枚 ,其中 3例患儿有 2处息肉 ;息肉直径约为 0 .8～ …     

无痛内镜下高频电凝切除大肠息肉的围手术期护理

目的总结无痛内镜下高频电凝切除大肠息肉的围手术期护理要点。方法回顾性分析72例在无痛电子结肠镜下行高频电凝切除术大肠息肉患者的临床资料,并总结有针对性的护理与配合方法。结果 72例行息肉切除术患者术程顺利,术后无严重并发症发生和麻醉意外发生。结论护士进行正确的术前准备和心理护理、术中配合及对术后并发症的观察和护理是无痛内镜下高频电凝切除结肠息肉术获得成功的重要保证。     

内镜下高频电凝治疗大肠息肉病人的护理

[目的]总结内镜下高频电凝治疗大肠息肉病人的护理。[方法]对469例大肠息肉病人术前充分准备,术中细致观察、有效配合及术后的精心护理。[结果]大肠息肉摘除术病人术中顺利无出血穿孔及其他并发症,术后1周迟发出血6例。[结论]加强内镜下高频电凝治疗大肠息肉病人的护理是手术成功的保证。     

临床路径在大肠息肉住院患者整体护理中的应用

目的 探讨临床路径在大肠息肉住院患者整体护理中的应用.方法 选取2010年1～7月收住我科的大肠息肉患者43例作为对照组,进行常规治疗和护理;将2010年8月至2011年3月收住我科的大肠息肉患者47例作为试验组,按临床路径进行整体护理.比较两组患者的住院时间、住院费用、并发症的发生率及患者和家属满意度等指标.结果 两组患者比较,试验组住院时间少于对照组,住院费用低于对照组,消化道出血等并发症的发生率低于对照组,患者满意度优于对照组,差异均有统计学意义.结论 应用临床路径对大肠息肉患者实施整体护理,不仅能减少患者的住院时间、降低住院费用,还能明显减少并发症的发生率,提高患者及家属对护理工作的满意度,从而提高护理质量.     

肠镜下高频电大肠息肉摘除术的配合及护理

目的探讨肠镜下高频电摘除大肠息肉术的护理配合及效果。方法对49例大肠息肉患者在肠镜下高频电摘除大肠息肉术的配合及护理进行回顾总结。结果本组49例患者息肉摘除效果满意，术中、术后均未发生出血、穿孔等并发症。结论加强对患者术前充分准备、术中默契配合、术后娴熟护理，可明显减轻患者的痛苦，减少并发症的发生，为手术成功提供保证。     

大肠出血的常见病因、鉴别及诊治

大肠疾病所致出血是下消化道出血的主要原因。大肠出血形式多样,与出血部位、出血量、出血速度等有关,难以一概而论,但较少发生大出血。大肠出血原因东西方国家疾病谱存在差异。西方国家下消化道出血的主要原因有:结肠憩室炎、炎症性肠病、血管发育不良和大肠息肉及息肉电切后出血。     

大肠息肉824例发病情况及内镜特点分析

目的:分析824例大肠息肉患者的临床资料及结肠息肉的内镜下特点,探寻其中的相关性.方法:收集我院近6年门诊及住院行结肠镜检查的患者,对其中824例结肠镜诊断并有病理证实为大肠息肉患者的年龄、临床表现及内镜下结肠息肉发生部位及大小进行分析总结.结果:检查患者4630例,检出大肠息肉824例,检出率18％,其中男494例,女330例.好发年龄45～65岁,占65.2％.息内部位分别为直肠28.73％,乙状结肠25.09％,降结肠10.45％,横结肠17.91％,升结肠10.73％,回盲部7.09％主要临床表现为腹痛腹胀发生率为36.8％；便血发生率为22.6％;大便习惯或性状改变发生率为17.3％.结论:大肠息肉患者多发生在中老年(年龄在45 ～ 65岁之间),临床表现以腹痛腹胀、便血和大便习惯或性状改变为主;分布部位以直肠、乙状结肠和横结肠为主.     

精细化护理对结肠息肉电切术后患者舒适度及血糖影响

目的 探讨精细化护理对结肠息肉电切术后患者舒适度及血糖影响.方法 将2018年4-9月住院的328例结肠息肉患者作为研究对象,根据患者性别、年龄、疾病类型均衡可比的原则分为对照组和观察组,每组164例.对照组患者围术期采用常规综合护理方法,观察组患者进行精细化护理干预.比较两组患者术后舒适度、心理状态、术后低血糖反应发...     

