Incidence Of Abdominal Distension Research Articles

Effects of remimazolam tosilate on gastrointestinal hormones and gastrointestinal motility in patients undergoing gastrointestinal endoscopy with sedation: a randomized control trial.

To investigate the impacts of remimazolam tosilate on gastrointestinal hormones and motility in patients undergoing gastrointestinal endoscopy with sedation. A total of 262 American Society of Anesthesiologists Physical Status I or II patients, aged 18-65years, scheduled for gastrointestinal endoscopy with sedation, were randomly allocated into two groups (n = 131 each): the remimazolam tosilate group (Group R) and the propofol group (Group P). Patients in Group R received 0.2-0.25mg/Kg remimazolam tosilate intravenously, while those in Group P received 1.5-2.0mg/kg propofol intravenously. The gastrointestinal endoscopy was performed when the Modified Observer's Assessment of Alertness/Sedation scores were ≤3. The primary endpoints included the endoscopic intestinal peristalsis rating by the endoscopist; serum motilin and gastrin levels at fasting without gastrointestinal preparation (T0), before gastrointestinal endoscopy (T1), and before leaving the Post Anesthesia Care Unit (T2); and the incidences of abdominal distension during Post Anesthesia Care Unit. Compared with Group P, intestinal peristalsis rating was higher in Group R (P < .001); Group R showed increased motilin and gastrin levels at T2 compared with Group P (P < .01). There was a rise in motilin and gastrin levels at T1 and T2 compared with T0 and at T2 compared with T1 in both groups (P < .01). The incidence of abdominal distension was lower in Group R (P < .05). Compared with propofol used during gastrointestinal endoscopy with sedation, remimazolam tosilate mildly inhibits the serum motilin and gastrin levels, potentially facilitating the recovery of gastrointestinal motility.

Factors affecting gastrointestinal function recovery after cesarean section among Chinese mothers: A cross-sectional study.

This study was conducted to explore the influencing factors of gastrointestinal function recovery after cesarean section (CS), which could provide a reference for the enhanced recovery after surgery in obstetrics. This is a cross-sectional survey on Chinese mothers receiving CS. The participants's socio-demographic characteristics, perioperative diet, medical condition and gastrointestinal function after surgery were collected by a self-designed questionnaire. Binary logistic regression analysis was employed to explore the influencing factors of gastrointestinal function recovery after CS. A total of 1501 (94.76%) valid questionnaires were collected. The first borborygmus was 2.21 ± 0.63 hours, and the first anal exhaust was 35.73 ± 14.85 hours after the CS. The incidence of abdominal distension and intestinal obstruction were 15.1% and 0.7%, respectively. The parity, type of CS, 2-hours bleeding after surgery, time of first meal after surgery, whether taking peppermint water after surgery were the independent influencing factors for gastrointestinal function recovery after CS. We should pay more attention to the mothers with scarred uterus, manage the labor process strictly, and reduce 2-hours bleeding after surgery. The mothers with CS should also be encouraged to eat early and take peppermint water to promote intestinal peristalsis actively.

Effect of thumb-tack needle on gastrointestinal function recovery after cesarean section under the concept of enhanced recovery after surgery

To observe the synergistic effect and safety of combined use of houpo paiqi mixture and thumb-tack needle on promoting gastrointestinal function recovery after cesarean section. Parturients receiving cesarean section were randomly divided into the control group (29 cases), the traditional Chinese medicine (TCM) group (30 cases) and needle+TCM group (30 cases). The control group received only routine postoperative treatment. Besides the treatment as the control group, parturients in the TCM group were given 50 mL houpo paiqi mixture 6 h and 10 h after cesarean section respectively. Besides the treatment as the TCM group, parturients in the needle+TCM group received thumb-tack needle treatment at bilateral Zusanli(ST36), Tianshu(ST25), Shangjuxu(ST37) and Sanyinjiao(SP6), Zhongwan(CV12), Qihai(CV6), with auricular pressure at bilateral otopoints Zigong(Uterus), Wei(Stomach) and Dachang(Large intestine), within 1 h after the parturients returned to the ward after the operation. Each acupoint was pressed for 10 s and performed acupressure every 4 h (except sleeping hours), continuously for 3 d. The time of bowel sound recovery, the time to the first postoperative exhaust and defecation, the time of postoperative semi-fluid diet recovery, incidence of postoperative nausea and vomiting (PONV) and abdominal distention, and abdominal pain VAS score were recorded and analyzed. The safety of the treatments was also evaluated. Compared with the control group, the time of bowel sounds recovery, the time to the first postoperative exhaust and the time of postoperative semi-fluid diet recovery were significantly shortened in the TCM and needle+TCM groups (P<0.01); the time to the first postoperative defecation were significantly shortened (P<0.01), incidence of both abdominal distention and PONV were significantly decreased in the needle+TCM group (P<0.05, P<0.01); incidence of abdominal distention were significantly decreased in TCM group (P<0.05). Compared with the TCM group, the time of bowel sounds recovery, the time to the first postoperative exhaust and defecation, and the time of postoperative semi-fluid diet recovery were significantly shortened (P<0.01), and incidence of both abdominal distention and PONV were significantly decreased in the needle+TCM group (P<0.05). VAS scores of the three groups decreased gradually over time (P<0.01). Compared with the control and TCM groups, VAS scores of the needle+TCM group significantly decreased at 24 h, 48 h and 72 h after operation (P<0.01). No treatment-related adverse reactions were observed during the whole trial. On the base of the treatment with houpo paiqi mixture, the addition of thumb-tack needle treatment exerted positive synergistic effect on gastrointestinal function recovery after cesarean section, with high safety, which is worthy of clinical application.

