BACKGROUND Breastfeeding not only meets the nutritional needs of newborn growth and development but also promotes uterine contraction and discharge of lochia,which helps in maternal recovery.However,some mothers exper...BACKGROUND Breastfeeding not only meets the nutritional needs of newborn growth and development but also promotes uterine contraction and discharge of lochia,which helps in maternal recovery.However,some mothers experience abnormal lactation and breast swelling due to a lack of breastfeeding knowledge,painful cesarean incisions,anesthesia,negative emotions,and other factors,resulting in a reduced breastfeeding rate,which adversely affects neonatal and maternal health.AIM To explore the effects of care intervention with a health education form for breastfeeding on breastfeeding-related conditions.METHODS In this study,207 mothers with postpartum breast pain and difficulty lactating were selected and divided into intervention and control groups using a random number table.Both groups of mothers were provided with basic nursing and related treatment measures after delivery.The intervention group additionally received care intervention with a health education form for breastfeeding.The scores of lactation volume,breast distension and pain,breastfeeding rate,breastfeeding self-efficacy,treatment effect,and complication rate of the two groups were compared.RESULTS After treatment,the breast pain score of the intervention group was significantly lower than that of the control group,while the lactation score,score of Breastfeeding Self-Efficacy Scale Short Form scale,parent-child communication score,maternal-infant interaction score,total score of maternal-infant communication,and breastfeeding rate of the intervention group were significantly higher than those of the control group.After intervention,the overall therapeutic effect of the intervention group was better than that of the control group,and the complication rate of the intervention group was lower than that of the control group.CONCLUSION Breastfeeding health education and nursing intervention combined with basic clinical treatment have good clinical effects in managing postpartum breast distension and pain and increasing lactation yield.展开更多
Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Metho...Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.展开更多
AIM: To establish a visceral pain model via colorectal distension (CRD) and to evaluate the efficiency of behavioral responses of CRD by measuring the score of abdominal withdrawal reflex (AWR) in rats. METHODS:...AIM: To establish a visceral pain model via colorectal distension (CRD) and to evaluate the efficiency of behavioral responses of CRD by measuring the score of abdominal withdrawal reflex (AWR) in rats. METHODS: Thirty-eight male SD rats weighing 180-240g were used to establish the visceral pain model. The rat was inserted intra-anally with a 7 cm long flexible latex balloon under ether anesthesia, and colorectal distensions by inflating the balloon with air were made 30 min after recovering from the anesthesia. Five AWR scores (AWR0 to AWR4) were used to assess the intensity of noxious visceral stimuli. It was regarded as the threshold of the minimal pressure (kPa). For abdominal flatting was induced by colorectal distension. RESULTS: A vigorous AWR to distension of the descending colon and rectum was found in 100% of the awake rats tested. The higher the pressure of distension, the higher the score of AWR. The distension pressures of 0, 2.00, 3.33, 5.33 and 8.00 kPa produced different AWR scores (P〈0.05). The pain threshold of AWR was constant for up to 80 min after the initial windup (first 1-3 distensions), the mean threshold was 3.69±0.35 kPa. Systemic administration of morphine sulfate elevated the threshold of visceral pain in a dosedependent and naloxone reversible manner. CONCLUSION: Scoring the AWR during colorectal distensions can assess the intensity of noxious visceral stimulus. Flatting of abdomen (AWR 3) to CRD as the visceral pain threshold is clear, constant and reliable. This pain model and its behavioral assessment are good for research on visceral pain and analgesics.展开更多
AIM: To investigate in patients with functional dyspepsia (FD) after an every-day meal whether (1) gastrointestinal (GI) and extra-GI symptoms had any relation with the degree of antral volume, (2) the onset of postpr...AIM: To investigate in patients with functional dyspepsia (FD) after an every-day meal whether (1) gastrointestinal (GI) and extra-GI symptoms had any relation with the degree of antral volume, (2) the onset of postprandial symptoms was associated with, and may predict, delayed gastric emptying. METHODS: In 94 symptomatic FD patients, antral volume variations and gastric emptying were assessed with ultrasonography after a 1050 kcal meal. Symptoms were evaluated with a standardized questionnaire. The association of GI and extra-GI symptoms with antral volumes and gastric emptying were estimated with logistic