BACKGROUND: Liver cirrhosis and cholelithiasis are both familiar diseases in China. However, the rates of operative complications and death are still high in patients with these diseases. This study was designed to de...BACKGROUND: Liver cirrhosis and cholelithiasis are both familiar diseases in China. However, the rates of operative complications and death are still high in patients with these diseases. This study was designed to determine the operative indications as well as suitable procedures in the treatment of patients with cholelithiasis and liver cirrhosis. METHODS: We studied retrospectively 60 patients with cholelithiasis and liver cirrhosis who had undergone operation from January 2000 to July 2006. We analyzed the loss of blood during operation, postoperative complications and death rate to determine the proper treatment. RESULTS: Fifty patients were cured and 10 (16.7%) died postoperatively, i.e., six patients died from hepatic-renal failure and multisystem organ dysfunction and 4 from massive bleeding in the gallbladder bed. The 10 patients were clearly correlated with the Child-Pugh classification: Child A (8%), Child B (20%) and Child C (30%). Postoperative bleeding occurred in 10 patients (16.7%), intraabdominal in 6 and gastrointestinal in 4. Seven of the 10 patients with bleeding died postoperatively. CONCLUSIONS: The proper perioperative management of patients with cholelithiasis and liver cirrhosis can decrease the mortality. Cholelithiasis should be managed first by emergency operation. It is safe for the patients of Child A to undergo laparoscopy. It is very safe for patients with cirrhosis and cholelithiasis to undergo devascularization and shunt operation followed by biliary tract surgery.展开更多
目的观察预见性护理干预在腹腔镜直肠癌根治术患者中的应用效果。方法将南华大学附属第二医院2010年1月至2015年1月收治的200例腹腔镜直肠癌根治术患者作为研究对象,其中2010年1月至2013年1月应用传统护理干预的100例患者作为对照组,201...目的观察预见性护理干预在腹腔镜直肠癌根治术患者中的应用效果。方法将南华大学附属第二医院2010年1月至2015年1月收治的200例腹腔镜直肠癌根治术患者作为研究对象,其中2010年1月至2013年1月应用传统护理干预的100例患者作为对照组,2013年2月至2015年1月应用预见性护理干预的100例患者作为观察组,比较两组患者的手术时间、并发症、出血量及住院时间等情况,调查患者对护理满意度及手术医生对护理人员的护理配合满意度。结果观察组患者的手术时间为(2.38±0.58) h,明显低于对照组的(3.01±0.79) h,手术出血量为(70.22±13.89) m L,明显低于对照组的(81.02±16.11) m L,差异均有统计学意义(P<0.05);观察组患者的住院并发症发生率为13.00%,明显低于对照组的44.00%,住院时间为(9.02±1.28) d,明显短于对照组的(11.21±2.06) d,差异均有统计学意义(P<0.05);观察组患者对护理人员满意度为99.0%,明显高于对照组的87.0%,差异具有统计学意义(P<0.05);观察组手术医生对护理人员的护理配合满意度为100.0%,对照组为63.64%,差异具有统计学意义(P<0.05)。结论预防性护理干预可以大幅度提高患者满意度,缩短腹腔镜直肠癌根治术患者的住院时间、减少并发症、降低出血量,对提高护理质量,树立医院形象具有积极作用。展开更多
目的分析比较微创钻孔引流术与小骨窗开颅术治疗不同出血量的高血压基底节区脑出血的临床疗效。方法随机将118例高血压基底节区脑出血患者分为微创组和开颅组。微创组(n=61例)行微创钻孔引流手术(微创A组:34例,出血量<45 m L。微创B...目的分析比较微创钻孔引流术与小骨窗开颅术治疗不同出血量的高血压基底节区脑出血的临床疗效。方法随机将118例高血压基底节区脑出血患者分为微创组和开颅组。微创组(n=61例)行微创钻孔引流手术(微创A组:34例,出血量<45 m L。微创B组:27例,出血量≥45 m L)。开颅组(n=57例)行小骨窗开颅手术(开颅A组:28例,出血量<45 m L;开颅B组:29例,出血量≥45 m L)。分别比较两种手术方案的治疗效果。结果术后2个月,微创A组治疗总有效率88.24%,高于开颅A组67.86%,2组比较,差异有统计学意义(P<0.05);微创B组治疗总有效率(59.26%)低于开颅B组(72.41%),但组间比较差异无统计学意义(P>0.05)。结论针对高血压基底节区脑出血患者,出血量<45 m L时行微创钻孔引流术疗效更佳,出血量≥45 m L时建议行小骨窗开颅术。展开更多
