Objective To study the relationship between autonomic nerve preservation and sexual and urinary functions after total mesorectal excision in patients with cancer of the lower rectum, and to explore improved nursing methods for these patients. Methods Eligible patients with cancer of the lower rectum were non-randomly assigned to either a control group (n=278)or an autonomic nerve-preserving group （n=263）. The recovery time of micturition desire, catherization time, lower urinary tract infection rate, residual urine, severity of urinary disorders and sexual disorders were observed. Results The recovery time of micturition desire, catherization time, lower urinary tract infection rate, residual urine, severity of urinary disorders and sexual disorders were lower in the autonomic nerve-preserving group than in the control group. (Plt;0.05) . Conclusion Autonomic nerve preservation radical resection leads to better maintenance of urinary and sexual functions for patients with cancer of the lower rectum. Nursing should be focused on the prevention of urinary tract complications and the rehabilitation of sexual and urinary functions.
目的 調查胃腸道疾病患者圍手術期的疼痛狀況，為建立無痛病房，優化醫療和護理服務提供依據。 方法 對2011年12月5日－2012年1月14日胃腸外科所有的新住院患者共227例，采用《四川大學華西醫院住院病人疼痛現狀調查問卷》進行調查，并同期調查胃腸外科27名主管醫師對疼痛藥物了解狀況。 結果 有明確行為能力的216例患者完成調查問卷，其中有195例（90.28%）接受手術治療，全身麻醉患者193例（占手術患者98.97%），診斷為胃腸道腫瘤163例（占手術人數的83.59%），手術等級為三級146例（占手術人數的74.87%）。有168例（86.15%）患者術后鎮痛，在術后鎮痛過程中使用鎮痛泵156例（92.86%），其中75例（48.08%）認為鎮痛泵鎮痛“基本有效”，30例（19.23%）認為“無效”。39例術后未使用鎮痛泵，其中20例（51.28%）認為“未使用術后鎮痛泵”最主要原因為“不了解鎮痛泵”。受調查的主管醫師了解的疼痛藥物僅占羅列藥物52種的（20 ± 5.36）種。 結論 疼痛現象在胃腸道疾病圍手術期患者中屬普遍現象，由于不斷增強鎮痛意識和鎮痛需求與相關知識缺乏的矛盾存在，及較少的醫療護理干預，導致鎮痛效果不佳，影響了疼痛管理長效機制的建立和無痛病房的建設。
【摘要】 目的 調查胃癌患者的營養風險及營養支持應用現狀。 方法 2009年9月-2010年1月，對某三甲醫院普外科收治的120例胃癌住院患者營養情況進行營養風險篩查2002（nutritional risk screening 2002，NRS 2002）評估，并就營養支持應用方式進行分析。 結果 所有患者中營養不足和營養風險的發生率分別為11.7%和27.5%；在33例有營養風險患者中，有26例（78.8％）接受了營養支持；在無營養風險的87例患者中，有30例（34.5％）接受了營養支持。 結論 對有營養風險的患者進行必要的營養支持，對于減少患者住院期間感染性并發癥或其他不良臨床結局的發生有積極作用。NRS 2002的方法簡便，適用于胃癌患者的營養風險篩查，但醫護人員需要進一步加強對腸外、腸內營養指南的認識。【Abstract】 Objective To investigate the clinical situation of nutritional risk screening for hospitalized patients with gastric cancer. Methods From September 2009 to January 2010, we applied nutrition risk screening 2002 (NRS 2002) to investigate the nutritional status of 120 hospitalized gastric cancer patients in the surgery department of a tertiary hospital, and analyzed the way of nutritional support for these patients. Results Among all the patients, the incidences of undernutrtion and nutritional risk were respectively 11.7% and 27.5%. Twenty-six out of the 33 nutritional risk patients received nutrition support, and 30 out of the 87 patients without nutritional risk received nutrition support. Conclusions Nutritional support for patients with nutritional risk is important in decreasing the occurrence of in-hospital infectious complications and other bad clinical outcomes. NRS 2002 is a simple and easy tool for predicting the nutrition risk in hospitalized gastric cancer patients, but the guideline of enteral nutrition and parenteral nutrition must be reinforced among doctors and nurses.
Objective To investigate the relevance among sarcopenia, peripheral inflammatory, and nutritional factors, as well as the impact of sarcopenia on the prognosis of gastric cancer. Methods A total of 174 patients with gastric cancer in Department of Gastrointestinal Surgery in West China Hospital of Sichuan University from July 2016 to December 2020 were retrospectively included. The skeletal muscle index (SMI) of the third lumbar vertebra level was calculated using CT images, and male patients with SMI<52.4 cm2/m2 and female patients with SMI<38.5 cm2/m2 were considered sarcopenia. The key clinicopathological features of patients were collected for prognostic analysis. ResultsAmong the 174 patients with gastric cancer, 73 patients (41.95%) were diagnosed with sarcopenia. Compared with those of non-sarcopenia, the patients who were diagnosed with sarcopenia showed a significantly elder age and lower body mass index (BMI). In addition, males demonstrated a significantly higher rate of sarcopenia. Further, patients with sarcopenia showed a significant increasing in the incidence of postoperative pulmonary infections and length of hospitalization than patients without sarcopenia. The two groups showed significant differences in type 2 diabetes, peripheral C-reaction protein (CRP), interleukin-6 (IL-6), albumin, prealbumin, and hemoglobin. Overall, the multivariate analysis and Kaplan-Meier survival curves indicated that sarcopenic patients had a significantly lower survival rate than the non-sarcopenia patients. Conclusion Sarcopenia is closely related to higher levels of inflammation, malnutrition, and poor prognosis in patients with gastric cancer. Therefore, we should diagnose sarcopenia patients as early as possible, and give nutritional support to the patients.