Time Of First Exhaust Research Articles

Impact of Ahmadi Continuing Nursing Model on self-care ability, stoma complications and quality of life of colostomy patients

ObjectiveTo analyze the effects of Ahmadi Continuing Nursing Model (ACNM) on the self-care ability, stoma complications and life quality in colostomy patients.MethodsThe clinical data of 120 patients who underwent postoperative colostomy in our hospital from June 2020 to June 2023 were retrospectively analyzed. The patients were divided into control group (n = 60, treated with routine nursing) and observation group (n = 60, treated with the ACNM on the basis of routine nursing) according to different nursing methods. Postoperative recovery of gastrointestinal function, ostomy adaptability, self-care ability, and life quality before and after nursing were compared. The probability of complications before and after nursing was recorded between the two groups.ResultsThe time of first exhaust was 3.65 ± 0.82 d, the time of first meal was 1.83 ± 0.65 d, and the first bowel sound recovery was 1.47 ± 0.53 d in the observation group, which were shorter than those in the control group (4.38 ± 1.20 d, 3.12 ± 1.15 d, 2.39 ± 1.06 d, P < 0.001). After intervention, the positive emotions in the ostomy adaptation score were 32.09 ± 5.03 points, negative emotions were 31.41 ± 5.70 points, social life adaptation were 27.12 ± 4.98 points, and the total score was 90.78 ± 5.98 points in the observation group, which were significantly higher than those in the control group (26.32 ± 4.52 points, 24.25 ± 6.02 points, 20.25 ± 4.02 points, 67.25 ± 6.09 points, P < 0.001). The self-willingness was 34.18 ± 4.02 points, self-care skill was 10.57 ± 2.23 points, self-care knowledge was 18.59 ± 3.10 points, and the total score was 63.18 ± 4.98 points in the observation group, which were significantly higher than those in the control group (25.25 ± 3.08 points, 8.72 ± 2.13 points, 15.26 ± 2.70 points, 45.69 ± 4.09 points, P < 0.001). The physical function was 79.74 ± 2.81 points, psychological function was 76.71 ± 3.05 points, social function was 78.11 ± 3.50 points, and material life status was 60.06 ± 2.98 points in the quality of life in the observation group, which were significantly higher than those in the control group (75.36 ± 2.68 points, 69.72 ± 2.93 points, 72.33 ± 3.42 points, 51.23 ± 3.08 points, P < 0.001).ConclusionACNM effectively promoted the recovery of gastrointestinal function after surgery in colostomy patients by improving patients’ stoma adaptability, self-care ability and life quality and reducing the occurrence of complications, which was worthy of promotion.

The Effect of Different Nutritional Nursing Support on the Nutritional Status and Disease Recovery of Elderly Patients with Gastrointestinal Tumors during the Perioperative Period.

Objective This study explored the effect of different nutritional nursing support on nutritional status, immune function, postoperative bowel motility, and complications in elderly patients with gastrointestinal tumors during the perioperative period. Methods 300 patients with gastrointestinal tumors treated in the Department of Gastroenterology and anorectal surgery of Hangzhou First People's Hospital Affiliated with the Medical College of Zhejiang University from February 2018 to March 2020 were selected as the research objects in this study. Patients were divided into the early enteral nutrition (EEN) and total parenteral nutrition (TPN) groups (150 cases in each group) according to the principle of odd and even admission numbers. The patients in the EEN and TPN groups were given enteral nutrition nursing support and parenteral nutrition nursing support, respectively. The nutritional status, immune function, postoperative bowel motility, and complication rate of the two groups were evaluated 7 days after the operation. Results The nutritional indexes decreased 3 days after the operation and gradually recovered 7 days after the operation in both groups with different nutritional nursing support. The Hb, TRF, PAB, and ALB indexes in the TPN group were significantly lower than those in the EEN group (P < 0.01). On the 7th day after the operation, the indexes of peripheral blood immunoglobulin (IgG, IgM, and IgA) were significantly lower than those in the TPN group, and T lymphocyte subsets (CD4, CD8, and CD4/CD8) demonstrated that the immunological indexes of patients in the EEN group were significantly higher than those in the TPN group (P < 0.01). In terms of intestinal peristalsis, the time of first exhaust and first defecation in the EEN group was significantly shorter than that in the TPN group (P < 0.01) during the perioperative period. Furthermore, both groups had different degrees of complications, while patients demonstrated a lower complication rate in the EEN group compared to those in the TPN group, suggesting a safer postoperative mode. The results of subgroup analysis showed that the nutritional indexes of the gastric cancer group 7 days after operation were significantly higher than those of the colorectal cancer group under EEN and TPN nutritional support modes. Conclusion Clinical results have suggested that enteral nutrition nursing support can improve the perioperative nutritional status of elderly patients with gastrointestinal tumors by enhancing the immune function and promoting intestinal peristalsis. Meanwhile, the postoperative EEN mode reduces the rate of complications and demonstrates higher safety. Therefore, it has a high clinical application value.

