结肠水疗法治疗功能性便秘患者的护理

目的 探讨结肠水疗法治疗功能性便秘的临床疗效及护理要点.方法 采用Hydro-San Model-A型结肠水疗仪对43例功能性便秘患者进行治疗,评估治疗前后临床症状改善情况.结果 通过治疗前全面的护理评估,治疗过程中水压、水量和按摩手法的正确选择,治疗后的健康指导及贯穿始终的心理护理,患者症状改善,总有效率72.1%.结论 结肠水疗法可改变结肠壁肌肉的健康状况,对治疗功能性便秘有良好的疗效.     

行气通便贴外敷脐部预防脑卒中患者便秘的护理

目的观察行气通便贴外敷脐部预防脑卒中患者便秘的效果。方法将2009年1月～9月脑卒中患者100例随机分为观察组和对照组,各50例。观察组采用行气通便贴外敷脐部,对照组采用常规护理方法。比较两组7天内排便情况。结果观察组显效率72%高于对照组20%,总有效率分别为98%和72%,两组比较有显著性差异（P〈0.01）。结论行气通便贴外敷脐部是预防脑卒中患者便秘发生的安全、有效的护理方法。     

功能性便秘结肠水疗与传统灌肠治疗疗效比较及护理

目的分析结肠水疗与传统吊袋灌肠治疗功能性便秘(FC)的效果和疗效持续时间№总结护理体会。方法将65例FC患者随机分为结肠水疗组(34例)和传统灌肠组(31例),前组应用GCJ-K型电脑灌肠机进行水疗,后组使用传统灌肠袋行大量不保留灌肠,并分别辅以相应的护理;观察2组患者便秘改善情况,并运用便秘患者生活质量问卷(PAC-QOL)积分比较,评价治疗效果和疗效持续时间。结果结肠水疗组有效率91.2%,传统灌肠组有效率61.3%,2者差异有统计学意义(P0.05),观察期间便秘改善的持续时间,结肠水疗组明显长于传统灌肠组(P0.05),且前者的生活满意度明显高于后者。结论结肠水疗能促进结肠蠕动,调节肠道菌群失调,持久地改善便秘,是一种纯物理自然疗法。     

非插入式结肠水疗在肛肠疾病患者术前肠道准备中的应用效果观察

目的:探讨非插入式结肠水疗在肛肠疾病患者术前肠道准备中的应用效果观察。方法:将120例肛肠疾病患者随机分为对照组和实验组各60例,实验组采用结肠水疗仪于术前反复冲洗30 min,对照组于术前用灌肠袋清洗4~5次。比较两组术后治疗护理效果。结果:实验组肠道清洁程度、患者对肠道准备的耐受程度、术后腹胀程度、术后出血及感染情况均优于对照组(P0.05)。结论:采用非插入式结肠水疗法对肛肠疾病患者行术前肠道准备可提高肠道清洁程度和耐受程度,减轻术后腹胀,延长术后控制大便时间,减少术后出血及感染。     

肠道水疗法治疗脊髓损伤合并机械性肠梗阻疗效观察

将59例脊髓损伤合并机械性肠梗阻患者,随即分为观察组与对照组,观察组为30例,由水疗法治疗,对照组29例,患者进行灌肠治疗,对比分析两组的治疗效果。水疗组总有效率83.3%,灌肠组的总有效率52.8%。结肠水疗法配合相应护理可明显改善脊髓损伤合并机械性肠梗阻患者症状,疗效确切,具有临床推广应用的价值。     

结肠水疗治疗108例功能性便秘患者的疗效观察

目的 观察结肠水疗对功能性便秘的临床疗效.方法 对108例功能性便秘患者给予饮食和生活习惯指导,同时用结肠水疗仪清洗结肠.结果 显效59例(54.6%,59/108),有效20例(18.5%,20/108),无效29例(26.9%,29/108),总有效率为73.1%(79/108).结论 应用结肠水疗治疗功能性便秘,疗效满意,且舒适安全,易被患者接受.     