Is monitoring of gastric residual volume for critically ill patients with enteral nutrition necessary? A meta-analysis and systematic review.

There are many controversies over the necessity of monitoring gastric residual volume in the nursing care of enteral nutrition. We aimed to conduct an updated meta-analysis to evaluate the effects of monitoring or not monitoring gastric residual volume on patients' outcomes and complications. We searched the Cochrane Library database to 15 April 2021 for randomized controlled trials (RCTs) on the effects of gastric residual volume and no gastric residual volume monitoring. Review Manager software was used for data analysis. A total of seven RCTs involving 1240 enteral nutritionpatients were included. Gastric residual volume monitoring was associated with reduced incidence of vomiting (OR2.33, 95% CI:1.68-3.24), whereas no gastric residual volume monitoring was associated with reduced incidence of unnecessary interruptions of enteral nutrition (OR0.38,95% CI:0.26-0.55). There were no significant differences on the incidence of abdominal distention (OR1.87, 95% CI:0.82-4.28), diarrhoea (OR1.03,95% CI:0.74-1.43), VAP (OR0.83, 95%CI:0.37-1.89), duration of mechanical ventilation (MD -0.06,95% CI:-1.22-1.10), length of ICU stay (MD -1.33, 95% CI:-3.58-0.91) and mortality (OR0.90,95% CI:0.61-1.34). Not monitoring gastric residual volume is associated with reduced unnecessary interruptions of enteral nutrition related to inadequate feeding and increased risk of vomiting.

Efficacy evaluation of probiotics combined with prebiotics in patients with clinical hypothyroidism complicated with small intestinal bacterial overgrowth during the second trimester of pregnancy.

ObjectiveTo explore the effect of probiotics combined with prebiotics on clinical hypothyroidism during pregnancy combined with small intestinal bacterial overgrowth.Methods(1) In total, 441 pregnant women were included in this study. A total of 231 patients with clinical hypothyroidism during the second trimester of pregnancy and 210 normal pregnant women were enrolled in the lactulose methane-hydrogen breath test. The positive rate of intestinal bacterial overgrowth (SIBO), gastrointestinal symptoms, thyroid function and inflammatory factors were compared between the two groups by chi-square test and two independent sample t-test. (2) SIBO-positive patients in the clinical hypothyroidism group during pregnancy (n=112) were treated with probiotics combined with prebiotics based on conventional levothyroxine sodium tablets treatment. The changes in the methane-hydrogen breath test, gastrointestinal symptoms, thyroid function and inflammatory factors were compared before treatment (G0) and 21 days after treatment (G21) by chi-square test and paired sample t test.Results(1) The positive rates of SIBO in pregnant women in the clinical hypothyroidism group and control group were 48.5% and 24.8%, respectively. (2) The incidence of abdominal distention and constipation in the clinical hypothyroidism group was significantly higher than that in the control group, and the risk of abdominal distention and constipation in SIBO-positive pregnant women was higher than that in SIBO-negative pregnant women. (3) The serum levels of hypersensitive C-reactive protein (hsCRP), IL-10, IL-6, TNF-α, low-density lipoprotein (LDL), total cholesterol (TC), free fatty acids (FFAs) and apolipoprotein B (ApoB) in the hypothyroidism group during pregnancy were higher than those in the control group. (4) After 21 days of probiotics combined with prebiotics, the incidence of pure methane positivity in the methane-hydrogen breath test in the G21 group was significantly reduced, and the average abundance of hydrogen and methane at each time point in the G21 group was lower than that in the G0 group. (5) The incidence of constipation in the G21 group was significantly lower than before treatment. (6) The levels of serum TSH, hsCRP, IL-6, TNF-α, TC and LDL in pregnant women after probiotics combined with prebiotics were lower than those before treatment.ConclusionProbiotics combined with prebiotics are effective in the treatment of pregnant patients with clinical hypothyroidism complicated with SIBO, providing a new idea to treat pregnant patients with clinical hypothyroidism complicated with SIBO.

