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Prognostic factors associated with gastrointestinal dysfunction after gastrointestinal tumor surgery:A meta-analysis
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作者 Jia Song Cong Zhou Tian Zhang 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第5期1420-1429,共10页
BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gas... BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gastrointestinal tumor surgery.AIM To investigate the potential risk factors for gastrointestinal dysfunction following gastrointestinal tumor surgery and to present information supporting the prevention and management of gastrointestinal dysfunction in surgery patients.METHODS Systematically searched the relevant literature from PubMed,Web of Science,Cochrane Library,Embase,CNKI,China Biomedical Database,Wanfang Database,and Weipu Chinese Journal Database self-established until October 1,2022.Review Manager 5.3 software was used for meta-analysis after two researchers independently screened literature,extracted data,and evaluated the risk of bias in the included studies.RESULTS A total of 23 pieces of literature were included,the quality of which was medium or above,and the total sample size was 43878.The results of meta-analysis showed that the patients were male(OR=1.58,95%CI:1.25-2.01,P=0.002)and≥60 years old(OR=2.60,95%CI:1.76-2.87,P<0.001),physical index≥25.3 kg/m2(OR=1.6,95%CI:1.00-1.12,P=0.040),smoking history(OR=1.89,95%CI:1.31-2.73,P<0.001),chronic obstructive pulmonary disease(OR=1.49,95%CI:1.22-1.83,P<0.001),enterostomy(OR=1.47,95%CI:1.26-1.70,P<0.001),history of abdominal surgery(OR=2.90,95%CI:1.67-5.03,P<0.001),surgical site(OR=1.2,95%CI:1.40-2.62,P<0.001),operation method(OR=1.68,95%CI:1.08-2.62,P=0.020),operation duration(OR=2.65,95%CI:1.92-3.67,P<0.001),abdominal adhesion grade(OR=2.52,95%CI:1.90-3.56,P<0.001),postoperative opioid history(OR=5.35,95%CI:3.29-8.71,P<0.001),tumor TNM staging(OR=2.58,95%CI:1.84-3.62,P<0.001),postoperative blood transfusion(OR=2.92,95%CI:0.88-9.73,P=0.010)is a risk factor for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors.CONCLUSION There are many factors affecting gastrointestinal dysfunction in gastrointestinal patients after surgery.Clinical staff should identify relevant risk factors early and implement targeted intervention measures on the basis of personalized assessment to improve the clinical prognosis of patients. 展开更多
关键词 gastrointestinal tumor surgery Postoperative gastrointestinal dysfunction Intestinal paralysis Risk factors Metaanalysis
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Clinical Evaluation of Enteral Nutrition+Probiotics in the Treatment of Gastrointestinal Dysfunction After Severe Traumatic Brain Injury
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作者 Lianyu Zhang 《Journal of Clinical and Nursing Research》 2024年第2期255-260,共6页
Objective:To evaluate the therapeutic effect of enteral nutrition+probiotics in patients with gastrointestinal dysfunction after severe craniocerebral injury.Methods:From September 2018 to February 2023,80 patients(20... Objective:To evaluate the therapeutic effect of enteral nutrition+probiotics in patients with gastrointestinal dysfunction after severe craniocerebral injury.Methods:From September 2018 to February 2023,80 patients(20-82 years old)with gastrointestinal dysfunction who were admitted to the Intensive Care Unit at the Third People’s Hospital of Xining were included in the study.Their primary condition was severe craniocerebral injury,and all of them received conventional symptomatic treatment.Group A received enteral nutrition+probiotic therapy,whereas group B received enteral