应用食盐蒜泥穴位外敷解除下肢骨折患者术后尿潴留

目的 探讨食盐蒜泥穴位外敷解除下肢骨折患者术后尿潴留的效果.方法 下肢骨折术后尿潴留患者61例,按住院单双号分为对照组(29例)和观察组(32例).观察组采用食盐蒜泥热敷脐部至膀胱区穴位(包括神阙、阴交、石门、关元、中极、曲骨),宽度5 cm、厚度1 mm;对照组采用听流水声、按摩下腹部、热敷膀胱区、温水冲洗会阴部等传统方法.结果 观察组有效率显著高于对照组,首次排尿时间显著短于对照组(均P<.001).结论 应用食盐蒜泥穴位外敷解除下肢骨折患者术后尿潴留时间短、效果好.     

下肢骨折拔管后尿潴留患者护理干预效果观察

目的:观察下肢骨折术后尿潴留患者护理干预效果。方法:将335例下肢骨折术后留置尿管患者随机分为两组,观察组173例进行护理干预,对照组162例进行常规基础护理及术后专科护理。比较两组拔除尿管后排尿情况。结果:观察组拔出尿管后出现尿潴留而重新置管发生率低于对照组(P<0.05)。结论:下肢骨折术后留置尿管患者采取护理干预措施可降低拔出尿管后出现尿潴留而重新置管发生率。     

术中肢体被动活动对全麻患者恢复期的影响

目的 探讨被动活动全麻恢复期患者下肢对缓解术中躁动及其他不良情况的效果.方法 将全麻开腹手术患者随机分为观察组和对照组各30例,观察组根据手术拔管时间在全麻开始2 h、3 h、4 h、手术结束前由巡回护士为患者做一系列下肢被动活动,对照组患者则不做任何被动活动.观察两组患者恢复期的拔管时间、清醒时间及躁动情况.结果 两组拔管时间比较,差异无显著性意义(P＞0.05);观察组完全清醒时间较对照组显著提前(P＜0.05),躁动发生率显著低于对照组(P＜0.01).结论 术中采取下肢被动活动,有利于减轻患者恢复期躁动,使患者感觉舒适.     

护理干预预防臀肌挛缩症术后尿潴留的效果观察

目的探讨护理干预预防臀肌挛缩症术后尿潴留的效果.方法将76例臀肌挛缩症患者随机分为对照组和观察组各38例.对照组术前术后进行常规护理.观察组进行解释、鼓励、暗示等支持性心理护理,于术前3 d开始床上排尿训练,并于术后进行行为干预.结果术后8 h内对照组患者自行排尿16例,观察组为33例,两组比较,差异有显著性意义(P＜0.01);且观察组术后首次自行排尿时间显著短于对照组(P＜0.01).结论手术前后的护理干预可明显减少臀肌挛缩症患者术后尿潴留的发生率.     

回肠膀胱术后患者Orem自理模式的应用

目的探讨回肠膀胱术后患者应用Orem自理模式的效果.方法将30例回肠膀胱术术后患者随机分为观察组和对照组各15例.对照组行常规术后护理,观察组术后根据患者自理能力应用Orem自理模式进行护理.结果观察组住院时间为(27.35±1.54) d、术后下床活动时间(38.00±3.73) h,与对照组比较,其下床活动时间显著提早(P<0.05),住院时间显著缩短(P<0.05);观察组并发症发生率显著少于对照组(P<0.05).结论在回肠膀胱术患者的护理中应用Orem护理模式有利于患者早日康复.     

饮用白萝卜汤对子宫切除患者术后肛门排气的影响

目的观察白萝卜汤对腹式子宫切除术患者术后胃肠蠕动功能恢复的影响.方法选择行腹式子宫切除术患者134例,按入院先后顺序以单、双号将患者分为观察组和对照组各67例.术后禁食水6 h后,观察组少量频饮白萝卜汤;对照组则少量频饮番泻叶浸泡汁.结果术后肛门排气时间观察组为(37.2±5.4) h,对照组为(36.1±4.9) h,两组比较,差异无显著性意义(P>0.05);对照组恶心、呕吐、腹痛和腹泻等胃肠道反应发生率均高于观察组,两者比较,差异有显著性意义(P<0.01);且观察组乐意服用白萝卜汤者65例(97.0%),对照组乐意服用番泻叶者42例(62.7%).结论饮用白萝卜汤对腹式子宫切除术患者术后胃肠蠕动功能的恢复疗效好,不良反应发生率低,患者乐意接受.     