Value of Auricular Point Pressing in Postoperative Pain Nursing Care of Laparoscopic Cholecystectomy Under the Guidance of Nano-Probe

This work aimed to investigate and analyse the application value of auricular point pressing (APP) in pain nursing care after laparoscopic cholecystectomy guided by nano-probe. In this study, 100 patients who underwent laparoscopic cholecystectomy guided by nanoprobes were selected. According to the difference in admission time and intervention measures, 100 patients meeting the inclusion criteria were enrolled into an observation group (n = 50) and a control group (n = 50). Then, patients as controls after surgery were treated with routine preventive nursing intervention measures, and patients for observation received APP on the basis of routine nursing. Anal exhaust time (AET), bowel sound recovery time (BSRT), incidence of abdominal distension, and clinical efficacy were compared. In addition, the degree of abdominal pain was evaluated at the 24th hour, 48th hour, and 72nd hour after surgery, as well as the degree of gastrointestinal reaction. There was no marked difference in the general data of patients from the two groups. The time of first exhaust defecation in the observation group was shorter (P &lt;0.05), indicating that the exhaust effect was better. The differences in degree of abdominal pain in patients were statistically marked between the 24th and 48th hours and the 48th and 72nd hours (P &lt;0.05), indicating that postoperative abdominal pain symptoms of both groups could be effectively improved. The degree of gastrointestinal reaction of patients showed obvious difference between the 24th and 48th hour and the 24th and 72nd hour (P &lt;0.05). However, there was no huge difference in the degree of gastrointestinal reaction between 72 hours and 48 hours (P &gt;0.05), suggesting that the gastrointestinal symptoms were improved after 48 hours. In conclusion, postoperative APP could effectively alleviate postoperative pain in patients.

Effect of wrist-ankle acupuncture on propofol dosage during painless colonoscopy: A randomized controlled prospective study

BACKGROUNDThe clinical advantages of painless colonoscopy can reduce the fear and discomfort of patients and increase the detection rate of diseases. Propofol has the characteristics of fast effect and short action time. It is a common choice for painless endoscopic sedation and anesthetics. However, propofol can cause severe respiratory and circulatory depression. Therefore, it is important to find a way to reduce the dose of propofol.AIMTo explore the effect of wrist-ankle acupuncture on propofol dose during colonoscopy. METHODSTwo hundred patients who were going to receive selective painless colonoscopy in Hebei Hospital of Traditional Chinese Medicine were selected and divided into wrist-ankle acupuncture group (WAA group, n = 100) and control group (CON group, n = 100). After entering the operation room, patients were given 0.025 mg/kg nabufine intravenously and propofol at the initial dose of 0.5 mg/kg. In patients who did not fall asleep, propofol (10 mg/time) was given until loss of consciousness. Prior to anesthesia, patients in WAA group were punctured by specialist in the inferior 1, 2 and 3 regions according to the zoning principle of wrist-ankle acupuncture. The primary endpoint was required dose of propofol, and the secondary endpoints were the incidence of hypoxemia and hypotension. Furthermore, the following data were recorded: The operation time, wake-up time, incidence of nausea and vomiting, incidence of abdominal distention, post-colonoscopy pain, examiners' satisfaction, patients' satisfaction and Borg fatigue index. This study has been registered in the Chinese Clinical Trial Registry (Registration Code: ChiCTR1900022177).RESULTSThe induced dose of propofol and the total dose of propofol in WAA group were 80 mg and 110 mg, respectively, which were significantly lower than those in CON group (P < 0.05). The incidences of hypoxemia and hypotension in the WAA group were 2.2% and 3.3%, respectively, significantly lower than those in the CON group (P < 0.05). The incidence of abdominal distension in the WAA group was 8.8%, which was significantly lower than that in the CON group (P < 0.05, 28.9%). The waking time of WAA group was 3.26 ± 0.87 min, which was significantly lower than that of CON group (6.06 ± 0.88 min, P < 0.05).CONCLUSIONWrist-ankle acupuncture can reduce the induction dose and total dose of propofol as well as the incidence of adverse reactions in painless colonoscopy without affecting the satisfaction of examiners and patients. This procedure is simple in operation and easy to promote in clinical practice.