nutrition only.The differences in the following indicators were compared before and after treatment:nutritional and biochemical indicators,gastrointestinal function indicators,Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA),APACHE II score,serum procalcitonin(PCT),neutrophil(N)ratio,and C reactive protein(CRP).Result:The nutritional and biochemical indicators in group A were higher than those in group B,P<0.05;the time to first passage of flatus,time to first passage of stool,and bowel sound recovery time in group A were shorter than those in group B,P<0.05;the GCS of group A was higher than that of group B,P<0.05;the SOFA and APACHEⅡscores of group A were not different from those of group B,P>0.05;and the PCT,N ratio,and CRP levels of group A were lower than those of group B,P<0.05.Conclusion:In patients with gastrointestinal dysfunction after severe craniocerebral injury,enteral nutrition+probiotic therapy is highly effective and feasible,as it can optimize various nutritional indicators,shorten the gastrointestinal function recovery time,and reduce the body’s stress response. 展开更多
关键词 Enteral nutrition PROBIOTICS Severe craniocerebral injury gastrointestinal dysfunction EFFICACY
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Gastrointestinal dysfunction is associated with mortality in severe burn patients:a 10-year retrospective observational study from South China 被引量:1
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作者 Qiu-Lan He Shao-Wei Gao +5 位作者 Ying Qin Run-Cheng Huang Cai-Yun Chen Fei Zhou Hong-Cheng Lin Wen-Qi Huang 《Military Medical Research》 SCIE CAS CSCD 2023年第3期299-312,共14页
Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotil... Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotility,and abdominal compartment syndrome(ACS)].We present a multicentre analysis of coincident GI dysfunction and its effect on burn-related mortality.Methods:This retrospective analysis was conducted on patients with severe[≥20%total burn surface area(TBSA)]and extensive(>50%TBSA or>25%full-thickness TBSA)burns admitted to three university teaching institutions in China between January 1,2011 and December 31,2020.Both 30-and 90-day mortality were assessed by collating demographic data,burn causes,admission TBSA,%full-thickness TBSA,Baux score,Abbreviated Burn Severity Index(ABSI)score,and Sequential Organ Failure Assessment(SOFA)score,shock at admission and the presence of an inhalation injury.GI dysfunction included abdominal distension,nausea/vomiting,diarrhoea/constipation,GI ulcer/haemorrhage,paralytic ileus,feeding intolerance and ACS.Surgeries,length of intensive care unit(ICU)stay,pain control[in morphine milligram equivalents(MME)]and overall length of hospital stay(LOHS)were recorded.Results:We analyzed 328 patients[75.6%male,mean age:(41.6±13.6)years]with a median TBSA of 62.0%(41.0%–80.0%);256(78.0%)patients presented with extensive burns.The 90-day mortality was 23.2%(76/328),with 64(84.2%)of these deaths occurring within 30 d and 25(32.9%)occurring within 7 d.GI dysfunction was experienced by 45.4%of patients and had a significant effect on 90-day mortality[odds ratio(OR)=14.070,95%confidence interval(CI)5.886–38.290,P<0.001].Multivariate analysis showed that GI dysfunction was associated with admission SOFA score and%full-thickness TBSA.Overall,88.2%(67/76)of deceased patients had GI dysfunction[hazard ratio(HR)for death of GI dysfunction=5.951],with a survival advantage for functional disorders(diarrhoea,constipation,or nausea/vomiting)over GI ulcer/haemorrhage(P<0.001).Conclusion:Patients with severe burns have an unfavourable prognosis,as nearly one-fifth died within 90 d.Half of our patients had comorbidities related to GI dysfunction,among which GI ulcers and haemorrhages were independently correlated with 90-day mortality.More attention should be given to severe burn patients with GI dysfunction. 展开更多