regression analysis. RESULTS: Forty percent of patients did not report any symptoms after a meal. Compared to the healthy controls, the antrum was more distended in patients throughout the entire observation period and 37 (39.4%) patients had delayed gastric emptying. Only postprandial drowsiness was associated with antral volume variations (AOR = 1.42; P < 0.001) and with delayed gastric emptying (AOR = 3.59; P < 0.03). CONCLUSION: In FD patients, GI symptoms are neither associated with antral distension nor with gastric emptying. Drowsiness is associated with antral distension and delayed gastric emptying. The onset of drowsiness is preceded by an increment of antral distension and the duration of the symptom appears to be related to the persistence of antral distension.展开更多
AIM:To evaluate the inhibitory effects of carbon dioxide (CO2) insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy (PEG).METHODS:A total of 73 consecutive patients who were ...AIM:To evaluate the inhibitory effects of carbon dioxide (CO2) insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy (PEG).METHODS:A total of 73 consecutive patients who were undergoing PEG were enrolled in our study.After eliminating 13 patients who fitted our exclusion criteria,60 patients were randomly assigned to either CO2 (30 patients) or air insufflation (30 patients) groups.PEG was performed by pull-through technique after threepoint fixation of the gastric wall to the abdominal wall using a gastropexy device.Arterial blood gas analysis was performed immediately before and after the procedure.Abdominal X-ray was performed at 10 min and at 24 h after PEG to assess the extent of bowel distension.Abdominal computed tomography was performed at 24 h after the procedure to detect the presence of pneumoperitoneum.The outcomes of PEG for 7 d postprocedure were also investigated.RESULTS:Among 30 patients each for the air and the CO2 groups,PEG could not be conducted in 2 patients of the CO2 group,thus they were excluded.Analyses of the remaining 58 patients showed that the patients' backgrounds were not significantly different between the two groups.The elevation values of arterial partial pressure of CO2 in the air group and the CO2 group were 2.67 mmHg and 3.32 mmHg,respectively (P = 0.408).The evaluation of bowel distension on abdominal X ray revealed a significant decrease of small bowel distension in the CO2 group compared to the air group (P < 0.001) at 10 min and 24 h after PEG,whereas there was no significant difference in large bowel distension between the two groups.Pneumoperitoneum was observed only in the air group but not in the CO2 group (P = 0.003).There were no obvious differences in the laboratory data and clinical outcomes after PEG between the two groups.CONCLUSION:There was no adverse event associated with CO2 insufflation.CO2 insufflation is considered to be safer and more comfortable for PEG patients because of the lower incidence of pneumoperitoneum and less distension of the small bowel.展开更多
Objective:To explore the effect of auricular point pressing combined with thunder-fire moxibustion in the treatment of abdominal distension and constipation after thoracic compression fracture.Methods:Totally 100 pati...Objective:To explore the effect of auricular point pressing combined with thunder-fire moxibustion in the treatment of abdominal distension and constipation after thoracic compression fracture.Methods:Totally 100 patients were randomly divided into 4 groups,the observation group 1(n=25)which were treated with conventional nursing combined with auricular piont pressing,observation group 2(n=25)treated with conventional nursing combined with thunder-fire moxibustion,observation group 3(n=25)treated with conventional nursing combined with auricular point pressing and thunder-fire moxibustion,and the control group(n=25)which adopted conventional nursing.First exhaust and defecation time after fracture in 4 groups were observed and compared.Results:The effect of observation group 3 was better than that of observation group 2,observation group 1 and control group(P<0.05).Conclusion:It is obvious that auricular point pressing combined with thunder-fire moxibustion has better result in treating abdominal distension and constipation after thoracic compression fracture.展开更多
