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81.
82.
目的:探究直肠癌保肛术的患者在手术之后进行提肛训练对暂时性大便失禁的影响。方法:选取我院患有直肠癌的80例患者,随机分为实验组和对照组,每组40例,实验组的患者在术前以及术后都给予嘱咐,要做好严格的提肛训练,而对照组的患者则只进行常规的护理,观察两组患者手术后大便失禁的发生率以及大便失禁的时间。结果:实验组术后发生大便失禁的概率为45.4%,对照组的概率是92.7%,两者相比存在显著性差异,有统计学意义(P〈O.05);同时,实验组失禁的持续时间是(14±0.4)天,对照组是(39±2)天,有统计学意义(P〈0.05)。结论:对于进行直肠癌保肛术的患者在手术之前以及手术之后进行提肛训练,能够显著降低手术之后发生暂时性大便失禁的概率,同时也缩短了大便失禁的持续时间,极大地减轻了患者的病痛,具有艮好的预后积极意义。 相似文献
83.
目的 评价阑尾原位造口顺行灌肠治疗神经源性大便失禁的临床疗效.方法 1998年6月至1999年12月间对13例伴有大便失禁的脊髓栓系综合征患儿,男9例,女4例,年龄6~13岁,全部施行阑尾原位造口附加阑尾套叠瓣手术,术后间断经阑尾造口插管灌肠.结果 13例均获随访,随访时间2~6年.4例分别于术后2个月、4个月、4个月、6个月停止灌肠后近2周发现造瘘口狭窄,2例经扩张治疗后狭窄消失,2例未行扩张,再2周后造瘘口闭塞.无发生造瘘口漏粪、漏气或插管困难,11例术后肛门功能明显改善.结论 应用阑尾原位造口施行顺行灌肠,可明显改善神经源性大便失禁患儿的肛门功能及生活质量,是一种理想的顺行灌肠方法 . 相似文献
84.
Markus V. Björkström Lina Hall Stina Söderlund Eva Grahn Håkansson Stellan Håkansson Magnus Domellöf 《Acta paediatrica (Oslo, Norway : 1992)》2009,98(11):1762-1767
Aim: To study the early faecal microbiota in very low-birth weight infants (VLBW, <1500 g), possible associations between faecal microbiota and faecal calprotectin (f-calprotectin) and to describe the faecal microbiota in cases with necrotizing enterocolitis (NEC) before diagnosis.
Methods: Stool samples from the first weeks of life were analysed in 48 VLBW infants. Bacterial cultures were performed and f-calprotectin concentrations were measured. In three NEC cases, cultures were performed on stool samples obtained before diagnosis.
Results: Bifidobacteria and lactobacilli were often identified in the first stool sample, 55% and 71% of cases, respectively within the first week of life. A positive correlation between lactic acid bacteria (LAB) and volume of enteral feed was found. Other bacteria often identified were Escherichia coli , Enterococcus and Staphyloccus sp. F-calprotectin was not associated with any bacterial species. All NEC cases had an early colonization of LAB. Prior to onset of disease, all cases had a high colonization of non- E. coli Gram-negative species.
Conclusion: In contrast to the previous studies in VLBW infants, we found an early colonization with LAB. We speculate that this may be due to early feeding of non-pasteurized breast milk. 相似文献
Methods: Stool samples from the first weeks of life were analysed in 48 VLBW infants. Bacterial cultures were performed and f-calprotectin concentrations were measured. In three NEC cases, cultures were performed on stool samples obtained before diagnosis.
Results: Bifidobacteria and lactobacilli were often identified in the first stool sample, 55% and 71% of cases, respectively within the first week of life. A positive correlation between lactic acid bacteria (LAB) and volume of enteral feed was found. Other bacteria often identified were Escherichia coli , Enterococcus and Staphyloccus sp. F-calprotectin was not associated with any bacterial species. All NEC cases had an early colonization of LAB. Prior to onset of disease, all cases had a high colonization of non- E. coli Gram-negative species.
