护理干预对子宫肌瘤切除术患者手术应激及性生活质量的影响

目的探讨护理干预对子宫肌瘤切除术患者手术应激及性生活质量的影响。方法选取2013年5月至2015年5月间收治的90例子宫肌瘤切除术患者,采取随机数字表法分为观察组和对照组,每组45例。观察组患者给予护理干预,对照组患者仅给予常规护理。比较两组患者手术应激及性生活质量。结果观察组患者焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、心率及收缩压均明显降低,与对照组比较,差异均有统计学意义(均P<0.05)。观察组患者每周性生活频率增高、性唤起时间缩短、获得高潮时间延长,与对照组比较,差异均有统计学意义(均P<0.05)。结论对子宫肌瘤切除术患者,给予积极有效的护理干预,可减少手术应激并改善性生活质量,值得推广应用。     

颅内肿瘤术后身材矮小患儿长期生长激素替代治疗过程中心理护理干预效果观察

目的 探讨颅内肿瘤术后身材矮小患儿长期生长激素替代治疗过程中心理护理干预的应用价值.方法 入组2015年1月至2018年6月郑州儿童医院内分泌遗传代谢科收治的颅内肿瘤术后身材矮小患儿17例,其中男9例、女8例,年龄4～14(9.86±4.50)岁,颅咽管瘤14例、垂体腺瘤3例,且均经临床病理证实存在生长激素缺乏,同时排...     

护理干预对颅内肿瘤患者围手术期便秘的影响

目的:观察护理干预对颅内肿瘤患者围手术期便秘的护理效果,探讨保持大便通畅的有效方法。方法:对128例颅内肿瘤围手术期患者进行分组,干预组采用预防便秘的护理干预措施,对照组按常规护理方法,评价两组护理干预后差异并对其原因进行观察及分析。结果:观察组采用预防便秘的护理干预措施后有18例发生便秘,对照组有30例发生便秘,针对便秘原因对颅内肿瘤围手术期患者进行护理干预能帮助患者保持大便通畅。结论:颅内肿瘤患者术后因多种原因易发生便秘,护理干预可预防便秘,以减少颅内压增高等严重并发症的发生。     

颅内肿瘤患者围手术期心理护理干预的分析

目的探讨心理护理对颅内肿瘤患者围手术期心理健康的影响。方法 2013年4月至2014年4月间收治的82例颅内肿瘤围手术期患者,按随机数字表法分为观察组和对照组,每组41例。对照组患者接受常规护理,观察组患者在常规护理基础上进行全面心理护理干预。对两组患者进行焦虑自评量表(SAS)、抑郁自评量表(SDS)及护理满意度评定。结果观察组患者的SAS和SDS评分分别为(38.4±9.5)分和(41.8±8.4)分,显著低于对照组的(50.7±9.3)分和(49.4±9.7)分。观察组护理满意度为97.6%,显著高于对照组的82.9%,组间差异均有统计学意义(均P<0.05)。结论在常规护理的基础上实施全面心理护理干预可有效改善颅内肿瘤患者的抑郁和焦虑情绪,提高护理满意率,促进患者早日康复,值得临床推广。     

个体化护理干预在喉癌患者术后护理中的应用

总结个体化护理干预在40例喉癌患者术后护理中的应用,针对患者不同的情况给予心理干预、行为干预和建立社会支持等个体化护理干预措施,取得良好效果,提高了患者对治疗的依从性,促进了患者康复.     