Analysis of the Influence of Comprehensive Nursing Intervention on Vital Signs and Negative Emotions of Patients with Gastrointestinal Polyps Treated by Digestive Endoscopy.

This research sets out to elucidate the influence of comprehensive nursing intervention (CNI) on vital signs (VSs) and negative emotions (NEs) of patients with gastrointestinal polyps treated by digestive endoscopy. To address this, from January 2020 to February 2021, 92 cases of gastrointestinal polyps treated by digestive endoscopy in the Yuyao People's Hospital of Zhejiang Province were partitioned into two different groups: the control group (CG; n = 46) intervened by routine nursing intervention, and the research group (RG; n = 46) treated by CNI based on routine care. The VSs, NEs, time of first postoperative exhaust and defecation, early food intake, length of stay (LOS), quality of life (QOL), nursing satisfaction, and the incidence of postoperative complications were compared between groups. When entering the operating room, elevated systolic/diastolic (SBP/DBP) was observed in CG compared with RG (P < 0.05) while there was no statistical difference in SBP/DBP in RG before intervention and when entering the operating room (P > 0.05). Statistically, less time of first exhaust and defecation as well as LOS and early food intake were observed in RG (P < 0.05). The HAMA and HAMD scores declined in both arms postintervention, and the decrease was more obvious in RG (P < 0.05). After intervention, the scores of various domains of GQOLI-74 elevated in both arms, and the increase was more obvious in RG (P < 0.05). RG also showed a lower total complication rate and a higher degree of nursing satisfaction than CG (P < 0.05). CNI for patients with gastrointestinal polyps treated by digestive endoscopy can obviously relieve their anxiety and depression, with stable VSs, short LOS, and low incidence of complications.

Impact of enhanced recovery after surgery strategy on early postoperative quality of recovery in patients undergoing laparoscopic surgery for gynecologic malignancy

