Clinical effects of a traditional Chinese medicine nursing programme to intervene in gastric pain of the spleen and stomach with Qi deficiency

BACKGROUND Gastroparesis is a common digestive disorder characterized by delayed gastric emptying,which can lead to symptoms such as nausea,vomiting,abdominal pain,and poor appetite.Traditional Chinese medicine(TCM)has been used for centuries to treat gastrointestinal disorders,including gastroparesis.TCM theory suggests that spleen and stomach qi deficiency syndrome is one of the main pathogenic factors in gastroparesis.Nursing care plays an important role in the treatment of gastroparesis,and TCM nursing interventions have shown promising results in improving patient outcomes.However,there is limited research on the clinical effectiveness of TCM nursing interventions for gastroparesis with spleen stomach deficiency syndrome.This study aimed to evaluate the clinical effect of TCM nursing intervention in the treatment of gastroparesis with spleen stomach deficiency syndrome and to compare it with routine nursing interventions.AIM To analyze the clinical effect of traditional Chinese medicine nursing intervention in the treatment of gastric paraplegia with spleen stomach deficiency syndrome.METHODS From January 2020 to July 2021,80 patients with gastroparesis of spleen stomach qi deficiency type diagnosed in our hospital were selected for the study.The 80 patients were randomly divided into a control group and an experimental group,with 40 cases in each group.During the treatment period,the control group received routine nursing interventions,while the experimental group received traditional Chinese medicine nursing procedures.Compare the nursing effects of the two groups and observe the changes in traditional Chinese medicine symptom scores,pain levels,and sleep quality before and after treatment.RESULTS After treatment,comparing the treatment effects of the two groups,the total effective rate of the experimental group was significantly higher than that of the control group,with statistical significance(P<0.05).There was no statistically significant difference in the TCM symptom score,visual analogue scale(VAS)score,and Pittsburgh sleep quality index(PSQI)score between the two groups before treatment(P>0.05).However,after treatment,the TCM syndrome scores,VAS scores,and PSQI scores of the experimental group were significantly lower than those of the control group,with a statistically significant difference(P<0.05).CONCLUSION In the clinical nursing intervention of patients with mild gastroparesis due to spleen and stomach qi deficiency,the traditional Chinese medicine nursing plan has good clinical application value and nursing effect,and has a good effect on improving patients’pain and sleep quality.

The Effect and Nursing of Indwelling Nasal Jejunal Feeding Tube for Enteral Nutrition in Acute Severe Pancreatitis

Objective:To analyze the effect of enteral nutrition and nursing intervention in patients with indwelling nasojejunal tube in acute severe pancreatitis.Methods:Sixty cases of patients with indwelt nasojejunal tubes treated in our hospital from August 2019 to August 2020 were divided into routine group and observation group as research subjects.Patients in both groups received enteral nutrition,patients in the routine group received routine care,and patients in the observation group received quality care.The recovery time of gastrointestinal function,length of hospital stay,hospitalization cost,nutritional indicators and incidence of complications in the two groups were compared.Results:The recovery time of gastrointestinal function in observation group was lower than that in routine group,P<0.05;The length and cost of hospitalization in observation group were lower than those in routine group,P<0.05;The nutritional indexes in observation group were higher than those in routine group,P<0.05;The incidence of complications in observation group was lower than that in routine group,P<0.05.Conclusion:Quality nursing service improve the effect of enteral nutrition,so as to ensure that patients get sufficient nutritional support.Its effect is remarkable and it is worthy of widespread clinical application.

