ObjectiveTo explore the clinical effect of healthy education on functional constipation caused by unhealthy lifestyle, and to analyze the disadvantages affecting the curative effect. MethodsA total of 167 cases of functional constipation from February 2009 to February 2012 were included. All of the patients were followed up for one year. We collected clinical data of curative effect and influencing factors, determined the clinical value of healthy education, and analyzed the influence of different factors on the curative effect of healthy education. ResultsThe total curative effect after one-year follow-up was 84.4%. The curative effect in elderly patients was significantly higher than that in middle-aged ones (P<0.05). The curative effect in urban patients was remarkably higher than that in rural ones (P<0.05). And the curative effect of patients with college degree wass much higher than that in patients with education background of primary school or below (P<0.05). ConclusionHealthy education has important value on releasing and eliminating functional constipation caused by unhealthy lifestyle. And it needs individual education aimed at patients with different age, education degree, and domicile.
ObjectiveTo systematically evaluate the effect of single-port totally extraperitoneal (SPTEP) and conventional totally extraperitoneal (CTEP) inguinal hernia repair in treatment of inguinal hernia. MethodsPubMed, Cochrane Library, Embase, WanFang Data, VIP, and CNKI databases were electronically searched and the randomized controlled trial (RCT) and non-RCT studies on the efficacy and safety of SPTEP versus CTEP for patients with inguinal hernia from January 2010 to November 2019 were collected. Two reviewers independently screened literatures, extracted data, and assessed risk of bias of included studies, then the meta-analysis was performed by using RevMan5.3 software. ResultsA total of 17 clinical studies were included in the analysis, with 1 106 cases in the SPTEP group and 966 cases in the CTEP group. The results of meta-analysis showed that: the hospital stay [SMD=–0.12, 95%CI (–0.22, –0.02), P=0.01] and the time to resume normal activity [SMD=–1.17, 95%CI (–2.10, –0.23), P=0.01] were shorter, the satisfaction score of incision scars [SMD=0.92, 95%CI (0.31, 1.53), P<0.01] was higher in the SPTEP group as compared with the CTEP group. However, the operative time of SPTEP group was longer than that of the CTEP group both for unilateral inguinal hernia [MD=4.08, 95%CI (0.34, 7.83), P=0.03] and bilateral inguinal hernia [MD=5.53, 95%CI (0.39, 10.68), P=0.04]. There were no statistical differences in the postoperative pain score (24 h and 7 d), incidence of postoperative complications, the rate of patients satisfied with the incision, and hospitalization costs between the two groups (P>0.05). ConclusionsFrom the results of this meta-analysis, SPTEP has some certain advantages in shortening hospital stay and returning to normal activity time, and improving incision satisfaction. However, compared with CTEP, mean operative time of SPTEP is longer. Although SPTEP has developed for several years, it is difficult to replace CTEP.
This article elaborates the concept, meaning and role of clinical pathway, discusses development stages and implementation effects of clinical pathway at home and abroad, and proposes that clinical pathway has been developed very well abroad, but it still has many problems in domestic gtowth which needs to be put into effect with Single-DRGs system in combination.
目的:探讨晚期血吸虫病巨脾型外科治疗和治疗效果。方法:对31例外科治疗的晚期血吸虫巨脾型患者临床资料进行回顾性总结。结果:接受脾切除和贲门周围血管离断术后，31例患者的劳动力有不同程度恢复，脾亢症状消失，上消化道出血减少。结论:脾切除加贲门周围血管离断术对晚期血吸虫病巨脾型患者的劳动力恢复，脾亢症状消除或改善，上消化道出血减少有显著治疗效果。
【Abstract】ObjectiveTo improve curative effects in the treatment of hilar bile duct stricture. MethodsIntrahepatic cholelithiasis was associated with the development of hilar bile duct stricture.Plastics of hilar bile duct stricture (PHBDS) using pedicled cholecystic graft and Roux-en-Y cholangiojejunostomy (RYCJ) were performed. The patients with hepatolithiasis treated with PHBDS or RYCJ between Jan. 1994 and Jan. 2004 were retrospectively analyzed.ResultsFollow-up was carried out from 16 months to 87 months with an average of 47 months. The postoperative morbidity of cholangitis was 5.66% and 21.88% (P=0.010) and recurring rate of hepatolithiasis was 3.77% and 16.67%(P=0.021).ConclusionPHBDS can preserve the physiological compatible, convenient and effective in treatment of hilar bile duct stricture. The late result after operation of PHBDS is better than that of RYCJ.