文摘BACKGROUND: Liver cirrhosis and cholelithiasis are both familiar diseases in China. However, the rates of operative complications and death are still high in patients with these diseases. This study was designed to determine the operative indications as well as suitable procedures in the treatment of patients with cholelithiasis and liver cirrhosis. METHODS: We studied retrospectively 60 patients with cholelithiasis and liver cirrhosis who had undergone operation from January 2000 to July 2006. We analyzed the loss of blood during operation, postoperative complications and death rate to determine the proper treatment. RESULTS: Fifty patients were cured and 10 (16.7%) died postoperatively, i.e., six patients died from hepatic-renal failure and multisystem organ dysfunction and 4 from massive bleeding in the gallbladder bed. The 10 patients were clearly correlated with the Child-Pugh classification: Child A (8%), Child B (20%) and Child C (30%). Postoperative bleeding occurred in 10 patients (16.7%), intraabdominal in 6 and gastrointestinal in 4. Seven of the 10 patients with bleeding died postoperatively. CONCLUSIONS: The proper perioperative management of patients with cholelithiasis and liver cirrhosis can decrease the mortality. Cholelithiasis should be managed first by emergency operation. It is safe for the patients of Child A to undergo laparoscopy. It is very safe for patients with cirrhosis and cholelithiasis to undergo devascularization and shunt operation followed by biliary tract surgery.
文摘目的观察预见性护理干预在腹腔镜直肠癌根治术患者中的应用效果。方法将南华大学附属第二医院2010年1月至2015年1月收治的200例腹腔镜直肠癌根治术患者作为研究对象,其中2010年1月至2013年1月应用传统护理干预的100例患者作为对照组,2013年2月至2015年1月应用预见性护理干预的100例患者作为观察组,比较两组患者的手术时间、并发症、出血量及住院时间等情况,调查患者对护理满意度及手术医生对护理人员的护理配合满意度。结果观察组患者的手术时间为(2.38±0.58) h,明显低于对照组的(3.01±0.79) h,手术出血量为(70.22±13.89) m L,明显低于对照组的(81.02±16.11) m L,差异均有统计学意义(P<0.05);观察组患者的住院并发症发生率为13.00%,明显低于对照组的44.00%,住院时间为(9.02±1.28) d,明显短于对照组的(11.21±2.06) d,差异均有统计学意义(P<0.05);观察组患者对护理人员满意度为99.0%,明显高于对照组的87.0%,差异具有统计学意义(P<0.05);观察组手术医生对护理人员的护理配合满意度为100.0%,对照组为63.64%,差异具有统计学意义(P<0.05)。结论预防性护理干预可以大幅度提高患者满意度,缩短腹腔镜直肠癌根治术患者的住院时间、减少并发症、降低出血量,对提高护理质量,树立医院形象具有积极作用。
文摘目的分析比较微创钻孔引流术与小骨窗开颅术治疗不同出血量的高血压基底节区脑出血的临床疗效。方法随机将118例高血压基底节区脑出血患者分为微创组和开颅组。微创组(n=61例)行微创钻孔引流手术(微创A组:34例,出血量<45 m L。微创B组:27例,出血量≥45 m L)。开颅组(n=57例)行小骨窗开颅手术(开颅A组:28例,出血量<45 m L;开颅B组:29例,出血量≥45 m L)。分别比较两种手术方案的治疗效果。结果术后2个月,微创A组治疗总有效率88.24%,高于开颅A组67.86%,2组比较,差异有统计学意义(P<0.05);微创B组治疗总有效率(59.26%)低于开颅B组(72.41%),但组间比较差异无统计学意义(P>0.05)。结论针对高血压基底节区脑出血患者,出血量<45 m L时行微创钻孔引流术疗效更佳,出血量≥45 m L时建议行小骨窗开颅术。