Effectiveness of the combination of workshops and flipped classroom model to improve tube fixation training for nursing students

BACKGROUND Tube indwelling is a key procedure in modern medicine.Careful tube setup is necessary to prevent unplanned extubation.The training for tube fixation is timeand resource-consuming,and optimal modes of training are currently being sought.Previous studies have compared workshops and flipped classroom models separately using conventional teaching strategies,but no study has examined a combination of both teaching models in nursing training.AIM To compare the effectiveness of workshops vs workshops combined with the flipped classroom model for improving tube fixation training for nursing students.METHODS This was a prospective cohort study.In this study,149 nurses who joined our hospital in 2019 underwent training using workshops combined with the flipped classroom model(experimental group),while 159 nurses who joined the hospital in 2018 received only workshop-based training(control group).The combination of workshops with the flipped classroom training model was divided into two modules:pre-class and in-class training.The participation of nurses in the training activities,onsite assessment of training,nurses’evaluation of their training,and related indicators of tube quality management were evaluated.RESULTS The average age of nurses in the control group was 22.94±0.94 years and that of nurses in the experimental group was 25.42±3.23 years(P<0.01).The qualified rate of after-class assessments for the experimental and control groups was 100.00%(average score:94.01±2.78 points)and 91.82%(average score:84.24±2.94 points),respectively(P<0.01).Most nurses in the experimental group completely agreed that the combined training was helpful to cultivate clinical thinking and independent learning ability and to master knowledge of tube fixation.In addition,the training content within the pre-class teaching video,pre-class tube atlas,pre-class main instructor guidance,in-class demonstration,and in-class practice was very informative.The experimental group had higher evaluation scores than the control group(4.88±0.38 vs 4.67±0.64;P<0.01).Comparison of tube quality management before and after training in 2018 to 2019 revealed that the unplanned ureteral tube removal rate dropped from 0.25‰to 0.06‰,the unplanned chest tube removal rate dropped from 1.07‰to 0.78‰,and the unplanned gastric tube removal rate dropped from 0.36‰to 0.17‰.The incidence rate of pressure ulcers caused by the tube decreased from 0.78‰to 0.45‰.CONCLUSION The combination of workshop and flipped classroom training is effective in improving tube fixation training of nurses,cultivating nurses’active learning abilities and clinical thinking,and improving the safety of the procedure.

Traditional Chinese Medicine Nursing Protocols for Gastric ulcer(peptic ulcer)

Objective Gastric ulcer( peptic ulcer) is one of the most common digestive system diseases. This paper aimed to summarize the common syndromes of gastric ulcer( peptic ulcer),and to discuss related Traditional Chinese Medicine nursing interventions and health guidance.

Knowledge and Tube Feeding Practices for Older Adult Patients among Japanese Registered Nurses

The aim of this study was to examine nurses’ thinking regarding the indications for tube feeding in older adults with eating difficulties and to determine whether the team approach can improve their knowledge and tube feeding practices. We sent self-administered questionnaires to 436 nurses and collected them from November to December 2010 (response rate, 70.0%). The results indicated that approximately 30% of the Japanese nurses thought that older patients with dementia should be on tube feeding and more than half of the nurses answered that tube feeding is indicated for aspiration-prone, frail, older adults. Moreover, our findings showed that nurses who organize multidisciplinary teams performed more interventions for dysphagia before introducing tube feeding than the reference group as analyzed by multivariate adjustment (odds ratio, 2.1-6.6). In conclusion, a multidisciplinary team approach is expected to make better decisions on the treatment and care of older patients with difficulty eating, including the need for tube

Adhesiolysis for Liver Resection in a Patient with a Reconstructed Stomach Tube after Esophagectomy

To our knowledge this is the first report to provide a detailed description of surgical procedure for adhesiolysis and hepatectomy in patients who have undergone esophagectomy and reconstruction. We performed a hepatic resection of the left medial segment in a patient with a reconstructed stomach tube after esophagectomy for the esophageal carcinoma. The reconstructed stomach tube overlapped with the left medial segment of the liver and the hepatoduodenal ligament and was extensively and strongly adhered to them. It is important for clinicians to know how to perform the detachment procedure successfully in order to secure a surgical field for liver resection without damaging the fragile reconstructed gastric tube. In order to avoid vascular injury of the stomach tube, it was decided that detachment around the hepatoduodenal ligament preceded detachment of the stomach tube from the liver. After complete separation of the hepatoduodenal ligament from the stomach tube, the hepatoduodenal ligament was encircled with tape. Subsequently, adhesiolysis was performed between the stomach tube and the liver. Finally, parenchymal transection was performed using the intermittent hepatic inflow occlusion and crush clamping techniques to dissect the parenchyma. The patient was discharged two weeks after surgery without complication.