Application Effect of Intra-Abdominal Pressure Monitoring System in Early Enteral Nutrition Nursing of ICU Patients.

In order to study and explore the application effect of intra-abdominal pressure monitoring in guiding ICU patients to implement early enteral nutrition therapy, we selected patients admitted to the emergency department of a hospital and classified them into groups A (n = 105) and B (n = 98). Among them, the A group gave early enteral nutrition treatment by monitoring the residual gastric mass, and the B group gave early enteral nutrition treatment by monitoring the stomach. It has been established that, compared to gastric residue monitoring, intra-abdominal pressure monitoring in ICU patients with early enteral nutrition therapy has an obvious advantage, it helps to improve the prognosis of patients, and intra-abdominal pressure combined with gastric residual monitoring scheme can effectively reduce the early enteral nutrition in the ICU patients, the incidence of abdominal distension, vomiting, and make it reach the goal as soon as possible. Early enteral nutrition in patients with increased tolerance is of great significance.

Application Value of Moxibustion Combined with Acupoint Application in Patients with Abdominal Distension after Gynecological Surgery

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 &lt; 0.05). The therapeutic effect of abdominal distension in group A was 87.50%, which was higher than 66.67% in group B (P &lt; 0.05). The recovery time of first defecation, first exhaust and bowel sound in group A was shorter than that in group B (P &lt; 0.05). All postoperative quality of life scores of group A were higher than that of group B (P &lt; 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.

Effect of total intravenous anesthesia or inhalation anesthesia on postoperative quality of recovery in patients undergoing total laparoscopic hysterectomy: A randomized controlled trial

Study objectiveTo investigate the effect of propofol-based total intravenous anesthesia (TIVA) or sevoflurane-based inhalation anesthesia on postoperative quality of recovery in patients undergoing total laparoscopic hysterectomy. DesignA prospective randomized controlled trial. SettingAn operating room, a postoperative recovery area, and a hospital ward. PatientsA total of 102 female patients scheduled for elective total laparoscopic hysterectomy were randomly divided into two groups: the propofol group (group P) or sevoflurane group (group S). InterventionsAnesthesia in group P was induced by propofol, fentanyl and rocuronium, and maintained by intravenous infusion of propofol and remifentanil. Anesthesia in group S was induced by a tidal volume inhalation technique with sevoflurane and rocuronium and maintained with sevoflurane and remifentanil. Patients in group P did not receive any volatile drugs. MeasurementsQuality of Recovery-40 (QoR-40), Pittsburgh Sleep Quality Index (PSQI) and Numerical Rating Scale (NRS) scores were assessed at 8, 24, 48, 72 h, 7 days and 30 days after surgery. Intraoperative hemodynamics, postoperative inflammatory indicators and adverse reactions were also recorded. Main resultsThe QoR-40 score and its 5 dimensions were similar in the two groups at each point in time (P > 0.05). Group S had less consumption of remifentanil (P < 0.001) but increased use of phenylephrine (P = 0.001) intraoperatively. PSQI scores were also comparable between groups at each point in time (P > 0.05). NRS scores at 72 h (P = 0.023) and 7 days (P = 0.017) after surgery, postoperative NLR (P = 0.024) and hs-CRP (P = 0.042), and the incidence of abdominal distension (P = 0.017) were significantly lower in group P than in group S. Multiple linear regression analyses demonstrated that duration of pneumoperitoneum and sleep quality were associated with postoperative recovery. ConclusionsThe choice of intravenous or inhalation maintenance anesthesia did not affect overall postoperative recovery as measured by the QoR-40 in patients undergoing total laparoscopic hysterectomy. Reducing the duration of pneumoperitoneum and improving sleep quality were conducive to postoperative recovery.