Conclusion: In contrast to the previous studies in VLBW infants, we found an early colonization with LAB. We speculate that this may be due to early feeding of non-pasteurized breast milk. 相似文献
85.
Lisa S. Hayward Rebecca K. Booth Samuel K. Wasser 《General and comparative endocrinology》2010,169(2):117-445
Avian endocrinology is a productive field that could benefit from increased application of non-invasive techniques. Although assay protocols vary, most studies that measure hormone metabolites in avian feces struggle with an artificial effect of sample mass on steroid metabolite concentration. Hormone metabolite concentrations measured in small samples are consistently higher than concentrations in larger samples, and this appears to be due to multiple methodological problems. We systematically tested several causal hypotheses for the mass effect. Based on results from these tests, we modified and validated our assay protocol to effectively eliminate the mass effect. Future studies should implement the following procedures when measuring hormone metabolites from small fecal samples (particularly of birds and reptiles): (1) remove urates from the fecal sample as completely as possible; (2) lyophilize the sample prior to extraction; (3) maximize accuracy of small mass measurements; (4) increase the volume of ethanol in the extraction to 15 ml per 0.05-0.1 g of dried feces; and (5) eliminate ethanol from all samples prior to radioimmunoassay by drying down extract solutions and rehydrating in buffer. By applying these precautions we successfully eliminated the mass effect from fecal samples ranging in mass from 0.001 to 0.1 g using a radioimmunoassay commonly employed for studies of fecal glucocorticoid metabolites. These corrections also resulted in a more than 3-fold increase in effect size in glucocorticoid concentrations from a controlled test of the effects of 1 h motorcycle exposure on northern spotted owls. These methods have important implications not only for avian studies, but for any study measuring hormone metabolites from small fecal samples. 相似文献
86.
Novel surgical repair with bilateral
gluteus muscle patching for intractable rectovaginal
fistula 总被引:4,自引:1,他引:3
Abstract.
We created a novel surgical repair for intractable
rectovaginal fistula and treated four patients who had
previously undergone unsuccessful surgery. An X-shaped skin
incision was made on the perineum, and then the rectum was
carefully divided from the vagina. Defects of both the rectum
and the vagina were closed with vertical mattress sutures. The
external sphincter muscle also was approximated. The gluteus
muscle was identified through another skin incision to the
buttock, and cut at the attachment to the femur. Bilateral
gluteus muscles were approximated at the midline of the perineum
so that the vagina was sufficiently separated from the rectum.
Established anorectal angle was 92.5° (SD=6.4°). Mean resting
pressure was 101.3 cm H2O (SD=13.1). All
patients retained complete anal function without soiling. The
unusual problem of erosion of the posterior vaginal wall with
fistulation in a sexually active woman justifies greater
efforts, and this surgical technique offers good prospects in
this small group of patients. 相似文献
87.
J.L. Lemelle F. Guillemin D. Aubert J.M. Guys H. Lottmann S. Lortat-Jacob P. Mouriquand A. Ruffion J. Moscovici M. Schmitt 《Quality of life research》2006,15(9):1481-1492
Purpose: Spina bifida (SB) is the most common congenital cause of incontinence in childhood. This study attempts to determine the relationships between urinary/faecal incontinence, methods of management, and Health Related Quality of Life (HRQoL) in people with SB.Patients and method: A total of 460 patients (300 adults and 160 adolescents) from six centres in France have taken part in this cross-sectional study. Clinical outcome measures included walking ability, urinary/faecal continence, and medical management. HRQoL was assessed using the SF36 in adults and the VSP in adolescents and their parents. Univariate and multivariate analysis was used to determine the relationships between clinical parameters and HRQoL.Results: HRQoL were significantly lower than in the general population. Adult women had significantly lower scores than men, and adolescent females had significantly lower scores for psychological well being. We did not found strong relationship between incontinence and HRQoL in this population. Moreover patients surgically managed for urinary/fecal incontinence did not show significantly higher scores of HRQoL.Conclusion: Using generic HRQoL measures, urinary/faecal incontinence and their medical management may not play a determinant role in HRQoL of persons with SB. However many other factors affect HRQoL in these patients. A longitudinal study design is recommended to assess whether incontinence management is associated with improve HRQoL. 相似文献
88.