胃癌围术期病人预后营养指数纵向变化规律及应用的研究进展

对胃癌病人的预后营养指数概念及影响因素、围术期纵向变化规律、营养干预对预后营养指数的影响及其在术前与术后的应用价值进行综述,旨在为临床医护人员精准应用营养监测指标、进一步完善胃癌营养管理方案提供参考。

PDCA管理模式在神经外科盲插鼻空肠管的应用效果

目的探析PDCA管理模式在盲插鼻空肠管的应用效果。方法回顾性分析77例神经外科行盲插空肠管患者的病历资料。根据置管时间完成分组,分别命名为对照组(n=33,给予常规盲插鼻空肠管法)、观察组(n=34,运用PDCA管理模式护理干预盲插鼻空肠管)。对比两组患者盲插鼻空肠管成功率、护理人员满意程度、护理质量评价情况。结果观察组患者盲插鼻空肠管成功率高于对照组(P<0.05)。观察组患者对护理服务质量满意度评价高于对照组(P<0.05)。对两种模式下的护理质量进行评价,观察组创新精神、团队精神、质量意识、临床思维能力、解决问题能力评分高于对照组(P<0.05)。结论应用PDCA管理模式有助于提高盲插鼻空肠管成功率,为患者提供更好的护理体验,对护理工作而言有积极的影响。

危重症患者肠内营养治疗后管饲依赖症状发生现况及影响因素研究

目的多中心调查国内危重症患者肠内营养治疗后管饲依赖症状发生现况,并对其影响因素展开系统分析。方法于2023年7月10日—20日,采用横断面调查法,对四川省、浙江省、江苏省、贵州省、重庆市等8个省市、12所三级综合医院内行肠内营养治疗结束后的危重症患者,使用一般资料调查表、管饲依赖症状评估量表展开问卷调查。结果该次调查共回收问卷225份,有效问卷221份,有效回收率为98%。危重症患者肠内营养治疗后管饲依赖症状发生率为64%。多因素Logistic回归分析结果显示,合并系统功能障碍数量[OR=4.605,95%CI(1.831~11.581)]、镇静与(或)镇痛药物使用天数[OR=1.578,95%CI(1.031~2.416)]、管饲进食天数[OR=1.634,95%CI(1.139~2.345)]以及促胃动力药物使用天数[OR=1.908,95%CI(1.089~3.345)]是危重症患者肠内营养治疗后管饲依赖症状发生的独立危险因素。结论危重症患者肠内营养治疗后,管饲依赖症状发生率较高,医护人员须建立和完善适用于危重症患者肠内营养治疗后管饲依赖症状的预防及管理机制。

成人患者经鼻胃管喂养临床实践指南(2023年更新版)

目的 对2015年构建的《成人患者经鼻胃管喂养临床实践指南》进行更新。方法 于2022年1月-2023年3月,基于NICE更新流程,通过专家函询和护士访谈确定需要新增和修订的章节,系统检索专业网站和数据库中关于鼻饲护理的最佳证据,3名研究者独立对文献进行资料提取和证据汇总,通过专家函询确定推荐级别;根据CheckUP更新指南报告清单形成指南初稿,通过现场论证和外部评审对指南进行修改及完善,形成指南更新的终稿。结果 与原版指南相比,更新版指南新增了改善胃肠道功能和血糖控制章节,删除了营养配方和鼻饲不良事件的上报章节,重点更新了鼻饲置管前评估、胃管置管、鼻饲喂养等13个章节,指南更新及补充的条目共67条,52条强推荐,15条弱推荐。结论 本研究汇总了目前成人患者鼻饲相关的最新证据,对原有的《成人患者经鼻胃管喂养临床实践指南》进行更新,可进一步为临床鼻饲护理管理提供最佳临床决策,规范鼻饲护理流程。

