Objective To explore the clinical effects of ileus tube in treatment of colonic obstruction caused by colorectal carcinoma. Methods Thirtytwo colorectal carcinoma patients with colonic obstruction admitted to our hospital from December 2005 to December 2008 were given onestage radical excision and anastomosis after transnasal or transanal placement of ileus tube for colonic decompression and drainage. Results Combined placement of transnasal and transanal ileus tube was successfully carried out in 19 cases, while the other 13 cases were treated only with transnasal ileus tube. Abdominal pain and distention of all cases were relieved 12-36 h after tube placement, while those of 26 cases disappeared 48-96 h later. Compared with before tube placement, abdominal circumferences of all cases were significantly reduced after tube placement, the mean reduction rate was (81.3±19.6)% vs. 100% (t=3.586, P=0.02). All cases were successfully treated by onestage radical excision and anastomosis 5-7 d after placement, and no serious complications such as peritoneal infection, anastomotic leakage etc. were found. Conclusion Preoperative intubation of ileus tube can enhance the therapeutic effects of onestage radical excision and anastomosis in patients with colorectal carcinoma combined with colonic obstruction.
Objective To investigate the current status of disease uncertainty and alexithymia in elderly hospitalized patients with chronic obstructive pulmonary disease (COPD). Methods By using the convenience sampling method, a total of 165 elderly patients with COPD were investigated by using general information questionnaire, Mishel's uncertainty in illness Scale (MUIS) and Toronto alexithymia scale (TAS-20). Results The disease course of the elderly hospitalized patients with COPD was mostly 3 - 6 years (40.0%), and most of them had 1 - 2 chronic diseases (59.4%). More than half of the elderly had a history of smoking and drinking. The severity of COPD in the elderly was moderate (57.0%), and the number of hospitalization in the year was more than 2 times (58.8%). The score of disease uncertainty in the elderly hospitalized patients with COPD was 89.49±9.45, and the score of uncertainty was the highest (36.59±4.08), followed by the lack of information (18.51±1.86). The score of alexithymia in the elderly hospitalized patients with COPD was 55.32±6.37, and the score of all dimensions was the highest (21.87±2.93), followed by affective recognition disorder (18.27±2.55). The results of correlation analysis showed that the total score and scores of each dimension were positively correlated (P<0.01). The results of multi-factor analysis showed that age and course of disease and severity of COPD were the main influencing factors of disease uncertainty in elderly hospitalized patients with COPD (P<0.05). Conclusions The elderly hospitalized patients with COPD have a moderate level of disease uncertainty and a high degree of alexithymia. Besides, the greater the disease uncertainty is, the more serious the alexithymia. Therefore, clinical doctors and nurses should pay more attention to give emotional and psychological support and education guidance to the elderly patients with COPD, in order to improve their clinical efficacy and quality of life.