两种灌肠液对脑卒中便秘患者通便效果的比较研究

目的比较两种灌肠液对脑中风便秘患者通便的效果。方法将100例脑卒中便秘患者随机分为两组,分别采用0.9%氯化钠溶液和0.1%～0.2%肥皂水溶液行灌肠;观察并比较两组药液通便效果及不良反应。结果采用0.9%氯化钠溶液作为灌肠液治疗脑卒中便秘患者疗效好且安全,不良反应少,结论治疗脑卒中便秘患者采用0.9%氯化钠溶液作为灌肠液优于传统的肥皂水溶液。     

食疗、足浴、按摩联合干预脑卒中患者便秘

目的观察饮食疗法、温水足浴法、腹部按摩三者联合干预脑卒中患者便秘的效果。方法选择确诊为脑卒中伴便秘的住院患者,按入院次序随机分为实验组64例、对照组70例。实验组采用饮食、温水足浴、腹部按摩联合干预,对照组采用通便药物治疗,比较两组的通便效果及不良反应。结果实验组和对照组有效率分别为88%和86%,差异无统计学意义;但对照组不良反应显著多于实验组。结论饮食、温水足浴、腹部按摩三者联合干预脑卒中患者便秘效果显著。     

通便贴膏治疗脑卒中病人便秘的效果观察

[目的]观察通便贴膏治疗脑卒中病人便秘的临床效果。[方法]将100例脑卒中便秘病人随机分为治疗组和对照组,每组50例。治疗组用通便贴膏贴脐治疗,对照组口服大黄治疗,疗程均为1周,并随访3个月。[结果]通便贴膏治疗脑卒中便秘的总有效率达92%。[结论]通便贴膏治疗脑卒中便秘使用方便、疗效快捷、无毒副反应。     

自拟通便汤治疗慢性便秘60例临床研究

目的系统观察通便汤治疗慢性便秘的临床效果,并探讨其作用机制。方法选取符合纳入标准的慢性便秘患者60例,应用通便汤治疗1个月,观察治疗后症状变化,并随访停药后15天、1个月、2个月症状的变化,评定患者疗效。结果患者治疗期间,总有效率93%;停药后半个月、1个月、2个月有效率分别为83%、75%、63%。结论通便汤治疗慢性便秘,短期疗效较好,长期亦有一定效果。     

大肠水疗联合中药口服治疗儿童功能性便秘临床观察

目的:观察大肠水疗合中药健脾化食液(JPHS)口服治疗儿童功能性便秘的治疗效果,为儿童功能性便秘的治疗寻找一条更为有效的中西医结合之路。方法:选取60例门诊诊断为功能性便秘的患儿,予大肠水疗进行灌肠,并联合健脾化食口服液口服治疗。大肠水疗每3天治疗1次,5次为1个疗程。1个疗程结束后,评价疗效。结果:大肠水疗法合用健脾化食液口服治疗儿童功能性便秘能够有效改善便秘患儿的排便时间、排便费力、排便疼痛、粪便性质等。结论:大肠水疗联合健脾化食口服液治疗儿童功能性便秘安全有效。     

复方黄柏液结肠水疗辅助治疗溃疡性结肠炎的护理

目的探讨复方黄柏液结肠水疗辅助治疗溃疡性结肠炎(ulcerativecolitis,UC)的效果,并总结护理经验。方法选择2008年10月-2010年10月80例UC患者,在常规治疗的基础上应用复方黄柏液结肠水疗辅助治疗,观察治疗1个疗程后的效果并总结护理要点。结果治愈48例,有效32例,无效0例。结论应用复方黄柏液结肠水疗辅助治疗UC能取得较好的效果,水疗过程中要严格把握给药剂量、浓度和温度,做好病情观察,其是结肠水疗取得成功的关键。     

肠道水疗法治疗脊髓损伤合并机械性肠梗阻的疗效

目的 探讨结肠水疗法对脊髓损伤合并机械性肠梗阻患者的疗效及优越性.方法 脊髓损伤合并机械性肠梗阻患者63例,随机分为结肠水疗组(n=32)和灌肠组(n=31),观察两组疗效及患者满意度.结果 在操作时间、操作耐受性及疗效三方面,水疗组和灌肠组之间有统计学差异(P＜0.05),水疗法效果优于灌肠治疗.结论 结肠水疗具有良好的耐受性和可操作性,可以有效地解决脊髓损伤患者排便困难,帮助患者恢复正常的排便功能.     