Objective:To explore the application value of moxibustion and acupoint application in the treatment of postoperative abdominal distention in patients undergoing gynecological surgery.Methods:Seventy-two patients who u...Objective:To explore the application value of moxibustion and acupoint application in the treatment of postoperative abdominal distention in patients undergoing gynecological surgery.Methods:Seventy-two patients who underwent gynecological surgery in our hospital from May 2020 to May 2021 were randomly divided into two groups.Group A was treated with moxibustion and acupoint application,and group B was treated with routine treatment.The incidence of postoperative abdominal distention,therapeutic effect of abdominal distention,defecation time,exhaust time,recovery time of bowel sounds and the changes of patients’quality of life were analyzed.Results:The incidence of abdominal distension in group A was 22.22%,which was lower than 41.47%in group B(P<0.05).The therapeutic effect of abdominal distension in group A was 87.50%,which was higher than 66.67%in group B(P<0.05).The recovery time of first defecation,first exhaust and bowel sound in group A was shorter than that in group B(P<0.05).All postoperative quality of life scores of group A were higher than that of group B(P<0.05).Conclusion:On the basis of routine postoperative intervention,moxibustion and acupoint application can reduce the risk of postoperative abdominal distention,reduce the degree of abdominal distention,promote the recovery of intestinal function,shorten the first postoperative exhaust and defecation time,and then improve the quality of life of patients.展开更多
To assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP).METHODSSystematic search and r...To assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP).METHODSSystematic search and review of articles in Medline and Embase pertaining to the use of FLIP in the esophagus was conducted in accordance with the PRISMA guidelines. Cross-sectional area and distensibility at the esophagogastric junction (EGJ) were abstracted for normal subjects, achalasia, and gastroesophageal reflux disease (GERD) patients, stratified by balloon length and volume of inflation.RESULTSSix achalasia studies (n = 154), 3 GERD (n = 52), and 5 studies including healthy controls (n = 98) were included in the systematic review. Normative data varied widely amongst studies of healthy volunteers. In contrast, studies in achalasia patients uniformly demonstrated low point estimates in distensibility ≤ 1.6 mm<sup>2</sup>/mmHg prior to treatment that increased to ≥ 3.4 mm<sup>2</sup>/mmHg following treatment at 40mL bag volume. In GERD patients, distensibility fell to the range of untreated achalasia (≤ 2.85 mm<sup>2</sup>/mmHg) following fundoplication.CONCLUSIONFLIP may be a useful tool in assessment of treatment efficacy in achalasia. The drastic drop in EGJ distensibility after fundoplication suggests that FLIP measurements need to be interpreted in the context of esophageal body motility and highlights the importance of pre-operative screening for dysmotility. Future studies using standardized FLIP protocol and balloon size are needed.展开更多
The effects of angiotensinⅡreceptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed.The ascending aortic distensibility in 26 patients(48±...The effects of angiotensinⅡreceptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed.The ascending aortic distensibility in 26 patients(48±3 years)with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan(50 mg/day)was evaluated by using two-dimensional echocardiography.M-mode measurements of aortic systolic(D_(s))anD_(d)iastolic diameter(D_(d))were taken at a level approximately 3 cm above the aortic valve.Simultaneously,cuff brachial artery systolic(SBP)anD_(d)iastolic(DBP)pressures were measured.Aortic pressure-strain elastic modulus(E p)was calculated as D_(d)×(SBP-DBP)/(D_(s)-D_(d))×1333 and stiffness index beta(β)was defined as D_(d)×Ln(SBP/DBP)/(D_(s)-D_(d)).Blood pressure significantly decreased from 148±13/95±9 mmHg to 138±12/88±8 mmHg(systolic blood pressure,P=0.001;diastolic blood pressure,P=0.003).There was no significant difference in pulse pressure before and after treatment with losartan(53±10 mmHg vs 50±7 mmHg).The distensibility of ascending aorta increaseD_(s)ignificantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42±5.79×10^(6)dynes/cm^(2)to 1.99±1.49×10^(6)dynes/cm^(2)(P=0.02)anD_(s)tiffness index beta from^(2)7.4±32.9 to 13.3±9.9(P=0.02).Although there was a weak correlation between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in diastolic blood pressure after losartan treatment(r=0.40,P=0.04 and r=0.55,P=0.004,respectively),no correlation was found between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in systolic blood pressure(r=0.04,P=0.8 and r=0.24,P=0.2,respectively).Our study demonstrated that angiotensinⅡreceptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential hypertension and this effect is partly independent of blood pressure reduction.展开更多
