老年女性患者导尿管气囊注水量对留置效果的影响

目的探讨老年女性患者留置导尿过程中,气囊注水量对留置效果的影响.方法将164例神经内科老年女性需留置导尿患者(平均年龄74.18岁)随机分为对照组与观察组,各82例.观察组患者导尿管气囊内注入15～20ml生理盐水固定,对照组气囊内注入生理盐水5～8 ml.结果观察组溢尿率显著低于对照组(P＜0.01),且留置导尿管2周泌尿系感染(发热、混浊血性尿液、膀胱刺激征、尿道口异常分泌物等)发生率显著低于对照组(P＜0.01).结论老年女性患者气囊导尿管注入15～20 ml生理盐水,可有效地防止尿液外渗及导尿管脱出,减少泌尿系感染率的发生,对临床留置导尿技术有指导意义.     

老年女性患者留置气囊导尿管漏尿原因分析及应对措施

目的:探讨老年女性患者长期留置气囊导尿管漏尿的原因和应对措施。方法:分析50例老年女性长期留置气囊尿管的患者发生漏尿的原因,找出相应对策。结果:生理退行性变化,导尿管引流不畅、膀胱痉挛和膀胱废用性萎缩是发生漏尿的四大因素。采用相应措施后,42例得到控制,8例减轻。结论:根据患者的生理特点进行针对性预防和护理,可有效预防和纠正漏尿的发生。     

老年患者长期留置气囊导尿管漏尿原因分析与对策

目的探讨老年患者长期留置气囊导尿管漏尿问题的解决办法。方法分析70例长期留置气囊尿管的老年患者发生漏尿的原因,找出相应对策进行护理。结果长期留置气囊尿管的老年患者漏尿与老年生理退行性变化、导尿管引流不畅和膀胱痉挛三大因素有关。通过采取克服生理因素的影响、保持导尿管引流通畅和避免膀胱痉挛等措施后,58例漏尿得到控制,12例漏尿减轻。结论根据老年患者各种生理特点进行针对性护理,可有效预防和纠正老年患者漏尿的发生。     

老年患者长期留置气囊导尿管漏尿原因分析与对策

目的探讨老年患者长期留置气囊导尿管漏尿问题的解决办法。方法分析70例长期留置气囊尿管的老年患者发生漏尿的原因,找出相应对策进行护理。结果长期留置气囊尿管的老年患者漏尿与老年生理退行性变化、导尿管引流不畅和膀胱痉挛三大因素有关。通过采取克服生理因素的影响、保持导尿管引流通畅和避免膀胱痉挛等措施后,58例漏尿得到控制,12例漏尿减轻。结论根据老年患者各种生理特点进行针对性护理,可有效预防和纠正老年患者漏尿的发生。     

老年患者气囊导尿管拔管困难的护理体会

目的:为解决老年患者排尿障碍,对老年患者气囊导尿管拔出困难的原因加以分析并总结经验。方法:针对我科10例长期留置尿管的老年患者拔管困难的原因,给予不同的护理措施。结果:本组10例患者均成功拔管。结论:熟悉老年患者的生理特点,给予必要的预防措施是减少拔管困难发生的有利保障。     

经气囊导尿管缓注法灌肠在老年患者中的应用

目的提高老年患者清洁灌肠的效果。方法将90例需行清洁灌肠的老年患者随机分为观察组和对照组各45例。观察组采用气囊导尿管进行灌肠,灌入速度60 ml/min;对照组采用传统肛管进行灌肠,速度200 ml/min。对两组患者的灌肠效果、漏灌(灌肠液一边灌入、一边流出)率及灌肠次数进行比较。结果观察组灌肠效果显著优于对照组,灌肠次数及漏灌率显著低于对照组(P<0.05,P<0.01)。结论应用气囊导尿管缓注法为老年患者清洁灌肠,肠道清洁效果好,能减少灌肠次数,减少漏灌现象,减轻护士工作量。     

自制气囊尿管外固定囊在女性患者留置导尿中的应用

目的 探讨女性患者留置导尿气囊导尿管最佳外固定方法.方法 将女性留置导尿患者60例按导尿先后顺序编号分组,单号为观察组(30例),双号为对照组(30例),观察组应用自制气囊尿管外固定囊固定导尿管,对照组用胶布将导尿管固定于患者一侧大腿内侧.比较两组患者留置尿管期间舒适度、导尿管相关菌尿症发生率.结果 留置尿管期间观察组舒适度显著高于对照组(均P＜0.05),留置导尿管第5、7天导尿管相关菌尿症发生率显著低于对照组(均P＜0.05).结论 气囊尿管外固定囊用于女性留置导尿患者,可提高患者舒适度,降低患者导尿管相关菌尿症发生率.     