关键词 Severe burn gastrointestinal dysfunction MORTALITY SEPSIS gastrointestinal haemorrhage Continuous analgesia
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Mechanisms of gastrointestinal barrier dysfunction in COVID-19 patients 被引量:1
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作者 Weijie Xue Masaki Honda Taizo Hibi 《World Journal of Gastroenterology》 SCIE CAS 2023年第15期2283-2293,共11页
Coronavirus disease 2019(COVID-19)caused by the novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has become a major global public health event,resulting in a significant social and economic burden.Alth... Coronavirus disease 2019(COVID-19)caused by the novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has become a major global public health event,resulting in a significant social and economic burden.Although COVID-19 was initially characterized as an upper respiratory and pulmonary infection,recent evidence suggests that it is a complex disease including gastrointestinal symptoms,such as diarrhea,nausea,and vomiting.Moreover,it remains unclear whether the gastrointestinal symptoms are caused by direct infection of the gastrointestinal tract by SARS-CoV-2 or are the result of systemic immune activation and subsequent dysregulation of homeostatic mechanisms.This review provides a brief overview of the mechanisms by which SARS-CoV-2 disrupts the integrity of the gastrointestinal barrier including the mechanical barrier,chemical barrier,microbial barrier,and immune barrier. 展开更多
关键词 gastrointestinal barrier dysfunction SARS-CoV-2 COVID-19 Angiotensinconverting enzyme 2 MICROBIOME Immune cells
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COVID-19-induced gastrointestinal autonomic dysfunction:A systematic review 被引量:1
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作者 Reem Elbeltagi Mohammed Al-Beltagi +1 位作者 Nermin Kamal Saeed Adel Salah Bediwy 《World Journal of Clinical Cases》 SCIE 2023年第22期5252-5272,共21页
BACKGROUND It is common for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection to occur in the gastrointestinal tract,which can present itself as an initial symptom.The severity of coronavirus diseas... BACKGROUND It is common for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection to occur in the gastrointestinal tract,which can present itself as an initial symptom.The severity of coronavirus disease 2019(COVID-19)is often reflected in the prevalence of gastrointestinal symptoms.COVID-19 can damage the nerve supply to the digestive system,leading to gastrointestinal autonomic dysfunction.There is still much to learn about how COVID-19 affects the autonomic nervous system and the gastrointestinal tract.AIM To thoroughly explore the epidemiology and clinical aspects of COVID-19-induced gastrointestinal autonomic dysfunction,including its manifestations,potential mechanisms,diagnosis,differential diagnosis,impact on quality of life,prognosis,and management and prevention strategies.METHODS We conducted a thorough systematic search across various databases and performed an extensive literature review.Our review encompassed 113 studies published in English from January 2000 to April 18,2023.RESULTS According to most of the literature,gastrointestinal autonomic dysfunction can seriously affect a patient's quality of life and ultimate prognosis.Numerous factors can influence gastrointestinal autonomic nervous functions.Studies have shown that SARS-CoV-2 has a well-documented affinity for both neural and