Object:To explore the role of personalized nutritional intervention based on nutritional assessment in long-term continuous nursing of elderly postoperative colorectal cancer patients.Methods:Elderly patients with colorectal cancer who received radical surgery in a tertiary hospital in Beijing were screened from January 2021 to January 2022 and a total of 100 patients at nutritional risk (defined as with a Nutritional Risk Screening 2002 [NRS 2002] score ≥ 3) were included in the study. Patients were stratified by age and then divided into control and intervention groups with 50 cases in each. The control group received regular health guidance and follow-up visits at postoperative outpatient clinics while the intervention group received personalized nutritional intervention based on nutritional assessment additionally. The intervention period was 12 months. Nutritional indicators including body mass index (BMI), upper arm circumference, grip strength and hemoglobin, as well as albumin and quality of life (QoL), are compared between the two groups.Results:Compared with the control group, the intervention group showed significantly better results of BMI [(18.46±0.53) vs (16.9±0.77)], upper arm circumference [(25.09±1.41)cm vs (23.49±1.45)cm], grip strength [(28.34±8.00)kg vs (23.97±7.19)kg], HGB [(135.10±9.27)g/L vs (106.40±8.73)g/L] and ALB [(41.62±3.41)g/L vs (28.62±2.38)g/L, all P < 0.01]. The intervention group also had significantly higher scores in physical [(20.96±2.03) vs (15.66±0.82)], emotional [(21.48±1.64) vs (15.76±1.00)], social [(23.44±1.67) vs (15.96±0.99)], and functional [(20.74±1.74) vs (5.46±0.97)] domains of QoL (all P<0.01). Conclusion:In elderly patients with colorectal cancer after radical resection, personalized nutritional intervention based on nutritional assessment can effectively control nutritional indicators, help reduce the incidence of malnutrition, improve postoperative quality of life, and inform the establishment of standardized process in nutrition management.

目的 探讨坐式八段锦对高龄衰弱老年患者疲乏程度和衰弱状态的影响.方法 选择2017年10月—2018年6月我科收治的高龄衰弱老年患者35名为研究对象,在规范临床治疗及护理的基础上,进行为期5个月的坐式八段锦锻炼,应用修订版Piper疲乏量表和Tilburg衰弱量表评价干预效果.结果 干预后高龄衰弱老年患者的疲乏量表等级和衰弱量表得分(包括心理衰弱维度、社会衰弱维度及总分)较干预前明显降低(P<0.05),而衰弱量表的躯体衰弱维度得分较干预前有所下降,但差异无统计学意义(P>0.05).结论 5个月的坐式八段锦锻炼可改善高龄衰弱老年患者整体衰弱状态,尤其是心理衰弱、社会衰弱2方面;不能有效改善其躯体衰弱状态,但可有效缓解其疲乏程度,值得广泛推广至社区.

Objective To explore the effect of Otago exercise program on mobility and fall efficacy for the homebound elderly.Methods Totally 36 homebound elderly received 6 months individualized Otago exercise in the form of home visits and telephone follow-up.Results A total of 30 homebound elderly completed the exercise program.During the program,3 elderly (5 case execution times)fell.After the program,the time of timed "up & go" of the homebound elderly was significantly shorter than that before the program,and the score of balance ability and fall efficacy were significantly higher than those before the program (P＜0.01 for all).Conclusion Otago exercise can improve the mobility ability and fall efficacy for the homebound elderly,and plays a certain role on prevention of elderly fall.

Objective To observe two different disinfection tool' s effect on tracheotomy wound infection.Methods To divide 50 patients who underwent tracheotomy into control group and experimental group,25 cases were in each group.To use a 20 cm aseptic cotton swab to disinfect the tracheotomy wound and change dressing in experimental group; use regular yarn ball to disinfect tracheotomy wound and change dressing in control group.To observe the situation of local skin around the wound and infection rate.Results There was no infection cases in experimental group,infection rate was 16.0％ in control group,the difference was statistically significant( x2 =3.170,P ＜0.05 ).Conclusions Use of long aseptic cotton swab in disinfecting the skin around the wound and change dressing can reduce the wound infection rate,and easy to operate for nursing staff,it is worth of clinical application.

肿瘤免疫治疗是目前肿瘤治疗领域中的研究热点之一,其主要通过调节或增强机体固有的防御体系来抑制或杀伤肿瘤细胞,或通过抑制肿瘤细胞转化、促进恶性细胞分化来降低肿瘤的恶性程度[1].

目的 观察恒康正清用于老年人结肠镜肠道准备的效果.方法 将100例患者分为2组,分别用恒康正清、番泻叶加灌肠清洁肠道,观察患者的肠道清洁效果及不良反应.结果 2组用于结肠镜前清洁肠道的效果和不良反应均有显著性差异(P＜0.01).结论 恒康正清可作为老年人结肠镜肠道准备的合理方法,清洁效果好,值得推广.

老年患者,尤其是危重患者、有意识障碍及呼吸衰竭使用机械通气的患者,胃动力较差,易产生腹胀,易发生胃排空障碍及胃食管反流现象[1],加之医护人员与患者间信息反馈障碍,轻者导致呛咳、误吸,重者可导致严重的肺部感染,甚至窒息,使得这些老年患者经鼻胃管的肠内营养不得不延迟、中断或停止.而采用经鼻-空肠管喂养时,营养液直接进入空肠内,完全不依赖胃的排空机制,可有效避免以上并发症的发生,保证肠内营养的供给.我科2006年1-10月共有32位老年患者采用鼻-空肠管行肠内营养,取得较好效果.下面是护理体会.