Objective To explore the application effects of innovative health education on patients undergoing ambulatory laparoscopic cholecystectomy (LC). Methods A total of 139 patients undergoing ambulatory LC from November to December 2016 were selected as the control group, receiving the traditional health education; and other 141 patients undergoing ambulatory LC from February to March 2017 were selected as the observation group, receiving the innovative health education. The two groups were followed up and observed 1 day, 2, and 28 days after the discharge, and the incidence rates of adverse reactions such as postoperative pain, bleeding and incision infection were measured, and the disease knowledge mastery, self-care skills, medication compliance and satisfaction to nursing and hospital were evaluated. Results The total incidence rate of adverse reactions was 7.8% in the observation group and 25.2% in the control group (P<0.001). Medication compliance from high to low was 90, 46 and 5 cases in the observation group and 59, 64 and 16 cases in the control group (P<0.001). In the observation group, the scores of disease knowledge mastery, self-care cognition, nursing satisfaction and hospital satisfaction were 93.4±5.5, 91.4±4.5, 96.4±3.7 and 98.1±3.7, respectively, which were higher than those in the control group (83.8±8.7, 83.2±9.1, 91.5±9.2 and 94.8±7.3, respectively) with statistical significance (P<0.001). Conclusion Innovative health education has certain application effects on ambulatory LC, and it can significantly improve disease knowledge mastery and self-care cognition, and help to ensure the medical quality and safety during perioperative period, and improve the patients’ satisfaction.
摘要:目的: 探讨临床护理安全规范化管理的有效方法和效果。 方法 :成立病房护理安全管理小组;完善护理安全管理制度,培养质量管理意识;改善重点环节工作流程,强化质量监控;构建护理安全文化氛围。 结果 : 患者满意度明显提高,用药错误、管道脱落、压疮、投诉等发生率明显降低(〖WTBX〗P lt;0005)。 结论 : 规范化的护理安全管理提高了护理质量,保障了患者的安全,有效降低了护理风险的发生。Abstract: Objective: To discuss a effective way and effect of standardardized management of clinical nursing safety.Methods :Setted up nursing safety management team; Improved the nursing safety management system and trained awareness of quality management; Improved workflow of key links,and strengthened the quality control; Built a nursing safety culture. Results : Patients satisfaction improved obviously, and the medication errors、 pipe off、pressure sores、the incidence of complaints such as decreased obviously(P lt;0005).Conclusion : Standardized management of nursing safety improved the nursing quality, protected patients safety, and effectively reduced the risk of the occurrence of nursing.
目的 探讨乳腔镜辅助下早期乳腺癌保乳治疗的优越性。方法 乳腔镜辅助下行保乳术37例，术后均行乳腺和病灶区放射治疗，并按病理及受体情况给予相应的辅助化疗及内分泌治疗。结果 乳腔镜辅助下保乳术成功35例，2例术中因腋窝出血量多而转开放性手术。患者无明显手术并发症, 且美容效果良好。术后随访时间最长27个月, 中位随访时间为18 个月,无一例局部复发、远处转移和死亡。术后乳腺美容效果评估： 优、良者术后6个月为68.2%，术后1年为83.4%。结论 乳腔镜辅助下早期乳腺癌保乳术以不降低生存率、不增加复发率为原则，联合多学科有机配合及综合治疗为保证，具有创伤小、并发症少、外形美观、生存质量高等优点。