gastrointestinal tissues,and the virus can produce various gastrointestinal symptoms by reaching neural tissues through different pathways.These symptoms include anorexia,dysgeusia,heartburn,belching,chest pain,regurgitation,vomiting,epigastric burn,diarrhea,abdominal pain,bloating,irregular bowel movements,and constipation.Diarrhea is the most prevalent symptom,followed by anorexia,nausea,vomiting,and abdominal pain.Although COVID-19 vaccination may rarely induce autonomic dysfunction and gastrointestinal symptoms,COVID-19-induced autonomic effects significantly impact the patient's condition,general health,prognosis,and quality of life.Early diagnosis and proper recognition are crucial for improving outcomes.It is important to consider the differential diagnosis,as these symptoms may be induced by diseases other than COVID-19-induced autonomic dysfunction.Treating this dysfunction can be a challenging task.CONCLUSION To ensure the best possible outcomes for COVID-19 patients,it is essential to take a multidisciplinary approach involving providing supportive care,treating the underlying infection,managing dysfunction,monitoring for complications,and offering nutritional support.Close monitoring of the patient's condition is crucial,and prompt intervention should be taken if necessary.Furthermore,conducting thorough research on the gastrointestinal autonomic dysfunction caused by COVID-19 is vital to manage it effectively. 展开更多
关键词 COVID-19 SARS-CoV-2 gastrointestinal autonomic dysfunction Long COVID Post-COVID Autonomic nervous system
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Effect of self-made exhaust plaster on patients with gastrointestinal dysfunction after gynecological operation
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作者 Wen-Ming Cao Xiu-Rong Wang Xiao-Xia Wang 《Psychosomatic Medicine Research》 2020年第2期54-59,共6页
Objective:To explore the effect of self-made exhaust patch(SMEP)on gastrointestinal dysfunction after gynecological operation.Methods:A total of 200 patients with gynecological operation in the gynecological ward of S... Objective:To explore the effect of self-made exhaust patch(SMEP)on gastrointestinal dysfunction after gynecological operation.Methods:A total of 200 patients with gynecological operation in the gynecological ward of Shandong Changle People's Hospital were randomly divided into the control group(n=100)and the treatment group(n=100).The recovery time of bowel sounds,the time of first anal exhaust,the duration of abdominal distention,the duration of abdominal pain,the incidence of abdominal distention and abdominal pain and linical efficacy of SMEP were observed.Results:Compared with the control group,the recovery time of gastrointestinal function and the first anal exhaust time in the treatment group were shorter;the duration of abdominal distention and abdominal pain in the treatment group were shorter than those in the control group(P<0.05);Cure rate of abdominal distention in the treatment is 62.5%and cure rate of abdominal pain in the treatment is 60%within 72 hours after operation,which is higher than that in the control group(44.%,45.9%).Conclusion:The results showed that the self-made exhaust patch can improve the clinical symptoms of patients after gynecological abdominal surgery,and the self-made exhaust patch had a significant effect on gastrointestinal dysfunction after gynecological surgery,which was worthy of clinical promotion. 展开更多
关键词 Self-made exhaust patch Gynecological operation gastrointestinal dysfunction Abdominal distention
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A randomized placebo-controlled trial of Chinese medicine acupoint application on gastrointestinal dysfunction after appendectomy