目的 探讨神经外科大便失禁患者留置带囊气管导管引流的效果.方法 对18例神经外科大便失禁患者进行带囊气管导管引流(实验组),观察其肛周皮肤受损情况并与15例前期采用传统护理方法的神经外科大便失禁患者(对照组)比较.结果 实验组的肛周皮肤受损率为5.6%,明显低于对照组(53.3%)(χ2=3.87,P<0.05).结论 带囊气管导管引流能明显降低神经外科大便失禁患者的肛周皮肤受损并发症,能极大地减轻病人痛苦. 相似文献
89.
Edefonti A Picca M Damiani B Loi S Consalvo G Giani M Ghio L Origgi G Ferrario M 《Pediatric nephrology (Berlin, Germany)》2000,15(1-2):25-30
To develop models to estimate nitrogen (N) losses of children on chronic peritoneal dialysis (CPD) from easily measurable
indexes and laboratory tests, we measured the N content and all nitrogenous compounds in dialysate (D), urine (U), and feces
over 3 days in 19 pediatric patients on CPD. Total measured N losses (TNm) were 5.56±2.26 g/day (69.9±11.1% in dialysate,
16.3±10.6% in urine, and 13.6±4.6% in feces). Correlation coefficients between measured dialysate and urinary N losses and
the single nitrogenous compounds indicated values of over 0.9 only for urea in dialysate and urine; fecal N losses correlated
well with body surface area (BSA). Taking into account these correlations, we developed a univariate additive model and three
multivariate models to predict total estimated N losses (TNe). The best prediction of TNm was obtained with model 3, which
considered not only urea output in dialysate and urine but also dialysate protein loss and BSA: TNe (g/day)=0.03+1.138 UN
urea+0.99 DN urea+1.18 BSA+0.965 DN protein. A confirmatory analysis performed on a second group of 23 pediatric patients
on CPD, using all four models, showed a higher percentage of studies with a relative difference between TNm and TNe less than
10% for model 3 than for the other models. Thus, N losses of pediatric patients on CPD can be estimated from measured urea
and protein losses in dialysate and urea loss in urine, together with BSA.
Received: 11 October 1999 / Revised: 1 March 2000 / Accepted: 1 March 2000 相似文献
90.
PURPOSE: Patients with fecal incontinence not amenable to simple repair may have to undergo major reconstructive surgery or resort to a stoma. Sacral nerve stimulation is an alternative approach that may diminish incontinence by altering sphincter and rectal motor function. This study is the first double-blind trial examining the effectiveness of this therapy. METHODS: Two patients with passive fecal incontinence who had been implanted for nine months with a permanent sacral nerve stimulator and electrode were studied using fecal incontinence diaries, anorectal physiological tests, and quality-of-life assessments (SF-36 health survey). The trial period consisted of two two-week periods, with the stimulator turned on for two weeks and off for two weeks. The main investigator and the patients were blinded to the status of the stimulator. RESULTS: There was a dramatic difference between the number and severity of episodes of incontinence when the stimulator was turned onvs. turned off (Patient 1, 20vs. 2 episodes; Patient 2, 4vs. 0 episodes; offvs. on). There was an increase in squeeze pressure (Patient 1, 70vs. 100 cm H2O; Patient 2, 60vs. 90 cm H2O; offvs. on), with moderate increases in resting pressure and rectal threshold and urge volumes. Quality-of-life measurements showed a marked improvement prestimulationvs. nine months after permanent stimulation. CONCLUSIONS: There is a marked, unequivocal improvement in symptoms of fecal incontinence with sacral nerve stimulation shown in this double-blind crossover trial. Sacral nerve stimulation improves the quality of life in selected patients with fecal incontinence.A grant and all the equipment used in this study were supplied by Medtronic INTERSTIM, Maastricht, the Netherlands. 相似文献