Purpose: During catheter angiogram (CA) there is momentary increase in intravascular volume and pressure due to intra-arterial injection that can potentially cause vascular distention at the stenotic site, whereas on ...Purpose: During catheter angiogram (CA) there is momentary increase in intravascular volume and pressure due to intra-arterial injection that can potentially cause vascular distention at the stenotic site, whereas on CT angiogram (CTA) is unlikely due to intravenous administration. Methods: CA and CTA of the carotid artery from 29 patients were retrospectively studied. CA and CTA were obtained for each patient. Curved sagittal MPRs mirroring the carotid artery on CA were used to measure the diameter at stenosis and at the distal lumen. Mural plaque calcium content was graded on axial CTAs. Results: Accounting for repeated measurements, the likelihood that the lumen diameter from CA will be larger than CTA was higher at stenosis than distal to it but the difference in lumen diameters at stenosis was similar to CTA. There is insufficient evidence that intra-arterial hand-injection during CA leads to underestimation of the degree of stenosis. Percentage stenosis using the NASCET criteria differed between the 3 measurements, post hoc analysis showed significant difference between CA and axial CTA (p p > 0.99). The difference in lumen diameter did not depend on our calcium grading (p = 0.484). Conclusions: There is insufficient evidence to suggest that intra-arterial hand-injection contributes to vessel distention and underestimation of percent stenosis during CA in this study. Mural plaque calcium does not affect the degree of stenosis on CTA.展开更多
文摘BACKGROUND Breastfeeding not only meets the nutritional needs of newborn growth and development but also promotes uterine contraction and discharge of lochia,which helps in maternal recovery.However,some mothers experience abnormal lactation and breast swelling due to a lack of breastfeeding knowledge,painful cesarean incisions,anesthesia,negative emotions,and other factors,resulting in a reduced breastfeeding rate,which adversely affects neonatal and maternal health.AIM To explore the effects of care intervention with a health education form for breastfeeding on breastfeeding-related conditions.METHODS In this study,207 mothers with postpartum breast pain and difficulty lactating were selected and divided into intervention and control groups using a random number table.Both groups of mothers were provided with basic nursing and related treatment measures after delivery.The intervention group additionally received care intervention with a health education form for breastfeeding.The scores of lactation volume,breast distension and pain,breastfeeding rate,breastfeeding self-efficacy,treatment effect,and complication rate of the two groups were compared.RESULTS After treatment,the breast pain score of the intervention group was significantly lower than that of the control group,while the lactation score,score of Breastfeeding Self-Efficacy Scale Short Form scale,parent-child communication score,maternal-infant interaction score,total score of maternal-infant communication,and breastfeeding rate of the intervention group were significantly higher than those of the control group.After intervention,the overall therapeutic effect of the intervention group was better than that of the control group,and the complication rate of the intervention group was lower than that of the control group.CONCLUSION Breastfeeding health education and nursing intervention combined with basic clinical treatment have good clinical effects in managing postpartum breast distension and pain and increasing lactation yield.
文摘Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.
基金Supported by Natural Science Foundation of Jiangsu Province,NO.BK2005033Medical Foundation of Department of Health,Jiangsu Province, No. H200325+1 种基金Natural Science Foundation of Department of Education, Jiangsu Province, No. 04kJB320127Medical Foundation of Department of Health, Zhejiang Province, No. 2004A084
文摘AIM: To establish a visceral pain model via colorectal distension (CRD) and to evaluate the efficiency of behavioral responses of CRD by measuring the score of abdominal withdrawal reflex (AWR) in rats. METHODS: Thirty-eight male SD rats weighing 180-240g were used to establish the visceral pain model. The rat was inserted intra-anally with a 7 cm long flexible latex balloon under ether anesthesia, and colorectal distensions by inflating the balloon with air were made 30 min after recovering from the anesthesia. Five AWR scores (AWR0 to AWR4) were used to assess the intensity of noxious visceral stimuli. It was regarded as the threshold of the minimal pressure (kPa). For abdominal flatting was induced by colorectal distension. RESULTS: A vigorous AWR to distension of the descending colon and rectum was found in 100% of the awake rats tested. The higher the pressure of distension, the higher the score of AWR. The distension pressures of 0, 2.00, 3.33, 5.33 and 8.00 kPa produced different AWR scores (P〈0.05). The pain threshold of AWR was constant for up to 80 min after the initial windup (first 1-3 distensions), the mean threshold was 3.69±0.35 kPa. Systemic administration of morphine sulfate elevated the threshold of visceral pain in a dosedependent and naloxone reversible manner. CONCLUSION: Scoring the AWR during colorectal distensions can assess the intensity of noxious visceral stimulus. Flatting of abdomen (AWR 3) to CRD as the visceral pain threshold is clear, constant and reliable. This pain model and its behavioral assessment are good for research on visceral pain and analgesics.
