结肠造口术后并发症的观察与护理

我科2002~2006年共行结肠造口术75例。现将术后主要并发症的发生情况、处理及护理总结如下。1临床资料本组男45例,女30例,年龄8月龄~75岁。其中直肠癌25例,结肠癌21例,肠梗阻11例,直肠破裂7例,结肠损伤5例,先天性巨结肠4例,多发性结肠息肉2例。行横结肠双腔造口术27例,乙状结肠双腔造口术22例,乙状结肠单腔造口术20例,盲肠造口术6例。术后发生造口肠管坏死3例,造口肠管脱出2例,造口狭窄5例,造口肠管回缩2例,造口周围皮炎7例。2观察与护理2.1造口肠管坏死本组3例于术后1~4 d发生造口肠管坏死。主要是造口肠管系膜牵拉过紧而使肠管缺血坏死,也…     

创伤及大手术后并发呼吸窘迫综合征的救治及护理

创伤及大手术后并发呼吸窘迫综合征的救治及护理３１００１６浙江省青春医院汪红慧成人呼吸窘迫综合征（ＡＲＤＳ）是由各种病因引起的，表现为急性进行性呼吸困难及低氧血症。我们自１９８８年至１９９２年共救治严重创伤及大手术后ＡＲＤＳ１６例，占同期严重创伤、大手...     

结肠造口术后护理30例分析

直肠癌占消化道肿瘤第2位,我国每年有近2万例行结肠造口,据国内资料表明,结肠造口早期并发症在30％～40％,造口手术并发症严重影响患者生活质量.我院2010-01-2011-01对30例直肠癌行结肠造口术后护理方法试行改进,在缩短水肿消退时间及降低造口并发症方面收到满意效果,现报告如下.1临床资料1.1一般资料本组男19例,女11例,年龄27～69岁.全部经病理诊断为直肠癌并进行腹会阴联合直肠癌根治术( Mile’s)及结肠造瘘术.8例出现并发症,通过对症治疗,精心护理,恢复良好,出院前均能掌握造口护理技术.     

直肠癌术后结肠造瘘口26例的护理

目的探讨直肠癌术后结肠造瘘口的临床护理方法。方法对北京市良乡医院2008-01-2010-06 26例直肠癌术后结肠造瘘患者的临床资料进行回顾性分析。结果所有患者均手术成功,术后造瘘口坏死1例,行肠段切除及造瘘口重建手术后痊愈,造瘘口周围皮炎2例,经过局部皮肤的护理和换药痊愈。结论术后高质量的临床护理对于造口患者心理、生理和社会适应能力的恢复起着至关重要的作用。     

内镜下结肠支架术临床应用及并发症护理

结直肠支架主要应用在恶性肿瘤所致急性结肠梗阻的术前过度和晚期的姑息治疗,替代结肠造瘘术,解除梗阻症状,恢复肠道通畅,提高患者生存质量。该项技术已在国内外得到逐步开展。内支架作为一种异物置入人体结直肠部位,不可避免的发生并发症,是值得关注和讨论的问题。现对结肠支架置入术临床应用及患者现存及潜在并发症原因并采取相应的护理措施综述如下。1结场支架常见类型内支架按制作材料分为塑料支架、金属支架及其它特殊生物材料支架。其中塑料支架口径固定,不具有扩张性。按表面是     

结肠代食管术后常见并发症的护理

作者对198例食管良性狭窄结肠代食管术后常见并发症的发生原因、临床表现、护理措施进行了总结，认为：针对患者病因进行耐心细致的心理护理；严密观察病情变化；认真完成护理计划是术后护理的关键。     

结肠代食管术后常见并发症的护理

作者对198例食管良性狭窄结肠代食管术后常见并发症的发生原因、临床表现、护理措施进行了总结,认为:针对患者病因进行耐心细致的心理护理;严密观察病情变化;认真完成护理计划是术后护理的关键.     