高龄患者使用气囊导尿管保留灌肠的临床研究

目的:探讨高龄患者使用气囊导尿管进行保留灌肠的临床效果.方法:将60例需要保留灌肠的高龄老年患者随机分为实验组30例和对照组30例,实验组采用气囊导尿管保留灌肠,对照组采用普通肛管进行灌肠.比较两组方法的疗效、保留时间及患者的接受程度.结果:实验组药液的疗效、保留时间及患者的接受程度均高于对照组(P＜0.05).结论:高龄老年患者用气囊导尿管保留灌肠患者易于接受,延长了药液在体内的保留时间,提高了治疗的效果.     

留置导尿病人尿道口及尿液的霉菌监测

为研究留置导尿病人尿道口及尿液的霉菌感染发生情况 ,对 31例住院病人 (观察组 )的尿道口在不同置管时间用灭菌棉拭子采样 ,同时取尿液进行霉菌培养 ,并与 31例非留置导尿病人 (对照组 )进行比较。结果观察组病人尿道口的霉菌检出率达 74.2 % ,尿液的霉菌检出率达 48.4% ,明显高于对照组 (P<0 .0 1) ,且随插管时间的延长而检出率增高。提示留置导尿病人尿道口及尿液的霉菌生长与原发疾病严重程度、置管天数、尿道口护理不当及泌尿道的自然屏障遭到破坏有关 ,在积极治疗原发病和抗细菌感染的同时 ,应积极监测霉菌并作出预防     

不同剂量乌司他丁对老年患者胃切除术后血红素氧合酶-1与细胞因子的影响

目的：探讨不同剂量乌司他丁（UTI）对老年患者胃切除术后血红素氧合酶-1（HO-1）活性和细胞因子变化的影响。方法：48例胃癌行胃切除手术的老年患者,随机分为4组：生理盐水对照组,UTI 0．5万U／kg、1．0万U／kg、2．0万U／kg。并分别于手术不同时间点取血,检测血清肿瘤坏死因子（TNV—α）、白介素-6（IL-6）及血红素氧合酶-1。结果：0．5万U／kg UTI仅抑制术后24h的IL-6释放,不能促进术后HO-1活性升高;1．0万U／kg UTI可抑制术后6、12、24h的IL-6、TNF—α释放,促进术后24h的HO-1活性升高;2．0万U／kg UTI对围术期TNF—α、IL-6释放有明显抑制作用,促进术后12、24h的HO-1活性明显升高。结论：UTI具有剂量依赖性抑制促炎因子释放,促进HO-1反应性上调,发挥脏器保护作用。     

社区护理干预对老年类风湿关节炎病人的影响

目的提 高社区老年类风湿关节炎病人的生活质量。方法 对152例社区老年类风湿关节炎(RA)病人的病残分级、日常活动能力、生活满意度等进行评估，根据评估结果进行心理调节、饮食指导、气候环境指导、理疗针灸治疗、医疗体育锻炼及自理能力训练等社区护理干预。结果持续干预1年后病人病残分级、日常生活能力、生活满意度显著优于干预前(P＜0．05，P＜0．01)，干预有效率达73．0％。结论 针对性的社区护理干预能有效促进老年RA病人病情的良性转归，改善生活质量。     

无张力阴道吊带术治疗女性压力性尿失禁(附20例报告)

目的 评价无张力阴道吊带术(tension-free vaginal tape，TVT)治疗女性压力性尿失禁的疗效。方法 总结采用TVT术治疗女性压力性尿失禁20例的临床资料。结果 平均手术时间26.5min。拔除尿管后，19例病人控尿满意，1例仍有轻微尿失禁。术后平均随访12(3-24)个月，20例病人均无尿失禁。合并症有1例膀胱穿孔，1例术后轻度排尿不畅，2例尿频尿急。结论 TVT术操作简便快捷，创伤小，合并症少，术后康复快，是一种治疗女性压力性尿失禁的理想方法。     

The artificial urinary sphincter in the treatment of incontinence in the female patient

Technical developments have led to a reliable artificial urinary sphincter prosthesis for female patients with otherwise intractable urinary incontinence. Candidates include patients with post-operative stressincontinence or congenital or acquired neuropathic dysfunction. Proper patient selection requires extensive urologic examinations in order to guarantee a high success rate. The most serious complications are due to cuff erosion or infection. With proper operative techniques continence rate is now about 90% in female patients. A new application of the sphincter prosthesis is seen in reconstructive procedures of the lower urinary tract, often with the use of intestinal segments. Careful follow up is warranted in patients with an artificial sphincter since the upper urinary tracts must be monitored and bladder function controlled.     