新生儿肠内营养胃管留置管理的最佳证据总结

目的检索、评价并整合国内外新生儿肠内营养胃管留置管理的相关证据。方法系统检索英国医学杂志最佳临床实践网、Up To Date、CINAHL、加拿大医学会临床实践指南网、国际指南网、WHO指南网、美国国立指南库、医脉通、Cochrane图书馆、PubMed、中国知网、中国生物医学文献数据库、万方数据库、维普等数据库等网站和数据库中关于新生儿肠内营养胃管留置管理的临床决策、推荐实践、证据总结、临床实践指南、技术报告、专家共识、系统评价,由2名研究者独立进行方法学质量评价后,根据主题对证据进行提取与汇总,检索时限为建库至2023年5月。结果共纳入14篇文献,包括指南2篇、证据总结1篇、系统评价5篇、专家共识3篇、最佳实践2篇、随机对照研究1篇。最后总结包括适应与禁忌、置管前的准备与评估、胃管位置验证、胃管固定、胃管维护5个方面的22条证据。结论本研究通过系统检索国内外高级别的循证资源,对新生儿肠内营养胃管留置的管理进行证据总结,所总结的新生儿肠内营养胃管留置管理证据全面、实用,可为规范新生儿胃管留置管理管理提供循证依据,保证新生儿肠内营养安全,提高新生儿护理质量。

患者自我报告结局在胃癌患者中的应用进展

对患者自我报告结局(PROs)在胃癌患者照护领域的应用现状进行综述,包括胃癌PROs概述、评估工具及临床应用3个方面,旨在为临床决策及制定相应措施提供参考。

老年重症患者PICC置管护理中应用PDCA循环的临床效果

目的分析老年重症患者PICC置管护理中应用PDCA循环的效果。方法选取厦门大学附属中山医院2022年4月至2023年4月实施PICC置管的110例老年重症患者,按随机数字表法将患者分为对照组与观察组,各55例,对照组采用常规护理,观察组在对照组基础上实施PDCA循环,对比两组护理干预的效果。结果护理后,观察组自我护理能力评分高于对照组、自我感受负担评分低于对照组(均P<0.05);观察组患者依从性、满意度、一次穿刺成功率均高于对照组,并发症发生率以及负性情绪评分低于对照组(均P<0.05)。结论老年重症患者PICC置管护理中应用PDCA循环具有良好的效果,能有效降低患者并发症发生率、提高患者一次穿刺成功率、减轻患者心理负担,且有利于提高患者对临床医护干预的依从性和满意度。

中医热熨疗法治疗脾胃疾病的研究现状分析

本文通过查找、检索有关热熨疗法的相关古籍及文献资料,总结中医热熨疗法的发展历史,以及脾胃疾病治疗方法、治疗效果和应用进展,旨在了解中医热熨疗法在脾胃疾病中的研究现状。中医热熨疗法治疗脾胃疾病效果良好,应不断深入研究,使其能更好地发挥治疗效果。

“互联网+护理服务”在留置胃管患者居家护理中的应用

目的运用线上预约咨询和线下上门服务的模式,探讨南京市中医院“互联网+护理服务”在留置胃管患者居家护理中的应用效果。方法选择2021年10月—2022年10月的60例出院留置胃管患者作为研究样本,通过患者线上预约和护士/护理人员线下上门服务,调查分析患者/照顾者对“互联网+护理服务”的满意度、患者的并发症发生率、照顾者对胃管知识掌握度评分等指标。结果患者/照顾者在护理干预后的胃管知识掌握度评分明显优于护理前(P<0.05),且患者整体护理满意度为98.33%,整体并发症发生率为8.34%,未出现严重并发症。结论对留置胃管患者进行居家护理时,采用“互联网+护理”干预方案,有效解决了长期卧床的居家患者更换胃管困难的问题,提高了照顾者的照护能力和患者满意度。

