ABSTRACT
Sixty two patients with small bowel bleeding underwent double balloon endoscopy (DBE).Clinical features were compared between patients with positive DBE findings (50 cases) and those with negative findings (12 cases).Results revealed that the causes of melena were discovered in 75.0％(21/28) patients via oral approach,while the lesions were found in 81.8％ (18/22) patients with hematochezia via anal approach ( P ＜ 0.01 ). Duration of bleeding was longer and number of bleeding episodes was higher in patients with positive DBE findings than those with negative findings (P ＜ 0.05 or P ＜ 0.01 ).The time interval between the latest bleeding and DBE was significantly shorter in patients with positive DBE findings (P ＜ 0.05).Positive diagnostic rate was significantly higher in patients with three or more bleeding episodes than those less than three times (92.5％ vs.11.1％,P ＜ 0.01 ).DBE performed within seven days or less increased the positive diagnostic rate significantly than that after seven days (97.1％ vs.59.3％,P＜0.01).
ABSTRACT
Objective To evaluate the efficacy,safety and points of Nursing care of intravenous anesthesia with remifentanil and propefol for painless gastroscope. Methods 180 patients scheduled for painless gastroscope were randomly allocated into remifentanil group and fentanyl given a bolas injection of fentanyl at 1.0 μg/kg intravenously. One minute later,all the patients were given a loading dose of propefol of 0.4mg/kg followed by boluses of propofol(0.2mg/kg)administered intermittently until Ramsay sedation scale Ⅲ～Ⅳ. The induction time of anesthesia,in-tubation time of gastroscope,time of recovery from anesthesia and stay in the post anesthesia care unit(PACU)were recorded. The mean arterial pressure(MAP),heart rate(HR),ptdse oxygen saturation(SPO2)and respiratory rate(RR)were measured and recorded with noninvasive moni-toring. The body movement,apnea,hypotension and bradycardiac were recorded during operation. All the patients were reviewed for satisfaction after the operation. Results The time of anesthesia induction,intubation time of gastroecope,time of recovery from anesthesia and stay in PACU in remifentanil group were shorter than those in fentanyl group(P < 0.05) ,and propofol eousumption was signitlcantly less in the former group (P < 0.05). Greater MAP decrement was observed in remifentanil group (P < 0.05). Much higher incidence of bradyeardia or hypotensian in remifentail groups was found than that in fentanil group(P < 0.05). Fewer patients had body movement while more had respiratory depression in remifentanil group than in fentanyl group(P < 0.05). No significant difference(P> 0.05)was observed between remifentanil group and fentanyl group in terms of the incidence of hypoxemial. The rate of patient-reed satisfaction was significantly higher in remifentanil group (P < 0.05). Conclusion Intravenous anesthesia with remifentanil and propofol for gastteseope is safe and reliable,Intravenous remifentsnil and propofol for gastroscopy provides more bradycanfia or hypoteusio compared with intravenous fentanyl and propofoL Cautions should be taken by the quent occurrence of hypoxemia with intravenous remifentani. The guardianship and the nursing care are important to painless gastroscope.
ABSTRACT
OBJECTIVE To discuss the related factors of toxigenic Helicobacter pylori(Hp) infection among adult population in Futian District,Shenzhen.METHODS A total of 1164 adults who had health examination in community centers were investigated through questionnaire and detected Hp antibodies.RESULTS The Hp and toxigenic Hp infection rates among them were 45.5% and 14.2%.Among them 46.3% and 14.8% were in males,and 44.7% and 13.4% in females.People less than 60 years old had higher incidence of Hp and toxigenic Hp,but decrease in people rnore than 60 years old.Hp and toxigenic Hp infection rate in married people were higher than those of unmarried.In workers,farmers and doctors were higher than staff and other occupations.The incidence were higher in drinking raw water than those drinking boiling water.in taking antibiotics before serologic examination were lower than no taking antibiotics;in peptic ulcer disease were higher than in no peptic ulcer disease;in per capita housing area over 6 m2 were higher than less 6 m2.CONCLUSIONS The infection rates of Hp and toxigenic Hp among our adult population are low,and positively correlated with age but gender.The social environment such as living condition,economic income,culture level and residential density maybe influence the infection of Hp.The route of transmission of Hp is unknown yet,water perhaps is an important dissemination medium.