洗肠散用于妇科手术前肠道准备清洁的疗效观察

目的观察洗肠散用于妇科手术前肠道准备清洁的效果。方法将98例需肠道准备清洁的妇科手术患者随机分为观察组和对照组两组。观察组术前口服洗肠散,对照组口服20％甘露醇注射液。观察并比较两组患者的肠道清洁度和排便次数、术后排气时间等情况。结果观察组肠道清洁度总有效率与对照组总有效率比较无显著性差异（P〉0．05）,但观察组的清洁度为优者占81．6％明显高于对照组的73．4％。观察组与对照组排便次数和术后排气时间比较均具有显著性差异（P〈0．05）。结论洗肠散用于妇科手术前肠道准备,能提高肠道清洁度,改善护理服务质量,是临床工作中值得推广的有效方法之一。     

The assessment of constipation in terminal cancer patients admitted to a palliative care unit: A retrospective review

Constipation is a frequent and distressing complication in patients with advanced cancer. However, very few studies have reviewed the assessment and management of these patients. The purpose of this study was to review the documentation and assessment and diagnosis of constipation in patients admitted to a Palliative Care Unit, and the correlation between those findings and radiological evidence of stool in the colon. The records of 122 consecutive patients admitted to the Palliative Care Unit, Edmonton General Hospital were reviewed in order to assess the physician's and the nurse's record of symptoms, physical findings, and diagnosis and treatment of constipation. All patients also underwent a flat abdominal radiograph that scored for the presence of stool in the colon (0 = no stool; and 12 = stool occupying all the lumen of the four quadrants of the colon). The radiograph was scored blindly by two different physicians. Of 103 evaluable patients, a rectal exam was reported only in 42. Correlation between the assessment by the two physicians' radiograph scow was high (0.78, P nd nurses' diagnosis of constipation, the presence of laxative treatment, the number of days since the last bowel movement, and the source of the admission (hospital vs home) were not associated with higher radiological scores for constipation. Assessment is insufficient in this population at high risk for severe constipation. Radiological examination may be necessary for adequate diagnosis in some patients. More research is needed in this area.     

乙状结肠冗长症22例外科治疗分析

目的 探讨乙状结肠冗长症的诊疗措施.方法 回顾分析22例乙状结肠冗长症患者的诊疗过程.结果 22例患者中3例行非手术治疗,疗效满意,有效率为100%;19例行手术治疗,17例疗效满意,有效率为89.47%.结论 对于顽固性便秘患者,医师应考虑到乙状结肠冗长症的可能,诊断主要依靠钡剂灌肠造影,治疗方法 首选非手术治疗,无效时手术治疗,手术指征应严格把握,术前应充分肠道准备.

Abstract：

Objective To investigate the diagnostic and therapeutic measurements for the disease of redundant sigmoid colon. Methods Twenty-two patients diagnosed as redundant sigmoid colon disease and received treatments were retrospectively analysed. Results Three of the 22 patients received conservative treatment with satisfactory efficacy (100. 00% ). Among the 19 patients who received surgical treatment, 17 have satisfactory efficacy (89. 47%). Conclusion For patients with intractable constipation, the possibility of redundant sigmoid colon should be considered. The diagnosis for this disease mainly depends on barium enema. Non-surgical treatment is prefered as first choice. Surgical procedure can be performed when conservative treatment fails. The indications of surgical treatment should be restrictly defined and a complete colon preparation is required before the operation.     

腹腔镜辅助结肠次全切除术治疗结肠慢传输性便秘48例临床效果研究

目的探讨腹腔镜辅助结肠次全切除术治疗结肠慢传输性便秘的临床效果。方法选择2009年1月～2012年3月在我院行结肠次全切除术的48例结肠慢传输性便秘患者,根据其手术方式将其分为腹腔镜组(25例)与开腹组(23例)。比较两组患者术中、术后情况及便秘症状改善率。结果腹腔镜组患者平均手术时间与开腹组相比,无统计学差异(P>0.05),但术中出血量明显少于开腹组,差异有统计学意义(P<0.05)。腹腔镜组患者肠道功能恢复时间及排便次数与开腹组相比,无统计学差异(P>0.05),而住院时间、术后引流管引流量、止痛剂使用次数、伤口并发症发生率显著低于开腹组,差异有统计学意义(P<0.05)。两组患者术后3、6个月便秘症状改善率无统计学差异(P>0.05)。结论腹腔镜辅助结肠次全切除术治疗结肠慢传输型便秘与传统开腹手术相比,治疗安全性高、并发症少、临床治疗效果良好,对缩短患者住院时间,促进其康复具有重要的临床意义。     