Effect of electroacupuncture at Zusanli (ST36) and Zhongwan (CV12) on intestinal nutritional feeding intolerance in patients with severe acute pancreatitis

To observe the effect of electroacupuncture (EA) of Zusanli(ST36) and Zhongwan (CV12) on intestinal nutritional feeding intolerance in patients with severe acute pancreatitis (SAP). A total of 68 SAP patients (hospitalized from January of 2018 to December of 2019 in Cangzhou Hospital of Integrated Medicine) were randomly divided into control and EA groups (n=34 cases in each group). All patients of the two groups received the same early enteral nutrition treatment through nasojejunal tube. EA (5-15 Hz, 1-5 mA) was applied to bilateral ST36 and CV12 for 20 min, twice a day for 7 days. The incidence of feeding intolerance (abdominal distension, vomiting, diarrhea, constipation, gastrointestinal bleeding), time to reach energy target, intraperitoneal pressure and the number of borborygmus in 1 min were recorded. The contents of plasma high sensitivity -C reactive protein (hs-CRP), IL-6 and endotoxin were measured using Latex immunoturbidimetric method, chemiluminescence and Tachypiens Amebocyte Lysate Azo substrate color development method, respectively, and the contents of urinary lactulose and mannitol detected using high-performance liquid chromatography. The total protein and albumin levels in the blood were measured for assessing the patients' nutrition status, and acute physiology and chronic health evaluation scoring system (APACHE-Ⅱ) score was determined for assessing the severity of disease. Compared with the control group, the incidence of abdominal distension, vomiting and constipation, intolerance rate to feeding, time to reach the energy target, intraperitoneal pressure on day 7, inflammatory indexes, hs-CRP, IL-6, endotoxin, urine L/M on day 4 and 7, and the APACHE Ⅱ score on day 7 were significantly lower (P<0.01), and the number of borborygmus in 1 min on day 4 and 7 after the treatment was significantly higher in the EA group (P<0.01). In comparison with pretreatment, the abdominal pressure and plasma endotoxin level on day 4 and 7, hs-CRP, IL-6 and L/M ratio on day 1, 4 and 7, as well as APACHE Ⅱ score on day 7 after the treatment were significantly decreased in the two groups (P<0.01), and the number of borborygmus on day 4 and 7, and the total protein and albumin on day 7 significantly increased in both the control and EA groups (P<0.01). EA of ST36 and CV12 can shorten the time to reach the energy target, reduce inflammatory response, improve the intestinal mucosal barrier function, and thus reduce the incidence of feeding intolerance in SAP patients.

Application Effect of Humanized Nursing in the Perioperative Period of Gastrointestinal Tumor

To observe the effect of humanized nursing in the perioperative period of gastrointestinal tumor. A total of 118 cases of gastrointestinal tumor patients treated in our hospital from March 2021 to May 2021 were selected. Patients were randomly assigned to the routine care control group or humanized nursing intervention group according to their willingness. The gastrointestinal function, psychological status, postoperative complications and nursing satisfaction status of the two groups were compared after intervention. The recovery rate of gastrointestinal function was faster in the study group, that is, the time of initial anal exhaust and initial defecation was lower in the study group than in the control group, and the incidence of abdominal distension was lower in the study group (P<0.05). The psychological status of the study group was significantly better than that of the control group, that is, the scores of all items of the Symptom Checklist-90 (SCL-90) in the study group were lower than those in the control group (P<0.05). Compared with the control group, the incidence of postoperative complications in the study group was lower and the nursing satisfaction was better (P < 0.05). The findings demonstrate application of humanized nursing for patients in the perioperative period of gastrointestinal tumor not only effectively promote the recovery process of patients, but also alleviate the adverse mood of patients and improve the quality of hospital nursing work, which has clinical application usefulness.

Effect of Nursing Intervention of Different Nutrition on Quality of Life of Patients with Intestinal Cancer During Perioperative Period by Artificial Neural Network Model

In order to explore the colorectal cancer during perioperative period based on the structure model of artificial neural network, and to provide reference for the selection of perioperative nursing measures for patients with colorectal cancer, the artificial neural network models of rectal colon cancer patients with different nutritional interventions based on biomedicine were established. 264 patients with rectal colon cancer and accelerated rehabilitation nutritional nursing group. There were 132 patients in each group who were given different nutritional intervention measures to compare the quality of life after nursing. The results suggested that artificial neural network had a certain value in predicting the impact of different nutritional interventions on patients’ quality of life. In addition, the initial anal ventilation time, initial anal defecation time, infusion time and hospitalization time of patients in accelerated rehabilitation nursing group were shorter than those in routine nursing group, and the incidence of abdominal distension after operation was significantly lower than that of routine nursing group (P &lt; 0.05). The cancer-related fatigue (P &lt; 0.05). To sum up, artificial neural network can adapt to the non-linear effect of the model and has a strong advantage in survival analysis. Accelerated rehabilitation nursing intervention measures can promote the rehabilitation of patients with rectal colon cancer during perioperative period and improve the overall quality of life, which is worthy of clinical reference.

