Objective:To investigate the effect of laparoscopic trans-abdominal preperitoneal hernia repair(TAPP) repair on postoperative recovery, coagulation function and prognostic recurrence rate of patients with inguinal hernia.Methods:A total of 116 patients with inguinal hernia in Handan Central Hospital from February 2018 to April 2020 were selected, and they were divided into TAPP group (n=58) and traditional group (n=58) according to the treatment method. The TAPP group received TAPP repair, and the traditional group received traditional tension-free hernia repair. To compare the levels of coagulation function indexes [activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB)] before operation, 1 days after operation, and 3 days after operation in the two groups. The incidence of postoperative complications, recurrence rate and scars aesthetics at 6 months after operation, and the sexual function indexes (testicular volume and maximum blood flow velocity of testis) before operation, 3 months and 6 months after operation were also calculated.Results:Although the operation time of the TAPP group was longer than that of the traditional group, the postoperative time of getting out of bed and hospital stay were shorter than those of the traditional group, and the intraoperative blood loss was lower than that of the traditional group (P<0.05). The serum APTT and PT levels of the two groups at 1 d and 3 d after operation were shorter than those before operation, and the FIB level was higher than before operation (P<0.05), but there was no significant difference between the groups (P>0.05). The incidence of postoperative complications in the TAPP group was lower than that in the traditional group (P<0.05). The scars aesthetics in the TAPP group at 6 months after surgery was better than that in the traditional group (P<0.05), and the recurrence rate in TAPP group at 6 months after surgery was lower (P<0.05). The testicular volume and maximum blood flow velocity at 3 and 6 months after surgery in both groups were lower than those before surgery, but those in TAPP group were higher than those in traditional group (P<0.05).Conclusion:TAPP in the treatment of inguinal hernia patients has the advantages of less trauma, less bleeding, quick postoperative recovery, fewer complications, better scar aesthetics and low recurrence rate. It can improve the appearance of scar and reduce the impact on the sexual function of male patients. However, the operation time is prolonged, and attention should be paid to the effect of pneumoperitoneum on the coagulation function during the operation.

目的 探讨脑蛋白水解物联合脑心通胶囊治疗缺血性脑血管病患者的疗效观察及对其血浆脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)和S100β表达.方法 前瞻性选取2017年6月至2019年6月邯郸市中心医院收治的缺血性脑血管病患者86例,依据随机数字表法将其分为观察组43例与对照组43例.2组患者入院后采取常规对症治疗.对照组给予脑蛋白水解物20 mL和250 mL 0.9％氯化钠溶液中,静脉滴注,每日1次;观察组在对照组基础上服用脑心通胶囊4粒/次,每日3次.2组疗程均为4周.比较2组疗效,治疗前、治疗4周后Barthel指数(BI)和神经功能缺损评分(NIHSS)、血浆BNDF、NSE和S100β表达影响.结果 观察组总有效率为93.02％,高于对照组的72.09％,差异有统计学意义(P<0.05).观察组治疗4周后BI评分为(69.42±6.25)分,高于对照组[(60.12±4.37)分],NIHSS评分为(10.29±2.64)分,低于对照组[(17.15±3.23)分],差异均有统计学意义(P<0.05).观察组治疗4周后血浆BNDF为(6.43±0.56)ng/mL,高于对照组[(5.37±0.39)ng/mL],NSE和S100β为(7.98±2.54)μg/L、(0.85±0.18)ng/L,均低于对照组[(14.23±4.12)μg/L和(1.63±0.32)ng/L],差异均有统计学意义(P<0.05).结论 脑蛋白水解物联合脑心通胶囊对缺血性脑血管病患者疗效良好,可上调BDNF表达及下调NSE和S100β表达.

Objective To explore in chronic renal failure patients water salt control mission problem.Methods Combined with clinical practice,patients on dialysis causes edema,the occurrence of symptoms,the intake of water salt content,water salt restriction measure and method of nursing problems were analyzed and summarized,and analyzed retrospectively from 2006 March to 2011 January 256 cases of hemodialysis patients water salt control,to patients through strengthening the the nursing management of patients,comparison of incidence of edema.Results Nurses enhancing in chronic renal failure patients after water and salt control of missionary work,significantly decreased the incidence of edema.Conclusion Attention in chronic renal failure patients water salt control mission,to patients and their families to carry out training,to grasp the correct water salt control method,dialysis patients can reduce the incidence of edema.

目的:探讨股静脉置管在血液净化中发生的护理问题及解决方法,便于指导临床护理工作。方法:将2003年1月～2011年10月我科收治的140例血液净化股静脉置管患者分为两组:2003年1月～2010年2月常规血液净化股静脉置管患者70例为对照组,2010年2月～2011年10月加强股静脉置管护理的血液净化股静脉置管患者70例为实验组;回顾性分析所有患者的护理资料,比较两组患者血液净化股静脉置管的护理并发症发生率。结果:对照组股静脉置管护理并发症发生率43%;实验组股静脉置管护理并发症发生率20%,实验组较对照组并发症明显减少,痛苦明显减轻。结论:置管后的精心护理可明显减少护理并发症、患者痛苦及导管留置时间,增加导管使用期限。