Observation on the effect of short single reverse-α fixation of nasobiliary tube / 中国实用护理杂志

Objective:To investigate the effect of short single reverse-α fixation of nasobiliary tube after endoscopic nasobiliary drainage.Methods:From January 2019 to October 2019, the patients who performed with endoscopic nasolbiliary drainage in Tongji University Affiliated Shanghai East Hospital were randomly divided into experimental group (short single reverse-α fixation, 155 cases) and control group (routine reverse-α fixation, 137 cases). The incidences of the fixation time, prolapse rate, nursing time, scores of nasal comfort and bile flow rate of nasobiliary duct were evaluated between the two groups.Results:The average time of nasobiliary duct fixation was (18.31±1.67) s, the prolapse rate was 5.2% (8/155) and the time of nursing was (35.03±2.68) s, which were lower than those of the control group (46.50±5.50) s, 13.9% (19/137) and (72.07±7.63) s. The difference was statistically significant ( t or χ 2 values were 60.795, 6.570, 56.629, P<0.01 or 0.05). The comfort score of the experimental group was (4.61±1.06) points, the bile flow rate was (241.52±53.95) ml/days, which were higher than (5.76±0.76) points and (174.09±47.55) ml/days of the control group, the difference was statistically significant ( t values were 10.448, 11.265, P<0.01). Conclusions:Shortening the length of nasobiliary duct combined with single reaction "α" method has the advantages of simper operation and nursing, low prolapse rate, high comfort and good drainage effect. It is worthy of clinical application.

The bile characters after endoscopic intubation of nasal biliary pancreatic drainage tube and the value of drainage tube irrigation / 实用医学杂志

Objective To investigate the bile characters and the value of drainage tube irrigation after endoscopic implantation of nasal biliary pancreatic drainage tube. Methods The clinical data of 331 patients having undergone intubation of integrated nasal biliary pancreatic drainage tube after remedial ERCP from Janu-ary 2012 to October 2017 were retrospectively analyzed. The patients were divided into the irrigation group and non-irrigation group. The bile characters and positive rate of bile bacterial culture were recorded. Results For all the 331 patients,the nasal biliary pancreatic drainage tubes were successfully intubated. The normal rate of bile characters and positive rate of bacterial culture were significantly different between the two groups on day 1 and 3 after operation(P < 0.05). There was no significant difference between them on the first day after opera-tion(P > 0.05),but the difference between the groups was statistically significant on day 3 after operation(P <0.05). The differences in the postoperative drainage tube blockage rate,prolapse rate and bleeding rate were sta-tistically significant between the two groups from day 3 to 7 after operation(P < 0.05). Conclusions The bile characters after endoscopic intubation of nasal biliary pancreatic drainage tube can indicate the biliary tract infec-tion,bleeding,bile drainage tube blockage and prolapse of bile drainage tube. Drainage tube irrigation can be used to control biliary tract infection and bleeding,and reduce the blockage and prolapse rate of postoperative drainage tube.

Nursing of endoscopic full-covered self-expanding removable metal stents implantation for bile duct anastomotic strictures after liver transplantation / 中国实用护理杂志

Objective To investigate the nursing points of endoscopic full-covered self-expanding removable metal stents (FCSERMS) implantation for bile duct anastomotic strictures after liver transplantation. Methods The clinical data of patients who were treated by endoscopic full-covered self-expanding removable metal stents implantation for bile duct anastomotic strictures after liver transplantation from January 2013 to July 2015 were retrospectively analyzed, and the nursing process were summarized. Results The group of 9 patients were successfully placed and removed with FCSERMS. There was no postoperative complication, such as stent migration, acute pancreatitis, biliary bleeding and intestinal leakage. All the bile duct strictures were relieved after FCSERMS removement. Followed up for 10-32 months, there was no symptom and sign of bile duct anastomotic stricture recurrent. Conclusions The key in nursing points of FCSERMS implantation for bile duct anastomotic strictures after liver transplantation are introducing the function of FCSERMS and therapeutic process to improve patient compliance, mastering the endoscopic operations, the placement and removal method of FCSERMS to short operation time, strengthening postoperative nasal bile duct care, paying attention to the observation, detection and treatment of postoperative complications after the metal stent placement and removement, as well as the continuing care during the period between placement and removment of FCSERMS.

Application and nursing care of persistent balloon dilatation for anastomotic stricture after choledochojejunostomy / 中国实用护理杂志

Objective To investigate the value and nursing of persistent balloon dilatation for anastomotic stricture after choledochojejunostomy. Methods The clinical data of 14 cases of anastomotic strictures after choledochojejunostomy accepted the treatment of persistent balloon dilatation were analyzed retrospectively. The effect, adverse reactions and approriate nursing were evaluated. Results Five patients were performed with persistent balloon dilatation thorough the output loop of intestine after choledochojejunostomy and 9 patients through percutaneous transhepatic cholangiography. There was no hemobilia, bile leak or other serious complications. There were 2 cases of balloon dilatation catheter damage, 5 cases of pressure pump damage and 4 cases of balloon migration with 25.0% (7/28) instrument damage rate and 4 cases of balloon migration. After persistent balloon dilation for 6 to 8 months, no anastomotic stricture was found by choledochoscopic examination. Follow up for 6 to 18 months, 2 cases had recurrent anastomotic stricture. Conclusions Persistent balloon dilatation by percutaneous transhepatic cholangiography is a simple, safe and effective method for anastomotic stricture after choledochojejunostomy. In the course of nursing, the balloon catheter and pressure pump damage, and balloon migration should be noted.

THE INVESTIGATION OF PALMAR PATTERNS IN HAN NATIONALITY OF CHINA / 解剖学报

An investigation of palmar patterns on 900 cases Han nationality of China wasmade.The main purpose of this paper is to provide the normal values of Chinese dermatoglyphics and human genetics.The main characters of palmar patterns of Han nationality are as follows:mainline A:type Ⅰ 7.89%,type Ⅲ 91%,type Ⅴ 1.11%;main line B:type Ⅴ 80.72%,type Ⅶ 16.78%,type Ⅸ0.67%,type Ⅺ0.06%,type O(absent)0.11%,typeⅢ 1.67%;main line C:type Ⅴ 38.78%,type Ⅶ 32.67%,type Ⅸ 16.06%,typeⅪ0.44%,type O(absent)12.06%;main line D:type Ⅶ and type Ⅸ all 40.61%,type Ⅺ 18.39%,type O(absent)0.39%.The average value of AD main line formula is 6.50?1.61(SD).There are sig-nificant difference between sexes and two hands(R.L.)(P0.05).The frequency of complicatedpalmar creases is 5.22%.The rate of symmetrical main lines between two hands is34.89%.The main type of A.B.C.D main line is 3.5′.5″.7(18.11%).