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作者 Hong Chen Yi-Yuan Liu +6 位作者 Yu-Tao Wang Cheng-Cheng Yang Xiu-Qin Xu Hai-Rong Hu Yun-Lan Jiao Xing-Tong Bao Ling Tang 《TMR Non-Drug Therapy》 2020年第4期158-164,共7页
Background:Gastrointestinal dysfunction is one of the common complications of appendectomy,which seriously affects the postoperative recovery and clinical prognosis.Through traditional Chinese medicine acupoint applic... Background:Gastrointestinal dysfunction is one of the common complications of appendectomy,which seriously affects the postoperative recovery and clinical prognosis.Through traditional Chinese medicine acupoint application is suggested for managing postoperative gastrointestinal dysfunction,supporting evidence is weak.Here,the prospective randomized placebo-controlled study was designed to provide high-level evidence regarding whether traditional Chinese medicine acupoint application is effective on the gastrointestinal dysfunction after appendectomy.Methods:A total of 60 patients who underwent appendectomy in Dongfang Hospital Beijing University of Chinese Medicine(Beijing,China)from November 2016 to December 2017 were selected as study objects and randomly divided into control group(n=30)and observation group(n=30).Based on routine postoperative care,the acupoints Zusanli(ST36)and Yongquan(KI1)were selected.The control group was given acupoint application of traditional Chinese medicine placebo and the observation group was given acupoint application of clinical empirical Chinese medicine called Wentongliqi prescription.The course of treatment was performed on the 1st,2nd,and 3rd days after appendectomy,once a day and 4 hours each time.The primary outcome includes the time until the recovery time of bowel sounds(h),the first postoperative flatus(h)and first bowel movement time(h)on the 1st,2nd,and 3rd days after appendectomy.The secondary outcome includes clinical symptom score,life ability score and adverse reactions were observed and recorded on the 1st,2nd,and 3rd days after appendectomy.Results:After treatment,the recovery time of intestinal sound in the observation group was earlier than that in the control group(P<0.05).However,there were no significant difference between the two groups in first anal exhaust time and first bowel movement time,clinical symptom scores and life ability scores between the two groups before and after treatment(P>0.05).Conclusion:Acupoint application therapy has limited effect on the recovery of gastrointestinal dysfunction after appendectomy.Further study with large sample size is needed to confirm its therapeutic effects. 展开更多
关键词 APPENDICITIS gastrointestinal dysfunction Acupoint sticking therapy Randomized controlled clinical trials Curative effect SECURITY
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尿毒症腹膜透析相关胃肠功能紊乱的临床特征及影响因素研究 被引量:1
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作者 李静 马雷雷 +3 位作者 王冠然 姜晨 邢海涛 杨洪涛 《中国全科医学》 CAS 北大核心 2024年第18期2198-2204,共7页
背景胃肠功能紊乱是腹膜透析患者常见的并发症,严重影响患者食欲和情绪,致使患者营养不良、脱水、电解质紊乱或诱发全身炎症反应等,还会导致腹膜透析效能下降,增加医疗难度,降低患者的生活水平。目的观察尿毒症患者腹膜透析相关胃肠功... 背景胃肠功能紊乱是腹膜透析患者常见的并发症,严重影响患者食欲和情绪,致使患者营养不良、脱水、电解质紊乱或诱发全身炎症反应等,还会导致腹膜透析效能下降,增加医疗难度,降低患者的生活水平。目的观察尿毒症患者腹膜透析相关胃肠功能紊乱的临床特征并分析其影响因素,为防治腹膜透析相关胃肠道功能紊乱的临床诊治提供参考。方法本研究为回顾性研究,选取2019-09-01—2021-09-01在天津中医药大学第一附属医院肾病科进行维持性腹膜透析的304例尿毒症患者为研究对象。根据是否合并胃肠功能紊乱将患者分为胃肠功能紊乱组和无胃肠功能紊乱组。收集两组患者的一般资料、合并症、实验室检查指标、透析充分性相关指标等并进行比较。运用SPSS 23.0软件对临床资料进行统计,总结分析腹膜透析相关胃肠功能紊乱的临床特征,采用多因素Logistic回归分析探讨尿毒症患者发生腹膜透析相关胃肠道功能紊乱的影响因素。结果304例尿毒症腹膜透析患者中合并胃肠道功能紊乱189例(62.2%),胃肠功能紊乱组患者中位年龄为62(52,67)岁。两组患者年龄、糖尿病肾病原发病比例、合并高血压比例、合并冠心病比例比较,差异有统计学意义(P<0.05);两组患者血钙、胆固醇、肌酸激酶、C反应蛋白、总胆红素、血糖、糖化血红蛋白、降钙素原、三酰甘油水平比较,差异均有统计学意义(P<0.05);两组患者血尿素氮、残肾尿素清除指数(Kt/V)、腹膜Kt/V、总肌酐清除率(Ccr)、残肾Ccr、总Ccr标准化比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,糖尿病肾病原发病(OR=7.471,95%CI=1.161~48.061,P=0.034)、糖化血红蛋白升高(OR=1.367,95%CI=1.080~1.731,P=0.009)是尿毒症患者发生腹膜透析相关胃肠功能紊乱的独立危险因素,残肾Ccr升高(OR=0.952,95%CI=0.908~0.997,P=0.038)是尿毒症患者发生腹膜透析相关胃肠功能紊乱的独立保护因素。结论尿毒症患者腹膜透析相关胃肠道功能紊乱发生率较高,多发于老年患者;糖尿病肾病原发病、糖化血红蛋白升高可能是尿毒症患者发生腹膜透析相关胃肠功能紊乱的独立危险因素,残肾Ccr升高可能是尿毒症患者发生腹膜透析相关胃肠功能紊乱的独立保护因素。 展开更多