整体护理干预在肛瘘术后的应用效果观察

目的：观察整体护理干预在肛瘘患者术后应用效果。方法：将30例肛瘘手术患者随机分为对照组和观察组,每组15例。对照组患者实施常规护理干预,观察组患者在对照组的基础上实施整体护理干预,比较2组患者术后不同时点疼痛程度、首次排尿时间、尿潴留发生率、术后锻炼依从性及护理满意度。结果：观察组患者术后6h、12h、24h疼痛评分均低于对照组（P <0.05）;观察组患者术后首次排尿时间短于对照组（P <0.05）,观察组患者无尿潴留发生,对照组尿潴留发生率为26.67%,差异有统计学意义（P <0.05）;观察组患者术后锻炼依从性和护理满意度均高于对照组（P <0.05）。结论：对肛瘘手术患者实施整体护理干预,可减轻患者术后疼痛,降低尿潴留发生率,提高其术后锻炼依从性及护理满意度,效果显著。     

坦索罗辛用于肛肠病术后尿潴留的疗效观察

为观察坦索罗辛用于肛肠病术后尿潴留的临床效果,将40例肛肠病术后患者随机分为对照组和观察组,每组20例.观察组患者于术前1d晚和术后4h口服坦索罗辛治疗,对照组以安慰剂治疗,比较2组患者术后尿潴留的发生率和术后首次排尿时间等情况.结果显示,观察组患者术后尿潴留的发生率为10％,对照组患者术后尿潴留的发生率为35％,2组...     

骨科择期术后患者进食时间的研究

目的 探讨骨科择期术后患者早期进食的安全性和可行性.方法 将116例骨科行择期手术的患者随机分为两组,观察组(57例)先进行健康教育,于术后2 h开始由责任护士对患者麻醉情况、胃肠功能恢复情况、进食意愿进行评估,合格后即鼓励进食;对照组(59例)严格按照医嘱要求进食.结果 观察组术后进食时间(3.71 士3.35)h,其中80.70%患者在术后2～4 h进食;对照组(8.63±6.32)h,两组进食时间比较,差异有显著性意义(P<0.01).现察组术后口渴、饥饿、便秘评分显著低于对照组,术后下床时间和出院时间显著短于对照组(均P<0.01);而两组术后呕吐发生率比较,差异无显著性意叉(P>0.05).结论 骨科择期手术患者术后2～4 h进食可行,先评估后进食方法是确保患者安全的必要措施.     

不同卧床时间对心脏起搏器植入术后患者功能恢复的影响

目的探讨不同卧床时间对心脏起搏器植入术后患者功能恢复的影响.方法将146例行心脏起搏嚣植入术后患者随机分为观察组和对照组各73例,对照组术后常规卧床72 h,观察组术后卧床12 h,比较两组患者术后起搏器功能、并发症发生率、拆线时间及术后住院时间.结果观察组起搏器起搏功能感知障碍发生率为5.5%,对照组为8.2%,两组比较,差异无显著性意义(P＞0.05);观察组术后并发症发生率显著低于对照组(P＜0.05);拆线时间、住院时间显著短于对照组(均P＜0.05).结论缩短卧床时间对患者术后起搏器功能无影响,可提高患者术后舒适度,减少并发症的发生,有利于伤口愈合、降低感染率、缩短住院时间.     

