目的:观察比较结肠镜检查前低渣饮食1天、3天对肠道准备效果和患者耐受性的影响.方法:将某医院结肠镜检查前预行肠道准备的门诊和住院患者221例随机分为低渣饮食1天组111例和低渣饮食3天组110例.所有患者均服用复方聚乙二醇电解质散和西甲硅油进行肠道准备.比较两组肠道准备质量,以及盲肠插镜时间、退镜时间、息肉检出率、患者耐受度和是否愿意再次采用该种饮食方式进行肠道准备等.肠道准备质量采用波士顿肠道准备量表(BBPS)进行评估,患者耐受度采用饥饿-舒适度标尺进行评价.结果:两组肠道准备BBPS总分低渣饮食1天组(6.54±1.45)分,与低渣饮食3天组(6.55±1.86)分比较,差异不显著(P＞0.05).两组在盲肠插镜时间、退镜时间、息肉检出率、患者耐受度等方面比较,差异不显著(P＞0.05).低渣饮食1天组受试者认为该种饮食方式"很简单遵从或简单遵从"的比例非常显著高于低渣饮食3天组(P＜0.01),低渣饮食1天组受试者愿意再次采用该种饮食方式进行肠道准备的比例显著高于低渣饮食3天组(P＜0.05).结论:低渣饮食1天或3天对结肠镜检查前肠道准备质量没有显著影响;低渣饮食1天受试者耐受度更高,更容易被接受.

目的 探讨循证护理在肝移植术后患者疼痛护理中的应用效果.方法 选取2015年1月至2016年7月行肝移植术的108例术后患者作为研究对象,患者随机分成对照组和观察组,每组54例,对照组患者给予常规护理干预,观察组患者在常规护理的基础上给予循证护理措施,比较2组患者术后疼痛的护理效果和满意度.结果 观察组术后中、重度疼痛的患者明显少于对照组,差异有统计学意义(P<0.05).观察组患者住院天数、睡眠时间及患者满意度均明显优于对照组,差异有统计学意义(P<0.05).观察组患者术后的胃肠系统并发症总发生率为31.48％明显低于对照组的11.1％,差异有统计学意义(P<0.05).结论 将循证护理应用于肝移植术后疼痛护理中能取得明显效果,可有效降低术后患者的疼痛度,提高患者的满意度,从而提高患者术后生存生活的质量.

Backgroud :A low-residue diet (LRD) can potentially reduce the hunger of patients while improving compliance and tolerance,without compromising the quality of bowel preparation.This study investigated the effects of 1-day low-residue diets compared with 3-day for colonoscopic bowel preparation . Methods: Patients undergoing bowel preparation before colonoscopy were randomly divided into 1-day and 3-day LRD groups.Oral polyethylene glycol (PEG) electrolyte solution and simethicone were applied to all patients submitted to bowel preparation. The primary outcome measure included the quality of the bowel preparation rated by the Boston bowel preparation scale(BBPS), and the secondary measures included (i) cecal intubation time and withdrawal time, (ii) polyp detection rate, (iii) patient tolerance and (iv) the willingness of the patient to repeat the diet protocol thereafter. Results: No significant difference was detected in regards the quality of the bowel preparation when comparing the two groups, since the mean of BBPS score was 6.54 versus 6.55 in the 1- and 3-day LRD groups. The cecal intubation times,withdrawal times, polyp detection rates,and the patient tolerance (i.e.hunger-comfort score[1]) showed no significant difference between the 1- and 3-day LRD groups. However,overall satisfaction was higher with the 1-day LRD group than with the 3-day LRD group. Conclusion: The 1-day and 3-day low-residue diets showed no major effect on bowel preparation previously to colonoscopy, while the tolerance and satisfaction of patients were higher after 1-day low-residue diet. Trial registration: Clinical Trial Registry Identifier:ChiCTR1900025843.Date of registration:September 10,2019 “Retrospectively registered”. Key words: colonoscopy; bowel preparation; low-residue diet; duration; bowel-cleansing quality

Objective To analyze the correlation between nutritional risk assessment and incidence rate of pressure ulcers in patients with digestive tract tumors in oder to provide a theoretical basis for the prevention of clinical pressure ulcer.Methods The nutritional risk assessment was performed in 105 hospitalization patients with digestive tract tumor according to nutritional risk screening 2002 (NRS-2002) to observe the incidence of pressure ulcers and carry out correlation analysis.Results There were 16 patients with nutritional risk,with the incidence rate of pressure ulcers being 27.12％,however there were 2 patients without nutritional risk,with the incidence rate of pressure ulcer being 4.35％.Logistic regression analysis showed that the incidence rate of pressure sores in patients with nutritional risk was 3.276 times as high as that in patients without nutritional risk.Conclusion The levels of nutrition risk are related with the occurrence of pressure ulcer at some extent,thus,the assessment of nutritional risk in patients with digestive tract tumor has some clinical significance for preventing the occurrence of pressure ulcer.

