Objective To explore the effects of psychological counseling coupled with health education on the alleviation of pain during dressing change after surgery in the patients with high and complex anal fistula incision .Methods Seventy-seven patients with high and complex anorectal surgery were divided into two groups in accordance with different nursing methods after surgery : the control group (n=38) and the observation group (n=39).The control group received routine nursing care , while the observation group was given psychological counseling coupled with health education in addition to routine nursing care .Then, comparisons were made in visual analogue scores ( VAS) at the time of dressing change and 10 min after dressing change , the rate of reaching the set health education standards/the rate of satisfaction with nursing care , the SF-36 scores at the time of dressing change and 10 min after dressing change , as well as the ability of self-care after dressing change .Results ( 1 ) Ten minutes after dressing change , the VAS scores of the 2 groups were all significantly lower than those at the time of dressing change (P<0.01).Furthermore, from the second day after surgery , the VAS scores of the observation group 10 min after dressing change were significantly lower than those of the control group at the same time point of dressing change (P<0.01).Statistical significance could be noted , when comparisons were made be-tween them(P<0.05).(2) The rate of reaching the set health education standards /the rate of satisfaction with nursing care for the ob-
servation group were as high as 94.84%and 100%, which were obviously higher than those of the control group (86.84%, 89.47%), with statistical significance(P<0.05).(3)The excellent rate of self-care after dressing change for the observation group was as high as 89.74%, which was significantly higher than that of the control group (81.58%), also with statistical significance (P <0.05). Conclusion Psychological counseling coupled with health education could effectively alleviate pain during dressing change after surgery in the patients with high and complex anal fistula incision , improve their life quality and increase the rate of satisfaction with nursing care and the ability of self-care.

Objective To investigate prospectively effects of different drainage methods on preventing anastomotie leakage after Dixon operation in rectal carcinomas.Methods During the period of January 2002 to January 2007,450 patients with rectal carcinomas received Dixon operation.They were divided into three groups ( group A,B,and C) in order of admission.Presacral drainage was done in Group A,presaeral drainage + drainage through anus with one tubes in Group B,and presacral drainage + drainage through anus with two tubes in Group C.The postoperative complications of three groups were observed.Results There was 7.33% (11/150) ,8.00% (12/150) and 6.67% (10/150) wound infection in group A,B and C respectively.8.67% (13/150),6.67% (10/150) and 1.33% (2/150) anastomotic leakage occurred in group A,B and C respectively.Three groups had a similar wound infection ineidence(P ＞0.05).The occurrence of anastomotic leakage in group C was statistically lower than that in group A and B ( P ＜ 0.05 ).Conclusion Presacral drainage + drainage through anus with two tubes can effectively prevent anastomotic leakage after Dixon operation in rectal carcinomas.

0.05).Conclusions There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery,1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients,and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.