关键词 尿毒症 腹膜透析 胃肠道功能紊乱 临床特征 影响因素分析
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厚朴排气合剂联合经皮穴位电刺激对产后抑郁合并胃肠功能障碍患者胃肠功能及抑郁情绪的影响 被引量:1
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作者 王海锋 孟怡 +1 位作者 刘青 景邵春 《陕西中医》 CAS 2024年第1期46-49,54,共5页
目的:探讨厚朴排气合剂联合经皮穴位电刺激对产后抑郁合并胃肠功能障碍的临床效果。方法:将120例产后抑郁合并胃肠功能障碍患者随机分为观察组(n=60)和对照组(n=60)。对照组给予经皮穴位电刺激治疗,观察组给予厚朴排气合剂联合经皮穴位... 目的:探讨厚朴排气合剂联合经皮穴位电刺激对产后抑郁合并胃肠功能障碍的临床效果。方法:将120例产后抑郁合并胃肠功能障碍患者随机分为观察组(n=60)和对照组(n=60)。对照组给予经皮穴位电刺激治疗,观察组给予厚朴排气合剂联合经皮穴位电刺激治疗,疗程均为7 d。比较两组患者胃肠功能恢复情况、胃肠道障碍症状评分、胃泌素(GAS)、胃动素(MTI)、腹胀发生率、腹胀程度、汉密尔顿抑郁量表评分以及不良反应发生情况。结果:与对照组相比,观察组患者的肠鸣音恢复、首次肛门排气、首次排便、总住院时间明显更短(P<0.05)。治疗后,两组患者胃肠道障碍症状评分均明显下降,观察组低于对照组(P<0.05)。治疗后,两组患者GAS、MTI水平和治疗前相比均明显升高,且观察组高于对照组(P<0.05)。治疗后,观察组患者腹胀发生率为11.7%,低于对照组的30.0%(P<0.05)。治疗后,观察组患者腹胀程度明显低于对照组(P<0.05)。治疗后,两组患者抑郁状态评分均明显下降,观察组低于对照组(P<0.05)。两组不良反应发生率(6.7%与5.0%)比较差异无统计学意义(P>0.05)。结论:厚朴排气合剂联合经皮穴位电刺激可有效促进产后抑郁合并胃肠功能障碍患者胃肠功能恢复,缓解腹胀和抑郁情绪,而且不会明显增加不良反应发生率。 展开更多
关键词 产后抑郁 胃肠功能障碍 腹胀 厚朴排气合剂 经皮穴位电刺激 不良反应
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自拟灌肠方辅助治疗对脓毒症胃肠功能障碍患者胃肠功能及炎症因子的影响 被引量:1
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作者 胡乃强 唐秋莲 +5 位作者 卢同兴 陈玉芳 欧日英 余梅平 黄盛海 何雪明 《中国中医急症》 2024年第1期53-56,共4页
目的 观察自拟灌肠方灌肠辅助治疗对脓毒症胃肠功能障碍患者的临床疗效。方法 选取脓毒症胃肠功能障碍患者100例,随机分为两组各50例,均给予西医常规治疗。对照组加用0.9%氯化钠注射液灌肠,治疗组加用自拟灌肠方灌肠,疗程均为7 d。结果... 目的 观察自拟灌肠方灌肠辅助治疗对脓毒症胃肠功能障碍患者的临床疗效。方法 选取脓毒症胃肠功能障碍患者100例,随机分为两组各50例,均给予西医常规治疗。对照组加用0.9%氯化钠注射液灌肠,治疗组加用自拟灌肠方灌肠,疗程均为7 d。结果 治疗组总有效率明显高于对照组(P<0.05);治疗后,两组胃肠动力指标血清胃动素(MTL)均较前升高、活性肠肽(VIP)均较前降低(P<0.05);治疗后两组患者急性生理与慢性健康量表(APACHE Ⅱ)评分、肠黏膜屏障功能指标、炎性指标均较治疗前降低,治疗组治疗后各指标较对照组降低(P<0.05);治疗后,两组中医症状积分、胃肠功能障碍积分有所改善,且治疗组指标较对照组降低(P<0.05);治疗组多器官功能障碍综合征(MODS)发生率(18.00%)低于对照组(42.00%)(P<0.05);两组28 d病死率相当(P>0.05)。结论 运用自拟灌肠方辅助治疗方案,可改善脓毒症胃肠功能障碍患者胃肠症状,恢复胃肠功能,降低炎症因子水平,降低MODS发生率,改善患者预后。 展开更多
关键词 脓毒症 胃肠功能障碍 灌肠方 随机对照试验
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君承合剂治疗重症监护病房老年重症肺炎患者急性胃肠功能障碍的临床研究 被引量:1
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作者 林朝亮 朱红林 +2 位作者 成向进 李长青 陈福来 《中医药临床杂志》 2024年第4期737-740,共4页
目的:评价君承合剂治疗重症监护病房(ICU)老年重症肺炎患者急性胃肠功能障碍的临床疗效及安全性。方法:选取符合标准的患者50例,采用随机分组,分为治疗组和对照组,对照组常规治疗,观察组在常规治疗基础上分别加用君承合剂及莫沙比利,评... 目的:评价君承合剂治疗重症监护病房(ICU)老年重症肺炎患者急性胃肠功能障碍的临床疗效及安全性。方法:选取符合标准的患者50例,采用随机分组,分为治疗组和对照组,对照组常规治疗,观察组在常规治疗基础上分别加用君承合剂及莫沙比利,评价治疗前后2组患者胃肠功能障碍积分、临床肺部感染评分改善情况,以及临床疗效总体评定。结果:治疗组在临床总有效率、治疗前后胃肠功能障碍积分改善等方面优于对照组、具有统计学差异性(P<0.05)。2组患者治疗前后临床肺部感染评分改善都有统计学差异(P<0.05),2组对照比较无差异性(P>0.05)。结论:君承合剂治疗ICU老年重症肺炎患者急性胃肠功能障碍临床疗效优于对照组,且具有良好的安全性。 展开更多
关键词 重症监护病房(ICU) 急性胃肠功能障碍 中医药疗法
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调神健脾针刺法联合电针治疗腹泻型肠易激综合征的疗效观察及对肥大细胞活化的影响
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作者 占道伟 刘军 +5 位作者 徐颖梅 洪中华 李玲 沈志炜 罗开涛 孙建华 《上海针灸杂志》 CSCD 2024年第6期594-598,共5页
目的观察调神健脾针刺法联合电针治疗对腹泻型肠易激综合征(irritable bowel syndromediarrheal,IBS-D)的临床疗效及其对患者肠黏膜肥大细胞活化的影响。方法将60例IBS-D患者按随机数字表法分为药物组和观察组,每组30例。药物组予口服... 目的观察调神健脾针刺法联合电针治疗对腹泻型肠易激综合征(irritable bowel syndromediarrheal,IBS-D)的临床疗效及其对患者肠黏膜肥大细胞活化的影响。方法将60例IBS-D患者按随机数字表法分为药物组和观察组,每组30例。药物组予口服马来酸曲美布汀分散片治疗,观察组予调神健脾针刺法联合电针治疗。观察两组治疗前后肠易激综合征症状严重程度量表(irritable bowel syndrome-symptom severity scale,IBS-SSS)评分、肠易激综合征生活质量量表(irritable bowel syndrome-quality of Life,IBS-QOL)评分和医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)评分及肠黏膜肥大细胞(mast cells,MCs)活化程度的变化。比较两组临床疗效。结果观察组总有效率优于药物组(P<0.05)。治疗后,两组IBS-SSS和HADS评分均降低(P<0.05),且观察组均优于药物组(P<0.05)。治疗后,两组IBS-QOL评分均升高(P<0.05),且观察组高于药物组(P<0.05)。治疗后,两组MCs数量与脱颗粒比例均降低(P<0.05),且观察组优于药物组(P<0.05)。结论“调神健脾”针刺法联合电针治疗IBS-D的临床疗效优于单一口服药物治疗,可缓解腹痛等临床症状,提高生活质量,改善抑郁状态,降低MCs活化程度。 展开更多