1例前臂游离皮瓣修补复发性外鼻基底细胞癌病人的护理

总结1例前臂游离皮瓣修补复发性外鼻基底细胞癌(BBC)病人的临床护理经验。护理要点包括动态评估转移皮瓣;制订口腔护理方案,促进口鼻瘘愈合;调整鼻腔支撑管,保持鼻腔通畅;加强围术期心理疏导;实施基于全病程个案管理的延续护理,建立长期随访方案。经过14 d的多学科护理,病人皮瓣愈合良好,顺利出院。术后随访半年,病人鼻腔通畅,外形满意。

早期集束化护理结合饲管定位经鼻空肠营养干预ICU重症患者的效果分析

目的探讨早期集束化护理结合饲管定位经鼻空肠营养干预ICU重症患者的效果。方法选取2022年6月至2023年6月在我院ICU重症病房收治的120例患者作为研究对象,按照随机数字表法分为观察组和对照组,每组60例。对照组采取ICU重症病房标准护理方案并给予常规肠内营养干预,观察组采取早期集束化护理和饲管定位经鼻空肠营养干预,观察比较两组患者的干预效果。结果护理后,两组患者的血清白蛋白(ALB)、前白蛋白(PA)和血红蛋白(Hb)水平均有所上升,且观察组患者的ALB、PA和Hb水平均高于对照组,差异均有统计学意义(均P<0.05)。观察组患者的肠内营养并发症发生率低于对照组,组间比较差异有统计学意义(P<0.05)。两组患者3 d热卡达标率比较,差异无统计学意义(P>0.05);观察组患者的7 d热卡达标率明显高于对照组,差异有统计学意义(P<0.05)。结论在ICU重症患者的营养干预中,采取早期集束化护理结合饲管定位经鼻空肠营养干预可保证患者热能和营养摄入,有效改善患者的营养状态,降低不良反应发生率,对促进患者康复具有重要意义,值得临床应用和推广。

管道护理风险评估在脑肿瘤外科手术后脑室引流管护理管理中的应用效果

目的探究管道护理风险评估在脑肿瘤外科手术后脑室引流管护理管理中的应用效果。方法选取2020年3月至2022年3月在我院外科进行脑肿瘤外科手术后脑室引流手术的86例患者为研究对象,按分层随机化法将其分为对照组与观察组,各43例。对照组采用常规管道护理,观察组在对照组基础上采用管道护理风险评估。比较两组的非计划性拔管发生情况、管道阻塞发生情况、并发症发生情况、疼痛程度及护理满意度。结果观察组的非计划性拔管率及管道阻塞率低于对照组,差异具有统计学意义(P<0.05)。观察组的颅内感染、脑膜炎及出血发生率均低于对照组,差异具有统计学意义(P<0.05)。插管时、插管3 d后,观察组的视觉模拟疼痛量表(VAS)评分低于对照组,差异具有统计学意义(P<0.05)。观察组的护理总满意率高于对照组,差异具有统计学意义(P<0.05)。结论管道护理风险评估应用于脑肿瘤外科手术后脑室引流管护理管理中,可以降低非计划性拔管率和管道阻塞率,减轻疼痛,减少并发症,可在临床上进一步推广。

恶性梗阻性黄疸PTCD带管病人出院经历的质性研究

目的:基于“以家庭为中心”的理论,探讨恶性梗阻性黄疸经皮肝穿刺胆管引流术(PTCD)带管病人出院经历的体验,为制定相应的护理支持方案提供依据。方法:采用现象学研究方法,选取2022年6月—12月在武汉市某三级甲等综合医院胆胰外科住院的13例携带PTCD引流管出院的病人,对其进行半结构访谈,应用Colaizzi 7步分析法对资料进行分析、归纳及提炼主题。结果:遵循“以家庭为中心”的理论,提炼出恶性梗阻性黄疸病人出院准备期、出院接受期、出院后期带管出院体验的3个主题。结论:恶性梗阻性黄疸PTCD带管病人出院照护体验动态变化,医护人员应有针对性地给予心理支持,强调家庭的参与感,增强家庭照护的延续性。

手指点穴联合中药膏摩治疗胃脘部胀痛1例的护理体会

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