文摘AIM: To investigate in patients with functional dyspepsia (FD) after an every-day meal whether (1) gastrointestinal (GI) and extra-GI symptoms had any relation with the degree of antral volume, (2) the onset of postprandial symptoms was associated with, and may predict, delayed gastric emptying. METHODS: In 94 symptomatic FD patients, antral volume variations and gastric emptying were assessed with ultrasonography after a 1050 kcal meal. Symptoms were evaluated with a standardized questionnaire. The association of GI and extra-GI symptoms with antral volumes and gastric emptying were estimated with logistic regression analysis. RESULTS: Forty percent of patients did not report any symptoms after a meal. Compared to the healthy controls, the antrum was more distended in patients throughout the entire observation period and 37 (39.4%) patients had delayed gastric emptying. Only postprandial drowsiness was associated with antral volume variations (AOR = 1.42; P < 0.001) and with delayed gastric emptying (AOR = 3.59; P < 0.03). CONCLUSION: In FD patients, GI symptoms are neither associated with antral distension nor with gastric emptying. Drowsiness is associated with antral distension and delayed gastric emptying. The onset of drowsiness is preceded by an increment of antral distension and the duration of the symptom appears to be related to the persistence of antral distension.
文摘AIM:To evaluate the inhibitory effects of carbon dioxide (CO2) insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy (PEG).METHODS:A total of 73 consecutive patients who were undergoing PEG were enrolled in our study.After eliminating 13 patients who fitted our exclusion criteria,60 patients were randomly assigned to either CO2 (30 patients) or air insufflation (30 patients) groups.PEG was performed by pull-through technique after threepoint fixation of the gastric wall to the abdominal wall using a gastropexy device.Arterial blood gas analysis was performed immediately before and after the procedure.Abdominal X-ray was performed at 10 min and at 24 h after PEG to assess the extent of bowel distension.Abdominal computed tomography was performed at 24 h after the procedure to detect the presence of pneumoperitoneum.The outcomes of PEG for 7 d postprocedure were also investigated.RESULTS:Among 30 patients each for the air and the CO2 groups,PEG could not be conducted in 2 patients of the CO2 group,thus they were excluded.Analyses of the remaining 58 patients showed that the patients' backgrounds were not significantly different between the two groups.The elevation values of arterial partial pressure of CO2 in the air group and the CO2 group were 2.67 mmHg and 3.32 mmHg,respectively (P = 0.408).The evaluation of bowel distension on abdominal X ray revealed a significant decrease of small bowel distension in the CO2 group compared to the air group (P < 0.001) at 10 min and 24 h after PEG,whereas there was no significant difference in large bowel distension between the two groups.Pneumoperitoneum was observed only in the air group but not in the CO2 group (P = 0.003).There were no obvious differences in the laboratory data and clinical outcomes after PEG between the two groups.CONCLUSION:There was no adverse event associated with CO2 insufflation.CO2 insufflation is considered to be safer and more comfortable for PEG patients because of the lower incidence of pneumoperitoneum and less distension of the small bowel.
文摘Objective:To explore the effect of auricular point pressing combined with thunder-fire moxibustion in the treatment of abdominal distension and constipation after thoracic compression fracture.Methods:Totally 100 patients were randomly divided into 4 groups,the observation group 1(n=25)which were treated with conventional nursing combined with auricular piont pressing,observation group 2(n=25)treated with conventional nursing combined with thunder-fire moxibustion,observation group 3(n=25)treated with conventional nursing combined with auricular point pressing and thunder-fire moxibustion,and the control group(n=25)which adopted conventional nursing.First exhaust and defecation time after fracture in 4 groups were observed and compared.Results:The effect of observation group 3 was better than that of observation group 2,observation group 1 and control group(P<0.05).Conclusion:It is obvious that auricular point pressing combined with thunder-fire moxibustion has better result in treating abdominal distension and constipation after thoracic compression fracture.
文摘Objective:To explore the application value of moxibustion and acupoint application in the treatment of postoperative abdominal distention in patients undergoing gynecological surgery.Methods:Seventy-two patients who underwent gynecological surgery in our hospital from May 2020 to May 2021 were randomly divided into two groups.Group A was treated with moxibustion and acupoint application,and group B was treated with routine treatment.The incidence of postoperative abdominal distention,therapeutic effect of abdominal distention,defecation time,exhaust time,recovery time of bowel sounds and the changes of patients’quality of life were analyzed.Results:The incidence of abdominal distension in group A was 22.22%,which was lower than 41.47%in group B(P<0.05).The therapeutic effect of abdominal distension in group A was 87.50%,which was higher than 66.67%in group B(P<0.05).The recovery time of first defecation,first exhaust and bowel sound in group A was shorter than that in group B(P<0.05).All postoperative quality of life scores of group A were higher than that of group B(P<0.05).Conclusion:On the basis of routine postoperative intervention,moxibustion and acupoint application can reduce the risk of postoperative abdominal distention,reduce the degree of abdominal distention,promote the recovery of intestinal function,shorten the first postoperative exhaust and defecation time,and then improve the quality of life of patients.
