[Application of clinical nursing pathway in fast-track program of splenomegaly advanced schistosomiasis patients].

OBJECTIVE: To evaluate the effect of clinical nursing pathway in fast-track program (FTS-CNP) in splenomegaly advanced schistosomiasis patients during the perioperative period. METHODS: A total of 80 patients with splenomegaly advanced schistosomiasis who were treated with selective operation in the Affiliated Xiangyue Hospital of Hunan Institute of Parasitic Diseases from January, 2012 to December, 2014 were divided into an observation group (n = 40) and a control group (n = 40). FTS-CNP was implemented in the observation group, while the routine nursing was used in the control group. Then the physical rehabilitation and psychological health levels of the patients in the two groups post-operation were observed and compared. RESULTS: After the operation, the duration of first taking food [(14.67 ± 2.90) h], first anus exhausting [(25.30 ± 3.46) h], first off-bed activity [ (29.40 ± 5.57) h], as well as the duration of hospital stays [(19.00 ± 2.82) d] of patients in the observation group were all shorter than those of the patients in the control group [(44.50 ± 6.71) h, (52.80 ± 6.95) h, (35.05 ± 10.37) h, (25.08 ± 2.39) d, respectively] , and the incidence rate of postoperative complications (7.50%) of the former was lower than that of the latter (25.00%), and all the differences were statistically significant (all P < 0.05). Both the scores of SAS (41.22 ± 5.60) and SDS (40.28 ± 6.67) of the patients in the observation group were lower than those of the patients in the control group (46.89 8.92, 47.06 ± 10.29), both differences were statistically significant (both P < 0.01). CONCLUSION: FTS-CNP can promote the physical and psychological recovery of the splenomegaly advanced schistosomiasis patients post-operation, and also can shorten the hospitals stays and reduce the complications.

[Application of health education path in advanced schistosomiasis patients with splenomegaly in perioperative period].

OBJECTIVE: To evaluate the effect of health education path on advanced schistosomiasis patients with splenomegaly in perioperative period. METHODS: A total of 60 advanced schistosomiasis patients with splenomegaly in perioperative period were randomly divided into an observation group and a control group (30 cases each group). The patients in the observation group were intervened by the nursing and health education from admission to discharge according to the standardized process of health education path, while those in the control group were implemented with the conventional health education. Then the satisfaction of nursing work, hospital stays, hospitalization expenses and mastery of health knowledge of the patients in the two groups were investigated and the results were compared. RESULTS: The satisfaction rates of nursing work of patients in the observation group and the control group were 90% and 60%, respectively, the difference between them was statistically significant (χ2 = 7.57, P < 0.05). The average hospitals stays of the above two groups were 14.0 ± 3.5 d and 19.0 ± 6.8 d (t = 2.85, P < 0.01), respectively, and the average hospitalization expenses were (1.5 ± 0.5) thousand Yuan and (2.2 ± 0.7) thousand Yuan (t = 24.57, P < 0.01), respectively, both of the differences were statistically significant. On the 10th day after surgery, the mastery rates of the health knowledge of the two groups were 96.7% and 50.0%, respectively, the difference was statistically significant (χ2 = 16.86, P < 0.001). CONCLUSIONS: The implementation of the health education path can promote the rehabilitation of advanced schistosomiasis patients with splenomegaly, and increase the satisfaction as well as improve the mastery of the health knowledge of the patients. Meanwhile, it also can cut down the hospital stays and save the hospitalization expenses.

[Analysis on depression of patients with advanced schistosomiasis and its influencing factors].

OBJECTIVE: To explore the status of depression in patients with advanced schistosomiasis and its influencing factors, so as to provide the evidence for improving psychological interventions. METHODS: A total of 206 patients with advanced schistosomiasis were investigated with the self-designed general information questionnaire, the Self-Rating Depression Scale, and WHOQOL-BREF Form. RESULTS: Among the 206 cases, the incidence of depression was 69.4%, and depression was negatively related to the quality of life (P = 0.000). The multiple logistic regression analysis showed that the times of hospitalization (ß = 0.442, P = 0.007) was a risk factor for depression, while the high education levels (ß = -0.583, P = 0.011) and the history of portal hypertension operation (ß = -0.917, P = 0.000) were the protective factors. CONCLUSION: The incidence of depression in advanced schistosomiasis patients is high, and it is influenced by various factors. Therefore, we should take corresponding interventions to reduce its occurrence.

[Study on risk factors of early complications after surgery for schistosomal portal hypertension].

OBJECTIVE: To explore the related factors of early complications after surgery for schistosomal portal hypertension, so as to provide a scientific basis for prevention of postoperative complications and development of perioperative prevention programe. METHODS: Case data of patients with schistosomal portal hypertension in Xiangyue Hospital affiliated to Hunan Institute of Parasitic Diseases from January, 2000 to September, 2009 were collected. With single factor analysis and relevant professional knowledge, related factors were analysed with logistic regression analysis. RESULTS: A total of 52 related factors from the data of 323 cases were analysed with univariate analysis, indicating that 17 factors, including sex, history of bleeding, history of smoking, history of ascites, preoperative length of stay, diameter of portal vein, A/G ratio, albumin, total bilirubin, blood ammonia, total bile acid, operative mode, blood loss, blood transfusion, size of the right liver, postoperative analgesia, time of indwelling gastric tube, were related to the incidence of postoperative complications (all P values < 0.05). Logistic regression results showed the portal vein diameter, A/G ratio, bleeding history, blood loss, time of indwelling gastric tube were risk factors of postoperative complications within 30 days. Postoperative analgesia was considered as the protection factor. CONCLUSIONS: The patients with larger portal vein diameter, lower of A/G ratio, history of bleeding, more loss of blood, longer retention with gastric tube have greater risk of postoperative complication. Loss of blood in operation was the greatest risk, but postoperative analgesia was the protection factor.