关键词 针刺疗法 电针 肠易激综合征 腹泻 肥大细胞 胃肠功能紊乱
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老年胃肠道肿瘤患者术后胃肠功能紊乱情况调查及其影响因素
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作者 牛育慧 张亚杰 韩婧 《中华老年多器官疾病杂志》 2024年第5期346-349,共4页
目的 调查老年胃肠道肿瘤患者术后胃肠功能紊乱情况,并分析其影响因素。方法 回顾性分析长治医学院附属和济医院2020年5月至2023年5月收治的185例胃肠道肿瘤患者的临床资料,依据进食、恶心、呕吐、体检与症状持续时间(I-FEED)评分系统... 目的 调查老年胃肠道肿瘤患者术后胃肠功能紊乱情况,并分析其影响因素。方法 回顾性分析长治医学院附属和济医院2020年5月至2023年5月收治的185例胃肠道肿瘤患者的临床资料,依据进食、恶心、呕吐、体检与症状持续时间(I-FEED)评分系统评估患者胃肠功能,将I-FEED评分<6分的患者分为恢复组(n=105),I-FEED评分≥6分的患者分为延迟恢复组(n=80)。采用SPSS 20.0统计软件进行数据分析。按照数据类型,分别选择t检验、方差分析或χ^(2)检验行组间比较。采用多元logistic回归分析患者术后胃肠功能紊乱的影响因素。结果 185例患者I-FEED评分为(4.26±1.04)分,胃肠功能延迟恢复发生率为43.24%(80/185)。多元logistic回归分析结果显示,体质量指数(OR=1.868,95%CI 1.235~2.825)、术前白蛋白(OR=0.643,95%CI 0.455~0.908)、术中出血量(OR=1.680,95%CI 1.044~2.705)及腹腔积液(OR=1.449,95%CI 1.063~1.975)是影响患者术后胃肠功能恢复情况的相关因素(P<0.05)。结论 老年胃肠道肿瘤患者术后较易出现胃肠功能延迟恢复现象,体质量指数高、术前白蛋白低、术中大出血及腹腔积液患者为胃肠功能紊乱高危群体,需要进行针对性干预,以促进患者术后胃肠功能的迅速恢复。 展开更多
关键词 老年人 胃肠道肿瘤 手术 胃肠功能紊乱
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GIDS在老年AECOPD呼吸衰竭患者病情及预后评估中的应用
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作者 刘艳 王红梅 +4 位作者 卢晓丽 杨菊荣 赵娟 杨春波 付晓乐 《检验医学与临床》 CAS 2024年第16期2324-2327,2333,共5页
目的 探讨胃肠道功能障碍评分(GIDS)与老年慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭患者疾病严重程度的相关性及对预后的预测价值,为疾病严重程度和预后评估提供参考依据。方法 收集2020年1月至2023年8月于该院ICU治疗的264例老年AE... 目的 探讨胃肠道功能障碍评分(GIDS)与老年慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭患者疾病严重程度的相关性及对预后的预测价值,为疾病严重程度和预后评估提供参考依据。方法 收集2020年1月至2023年8月于该院ICU治疗的264例老年AECOPD呼吸衰竭患者作为研究对象。根据患者GIDS,将患者分为低GIDS组(0~1分)和高GIDS组(2~4分)。比较不同GIDS组患者急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和序贯器官衰竭评估(SOFA)评分,以及患者住院结局指标,包括机械通气时间、ICU入住时间和预后情况。采用Spearman相关分析GIDS与APACHEⅡ评分、SOFA评分的相关性。采用受试者工作特征(ROC)曲线分析GIDS对预后的预测价值。结果 264例老年AECOPD呼吸衰竭患者GIDS为2.00(1.00,3.00)分,其中0分53例(20.1%),1分65例(24.6%),2分53例(20.1%),3分45例(17.0%),4分48例(18.2%)。高GIDS组APACHEⅡ评分和SOFA评分高于低GIDS组(P<0.05)。Spearman相关性分析结果显示,GIDS与APACHEⅡ评分、SOFA评分均呈正相关(r=0.458、0.392,P<0.05)。高GIDS组机械通气时间、ICU入住时间长于低GIDS组,预后不良发生率高于低GIDS组,差异均有统计学意义(P<0.05)。ROC曲线结果显示,GIDS预测老年AECOPD呼吸衰竭患者预后不良的曲线下面积为0.823,灵敏度和特异度分别为93.4%和60.1%。结论 老年AECOPD呼吸衰竭患者GIDS与疾病严重程度密切相关,该评分对患者预后不良具有良好的预测价值。 展开更多
关键词 老年 慢阻肺急性加重期 呼吸衰竭 胃肠道功能障碍评分 疾病严重程度 预后
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伊尼妥单抗治疗人表皮生长因子受体2阳性转移性乳腺癌伴胃肠功能紊乱1例
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作者 朱莉丽 付马墨阳 +3 位作者 鲁磊 刘湘晨 尚宏清 王冰涛 《中国当代医药》 CAS 2024年第3期24-28,共5页
乳腺癌是女性常见的肿瘤,如今乳腺癌实体肿瘤通过相应的治疗可取得较好的疗效,但人表皮生长因子受体2(HER2)阳性乳腺癌侵袭性较强、恶性程度高,需引起患者及医务人员的重视。本文回顾性分析1例激素受体阴性、HER2阳性伴胃肠功能紊乱的... 乳腺癌是女性常见的肿瘤,如今乳腺癌实体肿瘤通过相应的治疗可取得较好的疗效,但人表皮生长因子受体2(HER2)阳性乳腺癌侵袭性较强、恶性程度高,需引起患者及医务人员的重视。本文回顾性分析1例激素受体阴性、HER2阳性伴胃肠功能紊乱的乳腺癌患者诊治经过。患者初诊为局部晚期炎症乳腺癌伴腋窝淋巴结转移,给予新辅助化疗及手术治疗。术后3年后病情进展,予以伊尼妥单抗联合白蛋白紫杉醇,后续伊尼妥单抗单独靶向治疗,病情持续缓解。提示对于HER2阳性晚期乳腺癌,伊尼妥单抗是个很好的单抗类药物选择。 展开更多
关键词 伊尼妥单抗 转移性乳腺癌 胃肠功能紊乱 人表皮生长因子受体2阳性
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中医药联合常规西药对脓毒症胃肠功能障碍疗效的Meta分析
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作者 刘茜 卢伟 +6 位作者 邵旭鹏 谢娜 陆佳敏 张铎 刘荣飞 于子洲 范开亮 《中国中医急症》 2024年第9期1512-1518,1541,共8页
目的采用Meta分析对中医药与常规西药联合治疗脓毒症胃肠功能障碍临床疗效和安全性进行评价。方法计算机检索CBM、VIP、WanFang、CNKI及PubMed数据库2020年1月1日至2024年5月1日中医药治疗脓毒症胃肠功能障碍的临床随机对照试验。依据... 目的采用Meta分析对中医药与常规西药联合治疗脓毒症胃肠功能障碍临床疗效和安全性进行评价。方法计算机检索CBM、VIP、WanFang、CNKI及PubMed数据库2020年1月1日至2024年5月1日中医药治疗脓毒症胃肠功能障碍的临床随机对照试验。依据纳入与排除标准,对文献仔细筛选,提取相应数据,采用RevMan5.4及Stata16.0对数据进行统计分析。结果36项研究共纳入3279例脓毒症胃肠功能障碍患者,其中观察组1644例,对照组1635例。研究结果提示:相对于单纯常规西药治疗而言,联合中药可显著提高治疗疗效。临床总有效率[OR=3.66,95%CI(2.87,4.67),Z=10.43,P<0.00001]、改善胃肠功能障碍评分[MD=-0.60,95%CI(-0.63,-0.56),Z=32.44,P<0.00001]、APACHEⅡ评分[MD=-3.90,95%CI(-4.10,-3.71),Z=40.02,P<0.00001];降低白细胞计数[MD=-2.20,95%CI(-2.33,-2.08),Z=35.38,P<0.00001]、C反应蛋白[MD=-18.56,95%CI(-18.86,-18.26),Z=122.56,P<0.00001]、降钙素[SMD=-1.60,95%CI(-1.76,-1.44),Z=19.11,P<0.00001];减轻28 d死亡率[OR=0.43,95%CI(0.26,0.72),Z=3.26,P=0.001];安全性良好。结论中医药与常规西药合用治疗脓毒症胃肠功能障碍患者疗效明显优于常规西药,安全性好。 展开更多