快速康复外科理念在颅内肿瘤患者围手术期护理中的应用效果

目的探讨快速康复外科理念在颅内肿瘤患者围手术期护理中的应用效果。方法选取2016年2月至2018年2月间山东省立第三医院收治的64例行超声引导下颅内肿瘤切除术患者,采用随机数表法将患者分为研究组与对照组,每组32例。对照组患者采用常规围术期护理措施,研究组患者采用快速康复外科理念进行围术期护理。观察比较两组患者的手术时间、术中出血量、首次排便时间、首次下床活动时间、住院时间及术后并发症情况。结果两组患者的手术时间和术中出血量比较,差异无统计学意义(P> 0. 05)。研究组患者首次排便时间、首次下床活动时间和住院时间均低于对照组,差异均有统计学意义(均P <0. 05)。研究组患者术后并发症发生率为6. 3%,低于对照组患者的25. 0%,差异有统计学意义(P <0. 05)。结论快速康复外科理念在颅内肿瘤围手术期护理中具有显著的应用效果,可以加快患者的康复速度,降低术后并发症发生率,适于临床推广。     

磁共振质子波谱在颅内肿瘤放疗效果评价中的应用研究

Objective： To evaluate the clinical application of proton magnetic resonance spectroscopy （1HMRS） in patients with radiotherapy treated intracranial tumors. Methods： Forty patients with intracranial tumors underwent multivoxel 1HMRS examination before and after radiotherapy. The concentrations of N-acetyl aspartate （NAA）, choline （Cho） and creatine （Cr） were obtained both in the tumors and the contralateral normal brain regions, The ratios of NANCr, Cho/Cr and Cho/NAA were calculated at the same time and follow-up one year. Results： （1） After radiotherapy, tumors inhibited by radiation had decreased Cho, NAA and Cr on proton MRS. Some cases showed necrotic wave. （2） During the one year follow-up, local tumor recurred in 8 cases and their Cho and Cho/NAA increased high again. Other cases without recurrence, HMRS showed no change. Conclusion： Multivoxel proton MR spectroscopy is available for study of tumor metabolites after radiotherapy and it is a valuable method in the evaluation of radiotherapy treated tumors,     

人文关怀同质化干预在胃癌患者中的应用效果

目的 探讨人文关怀同质化干预在胃癌患者中的应用效果。方法 采用随机数字表法将84例接受放化疗的胃癌患者分为对照组和研究组,每组42例,对照组患者给予常规护理干预,研究组患者给予人文关怀同质化干预。比较两组患者的干预效果、疼痛程度、不良反应发生情况及满意度。结果 干预后,两组患者的健康知识评分、抗病信心评分均高于本组干预前,心理压力评分、焦虑情绪评分均低于本组干预前,研究组患者的健康知识评分、抗病信心评分均高于对照组,心理压力评分、焦虑情绪评分均低于对照组,差异均有统计学意义（P﹤0.05）。研究组患者的疼痛程度轻于对照组,不良反应总发生率低于对照组,满意度高于对照组,差异均有统计学意义（P﹤0.05）。结论 人文关怀同质化干预对胃癌患者具有较好的干预效果,可提高对胃癌的认识水平和抗病信心,降低心理压力,缓解焦虑情绪,降低疼痛程度和不良反应发生率,提高患者满意度。     

护理干预措施在肺癌患者全肺切除术后的应用效果

目的探讨护理干预措施对肺癌患者全肺切除术后并发症的应用。方法选取2014年5月至2015年5月间行全肺切除术的88例患者作为研究对象,根据随机数字表法分为研究组和对照组,每组44例。研究组患者术后在常规护理的基础上给予针对性护理干预措施,对照组患者术后给予常规护理干预措施,比较两组患者并发症的发生情况。结果研究组患者术后并发症发生率为13.6%,显著低于对照组的36.4%,差异有统计学意义(P<0.05)。研究组患者对护理工作的总满意率为100.0%,显著高于对照组的86.4%,差异有统计学意义(P<0.05)。结论针对外科全肺切除术患者并发症情况实施针对性护理措施,可以有效降低并发症发生率,提高护理满意度,适于临床应用。     

舒适护理在艾滋病合并颅内肿瘤患者中的应用及对生活质量的影响

目的 探讨舒适护理在艾滋病合并颅内肿瘤患者中的应用及对生活质量的影响.方法 选取2019年6月至2021年6月间空军军医大学第二附属医院收治的150例艾滋病合并颅内肿瘤患者作为研究目标,采用随机数表法分为对照组和观察组,每组75例.对照组以常规护理干预,观察组以舒适护理干预,研究两组护理满意度、心理症状评分和生活质量评...     

