围手术期护理干预对腹腔镜胆囊切除术疗效的影响

目的探讨围手术期实施护理干预措施,对腹腔镜胆囊切除术疗效的影响。方法腹腔镜胆囊切除术患者100例根据护理方法的不同随机分为护理干预和对照组各50例。对照组进行常规护理,护理干预在对照组的基础上采取一系列的术前、术中及术后的围手术期护理干预措施。观察比较两组腹腔镜胆囊切除术的疗效及并发症情况。结果护理干预组的手术时间、术中出血量及术后排气时间、术后住院时间均明显短于对照组（P〈0.05）。且护理干预组术后发生切口感染、出血以及胆漏、放射痛、肠粘连的发生率明显低于对照组（P〈0.05）。结论通过采取系列的围手术期护理干预措施,可以积极预防并发症的发生,缩短手术时间及住院时间,提高治疗效果。     

营养风险筛查与干预对食管癌术后康复效果的影响

目的：探讨与研究食管癌患者术前应用营养风险筛查与干预对患者术后康复效果的影响及临床应用价值。方法：选择在青岛市市立医院接受手术治疗的食管癌患者共174例纳入研究并分为观察组和对照组两组,对照组给予常规围手术期护理,观察组在常规围手术期护理基础上进行营养风险筛查和干预;比较两组术后2w营养状况、排气排便时间、胸腔引流管拔除时间、住院时间、术后并发症发生情况。结果：观察组患者术后营养状况明显优于对照组,差异显著（P＜0.05）;观察组术后排气排便时间、胸腔引流管拔除时间、住院时间、术后并发症发生率等均优于对照组,以上差别均具有统计意义（P＜0.05）。结论：将营养风险筛查与干预应用于食管癌患者围手术期护理中,可显著改善患者术后营养状况,促进康复,值得临床应用推广。     

临床护理路径对缓解膀胱癌患者负性情绪及预防复发的效果评价

目的:评价临床护理路径对缓解膀胱癌患者负性情绪及预防复发的效果.方法:将126例膀胱癌患者随机分入对照组与观察组,给予60例对照组患者常规护理方法,66例观察组实施临床护理路径.采用抑郁自评量表(SDS)和焦虑自评量表(SAS)评估患者干预前后心理状况,比较两组肿瘤术后并发症发生率、住院时间、住院费用及复发率.结果:观察组干预后SAS及SDS评分均显著低于对照组(P＜0.05);观察组并发症发生率及复发率均显著低于对照组(P＜0.05);观察组患者住院时间及住院费用少于对照组(P＜0.05).结论:对膀胱癌实施临床护理路径可显著缓解负性情绪,减少并发症的发生及复发率,促进患者更快康复.     

超声刀在开放性甲状腺次全切除术中的应用效果观察

目的:探讨开放性甲状腺次全切除术中应用超声刀的效果.方法:回顾性分析我院2006年7月-2012年7月收治的甲状腺次全切除术患者860例,按随机化原则分为超声组440例和电刀组420例,记录分析手术一般情况及并发症情况.结果:超声组术中切口长度、术中出血量、手术时间均较电刀组好,两组比较差异显著有统计学意义(P＜0.05);超声组在暂时性喉返神经损伤、术后出血方面少于电刀组,两组比较差异显著有统计学意义(P＜0.05).结论:甲状腺次全切除术中应用超声刀术后并发症少,术中切口长度、出血量及手术时间均显著减少,是疗效较好的术式,值得推广应用.     

舒适护理在腹腔镜下子宫肌瘤切除术围术期中的应用

目的探讨舒适护理在腹腔镜下子宫肌瘤切除术围手术期中的应用效果。方法将100例子宫肌瘤患者随机分为对照组和观察组各50例,对照组采用传统护理方法,观察组采用舒适护理模式,比较两组患者平均手术时间、术后并发症发生率和护理满意度。结果观察组平均手术时间、术后并发症发生率和护理满意度均明显优于对照组,差异有统计学意义(P0.05)。结论对腹腔镜下子宫肌瘤切除术患者实施舒适护理干预,能有效降低手术时间和并发症发生率,提高护理满意度。     

