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The role of the radiographer in gastroenterology
VOSEJPKA, Roman
This bachelor thesis focuses on radiological imaging methods that are used in gastroenterological examinations. In radiology, machines keep developing, improving and they become an inherent part of practically all branches of medicine. They are being applied in both, therapy as well as illness diagnosis. The thesis is divided into a theoretical and a practical part. The objective is to bring individual gastroenterological examinations closer using radiological assistance and to describe the role of a radiographer during these performances. The theoretical part mainly describes the anatomy of the digestive tract and its pathology. Further on, the theoretical part contains information on the individual gastroenterological examinations, contrast substances and radiological imaging methods. The practical part has been processed using the data collected from the NIS AKORD hospital system. Based on acquired data, tables and graphics were created, using percentage representation. NIS AKORD data has been accompanied by data that I aquired via a random choice from the Institute of Health Information and Statistics of the Czech Republic database. I have chosen a few figures that are linked to both, the area of radiology and imaging methods as well as gastroenterology. The objective is to describe the process of individual gastroenterology examinations utilizing radiological assistance and to bring the role of the radiographer in the above-mentioned performances to a closer focus.
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Imaging of the gastrointestinal tract - ERCP
HROCHOVÁ, Simona
The bachelor thesis on GIT imaging methods with focus on ERCP deals with diagnostic and therapeutic methods and provides an overview of the individual imaging methods used in diagnostics and therapy. In the practical part, the thesis focuses on the ERCP diagnostic and therapeutic method. Knowledge of anatomy is indispensable for the orientation in this field and for the quality work of radiological assistants and physicians, and therefore the introduction is dedicated to GIT anatomy. Diagnostic procedures, including imaging methods, are described in each individual anatomical area, and the most common diseases affecting the indicated GIT area are listed. The second half of the theoretical part describes the diagnostic and therapeutic imaging methods of the digestive tract with respect to the anatomical area in which the examination is carried out, which fall under the X-ray unit and are performed by radiological assistants and doctors. The practical part is focused on the diagnostic and therapeutic method ERCP and its use at the RTG unit at Thomayerova hospital in the years 2014-18. The work covers the entire course of the examination from the preparation of the patient to the therapeutic procedures. A set of patients is used in terms of the frequency of the examinations carried out in 2014-18. In the individual years, patients are further broken down and analysed based on the decade of birth and gender. The data sets obtained are processed into clear graphs and the use of the method today is evaluated based on the proportion of patients undergoing the examination in the individual years using the date of birth and gender criteria. Specialized books and articles as well as verified internet sources were used to write this bachelor thesis. The results of my work give answers to the research question about the preferences of using the ERCP examination. They reflect the ongoing trend in the use of ERCP in diagnostics and especially in therapy due to the undeniable advantage of the use of therapeutic interventions immediately during the diagnostic examination. The aim of the thesis is to create a general overview and description of the individual methods of GIT examination according to the individual anatomical area with focus and a more detailed description of the ERCP method. An analysis of the data set obtained at the Thomayer Hospital's RTG unit was carried out.
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Nursing care of the patient with acute pancreatitis
DOLEJŠÍ, Kateřina
This is a bachelor's thesis entitled Nursing Care of a Patient with Acute Pancreatitis. This thesis attempts to describe acute pancreatitis to health professionals and the general public. Nowadays, the incidence of acute pancreatitis is rising. The rise of this disease is associated with increased consumption of alcoholic beverages and increased amounts of animal fat in the diet. The first section is focuses on the medical part including symptoms, causes, diagnosis and treatment. The second part concentration the nursing care of a patient with acute pancreatitis is focused on patients in the intensive care unit but also on patients in the general admissions section. An integral part of nursing care is the education and nutrition of the patient, which is important during hospitalization and after discharge. The nurse must educate the patient about lifestyle changes (the right diet they have to follow, the absolute abstinence of alcohol consumption and the reduction of fatty foods) before leaving the hospital. It is also advisable for the patient to consult a nutritional therapist. Two goals were identified 1. Map peculiarities of nursing care of a patient with acute pancreatitis 2. Describe the principles that the patient must follow at home after discharge from hospital This bachelor thesis is written in the theoretical form and is processed by the method of review and synthesis. When writing the theoretical work, it was necessary to examine a large number of Czech and foreign literature, bachelor theses, expert articles and databases on the internet. In obtaining information on this work, it has been found that patient education is not always properly implemented. Inadequate education is primarily the cause of recurrence of pancreatitis. The recurrence of the disease can not always be attributed to inadequate education. In some patients, even if they were properly educated, were unable to reassess and change their lifestyle, leading to patient rehospitalization. The outcome, as well as the contribution of this bachelor thesis, is a study material that is intended for both non-health professionals and professionals.