Endoscopic snare excision of large pedunculated colorectal polyps: a new, safe, and effective technique

BACKGROUND AND STUDY AIMS: The endoscopic polypectomy of large pedunculated polyps can have serious complications, such as hemorrhage, which has an incidence of about 2 %. We describe here a new, safe, and effective technique of endoscopic polypectomy for the treatment of large pedunculated colorectal polyps using a standard detachable diathermic snare. PATIENTS AND METHODS: 35 patients (18 men, 12 women; mean age 67.3, range 35 - 82), with 43 pedunculated colorectal polyps, of benign appearance and of size 3 cm or larger (range 3 - 5 cm) on colonoscopy, were included in our study. The polypectomy was performed in two steps: a) we first placed a polypectomy snare round the middle of the stalk, as a prophylactic measure to prevent postpolypectomy bleeding, and we then took out the colonoscope without removing the snare after dismantling it and blocking with a clip; b) endoscopic polypectomy was done using a second polypectomy snare, and transecting the stalk of the polyps at 2 mm above the first snare. The first polypectomy snare was left in place, and the patients were discharged within 3 hours of endoscopic polypectomy. The first polypectomy snare sloughed off spontaneously and slipped down the anus, being evacuated within 4 days following the endoscopic polypectomy. RESULTS: The ensnared polyps were located in the rectosigmoid region (n = 27), and the descending (n = 13) and transverse colon (n = 3). Complete ensnarement of the head of the polyp with a single endoscopic treatment was obtained in all cases. In addition, no procedural or delayed bleeding was noted during a 6-month follow-up. CONCLUSIONS: Our technique allows us to overcome the risk of bleeding, since the use of a standard diathermic snare makes it easier to obtain optimal tightness. Moreover, this technique is cheaper than the use of the standard detachable snare currently available (the cost of the snares being $50.52 compared with $189.47).     

住院、日间和门诊行内镜下治疗结直肠息肉患者的风险与效益对比分析

目的 研究结直肠息肉(息肉)行内镜下切除患者围手术期不同流程并发症发生情况、相关危险因素及经济效益比。方法 回顾性研究2015年12月-2018年12月我院收治的内镜下治疗息肉患者1 720例,按随机数字表法分为住院组（588例,住院完善相关检查择期手术）,仅检查血常规后直接切除患者分为两个亚组,日间组（659例,术后收日间病房）,门诊组（473例,术后院外随访观察）,对并发症发生率、相关危险因素、床位使用及费用等指标进行分析。结果 术后发热住院组较其余两组升高(P＜0.01)。腹部不适门诊组最低,与其余两组比较差异有统计学意义(P＜0.01), 日间组次之,与住院组比较差异有统计学意义(P＜0.05)。肠道功能恢复时间和低血糖反应门诊组最少,与其余两组比较差异有统计学意义(P＜0.05或P＜0.01)。术中出血以升结肠和回盲部最为常见,其次为直肠,迟发性出血则以直肠最为常见,其次为升结肠和回盲部。无蒂型随息肉直径增加出血风险加大,1.0~2.0 cm范围息肉有蒂或亚蒂隆起型出血风险最高,而＞2.0 cm范围则发生出血特别是迟发性出血风险最小,与其他类型比较差异有统计学意义(P＜0.01),年龄最为显著增加出血风险,其次为收缩压水平和息肉直径,而高舒张压水平、手术史和全麻术式是出血风险保护因素。结论 门诊行息肉内镜下治疗并不增加并发症风险,只需对高风险人群使用日间病房,对提高患者满意度及内镜复查依从性,节约医疗资源和降低医保费用有益。     

上消化道纵轴超声内镜检查患者的护理

目的 探讨系统护理干预对顺利完成上消化道纵轴超声内镜检查的影响.方法 将2006年7月-2008年8月进行纵轴超声内镜检查的上消化道疾病患者80例,随机分为实验组和对照组各40例.实验组给予检查前心理护理,安慰、鼓励,消除其紧张心理;检查中指导患者放松,关闭照明灯,减轻患者目视粗大超声内镜插人口中的恐惧,便于医生操作;对照组采用常规消化内镜护理.应用x2检验比较2组患者检查中恐惧、恶心、咽喉部擦伤、重复插镜等异常情况的发生率.结果 检查中实验组异常情况的发生率显著低于对照组.结论 护理干预能有效提高检查成功率,减轻患者痛苦,保证检查顺利完成.     

Endoscopic removal of gastric and duodenal polyps.

As endoscopic surgery comes into its own, the applications of this modality are increasing. This is well illustrated by the use of endoscopic polypectomy in the colon, and more recently by endoscopic polypectomy in the stomach and duodenum. We can anticipate increased applicability of these technics as the experience widens and the margins of safety increase. The present series of six polypectomies from the stomach and duodenum confirms the applicability of endoscopic polypectomy for this portion of the gastrointestinal tract, attests to its safety, and indicates that these procedures can contribute materially to the care of patients with gastric or duodenal polyps. The real and potential problems are discussed.     

