消化性溃疡患者的饮食指导

消化性溃疡是指发生在胃和十二指肠球部的慢性溃疡，多发于青壮年，其形成和发展均与胃液中胃酸及胃蛋白酶的消化作用密切相关，不规律的生活习惯和进食是促发消化性溃疡的重要因素之一。笔者将消化性疡患者的饮食指导做一个初步的探讨，总结如下。     

胃和十二指肠溃疡的护理要点

胃和十二指肠溃疡的发病同胃酸和胃蛋白酶的消化作用有关，故称消化性溃疡。其临床表现主要表现为慢性、周期性及节律性疼痛，疼痛可表现为饥饿痛、钝痛、胀痛、灼痛或剧痛。胃溃疡疼痛多为餐后1小时左右开始，直至下餐前，而十二指肠溃疡多在餐后3-4小时出现，持续至下次进餐前，进餐可使疼痛缓解。[第一段]     

消化性溃疡患者的临床护理

消化性溃疡主要指发生于胃和十二指肠的慢性溃疡，是一种多发病、常见病。溃疡的形成有各种因素，其中酸性胃液对黏膜的消化作用是溃疡形成的基本因素，因此得名。酸性胃液接触的任何部位，如食管下段、胃肠吻合术后吻合口、空肠以及具有异位胃黏膜的Meckel憩室。绝大多数的溃疡发生于十二指肠和胃，故又称胃、十二指肠溃疡。笔者临床护理42例，报告如下。     

消化性溃疡患者的自我护理

消化性溃疡主要指发生在胃和十二指肠的慢性溃疡，约有100k的人在其一生中患过此病。我院2006年7月-2008年3月通过门诊胃镜检查共确诊消化性溃疡患者96例，大多数患者在门诊以服药治疗、饮食指导、心理护理等自我护理为指导思想的新的临床护理方式下取得了良好效果，现报道如下。     

胃镜检出消化性溃疡发病情况分析

该文收集湖南省人民医院1989～1996年期间所做胃镜检查资料,将检出消化性溃疡病例的检出率、平均年龄、男女性别比例、与季节关系及发病部位等情况分别归纳并进行分析讨论。     

消化性溃疡患者饮食知识调查及健康教育

目的探讨消化性溃疡患者科学饮食是否能缓解疼痛,促进溃疡愈合。方法护理人员指导398例消化性溃疡患者科学饮食。结果消化性溃疡患者疼痛明显减轻,溃疡愈合率明显上升。结论消化性溃疡患者科学饮食可达到治疗目的。     

消化性溃疡患者的出院指导

近几年来，我院消化内科收治的消化性溃疡患者较多，且复发率较高。为了预防复发，降低复发率，做好消化性溃疡患者的出院指导尤为重要。     

中药治疗消化性溃疡的临床举隅

消化性溃疡即胃十二指肠溃疡，是指发生在胃与十二指肠中，胃酸和胃蛋白酶的消化作用有密切关系的慢性溃疡。属临床多发病，多见于青壮年。病程长，易复发，且常伴一些严重的并发症。笔者临床应用半夏泻心汤加味治疗消化性溃疡80例取得满意的疗效，现报道如下。     