目的 探讨健康教育干预对肝移植患者术后胃肠功能恢复的应用效果.方法 选取2013年3月至2015年7月收治的肝移植患者84例,2013年3月至2014年4月肝胆外科的42例肝移植术后患者为对照组,2014年5月至2015年7月收治的42例肝移植术后患者为观察组.对照组采用常规的护理方式,观察组除常规的护理方式外再加上健康教育干预,比较2组患者肠功能恢复状况.结果 观察组的总掌握率为 92.86%,对照组为 64.29%,观察组对健康教育知识的掌握情况高于对照组,差异有统计学意义(P<0.05).察组患者术后肠鸣音恢复时间、排气时间、排便时间与对照组相比均明显缩短,差异有统计学意义(P<0.05).观察组患者腹胀情况与对照组相比均明显减少,腹胀评分亦小于对照组,差异有统计学意(P<0.05).结论 对肝移植患者术后给予健康教育干预,对患者胃肠功能恢复状况有促进作用.

目的：探讨贴近护理对肝移植患者术后生活质量的影响。方法将2011年1月至2012年12月行肝移植的82例患者，随机分为试验组和对照组。试验组采用贴近护理，对照组采用常规护理，对2组患者术后是否发生并发症、满意度及疾病知识的掌握情况进行比较。结果观察2组患者术后至出院后3个月，试验组患者并发症发生率明显低于对照组，患者满意度、疾病知识掌握，明显优于对照组（ P ＜0葺．01）。结论贴近护理用于肝移植术后患者，降低了术后并发症发生率，提高了患者及家属的满意度，促进了患者自我护理能力及生活质量，提高了护理价值。

Objective:To study 3% sodium bicarbonate solution and saline in the prevention of oral fungal infection in patients after liver transplantation . Methods:Randomly divided 112 cases of patients after liver transplantation into control group and observation group .The control group used saline solution for oral care; observation group was treated with 3% sodium bicarbonate solution for oral care.Oral fungal infection occurred after operation in two groups were compared.Results:The oral fungal infection rate of observation group was lower than that of the control group (P<0.05).Conclusion:Oral nursing with 3% sodium bicarbonate solution can effectively prevent oral fungal infection after liver transplantation .

Objective:To investigate the effect of evidence-based nursing in the prevention of aspergillosis infection after liver transplantation. Methods:Fif-ty-two patients who underwent liver transplantation in our hospital dated from September 2010 to November 2011 were selected as the control group and were treated by routine nursing. Fifty-six patients who underwent liver transplantation from December 2012 to October 2013 were selected as the observa-tion group and were treated by evidence-based nursing based on routine nursing. The aspergillosis infection occurrence of the two groups of liver transplan-tation patients was compared. Results:Aspergillosis infection rate in the observation group was lower than that in the control group (P<0. 05). Conclusion:The method of evidence-based nursing can effectively reduce the incidence of aspergillosis infection after liver transplantation.

肝移植术后患者常需静脉全身化疗、输注胃肠外营养药物等高渗药，测量中心静脉压等，深静脉置管能为患者提供中长期的静脉治疗通道，但深静脉置管使血液与外界处于相对开放状态，穿刺部位切口随着置管时间延长、局部潮湿等原因容易滋生微生物，细菌或真菌可通过这些“门户”入侵血液系统，从而继发感染。肝移植患者由于免疫抑制剂的应用，使机体抵抗力低下，深静脉置管又增加了移植术后患者感染风险。我科对深静脉置管的肝移植术后患者进行了规范化护理干预，有效降低了导管相关感染的发生。报告如下。

<正>肝硬化合并脾功能亢进患者由于肝脏功能损伤,凝血因子合成减少,同时脾功能亢进增加了血小板的破坏,使得凝血功能降低,所以此类患者存在着出血倾向,特别在静脉采血后穿刺部位常出现不同程度的皮下出血。由皮下出血造成的瘀斑在一定程度上影响了患者的心理,也对静脉给药的后期治疗造

目的讨论实施肠内营养(EN)及全肠外营养(TPN)两种不同的营养方式对肝移植术后患者进行营养支持治疗对术后各器官恢复的影响。方法将98例接受肝移植手术患者随机分为肠内营养组(EN组,n=42例)和全肠外营养组(TPN组,n=56例),EN组及TPN组分别检测3组患者术前1d、术后第5天和第10天时的营养状况及肝功能的变化,观察不同营养方式对患者术后各器官恢复的影响。结果 EN组和TPN组患者术后都无明显肝功能损害加重;EN组患者术后较早达到正氮平衡,体重减轻较少,感染率较低与TPN组比较差异均有统计学意义(P<0.01)。结论肝移植术后应用EN进行营养治疗是一种方便、安全、有效的临床营养支持方法。

随着电视腹腔镜技术的进步与发展,以及人们越来越对体表美的追求,腹腔镜下甲状腺切除术是近年发展起来的微创外科新技术.我院2002年12月至2003年10月行腹腔镜下甲状腺和甲状旁腺切除术16例,疗效满意,现将护理体会报告如下.