Objective: To investigate the impact of perioperative anesthesia management with enhanced recovery after surgery (ERAS) strategy on postoperative recovery in patients undergoing laparoscopic surgery for gynecologic malignancy. Methods: Ninety patients undergoing laparoscopic surgery for gynecologic malignancies from April 2018 to April 2019,aged 18-65 years,with American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, were recruited and randomly divided into two groups (n=45) using a random number table:ERAS group (group E) and control group (group C). Patients in group E received general anesthesia combined with transverses abdominis plane block and a series of interventions to optimize anesthetic and perioperative management, while patients in group C were treated with routine anesthesia management. Quality of Recovery-40 questionnaire (QoR-40) was administered to assess the early postoperative quality of recovery on 1 day before surgery, and at 24 and 48h after surgery. C-reactive protein (CRP) before and after the operation were evaluated. The incidence of nausea, vomiting and shivering, the time of first exhaust, ambulation, resumption of normal diet, postoperative hospital stay and complications were recorded. Results: The scores of QoR-40 [M(Q1, Q3)] in Group E were 175(171, 179) and 185(183, 189) at 24 h and 48 h after operation, which were higher than those in group C [162(160, 167) and 180(179, 183)] (both P<0.01). The levels of CRP in both group E and group C increased at 24 h and 72 h after operation. Moreover, the extent of increasing level of CRP in group C was much higher than that in group E [(39.8±18.0) mg/L vs (13.4±6.3) mg/L, (16.6±8.6) mg/L vs (6.7±2.5) mg/L] at 24 h and 48 h after operation (both P<0.01). Compared with group C, the numerical rating scale (NRS) for nausea decreased significantly in group E [0(0, 2) vs 3 (0, 5), P<0.01]. Meanwhile, the incidence of vomiting and shivering in group E was lower than that in group C [8.9% (4/45) vs 26.7% (12/45); 11.1% (5/45) vs 31.1% (14/45); both P<0.05]. The time of first exhaust, ambulation and resumption of normal diet in group E was (14±6) h, 6(6, 13) h and 1(1, 2) d, respectively, which was markedly shorter than that in group C [(25±10) h, 21(19, 27) h and 3(2, 3) d] (all P<0.01). Overall, the postoperative length of hospital stay reduced significantly for patients who followed the ERAS protocol [7(5, 11) d vs 10(7, 14) d, P<0.01]. The incidence of postoperative complications was 17.8% (8/45) and 37.8% (17/45) in group E and group C, respectively, with a significant difference (P<0.05). Conclusion: Implementation of ERAS anesthesia management in gynecologic oncology patients undergoing minimally invasive surgery alleviates perioperative discomfort, decreases surgical stress response, and improves the early postoperative quality of recovery.

Effect of ERAS Combined with Low-frequency Pulsed Electronic Bladder Therapy Instrument on Patients Who Received PPH

Objective: To assess effect of enhanced recovery after surgery (ERAS) combined with low-frequency pulsed electronic bladder therapy instrument on patients who received procedure for prolapse and hemorrhoids (PPH). Methods: rom January 2020 to December 2020, we collected valid data from 172 patients. According to the random number table method, the participants were divided into intervention group and control group, 86 cases in each group. We provided traditional nursing intervention to control group participants during non-surgery period. In addition, we provided ERAS combined with low-frequency pulsed electronic bladder therapy instrument to intervention group participants. Result: intervention group had better outcome in time of first exhaust, time of activity out of bed, and time of hospital stay compare with control group, that the results were significantly different (p < 0.05). In degree of wound pain of patient, NRS scores in preoperative, six hours after surgery, and 24 hours after surgery were lower in intervention compare with control group, that the results were significantly different. Conclusion: RAS combined with low-frequency pulsed electronic bladder therapy instrument can reduce wound pain of patient, and it speeds patient recovery, promotes early urination after surgery, reduces the risk of urinary retention, and shortens the length of hospital stay.

Effect of Modified Dachengqi Decoction Soup on Retention of Intestinal Peristalgia in Patients with Hepatic Biliary Surgery

To evaluate the effect of Modified Dachengqi Decoction Soup on retention of gastrointestinal motility in patients with hepatobiliary surgery after an enema. 100 patients with hepatobiliary surgery were randomly divided into group A and group B (n = 50). A group of postoperative parenteral nutrition, fasting and gastrointestinal decompression and other conventional treatment, B group on the basis of group A plus Modified Dachengqi Soup retention enema, compared the two groups of gastrointestinal motility. The time of first exhaust, abdominal distension disappeared and bowel sounds recovered in group B was significantly shorter than that in group A, which was statistically significant (P &lt;0.05). There was no significant difference between the two groups (P &gt; 0.05). The levels of motilin in group B were significantly higher than those in group A at 2 days after the operation, and there was a significant difference between group A and group B, P &lt; 0.05. The patients with hepatobiliary surgery can not only promote the recovery of the postoperative organs, but also can significantly improve the level of motilin in the body, and thus improve the patient’s gastrointestinal motility.