胰十二指肠切除术治疗胰头癌伴壶腹周围癌的近远期疗效及安全性

目的:研究胰十二指肠切除术治疗胰头癌伴壶腹周围癌的近远期疗效及安全性。方法:研究对象选取我院2009年8月到2013年6月间收治的胰头癌伴壶腹周围癌患者82例,采用随机数字法将其分为对照组和观察组,每组各41例。对照组患者接受姑息性手术治疗,观察组患者接受胰十二指肠切除术治疗,比较两组患者的手术时间、住院时间、术中出血量及并发症发生率,术后随访3年,比较两组患者术后1年、2年及3年生存率、术后1年复发率以及肿瘤根除率。结果:观察组的手术时间和术中出血量均明显高于对照组(P0.01),两组的住院时间比较无明显差异(P0.05);观察组的总并发症发生率(41.46%)明显高于对照组(22.96%)(P=0.03),术后2年和3年的生存率明显高于对照组(P0.05),术后1年的复发率明显低于对照组(P=0.04),肿瘤根除率明显高于对照组(P=0.04)。结论:胰十二指肠切除术治疗胰头癌伴壶腹周围癌虽可延长手术时间,提高术中出血量及并发症风险,但肿瘤根治效果更好,可减少术后复发,明显提高远期生存率。     

微切口超声乳化联合小梁切除术治疗白内障合并青光眼的疗效观察

目的:探讨微切口超声乳化联合小梁切除术治疗白内障合并青光眼的临床疗效。方法:选取2013年1月到2014年1月我院收治的白内障合并青光眼患者100例,按照随机数字表法将患者分为研究组和对照组,每组50例,对照组给予常规超声乳化联合小梁切除术进行治疗,研究组给予微切口超声乳化联合小梁切除术治疗,比较两组术前、术后裸眼视力、散光、眼压,并比较两组术后并发症。结果:两组术后裸眼视力、散光和眼压均较术前明显好转,与术前比较差异具有统计学意义(P0.05),且研究组术后裸眼视力、散光和眼压均优于对照组,两组比较差异具有统计学意义(P0.05);研究组术后并发症发生率显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论:微切口超声乳化联合小梁切除术治疗白内障合并青光眼疗效确切,且术后并发症较少。     

小切口阑尾切除术治疗急性阑尾炎临床疗效研究

目的:探讨小切口阑尾切除术治疗急性阑尾炎的临床疗效.方法:将我院2009年2月～2011年9月期间收治的120例急性阑尾炎患者随机分为对照组和观察组,每组60例.其中对照组在硬膜外麻醉后采用传统阑尾切除术进行治疗,观察组在连续硬膜外麻醉后采取小切口阑尾切除术进行治疗.对比两组手术时间、住院时间、切口感染发生率及不良反应发生情况.结果:两组患者临床治疗情况比较,观察组切口长度、住院时间短于对照组,差异有统计学意义(P＜0.05).手术时间比较无明显差异,无统计学意义.两组术后切口感染及并发症情况对比,对照组伤口感染3例、肺部感染1例、切口裂开1例、尿路感染1例、切口疝2例、肠粘连2例、肠梗阻3例;并发症发生率21.67％;观察组伤口感染4例,并发症发生率6.67％.两组比较观察组优于对照组,差异明显具有统计学意义.结论:小切口阑尾切除术具有损伤小、术后恢复快、不良反应少、住院时间短等特点,根据临床病情合理应用能够得到更好的临床效果.     

综合性护理干预对脊椎手术患者术后并发症的影响

目的:探讨综合性护理干预对脊椎手术患者术后并发症的影响。方法:选取我院2012年4月至2014年8月接收的脊椎手术患者96例,随机将患者分为对照组和实验组。对照组患者给予常规护理方法,实验组在对照组的基础上加用系统的综合护理方法进行康复护理,比较并分析两组患者护理后并发症的发生和心理状况情况。结果:通过护理康复治疗后,两组患者的临床症状和心理状况均得到明显改善,两组患者都有并发症的发生,相比于对照组,干预组在尿路感染、呼吸抑制、褥疮及下肢静脉血栓等并发症情况明显优于对照组,差异具有统计学意义(P0.05)。干预组抑郁和焦虑评分值均小于对照组,差异极显著具有统计学意义(P0.05)。结论:系统护理干预对于减少脊椎手术患者术后并发症的发生具有十分重要的临床意义,值得临床广泛应用。     

