Objective To explore the influence of peritoneal lavage therapy at different time on efficacy of severe acute pancreatitis (SAP)patients with intra-abdominal hypertension (IAH). Methods 68 SAP patients with IAH were divided into 3 groups according to time of peritoneal lavage therapy,including group A (n =20,≤24 hours),group B (n =26,>24 hours~≤ 48 hours)and group C (n =22,>48 hours~≤72 hours).APACHE-Ⅱscore was calculated and in-tra abdominal pressure (IAP)was measured before treatment and 7 days after peritoneal lavage therapy.Results APACHE-Ⅱscore and IAP 7 days after peritoneal lavage therapy in all groups decreased significantly (P <0.01).Along with the time delay of peritoneal lavage,the decline of APACHEII score and IAP 7 days after peritoneal lavage decreased gradually (P <0.05).7 days af-ter peritoneal lavage treatment,the degree of decline of IAP in group A was significantly greater than group B (P <0.05).Conclusion Application of peritoneal lavage therapy within 24 hours is the best time for treatment of SAP patients with IAH.

Objective To explore the influence of peritoneal lavage therapy at different time on efficacy of severe acute pancreatitis (SAP)patients with intra-abdominal hypertension (IAH). Methods 68 SAP patients with IAH were divided into 3 groups according to time of peritoneal lavage therapy,including group A (n =20,≤24 hours),group B (n =26,>24 hours~≤ 48 hours)and group C (n =22,>48 hours~≤72 hours).APACHE-Ⅱscore was calculated and in-tra abdominal pressure (IAP)was measured before treatment and 7 days after peritoneal lavage therapy.Results APACHE-Ⅱscore and IAP 7 days after peritoneal lavage therapy in all groups decreased significantly (P <0.01).Along with the time delay of peritoneal lavage,the decline of APACHEII score and IAP 7 days after peritoneal lavage decreased gradually (P <0.05).7 days af-ter peritoneal lavage treatment,the degree of decline of IAP in group A was significantly greater than group B (P <0.05).Conclusion Application of peritoneal lavage therapy within 24 hours is the best time for treatment of SAP patients with IAH.

Objective:To explore the clinical effect of multidisciplinary cooperative intervention in improving self-management and improving fluid retention in the elderly patients with chronic heart failure.Methods:Totally 130 cases of the elderly patients with chronic heart failure from January to December 2018 were enrolled and were divided into control group and observation group with 65 cases randomly. The control group received routine nursing instruction and telephone follow-up. The observation group was given multidisciplinary team guidance to patients self-management in addition to routine nursing instruction and telephone follow-up. After 3 months, the self-management and fluid retention of the two groups were compared.Results:After 3 months of intervention, the scores and total scores of the observation group in the four dimensions of drug management, diet management, psychological and social adaptation management, symptom management were 19.43±0.71,11.51±0.59,19.07±0.65,25.24±1.31, 72.65±7.16, the control group was 11.09±3.40, 6.05±1.71, 12.73±2.49, 15.72±4.18, 46.35±7.83. The scores and total scores of the observation group were better than those of the control group ( t value was 4.835-13.727, all P < 0.05).After intervention for 3 months, the proportion of severe edema, moderate edema and mild edema in the observation group was 4.61% (3/65), 13.85% (9/65), 81.54% (53/65), respectively, and the control group was 38.46% (25/65), 52.31% (34/65) and 9.23% (6/65) respectively. The degree of fluid retention in the observation group was better than that in the control group ( Z value was -2.373, all P < 0.05). Conclusion:Multidisciplinary cooperative intervention can improve self-management and improve fluid retention in elderly patients with chronic heart failure.