文摘To assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP).METHODSSystematic search and review of articles in Medline and Embase pertaining to the use of FLIP in the esophagus was conducted in accordance with the PRISMA guidelines. Cross-sectional area and distensibility at the esophagogastric junction (EGJ) were abstracted for normal subjects, achalasia, and gastroesophageal reflux disease (GERD) patients, stratified by balloon length and volume of inflation.RESULTSSix achalasia studies (n = 154), 3 GERD (n = 52), and 5 studies including healthy controls (n = 98) were included in the systematic review. Normative data varied widely amongst studies of healthy volunteers. In contrast, studies in achalasia patients uniformly demonstrated low point estimates in distensibility ≤ 1.6 mm<sup>2</sup>/mmHg prior to treatment that increased to ≥ 3.4 mm<sup>2</sup>/mmHg following treatment at 40mL bag volume. In GERD patients, distensibility fell to the range of untreated achalasia (≤ 2.85 mm<sup>2</sup>/mmHg) following fundoplication.CONCLUSIONFLIP may be a useful tool in assessment of treatment efficacy in achalasia. The drastic drop in EGJ distensibility after fundoplication suggests that FLIP measurements need to be interpreted in the context of esophageal body motility and highlights the importance of pre-operative screening for dysmotility. Future studies using standardized FLIP protocol and balloon size are needed.
文摘The effects of angiotensinⅡreceptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed.The ascending aortic distensibility in 26 patients(48±3 years)with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan(50 mg/day)was evaluated by using two-dimensional echocardiography.M-mode measurements of aortic systolic(D_(s))anD_(d)iastolic diameter(D_(d))were taken at a level approximately 3 cm above the aortic valve.Simultaneously,cuff brachial artery systolic(SBP)anD_(d)iastolic(DBP)pressures were measured.Aortic pressure-strain elastic modulus(E p)was calculated as D_(d)×(SBP-DBP)/(D_(s)-D_(d))×1333 and stiffness index beta(β)was defined as D_(d)×Ln(SBP/DBP)/(D_(s)-D_(d)).Blood pressure significantly decreased from 148±13/95±9 mmHg to 138±12/88±8 mmHg(systolic blood pressure,P=0.001;diastolic blood pressure,P=0.003).There was no significant difference in pulse pressure before and after treatment with losartan(53±10 mmHg vs 50±7 mmHg).The distensibility of ascending aorta increaseD_(s)ignificantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42±5.79×10^(6)dynes/cm^(2)to 1.99±1.49×10^(6)dynes/cm^(2)(P=0.02)anD_(s)tiffness index beta from^(2)7.4±32.9 to 13.3±9.9(P=0.02).Although there was a weak correlation between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in diastolic blood pressure after losartan treatment(r=0.40,P=0.04 and r=0.55,P=0.004,respectively),no correlation was found between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in systolic blood pressure(r=0.04,P=0.8 and r=0.24,P=0.2,respectively).Our study demonstrated that angiotensinⅡreceptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential hypertension and this effect is partly independent of blood pressure reduction.
文摘Purpose: During catheter angiogram (CA) there is momentary increase in intravascular volume and pressure due to intra-arterial injection that can potentially cause vascular distention at the stenotic site, whereas on CT angiogram (CTA) is unlikely due to intravenous administration. Methods: CA and CTA of the carotid artery from 29 patients were retrospectively studied. CA and CTA were obtained for each patient. Curved sagittal MPRs mirroring the carotid artery on CA were used to measure the diameter at stenosis and at the distal lumen. Mural plaque calcium content was graded on axial CTAs. Results: Accounting for repeated measurements, the likelihood that the lumen diameter from CA will be larger than CTA was higher at stenosis than distal to it but the difference in lumen diameters at stenosis was similar to CTA. There is insufficient evidence that intra-arterial hand-injection during CA leads to underestimation of the degree of stenosis. Percentage stenosis using the NASCET criteria differed between the 3 measurements, post hoc analysis showed significant difference between CA and axial CTA (p p > 0.99). The difference in lumen diameter did not depend on our calcium grading (p = 0.484). Conclusions: There is insufficient evidence to suggest that intra-arterial hand-injection contributes to vessel distention and underestimation of percent stenosis during CA in this study. Mural plaque calcium does not affect the degree of stenosis on CTA.