Diet and nutrition in ulcer disease

In this era of H2-inhibitors, the available evidence does not support the need to place peptic ulcer disease patients on restrictive diets. The major goal of diet is to avoid extreme elevations of gastric acid secretion and the direct irritation of gastric mucosa. In view of this, only slight modifications in the patient's usual diet are recommended. Table 1 depicts a sample menu for chronic peptic ulcer disease. Frequent milk ingestion as previously prescribed is not encouraged. This is owing to the transient buffering effect and significant gastric acid secretion effect of milk. The fat content of milk has no influence on these effects. Spices, in particular black pepper, red pepper, and chili powder, may produce dyspepsia. One study shows red chili powder to have no detrimental effect on duodenal ulcer healing. It has also been proposed that daily pepper ingestion may have a beneficial adaptive cytoprotective response. While still controversial and under evaluation, peptic ulcer patients should avoid any spice that causes discomfort, especially during exacerbation of peptic disease. Currently, studies indicate that it is prudent to avoid alcohol. This is especially true for the concentrated forms, such as 40% (80 proof) alcohol. Coffee should be avoided on the basis of its strong acid secretagogue property. Coffee can induce dyspepsia. Whether noncoffee caffeine-containing beverages (tea, soft drinks) induce peptic ulcer is unknown, but they are acid secretion stimulators. Decaffeinated coffee has an acid stimulating effect as well. It is reasonable to have peptic ulcer patients restrict decaffeinated coffee and all caffeine-containing beverages. There appears to be no evidence to restrict dietary fiber. Some fiber-containing foods may possess factors that are protective against ulcer disease. According to the Mayo Clinic Diet Manual, previously recommended small frequent feedings have not been shown to be more effective than three meals per day in the treatment of chronic peptic ulcer disease. This reference cites authorities advising against extra feedings because of increased acid secretion and unnecessary complication of eating patterns. However, some patients claim to be relieved of symptoms with more frequent feedings, especially during acute phases. Citric acid juices may induce reflux and cause discomfort in selective patients. Stomach distention with large quantities of food should be discouraged. Although there is now little role for dietary therapy, one should note that bland and ulcer diets probably are not detrimental to most persons if they are used for a short time and may have some psychological benefit.(ABSTRACT TRUNCATED AT 400 WORDS)     

A 60-year-old patient with sialadenitis, pulmonary round foci and vulvar ulcer

The unusual case of a 60 year-old woman is discussed. She presented with sialadenitis, paresis of the facial nerve, keratoconjunctivitis and ulcus vulvae. Basic anamnestic information revealed primary enlargement of the submandibular gland, fever, otitis, sinusitis and a pulmonary tumour. The serum immunoglobulin E level was raised. In addition to the necrotic granulomas in the lungs, spleen and kidney, characteristic changes were found in the lymph nodes, liver, pancreas and colon.     

院前急救病人情况调查分析

目的:了解本市区通过120电话获得急救的病人情况。方法:对2004年度本市区3929例院前急救病例进行分析。结果:65.82%病例年龄集中在16～45岁,急诊呼救频率最高的时间段为17:00～19:00,急救现场发病率最高的前6位病种分别为:车祸外伤、心脑血管疾病、中毒、外伤、呼吸系统疾病和产科分娩,按病情轻重分类,按病例数由多到少排顺依次为:中度病人、轻度病人和危重病人,院前急救死亡率最高的前4位病种分别为:心脑血管疾病、车祸、服毒、外伤。     

多器官功能障碍综合征患者呼吸机相关性肺炎的危险因素分析

目的分析多器官功能障碍综合征(MODS)患者机械辅助通气时发生呼吸机相关肺炎(VAP)的危险因素。方法回顾性研究32家参研单位ICU的411例MODS患者。记录并分析患者中VAP发生例数及所有患者的年龄,既往慢性疾病,呼吸机使用时间,循环、呼吸、凝血、肝脏、胃肠道等器官功能,病死率等指标。结果411例MODS患者中VAP的发生率为31·8%。合并慢性阻塞性肺病(COPD)、脑血管病的患者中VAP的发生率显著增高。高龄、合并循环系统功能损伤、凝血系统功能损伤、中枢神经系统功能损伤的患者VAP的发生率也显著增高。合并VAP的MODS患者病情严重度增加,病死率增高。结论在MODS患者中,年龄、COPD、脑血管病、循环系统功能损伤、凝血系统功能损伤是VAP发生的危险因素。VAP是MODS患者的重要死亡原因。     

住院患者信息化服务需求分析

目的了解住院患者的信息化服务需求,从而使护理信息化服务得到持续改进,不断提高护理质量。方法采用自行设计的患者信息化服务需求问卷对新疆5所三级甲等综合医院1 375例住院患者进行调查。结果 1 375例住院患者信息化服务需求总分为(46.24±5.13)分。民族、住院次数、病程是住院患者对信息化服务需求的影响因素。结论少数民族地区不同民族、住院次数、病程的住院患者对于信息化服务的需求具有差异,同时存在地区特色,因此信息化护理服务发展要以当地患者需求为导向,才能使少数民族地区护理信息化服务得到持续改进,从而不断提高护理质量。