临床护理路径在经内镜逆行胰胆管造影患者中的应用

目的:探讨临床护理路径在经内镜逆行胰胆管造影患者中的应用。方法:将107例行内镜下逆行胰胆管造影(ERCP)患者随机分成实验组56例和对照组51例,对照组采用常规护理干预,实验组使用临床护理路径(CNP)进行全程的护理干预,观察两组患者的心理状况、对疾病的相关知识的认知度及对医嘱的依从性及满意度。结果:实验组患者术前心理状况、对疾病知识认知度、对遗嘱依从性和对护理服务满意度明显优于对照组(P<0.05,P<0.01)。结论:CNP应用在ERCP患者中,可以减轻患者的焦虑状况,提高患者的依从性,保证护理质量,提高患者的满意度。     

Incidence and predictors of bleeding or thrombosis after polypectomy in patients receiving and not receiving anticoagulation therapy

Summary. Background and aims: To assess the effect of warfarin anticoagulation therapy (AC) on the incidence of colon bleeding after elective colonoscopy with polypectomy and to identify independent predictors of post‐polypectomy colon bleeding. Methods: This was a retrospective cohort analysis. Patients interrupting warfarin AC therapy for polypectomy (AC group) were matched on age (± 3 years) with up to two patients who underwent polypectomy but were not receiving AC (non‐AC group). Data were extracted from electronic medical, pharmacy and laboratory claims and records and manual medical chart review. Incidence rates of colon bleeding requiring hospitalization, other gastrointestinal bleeding, thrombosis and death in the 30 days post‐polypectomy were compared between groups. Multivariate regression techniques were used to identify independent predictors of post‐polypectomy colon bleeding. Results: A total of 425 AC group patients were matched to 800 non‐AC group patients. Post‐polypectomy colon bleeding occurred more often in AC group patients (2.6% vs. 0.2%, P = 0.005). There were no differences in the rates of other outcomes (P > 0.05). Independent predictors of colon bleeding included AC group status [adjusted odds ratio (AOR) = 11.6; 95% confidence interval (CI) = 2.3–57.3], number of polyps removed (AOR = 1.2; 95% CI = 1.1–1.4) and male gender (AOR = 9.2, 95% CI = 1.1–74.9). Conclusions: The incidence of post‐polypectomy colon bleeding was higher in patients receiving AC even although warfarin was interrupted for the procedure. Independent predictors of colon bleeding were identified as: receiving AC, removal of multiple polyps and male gender. Our findings suggest that additional methods to reduce the likelihood of post‐polypectomy colon bleeding in AC patients should be investigated.     

协作式无缝隙全期护理模式在胃息肉内镜下黏膜切除术病人中的应用效果

[目的]观察协作式无缝隙全期护理在胃息肉内镜下黏膜切除术中的应用效果。[方法]将协作式无缝隙全期护理实施前(2015年1月—2015年6月)和实施后(2015年7月—2015年12月)接受胃息肉内镜下黏膜切除术治疗的住院病人108例为研究对象,实施前后病例分别设为对照组(54例)和试验组(54例),对照组接受常规护理,试验组接受协作式无缝隙全期护理干预,对两组干预后的各观察指标进行比较。[结果]试验组病例干预后的状态与特质焦虑评分、内镜治疗并发症总发生率均显著低于对照组,内镜治疗护理配合满意度评分则显著高于对照组(P0.05)。[结论]对胃息肉内镜下黏膜切除术病人施予协作式无缝隙全期护理,能够显著改善该类手术治疗病例的焦虑程度,降低内镜治疗相关并发症发生率,提高护理服务满意度。     

Colonoscopy in the diagnosis and follow-up of colonic polyps

Out of 5000 patients examined endoscopically colon polyps were detected in 64%. The polyps were characterized by: higher incidence in 70-79-year-olds, high percentage of tubular adenomas (79%), large sizes of polyps with complex structure and their prevalence in the left colon, signs of malignancy in 0.64% of the removed polyps. The chance to develop cancer from tubular adenoma was 0.28%, tubular-villous, 1.4%, villous 3%. Recurrent polyps following polypectomy arose in 65% of cases. Tumor relapses emerging mainly within the first postoperative year occurred in 14% of cases. In 4 patients with cancer its onset was registered at the site of the removed large adenomas of complex histological structure. Colonoscopy proved an adequate method of diagnosis and follow-up of colon polyps. Endoscopic polypectomy can be considered as a measure to prevent colon cancer.