手术室护理干预对腹腔镜下结直肠肿瘤切除术患者术后康复的影响

目的探讨手术室护理干预对腹腔镜下结直肠肿瘤切除术患者术后康复的影响。方法选取2015年3月至2018年8月间陕西安康市中心医院收治的80例行腹腔镜下结直肠肿瘤切除患者,采用随机数表法分为观察组和对照组,每组40例。对照组患者采用常规护理,观察组患者在常规护理基础上采用手术室护理干预,比较两组患者术后恢复、负面情绪、生活质量及并发症等情况。结果观察组患者手术出血量、手术时间、肠鸣音恢复时间、肠蠕动恢复时间和下床时间均少于对照组,差异均有统计学意义(均P<0.05)。干预后,观察组患者焦虑和抑郁评分均低于对照组,差异均有统计学意义(均P<0.05)。干预后,观察组患者躯体功能、社会支持、疼痛、精神健康、社会功能、情绪、心理状态和总体健康评分均高于对照组,差异均有统计学意义(均P<0.05)。观察组患者不良反应率为5.0%,低于对照组的20.0%,差异有统计学意义(P<0.05)。观察组患者护理满意度为92.5%,高于对照组的77.5%,差异有统计学意义(P<0.05)。结论手术室护理干预可减少腹腔镜下结直肠肿瘤切除患者手术出血量、手术时间,缩短恢复时间,改善负面情绪,减少不良反应,提高生活质量和护理满意度。     

系统护理干预对转移性脊柱肿瘤患者手术切除治疗后的影响

目的探讨系统护理干预对转移性脊柱肿瘤患者手术切除治疗后压疮和焦虑抑郁情绪的影响。方法选取2014年1月至2016年4月间西南医科大学附属医院收治行手术切除治疗的120例转移性脊柱肿瘤患者,采用随机数表法分为观察组与对照组,每组60例。观察组患者在压疮常规护理的基础上予以系统干预护理,对照组患者予以压疮常规护理。比较两组患者护理干预前后焦虑与抑郁改善情况及压疮发生情况。结果干预前,两组患者焦虑和抑郁评分比较,差异均无统计学意义(均P>0.05)。干预后,两组患者焦虑和抑郁情况均有好转,且观察组患者好转情况明显优于对照组,差异均有统计学意义(均P<0.05)。干预后,观察组患者压疮发生率为3.3%,明显少于对照组的23.3%,差异有统计学意义(P<0.05)。结论系统护理干预能改善转移性脊柱肿瘤患者手术切除后的抑郁和焦虑情况,降低压疮发生率,提高生活质量。     

Assessment of systemic inflammatory response (SIR) in patients undergoing radiofrequency ablation or partial liver resection for liver tumors

Introduction

Local therapies for liver tumors are considered to be safe. However, cryoablation (CA) has been associated with an exaggerated systemic inflammatory response (SIR). Aim of this study was to assess the degree of SIR after radiofrequency ablation (RFA) in comparison with major (MR) or minor (mR) liver resection.

Material and methods

Thirty-nine patients were treated with RFA (n = 11), MR (n = 10) or mR (n = 18). SIR parameters [white blood count (WBC) and C-reactive protein (CRP)], proinflammatory mediators [IL-6, TNF-α and sPLA2], liver damage parameters [AST/ALT] and platelet counts were determined at different time points. The volume of ablated liver was calculated on the first CT after RFA in order to correlate ablated liver volume with liver enzyme release and SIR. All data are expressed as median values with quartiles [25%, 75%].

