1例肝肠联合移植术后并发支气管痉挛应用呼吸机的护理

短肠综合征(Short-bowel syndrome)是因先天或后天原因造成肠道解剖学缺失,患者丧失营养的消化和呼吸功能,终生必须依赖静脉营养(TPN)维持生命.但由于TPN昂贵的治疗费用和复杂严格的操作程序,以及应用TPN的并发症如:感染、血栓形成、进行性肝损害等,都给病人生命带来威胁.较为理想的治疗方法是进行肝肠移植术.我院于1999年4月15日为一例短肠综合征伴肝功能损害的患者施行国内首例肝肠联合移植术,术后由于多种原因并发支气管痉挛,经应用呼吸机治疗和护理后,获得明显效果.现就呼吸机治疗过程中的护理体会报告如下.     

重症患者肠内及肠外营养支持的效果分析

目的 探讨重症患者肠内及肠外营养支持的效果及其护理方法.方法 将63例重症患者分为肠内营养组45例和肠外营养组18例,分别进行护理治疗,并进行治疗前后及组间对比分析.结果 2种不同的营养支持对改善2组患者营养机能效果相同,但肠外营养组并发症较肠内营养组严重.结论 肠内营养能较好促进患者康复,正确的护理可减少并发症及不良反应的发生.     

短肠综合征的营养康复治疗及护理

肠道的代偿能力甚强,切除50％的小肠并不引起症状;但切除75％以上可因吸收面积减少而出现严重腹泻、吸收不良,水、电解质紊乱,代谢障碍和进行性营养不良。短肠综合征（以下简称短肠）是指因各种原因引起广泛小肠切除,造成剩余的功能性小肠过短而导致水、电解质代谢紊乱以及各种营养物质吸收不良的综合征。肠外营养问世以前,造成短肠患者死亡的主要原因是原发病本身（如广泛的血管病变或肿瘤）、肠道吸收功能障碍导致的营养不良和肠外营养及其并发症所造成的肝肾功能损害。随着肠外营养技术的进步以及对短肠病理生理过程和肠道代偿机制认识的深入,短肠的病死率已有显著下降,部分患者已能长期存活。南京军区总医院普通外科研究所对1997年1月～2005年4月收治的114例短肠患者施行了营养康复治疗,取得满意的临床效果,现将有关护理体会报告如下。     

《实用临床医药杂志》继续医学教育试题(6)

1名词解释(1)短肠综合征(2)迟发性颅内血肿(DTICH)2单项选择题(1)重症胰腺炎术后营养支持一般应在术后()A.12~24 h B.24~36 hC.36~48 h D.48~72 h、72 h以上(2)短肠综合征的营养康复治疗不包括()A.补充体液丢失B.采用肠内或肠外营养预防和治疗营养不良C.每月评估营养治疗效果D.预防和治疗短肠综合征E.促进残余肠管的代偿(3)晚期癌性肠梗阻患者一般治疗不包括()A.禁食B.PEG(经皮内镜下胃造口)C.镇痛D.止吐E.全肠外营养支持(4)重型颅脑损伤患者肠内营养支持鼻饲管最危险的并发症是()A.误吸B.感染C.腹泻D.消化不良E.肠道菌群失调(5)…     

3例短肠综合征营养康复治疗的应用与护理

短肠综合征的治疗方法主要是营养支持和小肠移植，但两种方法均有其限制和不足。随着基因工程的不断发展，短肠病人的营养康复治疗应运而生，即在静脉营养的基础上，联合应用重组人生长激素、谷氨酰胺和纤维饮食。特概述营养康复治疗的方法及护理。     

重症患者肠内及肠外营养支持的效果分析

目的探讨重症患者肠内及肠外营养支持的效果及其护理方法。方法将63例重症患者分为肠内营养组45例和肠外营养组18例,分别进行护理治疗,并进行治疗前后及组间对比分析。结果2种不同的营养支持对改善2组患者营养机能效果相同,但肠外营养组并发症较肠内营养组严重。结论肠内营养能较好促进患者康复,正确的护理可减少并发症及不良反应的发生。     

重症急性胰腺炎早期肠内营养结合肠外营养治疗的护 理

目的 总结早期肠内营养结合肠外营养治疗重症急性胰腺炎的护理体会.方法 对南昌大学第一附属医院2012年8月至2013年3月收治的60例采用早期肠内营养结合肠外营养支持治疗的SAP患者的临床治疗及护理资料进行回顾性分析.结果 60例SAP患者43例治愈出院,3例转院,8例自动出院,6例死亡出院.结论 早期肠内营养结合肠外营养治疗是治疗重症急性胰腺炎综合治疗方法之一,做好营养支持的护理,预防并发症,可促进疾病康复,提高治愈率,降低死亡率.     