Urinary modified nucleosides as tumor markers in cancer of the urinary organs or female genital tract

Summary Using a sensitive and specific method involving high-performance liquid chromatography, urinary levels of four modified nucleosides — pseudouridine (), 1-methylinosine (m¹I), 1-methyladenosine (m¹A), and 1-methylguanosine (m¹G)-were investigated before and after treatment in 31 patients with cancer of the urinary organs or the female genital tract. Before treatment m¹I was the most frequently elevated nucleoside (77%). Pretreatment urinary levels of , m¹I, and m¹A in patients with stage 2–4 cancer of the female genital tract were significantly elevated compared to human healthy volunteers (p<0.005). Compared with the other nucleosides, appeared to correlate more closely with the clinical outcome (progression or regression) of patients with cancer of the female genital tract. In the case of patients with cancer of the urinary organs, m¹I followed the clinical outcome better than the other nucleosides measured. Therefore and m¹I seem to be useful for monitoring genito-urinary cancers.     

The relationship between juxtapapillary duodenal diverticula and the presence of bacteria in the bile

A total of 432 patients with gallstone disease were studied with respect to the existence of juxtapapillary duodenal diverticula and their relationship to the presence of bacteria in the bile. A total of 63 patients were found to have diverticula with an incidence of 14.6 per cent, being significantly higher in the elderly group aged 60 years or older (p<0.01), and no sex difference was noted. Among the patients with diverticula, positive bacterial cultures of bile were recognized at a significantly higher frequency, being found in 49 of the 63 patients (77.8 per cent; p<0.01), and the probability of bilirubinate stones was also higher, being found in 35 of 37 patients (94.6 per cent; p<0.01). The presence of a diverticulum bore significant relation to a higher positive bile bacterial culture (p<0.05), dilatation of the common bile duct (p<0.05), and elevation of the bile duct pressure (p<0.05), even when the conditions were divided into cholecystolithiasis or choledocholithiasis. It was suggested that the presence of a diverticulum affected the flow in the bile duct by narrowing it from the outside and chronically stimulating the papilla, inducing biliary tract infection and/or the formation of gallstones. As the surgical procedures for juxtapapillary duodenal diverticula, including its indications, have not been established, long term follow up investigations seem necessary.     

Three-Dimensional Evaluation of Innominate Bone Rotation in Female Patients with Developmental Dysplasia of the Hip

BackgroundPatients with developmental dysplasia of the hip (DDH) are known to have abnormal pelvic morphologies; however, rotation of innominate bone features remains unclear. Thus, we investigated innominate bone rotation in patients with DDH by measuring the associated angles and distances using three-dimensional (3D) computed tomography.MethodsWe defined four straight lines in pelvic 3D models: from the anterior superior iliac spine to the posterior superior iliac spine, from the anterior inferior iliac spine to the posterior inferior iliac spine, from the pubic tubercle to the ischial spine, and from the pubic tubercle to the ischial tuberosity. Similarly, we measured the angles formed by these lines using the vertical axis of the anterior pelvic plane on the horizontal plane and the horizontal axis on the sagittal plane. Additionally, we measured the distances between the femoral head centers and the acetabular centers in the coronal plane.ResultsThe difference in internal rotation angle between the superior and inferior parts of the iliac bone was significantly lower, by approximately 1.7°, in the DDH group than in the control group (p = 0.007); the difference between the inferior and superior parts of the ischiopubic bone was significantly higher, by approximately 1.5°, in the DDH group (p < 0.001). In the sagittal plane, the sum of the superior aspect of the iliac bone and the inferior aspect of the ischium was significantly lower in the DDH group (p = 0.001) than in the control group. The distances between the femoral heads and the acetabula were significantly greater in the DDH group than in the control group (p = 0.03, p < 0.01, respectively).ConclusionsPatients with DDH had a more internally rotated ilium and ischiopubic bone than normal individuals; however, it should be emphasized that internal rotation was reduced near the acetabulum, and the acetabulum was shifted laterally. Similarly, it was shown that patients with DDH had different rotations of the ilium and ischiopubic bone in the sagittal plane.