Soluble Dietary Fiber Reduces Feeding Intolerance in Severe Acute Pancreatitis: A Randomized Study.

Feeding intolerance of enteral nutrition (EN) frequently occurs in patients with severe acute pancreatitis (SAP) because of intestinal motility disorders. Soluble dietary fiber (SDF) modulates the intestinal motility. The present study examined whether SDF can improve intestinal motility and permeability, and thereby reduce feeding intolerance, in patients with SAP. This study was a single-blind, randomized, controlled, single-center trial. Forty-nine patients with SAP were included. The control and SDF groups received the same EN solution via a nasojejunal tube. The SDF group additionally received 20-g/d polydextrose. The primary outcome was the time to reach the energy goal. Follow-up was continued for 28 days after admission or until discharge from the hospital. Among 49 randomized patients, 46 patients (n=22, control group; n=24, SDF group) were included in the intent-to-treat analysis. The time to reach the energy goal was 7.00 (6.00, 8.25) days and 5.00 (4.25, 6.00) days in the control and SDF groups, respectively (P<0.001). The rates of feeding intolerance were significantly reduced in the SDF group (59.09% vs 25.00%, P<.05). SDF was associated with decreases in the incidence of abdominal distension (72.73% vs 29.17%, P<.01), diarrhea (40.91% vs 8.33%, P<.05), and constipation (72.73% vs 12.50%, P<.001). The time to first flatus and first defecation were significantly shorter in the SDF group (P<.001). The intestinal mucosal barrier function and levels of gastrointestinal hormone were improved by SDF, as evidenced by significantly reduced blood levels of diamine oxidase, D-lactic acid, endotoxin, and vasoactive intestinal peptide (P<.05). SDF shortens the time to reach the energy goal during EN and improves intestinal permeability and motility disorders, thus reducing the incidence of feeding intolerance in SAP patients.

Effects of abdominal massage on gastrointestinal tolerance in critically ill patients fed by nasogastric tube: a systematic review and Meta-analysis

Objective To evaluate the effect of abdominal massage on gastrointestinal tolerance in critically patients with nasogastric tube feeding. Methods The Chinese Biomedical Literature Database, China National Knowledge Infrastructure, The Wang fang database, Chinese Science and Technology Periodical Database, Cochrane Libraty, PubMed, Embase, CENTRAL were searched. Two researchers conducted quality evaluation and data extraction on studies that met the inclusion criteria. Data were analyzed with RevMan5.3 software. Results Eight randomized controlled trials were included, including 628 patients. The results of Meta-analysis showed that abdominal massage could reduce the gastric residual volume of critically ill patients (WMD=-45.45, 95%CI -56.62--34.28, P<0.01), and reduce the incidence of gastric retention (OR=0.13, 95%CI 0.06 -0.29, P<0.01), incidence of abdominal distension (OR=0.23, 95% CI 0.13-0.43, P<0.01), incidence of vomiting (OR=0.14, 95% CI 0.06-0.36, P<0.01). Conclusions For critically ill patients with nasogastric tube feeding, abdominal massage can reduce the gastric residual volume and reduce the incidence of gastric retention, distension and vomiting. Key words: Abdomen; Massage; Critical care; Enteral nutrition; Meta-analysis

Protein hydrolysate versus standard formula for preterm infants.