肠外营养在大肠癌术后患者中的应用及护理

总结了104例大肠癌术后患者应用肠外营养的效果及护理措施,包括肠外营养的配制、心理护理、术后加强病情观察、预防感染和空气栓塞等并发症,认为严格无菌操作,加强临床护理,有效的预防了术后并发症的发生,促进患者康复。     

肠液收集回输治疗肠漏的临床观察及护理

目的:探索肠液收集回输方法在肠外漏治疗过程中的应用价值.方法:将引出的肠液收集,回输到远侧肠道内,并早期恢复肠道内营养,共治疗肠外漏13例,其中十二指肠肠漏3例,小肠漏10例.结果:十二指肠漏2例经1～2月保守治疗痊愈,1例在术后3个月手术治疗痊愈;小肠漏9例在肠液收集回输1～2月后行肠吻合痊愈,短肠综合征1例自动出院.结论:在肠外漏病人治疗过程中利用仍然存在的肠道功能实施消化液收集回输,更符合人的肠道生理特点,可较早地恢复肠道内营养,具有生理干扰小,病人康复快,治疗费用低和护理简单等优点.     

1例肝肠联合移植术并发支气管痉挛应用呼吸机的护理

短肠综合征 (Ｓｈｏｒｔ-ｂｏｗｅｌｓｙｎｄｒｏｍｅ)是因先天或后天原因造成肠道解剖学缺失 ,患者丧失营养的消化和呼吸功能 ,终生必须依赖静脉营养 (ＴＰＮ)维持生命。但由于ＴＰＮ昂贵的治疗费用和复杂严格的操作程序 ,以及应用ＴＰＮ的并发症如 :感染、血栓形成、进行性肝损害等 ,都给病人生命带来威胁。较为理想的治疗方法是进行肝肠移植术。我院于 1999年 4月 15日为一例短肠综合征伴肝功能损害的患者施行国内首例肝肠联合移植术 ,术后由于多种原因并发支气管痉挛 ,经应用呼吸机治疗和护理后 ,获得明显效果。现就呼吸机治疗过程中的…     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Rosamicin in Urethral and Vaginal Secretions and Tissues in Dogs and Rats

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.     

Similarities and differences in clients treated and in medications prescribed by APRNs and psychiatrists in a CMHC

This study is part of a larger study comparing prescribing practices of psychiatrists and advanced practice psychiatric nurses (APRNs) using the following three groups of patients: patients treated by psychiatrists, those treated by APRNs, and those treated by both APRNs and psychiatrists at different times in 1 year. Demographics for 5507 patients were examined. A subsample of APRNs and psychiatrists prescribed similar total numbers of medications. Psychiatrists prescribed more types of antidepressant medications other than the SSRI antidepressants, and they prescribed more than twice the number of benzodiazepines. APRNs prescribed more SSRIs and spent more time with clients during medication visits.     

Racial differences in oxidative stress and inflammation: in vitro and in vivo

African American race is an independent risk factor for enhanced oxidative stress and inflammation. We sought to examine whether oxidative-stress and inflammatory markers that are typically measured in humans also differ by race in cell culture. We compared levels between African American and Caucasian young adults and then separately in human umbilical vein endothelial cells (HUVECs) from both races. We found heightened oxidative stress and inflammation in the African Americans both in vitro and in vivo. African American HUVECs showed higher nitric oxide (NO) levels (10.8 ± 0.4 vs. 8.8 ± 0.7 μmol/L/mg, p = 0.03), Interleukin-6 (IL-6) levels (61.7 ± 4.2 vs. 23.9 ± 9.0 pg/mg, p = 0.02), and lower superoxide dismutase activity (15.6 ± 3.3 vs. 25.4 ± 2.8 U/mg, p = 0.04), and also higher protein expression (p < 0.05) of NADPH oxidase subunit p47phox, isoforms NOX2 and NOX4, endothelial nitric oxide synthase (NOS), inducible NOS, as well as IL-6. African American adults had higher plasma protein carbonyls (1.1 ± 0.1 vs. 0.8 ± 0.1 nmol/mg, p = 0.01) and antioxidant capacity (2.3 ± 0.2 vs. 1.1 ± 0.3 mM, p = 0.01). These preliminary translational data demonstrate a racial difference in HUVECs much like that in humans, but should be interpreted with caution given its preliminary nature. It is known that racial differences exist in how humans respond to development and progression of disease, therefore these data suggest that ethnicity of cell model may be important to consider with in vitro clinical research.     

Postural strategies and falls in elderly and in parkinsonism]

OBJECTIVE: To use a posture analysis to show the evolution of postural pattern connected with falls.MATERIAL AND METHOD: It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year. RESULTS: Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters. DISCUSSION: A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies. CONCLUSION: A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.