目的探讨快速康复外科(enhanced recovery after surgery,ERAS)在食管裂孔疝修补联合胃底折叠术围手术期护理中的应用价值。方法 2016年1月~2017年2月对32例食管裂孔疝修补联合胃底折叠术的护理分别采用ERAS护理(ERAS组)或传统护理(传统...目的探讨快速康复外科(enhanced recovery after surgery,ERAS)在食管裂孔疝修补联合胃底折叠术围手术期护理中的应用价值。方法 2016年1月~2017年2月对32例食管裂孔疝修补联合胃底折叠术的护理分别采用ERAS护理(ERAS组)或传统护理(传统组)。结果 ERAS组术后肠鸣音恢复时间(9.3±2.1)h,明显短于传统组(12.8±2.4)h(t=-4.177,P=0.000);术后首次肛门排气时间(16.4±2.5)h,明显短于传统组(22.3±3.8)h(t=-4.778,P=0.000);拔除胃管时间(17.8±2.3)h,明显短于传统组(24.5±3.5)h(t=-5.892,P=0.000);术后进食时间(18.0±2.4)h,明显短于传统组(46.6±11.2)h(t=-8.673,P=0.000);术后住院时间(6.0±1.3)d,与传统组(6.9±2.3)d无统计学差异(t=-1.237,P=0.226)。结论食管裂孔疝修补联合胃底折叠手术应用ERAS理念进行围手术期护理可以取得良好的护理效果。展开更多
While lifestyle modifications are currently used as firstline treatment for subjects with gastroesophageal reflux disease (GERD), the pathogenetic role of lifestyle factors and consequently, the efficacy of lifestyle ...While lifestyle modifications are currently used as firstline treatment for subjects with gastroesophageal reflux disease (GERD), the pathogenetic role of lifestyle factors and consequently, the efficacy of lifestyle measures is controversial. Our aim was to systematically review the pathogenetic link between overweight/ obesity, dietary habits, physical activity and GERD, and the beneficial effect of specific recommended changes, by means of the available literature from the 1999 to the present. Obesity, in particular, abdominal obesity, plays a key role in determining GERD symptoms and complications through mechanical and metabolic effects. Controlled weight loss (by diet or surgery) is effective in improving GERD symptoms. No definitive data exist regarding the role of diet and, in particular, of specific foods or drinks, in influencing GERD clinical manifestations. Moderate physical activity seems to be beneficial for GERD, while vigorous activity may be dangerous in predisposed individuals. In conclusion, being obese/overweight and GERD-specific symptoms and endoscopic features are related, and weight loss significantly improves GERD clinical-endoscopic manifestations. The role of dietary behavior, mainly in terms of specific dietary components, remains controversial. Mild routine physical activity in association with diet modifications, i.e. a diet rich in fiber and low in fat, is advisable in preventing reflux symptoms.展开更多
文摘While lifestyle modifications are currently used as firstline treatment for subjects with gastroesophageal reflux disease (GERD), the pathogenetic role of lifestyle factors and consequently, the efficacy of lifestyle measures is controversial. Our aim was to systematically review the pathogenetic link between overweight/ obesity, dietary habits, physical activity and GERD, and the beneficial effect of specific recommended changes, by means of the available literature from the 1999 to the present. Obesity, in particular, abdominal obesity, plays a key role in determining GERD symptoms and complications through mechanical and metabolic effects. Controlled weight loss (by diet or surgery) is effective in improving GERD symptoms. No definitive data exist regarding the role of diet and, in particular, of specific foods or drinks, in influencing GERD clinical manifestations. Moderate physical activity seems to be beneficial for GERD, while vigorous activity may be dangerous in predisposed individuals. In conclusion, being obese/overweight and GERD-specific symptoms and endoscopic features are related, and weight loss significantly improves GERD clinical-endoscopic manifestations. The role of dietary behavior, mainly in terms of specific dietary components, remains controversial. Mild routine physical activity in association with diet modifications, i.e. a diet rich in fiber and low in fat, is advisable in preventing reflux symptoms.