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Of bowel preparation before gynecologic surgery annex return of bowel function after surgery


Water fasting the day of surgery; 89 cases of emergency surgery as a control group without preoperative fasting enema no water,[link widoczny dla zalogowanych], no squat significant difference in operative time,[link widoczny dla zalogowanych], narcotic drugs and doses were no significant differences. Results First,[link widoczny dla zalogowanych], patients after discharge were observed compared to the situation shown in Table l. Table 1 Comparison of two groups of patients surgical cases,[link widoczny dla zalogowanych], after statistical analysis in Table 2. Table 2 groups the comparison operation between the two groups of patients significant differences r = 8.4, dead <0.05 was statistically significant, the control group was the first time to flatus earlier than the observation group. Discussed before surgery enema, fasting water has been used as a routine gynecological surgery for decades, its purpose is to ensure that the operation, empty gut, preventing induction of anesthesia and surgery in the visceral and vomiting caused by aspiration. But before the operation of water enema and fasting can bring greater negative impact. Fasting before surgery because of hunger caused by the water body can be a series of physiological changes, resulting in an increase in the acid in the body, resulting in physical consumption, a common clinical enema in some patients can not tolerate due to intestinal cramps and colic caused by the lead to collapse. At the same time also increase the patients before surgery enema fear, pain and discomfort. Because preoperative enema and fasting in water, the stomach of 83 normal bowel function, coupled with slowed gastrointestinal motility rate of emptiness, leading to the observation group and control group on the recovery of intestinal function after surgery a significant difference Therefore, the observation group of patients that did not benefit from the enema. Even some patients a good night of rest before the surgery, resulting in psychological stress, we can always hear when enema patient complained of nagging like to be in pain. Intestinal surgery involves very little attachment of the 89 patients in the control group, nor because of enema and cause difficulties to the operation. In contrast, in patients with reduced preoperative psychological fear and pain, to ensure its adequate sleep and good rest. In the physiological early resumption of intestinal function, the control group were eating earlier than the observation group, which is no doubt the recovery of physical and mental health is extremely beneficial. In conclusion, preoperative enema gynecology annex, the practice of fasting water, did not improve post-operative recovery of intestinal peristalsis, while the patient there is the fear of surgery based on the enema has deepened concerns, fear and discomfort of these various psychological pressure, often lead to patients not in a good rest before the operation, causing the body intolerance, increasing the probability of complications, a direct impact on the patient's recovery. Health care should be taken into account as a preoperative preparation, especially the sausage and its negative psychological impact of care, increased tolerance of surgical patients to reduce the consumption of physical fitness. Therefore proposed annex surgery for gynecological patient should be improved method of bowel preparation before surgery so that postoperative rehabilitation as soon as possible. Laparoscopic cholecystectomy in the elderly diagnosis and treatment of Xinjiang Production and Construction Corps, Second Division Yanqi Hospital (841100) Bin Zhao Bao Yu Xuemei our hospital in 2000 - 2003 laparoscopic cholecystectomy (Lc) 361 cases, including elderly patients over 60 years old 66 cases, accounting for 18% of surgery over the same period. Now the clinical features of elderly patients, preoperative preparation and treatment, combined with their own experience for discussion. Materials and Methods I. General information: The group of 66 cases in 21 males and 45 females, aged 60 years minimum, maximum 81 years, mean age 62.5 years. Preoperative B-confirmed 52 cases of gallbladder stones, gallbladder polyps l4 cases, 28 cases associated with biliary colic symptoms. The shortest duration of 5 days, the longest 44 years, repeated attacks by conservative medical treatment of 44 cases, accounting for 66%. Second, the complications: preoperative routine examination revealed coronary artery disease, hypertension, diabetes, chronic bronchitis, emphysema and other complications in 45 cases, accounting for 68%. 3 cases of gastric resection, liver hydatid cyst excision in 2 cases, accounting for 7.5%. Third, the surgical method: are intravenous anesthesia with tracheal intubation, preoperative cleansing enema, intraoperative indwelling catheter, a low pneumoperitoneum, to meet the operation field is appropriate. Surgery because of previous laparotomy had surgery in 5 patients converted to open cholecystectomy in 3 cases Triangle adhesion. Fourth, postoperative complications and Results: The day after Lc into the liquid, return to normal bowel function within 3 days. 8 cases were converted to laparotomy, postoperative wound infection in 2 cases, 1 case Lc oozing wound after discharge, severe anemia, renal failure, death. Average length of stay 7 days to discuss the incidence of gallstones increases with age. ... Cholecystectomy in the elderly common surgery, open cholecystectomy (0c) with the annual increase in complications, especially respiratory and cardiovascular morbidity in elderly patients increased significantly. Laparoscopic cholecystectomy (Lc) can reduce complications. Caesarean section for the elderly can cause greater stress. Lc has the advantage of trauma, less pain, quick recovery, but also less stress. However, due to the body unresponsive elderly patients, immunocompromised,