When human milk is not available for feeding preterm infants, protein hydrolysate, rather than standard cow's milk formulas (with intact proteins), is often used because it is perceived as being tolerated better and less likely to lead to complications. However, protein hydrolysate formulas are more expensive than standard formulas, and concern exists that their use in practice is not supported by high-quality evidence. To assess the effects of feeding preterm infants hydrolysed formula (vs standard cow's milk formula) on risk of feed intolerance, necrotising enterocolitis, and other morbidity and mortality. We used the standard Cochrane Neonatal search strategy including electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 1), in the Cochrane Library; Ovid MEDLINE (1966 to 28 January 2019); Ovid Embase (1980 to 28 January 2019); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (28 January 2019), as well as conference proceedings and previous reviews. Randomised and quasi-randomised controlled trials that compared feeding preterm infants protein hydrolysate versus standard (non-hydrolysed) cow's milk formula. Two review authors assessed trial eligibility and risk of bias and extracted data independently. We analysed treatment effects as described in the individual trials and reported risk ratios and risk differences for dichotomous data, and mean differences for continuous data, with respective 95% confidence intervals (CIs). We used a fixed-effect model in meta-analyses and explored potential causes of heterogeneity in sensitivity analyses. We assessed quality of evidence at the outcome level using the GRADE approach. We identified 11 trials for inclusion in the review. All trials were small (total participants 665) and had various methodological limitations including uncertainty about methods to ensure allocation concealment and blinding. Most participants were clinically stable preterm infants of less than about 34 weeks' gestational age or with birth weight less than about 1750 g. Fewer participants were extremely preterm, extremely low birth weight, or growth restricted. Most trials found no effects on feed intolerance, assessed variously as mean pre-feed gastric residual volume, incidence of abdominal distension or other gastrointestinal signs of concern, or time taken to achieve full enteral feeds (meta-analysis was limited because studies used different measures). Meta-analysis showed no effect on the risk of necrotising enterocolitis (typical risk ratio 1.10, 95% CI 0.36 to 3.34; risk difference 0.00, 95% CI -0.03 to 0.04; 5 trials, 385 infants) (low-certainty evidence; downgraded for imprecision and design weaknesses). The identified trials provide only low-certainty evidence about the effects of feeding preterm infants protein hydrolysate versus standard formula. Existing data do not support conclusions that feeding protein hydrolysate affects the risk of feed intolerance or necrotising enterocolitis. Additional large, pragmatic trials are needed to provide more reliable and precise estimates of effectiveness and cost-effectiveness.

Nasointestinal Tube in Mechanical Ventilation Patients is More Advantageous.

ObjectiveTo assess the effects of two different nutritional mode on the occurrence of ventilator-associated pneumonia (VAP) in patients on mechanical ventilation.Methods70 patients admitted to the ICU and under mechanical ventilation, were randomly divided into the nasointestinal tube group and nasogastric tube group. Patients from both groups received enteral nutrition, using the same nutritional agent, through intubation. The duration of stay in the ICU, duration of mechanical ventilation, incidence of VAP, nutritional state, and survival of the intestinal tract were compared between the two groups.ResultsThe duration of stay in the ICU, duration of mechanical ventilation and incidence of VAP in the nasointestinal tube group was lower than that in the nasogastric tube group (P<0.05). There was an increase in the levels of prealbumin and transferrin in the nasointestinal tube group (P<0.05). However, there were no obvious difference in the nasogastric tube group (P<0.05). The incidence of abdominal distension, diarrhea, regurgitation, aspiration, and hyperglycemia in the nasointestinal tube group was much lower than that in the nasogastric tube group (P < 0.05).ConclusionThis study showed that enteral nutrition delivery using a nasointestinal way can effectively reduce the incidence of VAP and improve the nutritional status of patients under mechanical ventilation.

The efficacy of knee-chest position on exhaust and defecation of gynecologic diseases patients after laparoscopy

Objective To investigate the effect of knee-chest position on exhaust and defecation of gynecologic diseases patients after laparoscopic surgery. Methods This quasi-experiment trail was conducted between July 2016 to May 2017, in a birth control ward at an obstetrics and gynecology hospital in Beijing, China. The study included a total of 258 patients who had gynecological benign diseases and received gynecological laparoscopic surgery. Participants were recruited in the trail by using a convenient sampling method with 130 patients who received gynecological laparoscopic surgery from July 2016 to December 2016 in the experimental group (on the basis of routine care, patients preformed a knee-chest position intervention after 6 hours of the surgery) and 128 patients who received gynecologic laparoscopic surgery between January 2017 and May 2017 in the control group (patients received a routine care). The primary end point was the postoperative anal exhaust. Results The ambulation rate before post-operative ventilation of the experimental group was 21.5% (28/130) less than that of the control group (91.4%, 117/128). The difference was statistically significant (χ2=127.903, P<0.01). The incidence of abdominal distension after operation was 0, lower than that of the control group 7.0% (9/128), the difference was statistically significant (χ2=9.471, P<0.01). The postoperative exhaust time and defecation time of the experimental group was (8.17 ± 2.88) h,(27.86 ± 4.29) h, earlier than that of the control group, (21.24 ± 5.90) h,(38.69 ± 7.73) h, and the differences were statistically significant (t=22.580, 13.885, P<0.01). Conclusions Postoperative knee-chest position significantly improved the exhaust and defecation of patients with gynecological benign disease after laparoscopic surgery. Key words: Knee-chest position; Laparoscopic surgery; Gynecology; Anal exhaust

Protein hydrolysate versus standard formula for preterm infants.