音乐干预改善门诊痔疮手术患者心理状态临床研究

目的:探讨门诊手术室应用音乐干预护理痔疮手术患者的临床效果.方法:选取痔疮手术患者72例,随机分为试验组和对照组,各36例.对照组给予常规护理,试验组在对照组基础上进行音乐干预,观察2组患者生理指标的变化及疼痛的发生情况,并采用焦虑自评量表(SAS)评估两组患者焦虑情况.结果:试验组实施干预后,心率、血压、血浆皮质醇浓度低于对照组(P＜0.05),术中疼痛程度低于对照组(P＜0.01);试验组SAS评分明显低于干预前(P＜0.01),对照组治疗前后SAS评分比较无显著差异(P＞0.05),试验组干预后gAS评分低于对照组(P＜0.01).结论:门诊痔疮手术患者采用音乐干预,能缓解患者的紧张心理,减少术中并发症,有利于手术的顺利进行.     

Vulvar Paget's disease. Cytologic and immunohistologic diagnosis of a case

An exfoliative smear from the vagina in a case of vulvar Paget's disease extending into the vagina and urethra was cytologically diagnosed as showing a large cell carcinoma. The malignant cells proved to be Paget cells by comparison of the cytologic specimen with subsequent biopsy specimens and by immunohistochemical studies using antibodies for glandular cytokeratin, epithelial membrane antigen, carcinoembryonic antigen and gross cystic disease fluid protein. These studies demonstrated that the Paget cell is probably of apocrine derivation. Exfoliative cytology and immunohistochemistry of exudative vulvar lesions may be helpful in the identification of Paget cells.     

Vulvar syringoma,report of a case and review of the literature

Syringomas are common intraepidermal sweat gland tumors most often found in women around the time of adolescence. Frequent sites of involvement include the lower eyelids and malar areas, however vulvar involvement is relatively rare. These lesions often present as small, multiple, skin-colored-to-yellowish papules and are often associated with increased vulvar discomfort and itching. We present a case of a 29-year old female who presented to her gynecologist complaining of vulvar itching and burning. A small condylomatous-type wart observed on her vulva was biopsied and found to be a syringoma. Because of their clinical presentation and associated symptoms, vulvar syringomas should be considered in the differential diagnosis of any multicentric papular lesion of the vulva, vulvar pain syndrome, and pruritis vulvae.     

Contact Hypersensitivity to Oxazolone Provokes Vulvar Mechanical Hyperalgesia in Mice

The interplay among pain, allergy and dysregulated inflammation promises to yield significant conceptual advances in immunology and chronic pain. Hapten-mediated contact hypersensitivity reactions are used to model skin allergies in rodents but have not been utilized to study associated changes in pain perception in the affected skin. Here we characterized changes in mechanical hyperalgesia in oxazolone-sensitized female mice challenged with single and repeated labiar skin exposure to oxazolone. Female mice were sensitized with topical oxazolone on their flanks and challenged 1-3 times on the labia. We then measured mechanical sensitivity of the vulvar region with an electronic pressure meter and evaluated expression of inflammatory genes, leukocyte influx and levels of innervation in the labiar tissue. Oxazolone-sensitized mice developed vulvar mechanical hyperalgesia after a single labiar oxazolone challenge. Hyperalgesia lasted up to 24 hours along with local influx of neutrophils, upregulation of inflammatory cytokine gene expression, and increased density of cutaneous labiar nerve fibers. Three daily oxazolone challenges produced vulvar mechanical hyperalgesic responses and increases in nerve density that were detectable up to 5 days post-challenge even after overt inflammation resolved. This persistent vulvar hyperalgesia is resonant with vulvodynia, an understudied chronic pain condition that is remarkably prevalent in 18-60 year-old women. An elevated risk for vulvodynia has been associated with a history of environmental allergies. Our pre-clinical model can be readily adapted to regimens of chronic exposures and long-term assessment of vulvar pain with and without concurrent inflammation to improve our understanding of mechanisms underlying subsets of vulvodynia and to develop new therapeutics for this condition.