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The role of nurses in endoscopic examinations
URBANOVÁ, Radka
Nowadays, endoscopy is considered one of the most widely used methods of examination. It enables not only the examination of bodily cavities, but also the extraction of tissue or other medical procedures. Endoscopic examinations are widely used. Thanks to preventive colonoscopies, diagnoses of the widely spread colorectal carcinoma occur in time. Another type of an endoscopy selected for the thesis is a gastroscopy. It allows the removal of foreign objects or the diagnosis of pathological changes in the upper part of the gastrointestinal tract. The last of the selected examinations is the Endoscopic Retrograde Cholangiopancreatogram (ERCP). It is considered the most reliable method for the diagnosis of pancreatic cancer, which occurs with increasing frequency. Additionally, it is the only one of the selected endoscopic examinations which combines endoscopy with X-ray imaging. It has, therefore, become unique due to the direct imaging of the pancreatic and biliary tracts. This disadvantage of endoscopic examination creates certain complications. These may occur during the procedure as well as in various intervals following the examination. It is, therefore, essential that patients are thoroughly prepared, examined by a doctor beforehand and that the execution of each examinations is sufficiently thought through. The work of nurses in endoscopic workplaces has certain specifics. These nurses must be able-bodies and must have technical and manual skills, since they need to operate costly endoscopic equipment. It is of utmost importance that the nurses have good communication skills, as they are the ones who come into contact with the patients most often. They should be able to alleviate the concerns of the patient, since this is the main purpose of their work. Last but not least, every endoscopic nurse should also have very good theoretical knowledge regarding the anatomy and physiology of the digestive tract, as well as expertise in the field of endoscopy.
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Problems of nursing care in endoscopic retrograde cholangiopancreatography.
RYVOLA, Lukáš
Theoretical groundwork Endoscopic Retrograde Cholangiopancreatography (ERCP from now on) is nowadays referred to as the golden standard in diagnostics and treatment of bile duct and pancreas diseases. At the same time it is regarded as the most reliable method of modern medicine in diagnostics of most common oncogenic diseases of pancreas. This examination combines endoscopic diagnostics with X-ray screening and it is unique thanks to the direct display of bile and pancreas ducts. Final picture is made by probing of Vater papillae filled by a contrastive liquid. Other merit consists of completing eventual therapy that follows the diagnostic ERCP. Disadvantages of this examination are complications that may arise already when probing or after a certain period of time. Therefore it is essential to consider each ERCP procedure carefully. Nursering ERCP at the endoscopy section as well as at the ward block of the gastrointestinal department bears its particularities. The priority at the endoscopic section is to employ manually and technically competent nurses skilled in ERCP so they can assist the gastrointestinalist properly. The nurses must be also able to establish contact with the patient to guide him through the examination, using professional skills. Exactly the nurses moderate possible concerns of the examined person. Communication at the ward block is crucial as well ? the nurses explain particularities of the treatment and instruct the patient in basic rules of hospitalisation. They also must be professionally skilled to care for patients after ERCP. Goals of the thesis The aim of this thesis is to monitor particularities of nursing ERCP at the endoscopic section of the gastrointestinal department and to learn how the general treatment of ERCP patients is carried out at the ward block.Qualitative methodology was used for the empirical part of the thesis. Data were collected by interviewing and hidden observations.Results The research survey indicated that ERCP examination nursing treatment bears its particularities that are well known and reflected by nurses at the endoscopy section. Patients confirm that the skills of nurses minimize their stress when undergoing the treatment. The survey indicated that an ERCP examination should be assisted by a nurse with not only technical and manual skills but also empathic and anticipating qualities in order to react appropriately without confusion. Nurses should be able to explain the treatment to the patient properly and to create a comfortable ambience. The survey also indicates that nurses actively seek for courses to keep their knowledge up to date. Particular complications are managed very well by the nurses, they are familiar with specific complications and are always prepared and able to provide the patients adequate nursing. Nursing at the ward block is also at high level in the field of knowledgeableness when informing patients or preparing arrangements and regimes. The patients themselves are satisfied with the overall care after the ERCP examination. The hidden observations show that the nursing after ERCP examination follows the literature properly. Pleasant surprise was that nurses at the ward block of the gastrointestinal department fully implement the five parts of nursing process ? from reviewing the health status of the patient in the beginning to their final evaluation, and that they concurrently create up-to-date nursing diagnoses.