Ultrasonographic assessment of sigmoid colon in patients with irritable bowel syndrome

Although the pathophysiological factors may play a role in the pathogenesis of irritable bowel syndrome (IBS), the function of sigmoid colon has been reported as a major pathogenesis of IBS. Our objective was to evaluate motility patterns of sigmoid colon by using ultrasonography(US) in patients with IBS compared to healthy volunteers (HV). SUBIECTS AND METHODS: US examination of sigmoid colon was performed in 69 patients with IBS and 69 HV with 3.75 MHz curved array scanner and 7.5 MHz linear array scanner. The US probe was positioned longitudinally to permit simultaneous visualization of sigmoid colon crossing over the iliopsoas. We classified 3 types of fasting sigmoid colon, spastic type, empty type, and normal type, according to the US findings. Four IBS patients with diarrhea, 4 with constipation and 4 HV were given the liquid test meal (200ml, 400kcal). The frequency of segmental contractions (contractions without propagation) and propulsion were evaluated by US in the same fashion for 30 minutes before and for 60 minutes after investigation. RESULTS: Sixty-two percent of IBS showed spastic type and 65% of HV showed normal type. IBS patients accounted for 80 % of spastic type (IBS vs spastic type of US findings: Sensitivity 62%, Specificity 91%). The changes of frequency of segmental contractions were smaller in IBS patients with constipation. The changes of frequency of propulsion were larger in IBS patients with diarrhea. CONCLUSION: Ultrasonographic assessment of sigmoid colon may provide a better understanding of the pathogenesis of IBS.     

Comparison between electro-acupuncture and hydrotherapy, both in combination with patient education and patient education alone, on the symptomatic treatment of osteoarthritis of the hip

OBJECTIVES: The aim of the study was to evaluate the therapeutic effect of electro-acupuncture (EA) and hydrotherapy, both in combination with patient education or with patient education alone, in the treatment of osteoarthritis in the hip. METHODS: Forty-five patients, aged 42-86 years, with radiographic changes consistent with osteoarthritis in the hip, pain related to motion, pain on load, and ache were chosen. They were randomly allocated to EA, hydrotherapy, both in combination with patient education, or patient education alone. Outcome measures were the disability rating index (DRI), global self-rating index (GSI), and visual analogue scale (VAS). Assessments were done before the intervention and immediately after the last treatment and 1, 3, and 6 months after the last treatment. RESULTS: Pain related to motion and pain on load was reduced up to 3 months after last the treatment in the hydrotherapy group and up to 6 months in the EA group. Ache during the day was significantly improved in both the EA and hydrotherapy group up to 3 months after the last treatment. Ache during the night was reduced in the hydrotherapy group up to 3 months after the last treatment and in the EA group up to 6 months after. Disability in functional activities was improved in EA and hydrotherapy groups up to 6 months after the last treatment. Quality of life was also improved in EA and hydrotherapy groups up to 3 months after the last treatment. There were no changes in the education group alone. DISCUSSION: In conclusion, EA and hydrotherapy, both in combination with patient education, induce long-lasting effects, shown by reduced pain and ache and by increased functional activity and quality of life, as demonstrated by differences in the pre- and post-treatment assessments.     

重组人血管内皮抑制素联合化疗治疗老年晚期大肠癌临床观察

目的观察重组人血管内皮抑制素(恩度)联合化疗治疗老年晚期大肠癌的近期疗效和毒副反应。方法 30例老年晚期结大肠癌患者为治疗组,35例非老年晚期结大肠癌患者为对照组,治疗组接受重组人血管内皮抑制素联合XELOX方案化疗。按照RECIST标准评价近期疗效,毒性反应按照WHO抗癌药物急性和亚急性毒性表现和分级标准评价。结果 65例患者64例可评价疗效,1例患者无法评价疗效;其中治疗组治疗的30例患者中,CR 3例,PR 16例,SD 8例,PD 3例,有效率63.3%。对照组治疗的35例患者中,CR 1例,获PR 12例,获SD 17例,PD 5例,1例无法评价疗效,有效率37.1%。主要毒副反应为骨髓抑制,食欲不振、乏力、腹泻、便秘等胃肠道反应,心脏毒副及外周神经毒性。结论老年晚期大肠癌患者可以耐受重组人血管内皮抑制素联合化疗,疗效好,毒副性低,值得临床进一步观察老年晚期大肠癌患者的使用情况。