关键词 脓毒症 胃肠功能障碍 中西医结合 META分析 随机对照试验
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宣白承气汤治疗肺热腑实型重症肺炎合并胃肠功能障碍的临床研究
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作者 朱桂松 尹小芳 +3 位作者 诸虹 贾蓉 邹子萌 许飚 《南京中医药大学学报》 CAS CSCD 北大核心 2024年第8期831-837,共7页
目的探讨宣白承气汤对肺热腑实型重症肺炎合并胃肠功能障碍患者呼吸、氧合功能及血清水通道蛋白(AQP)1和AQP5表达水平的影响。方法60例肺热腑实型重症肺炎合并胃肠功能障碍患者随机分为对照组和试验组各30例。对照组采用西医常规治疗,... 目的探讨宣白承气汤对肺热腑实型重症肺炎合并胃肠功能障碍患者呼吸、氧合功能及血清水通道蛋白(AQP)1和AQP5表达水平的影响。方法60例肺热腑实型重症肺炎合并胃肠功能障碍患者随机分为对照组和试验组各30例。对照组采用西医常规治疗,试验组在对照组治疗基础上加服宣白承气汤,2组疗程均为7 d。比较治疗前后2组患者呼吸频率和氧合指数、机械通气使用率、临床疗效评分(CURB-65、CPIS量表)、中医证候积分、胃肠功能指标[腹内压、血清促胃液素(GAS)和血管活性肠肽(VIP)]、血清AQP1和AQP5水平,记录并比较2组患者治疗期间机械通气天数及ICU住院天数。结果治疗后,与对照组比较,试验组患者呼吸频率、中医证候积分、腹内压均显著下降(P<0.05,P<0.01),血清GAS、AQP1和AQP5水平及氧合指数显著提高(P<0.05,P<0.01)。结论宣白承气汤能显著改善患者的呼吸和氧合功能等临床症状,其机制可能与调控AQP1和AQP5有关。 展开更多
关键词 宣白承气汤 重症肺炎 胃肠功能障碍 肺热腑实型 氧合指数 水通道蛋白1 水通道蛋白5
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叩齿咽津法对腹腔镜胃癌根治术后患者实施早期肠内营养的效果观察
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作者 张敏 黄晓钰 +2 位作者 许可慧 吴蓉 吴丽红 《中国护理管理》 CSCD 北大核心 2024年第9期1298-1302,共5页
目的:观察叩齿咽津法对腹腔镜胃癌根治术后患者实施早期肠内营养的效果,为胃癌患者术后早期营养管理提供临床参考。方法:便利选取140例腹腔镜胃癌根治术患者为研究对象,随机分为对照组和实验组,两组各70例。对照组实施胃癌患者规范化围... 目的:观察叩齿咽津法对腹腔镜胃癌根治术后患者实施早期肠内营养的效果,为胃癌患者术后早期营养管理提供临床参考。方法:便利选取140例腹腔镜胃癌根治术患者为研究对象,随机分为对照组和实验组,两组各70例。对照组实施胃癌患者规范化围手术期护理及循序渐进式营养支持治疗,实验组在对照组的基础上加用叩齿咽津法。干预后评估患者术后首次排气时间、排便时间,术后肠内营养中断率、术后第2天及第7天肠内营养达标率、术后第7天口服能量达标率及血清前白蛋白水平。结果:干预后两组患者术后首次排气时间、排便时间,术后肠内营养中断率,术后第7天肠内营养达标率、口服能量达标率及血清前白蛋白水平比较差异有统计学意义(P<0.05)。结论:叩齿咽津法联合术后循序渐进式营养支持可以改善腹腔镜胃癌根治术后患者早期胃肠功能,促进术后早期肠内营养的有效实施,帮助患者更有效地过渡到口服营养补充。 展开更多
关键词 叩齿咽津 胃肠功能障碍 早期肠内营养
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厚朴三物汤调节脓毒症急性胃肠功能障碍的疗效观察
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作者 毛诗昊 智屹惠 +2 位作者 江荣林 冯丹丹 王希 《浙江临床医学》 2024年第1期51-53,共3页
目的探讨厚朴三物汤调节脓毒症急性胃肠功能障碍的疗效及对肠道微生态的影响。方法选择2022年2月至2023年2月脓毒症并发急性胃肠功能障碍患者60例。采用随机数表法分为2组。对照组予常规西医治疗,观察组在常规治疗基础上加用厚朴三物汤... 目的探讨厚朴三物汤调节脓毒症急性胃肠功能障碍的疗效及对肠道微生态的影响。方法选择2022年2月至2023年2月脓毒症并发急性胃肠功能障碍患者60例。采用随机数表法分为2组。对照组予常规西医治疗,观察组在常规治疗基础上加用厚朴三物汤治疗。留取患者入ICU治疗7 d后的粪便标本进行高通量16S rRNA基因测序分析。对比患者治疗前、治疗7 d后的炎症因子、肠道通透性因子及免疫屏障功能指标水平。结果观察组患者粪便中,厚壁菌门中兼性厌氧菌属的相对丰度较高,包括颗粒链球菌、孪生球菌属、肉杆菌科属及嗜血菌属等;对照组患者粪便中以厌氧厚壁菌门菌属为主,包括梭菌属、月形单胞菌属、韦荣球菌属及厌氧棍状菌属,其肠道菌群的丰富度和多样性明显低于观察组。治疗7 d后,两组患者血清TNF-α、hs-CRP、WBC、IL-6指标水平均降低,且观察组血清TNF-α、hs-CRP、WBC、IL-6指标比对照组低(P<0.05);两组患者肠道通透性因子DAO、D-乳酸指标水平低于治疗前,观察组DAO、D-乳酸指标比对照组低(P<0.05);两组患者肠道免疫屏障功能IgA、IgM、IgG指标较治疗前升高,观察组IgA、IgM、IgG指标高于对照组(P<0.05)。结论厚朴三物汤可以有效改善脓毒症急性胃肠功能障碍患者的肠道微生态,降低炎症反应,进而提高肠道免疫屏障功能,有利改善患者预后康复质量。 展开更多
关键词 肠道微生态 厚朴三物汤 脓毒症 急性胃肠功能障 肠道通透性 肠道免疫屏障
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针灸治疗剖宫产术后胃肠功能障碍临床研究进展
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作者 王鹏 韦珏春 +1 位作者 黄梅艳 贾树山 《中医临床研究》 2024年第6期113-118,共6页
由于麻醉、手术创伤等诸多因素影响,胃肠功能障碍是剖宫产术后最常见的并发症之一,剖宫产术后胃肠功能障碍对于产妇的早期康复及新生儿均有一定不利影响,因此,及早胃肠功能恢复就显得尤为重要。笔者阅读近年来有关将中医药技术应用于围... 由于麻醉、手术创伤等诸多因素影响,胃肠功能障碍是剖宫产术后最常见的并发症之一,剖宫产术后胃肠功能障碍对于产妇的早期康复及新生儿均有一定不利影响,因此,及早胃肠功能恢复就显得尤为重要。笔者阅读近年来有关将中医药技术应用于围手术期治疗剖宫产术后胃肠功能障碍的文献,发现针灸作为主要的治疗方法显示出一定疗效,且未发现明显不良反应。针灸治疗方式多种多样,既能和西医联合应用,也可与中医药技术合并应用。目前主要的针灸方法包括体穴治疗(针刺疗法、电针疗法、经皮穴位电刺激、穴位敷贴、穴位按摩、穴位注射、穴位埋线、艾灸疗法等)、耳穴治疗(耳穴压豆、耳针疗法等)或多种方法联合应用,各种方式均有其独特优势。同时笔者发现,足三里穴具有疏通经络、调理气血、恢复脏腑功能及调和阴阳之功效,可促进术后胃肠功能恢复,因此在针灸治疗选取穴位时多以足三里穴为主或联合其他穴位,且针灸在治疗剖宫产术后胃肠功能障碍方面具有操作简便、不良反应小、安全性高等特点,在本领域显示出广阔的应用前景。文章就针灸疗法治疗剖宫产术后胃肠功能障碍的临床研究作一综述。 展开更多
关键词 针灸 体穴 耳穴 剖宫产 胃肠功能障碍
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