目的 探讨早产儿配方奶及水解蛋白奶在住院早产低出生体重儿喂养过程中，在胃肠保护作用方面有无差异，以期进一步有效指导入院低体重儿乳制品的合理选择。 方法 收集新生儿科NICU 2008年2月－2010年8月收治的早产低出生体重儿156例，采用回顾性调查分析方法，通过翻阅病历收集新生儿的性别、孕周、出生体重、开奶日龄、持续喂养天数以及所患疾病。按照喂养开奶类型不同分为水解蛋白奶喂养组（A组，111例）和早产儿配方奶喂养组（B组，45例）。 结果 两组患儿性别、开奶日龄、持续喂养天数、胎龄、疾病分布上均无统计学差异（P＞0.05），A组和B组的胃肠功能障碍各临床特点发生概率无统计学差异。 结论 在住院生命体征相对稳定的早产低出生体重儿，无论是早产儿配方奶喂养还是水解蛋白奶喂养，其患儿的喂养不耐受发生情况无统计学差异。
【作者简介】〖KG2〗〖HTSS〗蒋青(1963-),女,四川遂宁人,主管护师,硕士,Email:jq0987@yahoo.cn
目的:总结60 例胃癌患者术后早期应用三腔喂养管行肠内营养支持的护理体会。方法:所有患者均于术晨放置三腔喂养管,术后早期行肠内营养支持,观察患者胃肠道反应及血清蛋白营养指标变化(白蛋白、前白蛋白、转铁蛋白)。结果:术后1 天患者白蛋白、前白蛋白、转铁蛋白均明显下降,术后10 天营养指标,明显高于术后1 天(P lt;0.05)。结论:胃癌患者术后早期应用三腔喂养管行肠内营养支持可促进胃肠道功能的恢复,减少患者术后并发症,减轻患者经济负担,是一种安全有效的营养支持方法。
ObjectiveTo summarize the experiences of application and nursing measures of three-lumen gastrojejunal tube for enteral nutrition in postoperative patients with gastric carcinoma. MethodsWe analyzed the clinical data of 60 gastric cancer patients undergoing treatment with three-lumen gastrojejunal tube after surgery between June and September 2012. And then we summarized the nursing experiences including fixation and flushing of the tube, plugging disposal, management of the nutrition temperature, and infusion speed choice. ResultsPostoperative nutritional status of all the 60 patients were improved. Their plasma albumin level reached (34.58±5.29) g/L, plasma hemoglobin reached the level of (113.90±19.12) g/L, and score of nutrition risk screening 2002 reached 3.47±0.71. Meanwhile, earlier recovery of enteric function made shorter average hospitalization. Decreasing use of parenteral nutrition avoided related complications. ConclusionApplication of the three-lumen gastrojejunal tube in postoperative patients with gastric carcinoma for enteral nutrition can improve their nutritional status and promote their recovery at an early time.
ObjectiveTo assess the clinical efficacy of sonography guided Freka Trelumina placement by stylet displacement in patients with severely impaired gastric emptying. MethodsTwenty-two patients with severely impaired gastric emptying monitored in the Intensive Care Unit from January 8 to May 18, 2016 were chosen to be our study subjects. Freka Trelumina was placed under ultrasonic guidance, and the guide wire displacement was used to determine the location of the catheter. We recorded whether the patient had an intra-gastric injection of warm water, the manual pushing times before the catheter passed through the pylorus, whether the operation succeeded, the time spent on guiding the placement, and the catheter depth. The pros and cons of the method in clinical use, and whether fasting state helped reduce the operating time were analyzed. ResultsAmong the 22 patients, 20 had a successful Freka Trelumina placement, and the success rate was 91%. The number of manual pushing before the catheter passed through the pylorus was 1 in 4 cases (20%), 2 in 5 (25%), and equal to or more than 3 in 11 cases (55%). The catheter could be seen in the third part of duodenum only in 9 cases (45%). The mean placement procedure lasted (20.35±12.93) minutes for the successful cases. The time spent in the 11 patients with empty stomach was (15.00±9.87) minutes, less than (26.89±14.45) minutes in those 9 post prandial patients (P＜0.05). ConclusionsWith stylet displacement to determine the location of the catheter, sonography guided Freka Trelumina placement has a high success rate. Ultrasonic guidance facilitates the insertion of the tubes in critically ill patients. For patients with empty stomach, it may help reduce the operating time.