Results

RFA induced a moderate SIR, as demonstrated by a significant elevation of CRP (77 mg/L vs 3 mg/L), IL-6 (96 pg/ml vs 4 pg/ml) and sPLA2 (41 ng/ml vs 7 ng/ml, p < 0.05).Peak point values of SIR (WBC and CRP at 24 vs 48 h and 48 vs 72 h) and proinflammatory response parameters (24 vs 48 h) occurred earlier after RFA than after mR or MR. Time-to-time comparison revealed even increased levels of CRP (77 mg/L [59, 160]) 24 h after RFA when compared to patients undergoing major or minor resection (50 mg/L [28, 66] and 59 mg/L [24, 91], respectively) and increased levels of IL-6 (67 pg/ml [42, 131]) 4 h after RFA when compared to patients undergoing minor resection (29 pg/ml [20, 55]). Postoperative levels of AST and LDH correlated significantly with the ablated liver volume 1 h after RFA (RC = 0.860 and RC = 0.868, respectively, p < 0.05).

Conclusion

RFA induced a moderate SIR of the same magnitude as in patients undergoing partial liver resection. None of the patients showed signs of an exaggerated SIR, as has been reported after cryoablation.     

介入栓塞术治疗颅内肿瘤的效果观察

目的探讨介入栓塞术对颅内肿瘤患者核因子κB(NF-κB)、血管内皮生长因子(VEGF)水平及脑血管痉挛的影响。方法选取2018年7月至2021年5月大连市第五人民医院诊治的88例颅内肿瘤患者作为研究对象,根据随机1∶1信封抽签法将其分为介入组与手术组,每组44例。介入组给予介入栓塞术治疗,手术组给予开颅夹闭术治疗,治疗观察1个月。结果介入组术后1个月的总有效率为95.5%,高于手术组的79.5%,差异有统计学意义(P <0.05)。两组术后1个月的美国国立卫生研究院卒中量表(NIHSS)评分低于术前1d,介入组低于手术组,差异均有统计学意义(均P <0.05)。介入组术后1个月的剧烈头痛、短暂性偏瘫和意识障碍程度加深等脑血管痉挛发生率为4.5%,低于手术组的29.5%,差异有统计学意义(P <0.05)。两组术后1个月的血清NF-κB和VEGF水平低于术前1d,介入组低于手术组,差异均有统计学意义(均P <0.05)。结论介入栓塞术在颅内肿瘤患者的应用能抑制血清NF-κB、VEGF的表达,降低脑血管痉挛的发生率,改善患者的神经功能,提高总体治疗效果。     

Trends in the incidence of primary intracranial tumors in Kumamoto, Japan

Background. The introduction of modern neuro-imaging techniques, as well as various environmental factors, have been changing the incidence and the proportions of the types of clinically diagnosed intracranial tumors. The aim of this study was to determine recent trends in the occurrence of primary intracranial tumors in the residents of Kumamoto Prefecture, Japan. Methods. We surveyed 2129 patients who were diagnosed with primary intracranial tumors between 1989 and 1998, with histological diagnosis being obtained in 71% of the patients. Results. Of the 2129 patients, 710 (33.3%) had meningiomas, 390 (18.3%) had pituitary adenomas, 315 (14.8%) had malignant gliomas, and 208 (9.8%) had schwannomas. The overall age-adjusted incidence rates were 10.97/100 000/year (males, 9.70; females, 11.86). One hundred and nine patients (5.1%) were younger than 15 years, and 480 patients (22.5%) were older than 70 years. The most common tumors in children were astrocytomas (37.6%), followed by germ-cell tumors (16.5%) and craniopharyngiomas (11.9%), medulloblastomas (11.0%), and ependymomas (4.6%). Meanwhile, the most common tumors in elderly residents were meningioma (51.7%), followed by malignant glioma (13.7%), pituitary adenoma (11.4%), schwannoma (7.7%), malignant lymphoma (4.6%), and astrocytoma (2.7%). The proportion of asymptomatic tumors increased, from 24.6% in 1989–1994 to 33.0% in 1995–1998; 169 (62.8%) were meningiomas, followed by pituitary adenomas (14.1%). Conclusion. The detection rate of asymptomatic intracranial tumors, particularly that of meningiomas, and the incidence of brain lymphoma are on the increase. Differences in the incidence of gliomas, pituitary adenomas, medulloblastomas, and germ-cell tumors between the Japanese population and populations in Western countries may be attributable to ethnic differences. Received: February 19, 2001 / Accepted: May 25, 2001     