When human milk is not available for feeding preterm infants, protein hydrolysate rather than standard cow's milk formulas (with intact proteins) are often used because they are perceived as being tolerated better and less likely to lead to complications. However, protein hydrolysate formulas are more expensive than standard formulas, and concern exists that their use in practice is not supported by high-quality evidence. To assess the effect of feeding preterm infants with hydrolysed formula (versus standard cow's milk formulas) on the risk of feed intolerance, necrotising enterocolitis, and other morbidity and mortality in preterm infants. We used the standard Cochrane Neonatal search strategy including electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 4), Ovid MEDLINE, Ovid Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (to April 2017), as well as conference proceedings and previous reviews. Randomised and quasi-randomised controlled trials that compared feeding preterm infants with protein hydrolysate versus standard (non-hydrolysed) cow's milk formula. Two review authors assessed trial eligibility and risk of bias and extracted data independently. We analysed treatment effects as described in the individual trials and reported risk ratios and risk differences for dichotomous data, and mean differences for continuous data, with respective 95% confidence intervals (CI). We used a fixed-effect model in meta-analyses and explored potential causes of heterogeneity in sensitivity analyses. We assessed quality of evidence at the outcome level using the GRADE approach. We identified 11 trials for inclusion in the review. All trials were small (total participants 665) and had various methodological limitations including uncertainty about methods to ensure allocation concealment and blinding. Most participants were clinically stable preterm infants of gestational age less than about 34 weeks or birth weight less than about 1750 g. Fewer participants were extremely preterm, extremely low birth weight, or growth-restricted. Most trials found no effects on feed intolerance assessed variously as mean prefeed gastric residual volume, incidence of abdominal distention or other concerning gastrointestinal signs, or time taken to achieve full enteral feeds (meta-analysis was limited because studies used different measures). Meta-analysis found no effect on the risk of necrotising enterocolitis (typical risk ratio 1.10, 95% CI 0.36 to 3.34; risk difference 0.00, 95% CI -0.03 to 0.04; 5 trials, 385 infants) (low quality evidence; downgraded for imprecision and design weaknesses). The identified trials provide only low quality evidence about the effects of feeding preterm infants with protein hydrolysate versus standard formula. The existing data did not support conclusions that feeding with protein hydrolysate affects the risk of feed intolerance or necrotising enterocolitis. Further large, pragmatic trials are needed to provide more reliable and precise estimates of effectiveness and cost-effectiveness.

Quality of defoamer enema combined with bellym assage on the colonic preparation in elderly patients with constipation

Objective To explore the role of defoamer enema combined with bellym assage on the colonic preparation in elderly patients with constipation. Methods One hundred patients were divided into two groups by random number table method, the experimental group and the control group with 50 cases each. Patients in the control group were told to drink polyethyleneglycolelectrolytesolution 3 000 ml. Patients in the experimental group were told to drink polyethyleneglycolelectrolytesolution 2 000 ml. After medicinepre paration, the patients of experimental group were given defoamer enema. After that, they were undertaken counterclockwise massage for10 mins, then massageing clockwise until defecation. Results 14 patients with oral catharsis drugs failed to give up check, 46 cases of intervention group and 40 cases of control group finally complete intestinal preparation and colonoscopy. Intervention group patients after bowel preparation before the incidence of abdominal distension, abdominal pain were 6.52% (3/46), 8.70%(4/46), lower than the control group 65.00% (26/40), 25.00% (10/40), the difference was statistically significant (χ2= 32.74, 4.17, P< 0.05). Percent of pass was 65.22%(30/46) for intestinal preparation intervention group, significantly higher than the control group 35.00% (14/40), the difference was statistically significant (χ2= 7.82, P< 0.05). Intervention group intestinal cleanliness ratings of Ottawa total score was 4.00 (4.00), which was lower than the control group7.00 (4.50), the difference was statistically significant (Z= 3.80, P< 0.05). Endoscopic check process, the intervention group arrived at the terminal ileum and mirror back time were 7.00 (3.00) and 9.00 (1.00) min, were less than 9.00(6.50) and 10.50 (3.00) min in the control group, the difference was statistically significant (Z= 2.09, 4.53, P< 0.05). Intervention group of colons polyps detection rate was 67.39% (31/46), higher than that of control group 30.00% (12/40), the difference was statistically significant (χ2= 11.97, P< 0.05). Conclusions The bowel preparation with defoamer enema will enhance the intestinal tract cleaness and the detection rate of polyps in elderly patients with constipation. Key words: Aged; Constipation; Retention enema; Colonoscopy; Colonic preparation