ObjectiveTo assess effect of the self-made traditional Chinese medicine iontophoresis in treatment of acute lactation mastitis. MethodsTwo hundred cases of acute lactation mastitis who were treated in Langfang Maternal and Child Health-Care Hospital from Apr.to Nov.in 2012 were divided into traditional Chinese medicine group and control group by number of cases, each group enrolled 100 cases.The cases of traditional Chinese medicine group were treated with traditional Chinese medicine iontophoresis by using photoelectric ion therapeutic apparatus, and cases of control group were treated with 0.9% saline iontophoresis by using the same device.All of the 200 cases were treated with 1-3 courses (5 days per course), 2 times per day, and every time needed 30 minutes.At the same time, cases were educated the breast-feeding knowledge.Effect evaluation was performed after 1 course and 3 courses of treatment.The cases who were not cured after 3 courses needed to weaning, and needed to receive abscess incision drainage surgery.In 3 months after stopping therapy, telephone interview was performed to investigate the situation of recurrence. ResultsAfter 1 course of treatment, the effect was as follows:recovery in 89 cases, effective in 6 cases, invalid in 5 cases, and the total effective rate was 89%(89/100) in traditional Chinese medicine group; recovery in 71 cases, effective in 16 cases, invalid in 13 cases, and the total effective rate was 87%(87/100) in control group.After 3 courses of treatment, the effect was as follows:recovery in 97 cases, invalid in 3 cases, and the total effective rate was 97%(97/100) in traditional Chinese medicine group; recovery in 86 cases, invalid in 14 cases, and the total effective rate was 86%(86/100) in control group.There were 3 cases and 14 cases underwent abscess incision drainage surgery in Chinese medicine group and control group respectively.The clinical effect of Chinese medicine group were better than that of control group in 1 course (χ2=3.96, P < 0.05) and 3 courses (χ2=7.78, P < 0.01) of treatment.The recurrence rate of Chinese medicine group and control group were 5%(5/100) and 35%(35/100) respectively, and the rate of control group was higher (χ2=28.13, P < 0.01). ConclusionsCom-pared with 0.9% saline iontophoresis, the effect of traditional Chinese medicine iontophoresis in the treatment of acute lactation mastitis is better, which contribute to the breastfeeding.In addition, it is worth popularizing for that it can reduce the operation rate and recurrence rate effectively.
ObjectiveTo compare clinical outcomes between triluminal-tube feeding combined with tubular stomach and traditional esophagectomy for the treatment of esophageal carcinoma (EC)in elderly patients. MethodsA total of 196 elderly patients (>60 years)with EC who received esophagectomy in the Department of Cardiothoracic Surgery, Mianyang Central Hospital from January 2007 to January 2013 were enrolled in this study. According to different surgical methods, all the patients were divided into triluminal-tube feeding combined with tubular stomach group (group A)and traditional esophagectomy group (group B). There were 96 patients including 51 males and 45 females in group A with their age of 60-81 (66.21±7.32)years, and 100 patients including 54 males and 46 females in group B with their age of 60-82 (65.43±6.37)years. Clinical indexes were compared between the 2 groups. ResultsRadical esophagectomy was successfully performed for all the patients. There was no statistical difference in operation time, intraoperative blood loss, postoperative incidence of chylothorax, recurrent laryngeal nerve paralysis, anastomotic leakage, anastomotic stricture or mortality between the 2 groups (P > 0.05). Time to first passage of flatus and postoperative length of hospital stay of group A were significantly shorter than those of group B, and the incidences of postoperative arrhythmias, pulmonary complications and thoracic-stomach syndrome of group A were significantly lower than those of group B (P < 0.05). ConclusionTriluminal-tube feeding combined with tubular stomach can significantly reduce postoperative morbidity, shorten hospital stay and improve quality of life of elderly patients undergoing esophagectomy.
ObjectiveTo observe the effect of breastfeeding on the incidence of retinopathy of prematurity (ROP).MethodsA retrospective clinical study. From June 2017 to December 2019, 1256 eyes of 628 premature infants who were born in Ningbo Women and Children's Hospital and were screened for ROP were included in the study. Among them, there were in 325 males (650 eyes) and 303 females (606 eyes). According to the feeding situation, premature infants were divided into breastfeeding (research) group and formula feeding (control) group, with 390 cases of 780 eyes and 238 cases of 476 eyes, respectively. The changes in the retina of the fundus of the two groups of premature infants during the observation period were compared. The qualitative data comparison between groups was performed by the χ2 test; the quantitative data comparison was performed by the two independent sample t test.ResultsThe sex ratio of premature infants in the study group and control group (χ2=0.217), birth weight (t=0.728), gestational age at birth (t=0.351), Apgar score at birth (t=0.816), oxygen inhalation time (t=0.427), were compared with the length of stay in the neonatal intensive care unit (t=1.580), the difference was not statistically significant (P＞0.05). Among the 390 cases in the study group, 108 cases (27.7%, 108/390) and 282 cases (72.3%, 282/390) were with or without ROP, respectively; in the 238 cases in the control group, 86 (36.1%, 86/238) were with ROP, 152 (63.9%, 152/238) cases were without ROP. There was a statistically significant difference in the incidence of ROP between the two groups (χ2=4.934, P=0.026). Among the 108 cases of ROP in the study group, 50 (12.8%, 50/108), 35 (9.0%, 35/108), 23 (5.9%, 23/108) cases were in stage 1, 2 and 3, respectively. Among the 86 ROP cases in the control group, stages 1, 2 and 3 were 25 (10.5%, 25/86), 40 (16.8%, 40/86), and 21 (8.8%, 21/86), respectively. In the comparison of ROP staging between the two groups, the difference in stage 1 was not statistically significant (χ2=0.754, P＞0.05), and the difference in stage 2 and above was statistically significant (χ2=11.400, P＜0.05).ConclusionBreastfeeding may reduce the incidence and severity of ROP.