Diagnosis, etiology, and management of fibromyalgia syndrome: an update

Recent controlled studies suggest a physiologic basis for FMS, which should be diagnosed by its own characteristic features and not by exclusion of other conditions alone. Diffuse musculoskeletal aching, accompanied by multiple TPs in the absence of an underlying arthritic or systemic condition, are the key features for diagnosis. Based on our controlled study, guidelines for diagnosis are provided in Table 5. Successful management of an FMS patient is often challenging, but frequently gratifying if approached with a positive and caring attitude. The most important aspects of management are a firm diagnosis, reassurance regarding the benign nature of the condition, help in changing patient behavior in order to accept pain and increase functional activities and exercise tolerance, and the use of tricyclic agents. Overall, management of fibromyalgia is an art that requires the combined ingredients of patience, understanding, and firmness in helping patients to assume responsibility for their pain management through behavior modifications.     

The clinical course and management of thoracic empyema

We report a prospective multi-centre study of the clinical course and hospital management of thoracic empyema in 119 patients (mean age 54.8). The commonest presenting symptom was malaise (75%), 55% were febrile; 31% were previously well with no predisposing condition. Initial treatments were antibiotics alone (5), needle aspirations (46), intercostal tube drainage (61), rib resection (3) and decortication (4). Overall, intercostal drainage was used in 77 patients (16 failed aspirations), surgical rib resection in 24 (1 failed aspirations, 20 failed drainage), and surgical decortication in 28 (6 failed aspirations, 17 failed drainage). Only 4 patients received intrapleural fibrinolytic agents. Aspiration and drainage were likely to fail if the empyema was &gt;40% of the hemithorax. Median time from treatment start to discharge was: aspirations, 26 days; drainage, 23 days; resection 11 days; decortication, 12 days. Overall 21 patients died (12 with empyema as the major cause); two had been surgically treated. Mortality correlated with age, diabetes, heart failure, and low serum albumin at admission. Infecting organisms, identified in 109 patients (92%) included anaerobes (37), <it>Str. melleri</it> (36), and <it>Str. pneumoniae</it> (28). Six months after discharge, all but six survivors had regained their previous health.      

Thoracic outlet syndrome Part 2: Conservative management of thoracic outlet

Thoracic outlet syndrome (TOS) is a symptom complex attributed to compression of the nerves and vessels as they exit the thoracic outlet. Classified into several sub-types, conservative management is generally recommended as the first stage treatment in favor of surgical intervention. In cases where postural deviations contribute substantially to compression of the thoracic outlet, the rehabilitation approach outlined in this masterclass will provide the clinician with appropriate management strategies to help decompress the outlet. The main component of the rehabilitation program is the graded restoration of scapula control, movement, and positioning at rest and through movement. Adjunctive strategies include restoration of humeral head control, isolated strengthening of weak shoulder muscles, taping, and other manual therapy techniques. The rehabilitation outlined in this paper also serves as a model for the management of any shoulder condition where scapula dysfunction is a major contributing factor.     

The failing Fontan: etiology, diagnosis and management

While the Fontan operation has facilitated the survival of a generation of children born with congenital heart disease resulting in a functional single ventricle, it does not recreate a normal circulation. Over time, survivors of the Fontan operation are at risk for ventricular dysfunction, plastic bronchitis, protein-losing enteropathy and chronic Fontan failure. New techniques and therapies are emerging to address the long-term risks associated with Fontan physiology, but as the number of survivors continues to grow, the recognition of the limitations of this circulation is increasing. Novel investigations of possible mechanical devices designed to function as a subpulmonary ventricle are underway, but are still many years away from clinical use. In the meantime, continued development of medical therapeutics targeted at the specific problems of the Fontan circulation will be beneficial and might reduce the need for cardiac transplantation.     

胸出口综合征的澳式手法治疗

目的:探讨胸出口综合征的保守治疗的效果。方法:对20例胸出口综合征的患者进行C3—7及T1的由后向前按压棘突和由后向前按压横突的手法治疗,配合按摩、超短波、激光或超声治疗,并指导其矫正姿势,肩胛带肌力训练以及在生活、工作中的行为改变,疗前疗后比较其疼痛、患手握力及日常生活活动能力的改善。结果:经过一或二个疗程的治疗,疼痛评分有显著性改善(P<0.05),手握力明显提高(P<0.05),临床症状消失或明显减轻,患者恢复工作。结论:对胸出口综合征患者进行以澳式手法治疗为主,结合理疗及健康教育指导的综合治疗,对缓解其临床症状有较好的效果。