Clinical benefit from resection of recurrent glioblastomas: results of a multicenter study including 503 patients with recurrent glioblastomas undergoing surgical resection

Background

While standards for the treatment of newly diagnosed glioblastomas exist, therapeutic regimens for tumor recurrence remain mostly individualized. The role of a surgical resection of recurrent glioblastomas remains largely unclear at present. This study aimed to assess the effect of repeated resection of recurrent glioblastomas on patient survival.

Methods

In a multicenter retrospective-design study, patients with primary glioblastomas undergoing repeat resections for recurrent tumors were evaluated for factors affecting survival. Age, Karnofsky performance status (KPS), extent of resection (EOR), tumor location, and complications were assessed.

Results

Five hundred and three patients (initially diagnosed between 2006 and 2010) undergoing resections for recurrent glioblastoma at 20 institutions were included in the study. The patients’ median overall survival after initial diagnosis was 25.0 months and 11.9 months after first re-resection. The following parameters were found to influence survival significantly after first re-resection: preoperative and postoperative KPS, EOR of first re-resection, and chemotherapy after first re-resection. The rate of permanent new deficits after first re-resection was 8%.

Conclusion

The present study supports the view that surgical resections of recurrent glioblastomas may help to prolong patient survival at an acceptable complication rate.     

手术室人性化护理对腹腔镜结肠癌根治术患者术后康复的影响

目的探讨手术室人性化护理对腹腔镜结肠癌根治术患者术后康复的影响。方法选取2016年1月至2019年1月间复旦大学附属肿瘤医院收治的120例腹腔镜结肠癌根治术患者。根据护理方法不同进行分组,采用常规护理的60例患者纳入对照组,在常规护理基础上采用手术室人性化护理的60例患者纳入观察组。比较两组患者手术相关指标、心理状态及术后不良反应发生率。结果与对照组相比,观察组患者的手术时间、肠道功能恢复正常时间和住院时间均较短,且术中出血量较少,差异均有统计学意义(均P<0.05)。护理前,两组患者焦虑和抑郁量表评分比较,差异无统计学意义(P>0.05);护理后,两组患者的焦虑和抑郁评分均比护理前减少,且观察组患者的焦虑和抑郁评分均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者的不良反应总发生率为3.3%,明显低于对照组的16.7%,差异有统计学意义(P<0.05)。结论手术室人性化护理应用于腹腔镜结直肠癌根治术患者,可明显改善患者的消极情绪,优化手术相关指标,减少并发症,值得推广。     

高位骶骨肿瘤切除与重建术患者围术期护理干预的效果分析

目的探讨高位骶骨肿瘤切除与重建术患者围术期护理干预的效果。方法选取2013年1月至2017年12月间陕西省延安大学附属医院收治的33例高位骶骨肿瘤患者的临床资料进行回顾性分析,均采用围术期护理干预措施,并对其护理效果进行分析和探讨。结果高位骶骨肿瘤患者术后近期腰骶椎疼痛和大便梗阻感消失,疗效基本满意。术后并发症主要包括排尿困难3例、便秘2例、脑脊液漏3例和术后切口感染6例,经过针对性干预后,患者并发症均得到有效改善。术后2年随访发现,5例患者因肿瘤复发或转移死亡。结论高位骶骨肿瘤切除与重建术患者围术期加强护理干预,可减少并发症,提高手术治疗效果,改善预后。