Quality of Life After Abdominoplasty in Women After Bariatric Surgery

Background Abdominal skin overhang is not unusual after massive weight loss induced by antiobesity interventions, and poor quality of life should be feared in such circumstances, especially in women. However, long-term results of quality of life have not been often documented in this setting. With the purpose of addressing this question, a prospective study was designed. Methods Patients (n = 16, 100% females, age 40.1 ± 8.0 years) submitted to standard or combined circumferential abdominoplasty were recruited for this study. All had undergone open Roux-en-Y gastric bypass between 24 and 48 months earlier with stable weight in the last 12 months. Quality of life was assessed by a trained psychologist employing of a semistructured interview, the Adaptative Operationalized Diagnostic Scale (AODS), covering affectivity/personal relations, productivity, social/cultural performance, and organic/somatic health. Results Circumferential abdominoplasty was followed by few problems (serous fluid collections in 18.8%, anemia because of blood loss in 6.3%). The best overall response to the AODS questionnaire corresponded to the social and cultural domain where 81.3% of the patients had excellent adaptation (level 1). For the other three domains, results were remarkably similar with 62.5% of the tests displaying the highest value of adaptation and rare total failures. Conclusions (1) The current operation corresponded to the expectations of the patients with few complications and favorable body contouring result. (2) Quality of life, quantified by means of adaptation and social adjustment scores, was adequate in most circumstances. (3) Outstanding responses for social/cultural performance were registered with encouraging findings for affectivity/personal relations, productivity, and organic/somatic health as well.     

Pancreaticojejunostomy Stricture After Pancreatoduodenectomy: Outcomes After Operative Revision

Introduction

The natural history of radiographic strictures of the pancreaticojejunostomy (PJ) after pancreatoduodenectomy (PD) is difficult to characterize. The purpose of this study was to identify the indications for operative revision of PJ strictures after PD for benign and malignant disease and to evaluate its safety and clinical efficacy.

Methods

A retrospective review of all patients undergoing operative revision of PJ strictures following PD at a single academic institution over an 8-year period (2006–2014) was performed.

Results

Twenty-seven patients underwent revision of a symptomatic radiographically detectable PJ stricture. The median time from PD to PJ stricture diagnosis was 46 months. The median increase in the main pancreatic duct diameter between the time of PD and PJ revision was 2 mm. The overall morbidity after PJ revision was 26 %. No postoperative mortality occurred. Twenty-one (78 %) patients experienced resolution of symptoms without recurrent acute pancreatitis after PJ revision during a median follow-up of 30 months. Durable symptom resolution was reported among 60 % of patients with chronic pancreatitis.

Conclusions

Surgical revision of pancreaticojejunostomy strictures is technically safe and clinically effective for selected patients who experience recurrent acute pancreatitis after pancreatoduodenectomy for either benign or malignant disease.

     

Role of Percutaneous Glue Treatment After Persisting Leak After Laparoscopic Sleeve Gastrectomy

Background

Over the years, many treatment modes have been attempted for gastrocutaneous fistula (GCF) after laparoscopic sleeve gastrectomy (LSG). Minimally invasive techniques for GCF treatment include stent placement and radiological percutaneous glue treatment (GT).

Material and Method

Ten patients underwent a radiological acrylate mixed with contrast medium GT combined or not with other treatment strategies such as relaparoscopy, ultrasound, or computerized tomography scan (CT scan)-guided drain and endoscopic stent placement.

Results

Ten patients (mean age 47.1 years, range 64–29) were treated by percutaneous injection of glue after LSG leak. Body mass index (BMI) was 42.2 kg/m²?±?6.7 at the time of LSG surgery. Mean time between LSG and leak diagnosis was 12 days (range 4–31 days). GT was only effective when performed after endoscopic stent placement (80 % resolution). With this regimen, five patients required a laparoscopic Roux limb placement. All fistulas eventually healed a mean of 75 days (range 29–293 days) after GCF diagnosis.

Conclusions

Percutaneous glue treatment alone does not seem to provide adequate results. Stenting previous to the glue treatment allows for better results.

     

Internal Fixation After Subtrochanteric Femoral Fracture After Hip Resurfacing Arthroplasty

Periprosthetic fractures around total hip arthroplasty create surgical challenges with many described techniques of either fixation or revision. The increasing popularity of hip resurfacing arthroplasty poses different problems especially if there is a desire to retain the prosthesis rather than converting to a total hip arthroplasty. We describe a previously unreported technique of fixation for a comminuted, proximal femoral fracture, beneath a hip resurfacing.