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X-RAY controlled implantation stents to stenoses in gastrointestinal system.
CERKUNÍKOVÁ, Anna
X-ray controlled stent implantation into gastrointestinal tract stenoses is a modern mini-invasive method. Many medicine branches have gone through considerable development in the second half of 20th century. In many cases it has been based on new discoveries in disease pathogenesis, new approaches in therapy and most importantly on new technical possibilities. This thesis describes treatment of stenotic tumors in gastrointestinal tract that used to belong to frequent surgery indication, regardless of possible radicality. Intervention radiology is a dynamic and quickly developing specialisation. New material and procedures development extends the possibilities of mini-invasive therapy in gastrointestinal tract illness. Instead of surgery, stent implantation is indicated in many cases. This method has many advantages when comparing with surgery, e.g. lower invasivity without general anesthesia usage and short recuperation. Indications of stent implantation into gastrointestinal tract stenoses can be divided according to more aspects, e.g. stenosis localisation, stenosis etiology, inborn or acquired stenoses and last but not least benign and malign stenoses that are the main topic of this thesis. The aim of this thesis is success and effectively assessment in stent implantation into gastrointestinal tract stenoses. The procedures are divided according to stenosis localisation in a certain period. The results are compared with other centers in the Czech Republic. In every procedure, we assess the etiology, stenosis localisation, patient age and sex, procedure type and its success rate, early and late complications (to 30 days from the procedure). As in the majority of cases we analysed patients with inoperable malign tumors, the mortality was not assessed. This thesis confirms the only chosen hypothesis ? the stent implantation in gastrointestinal tract stenosis is a quick and effective method with a low number of complications. Our department wants to use the data acquired in practise to compare the success rate and complication number with other centers and according to the results to confront the procedure method.
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Support - intervention radiology diagnostic methods at liver´s investigation
MÁDR, Robert
The special field of radiology, interventional radiology, is a logical result of the current technological development in medicine. The purpose of interventional radiology is to include the knowledge of clinical, especially surgical, procedures, and a considerable development of imaging methods for treatment some diseases and conditions with minimum damage of the exterior integtiry og human body. This is made possible only by using the current imaging methods based not only on the X-ray radiation but also on ultrasound and magnetic resonace imaging to guiding surgical instruments in body cavities and organs. Intervention radiological methods achieved considerable technological progress expressed mainly in quality and sensitivity of medical examinations which increases the possibilities to make the correct diagnosis and achieve succesful treatment. My thesis deals with liver, gallblader and gall ways diseases and the radiological imaging of these parts of the body. Together with the development of various hepatobiliary system diseases upgrade examination techniques are being developed. The examination techniques include classical radiological methods, endoscopic methods, CT and magnetic resonace imaging and also the intervention diagnostics and hepatobiliary surgical treatment. In the practical section of my thesis I describe the anatomy, pathology, examination indications and examination methods themselves. I also refer to the special instrumenarium {--} a collection of instruments and other equipment for an operation or for a medical procedure. The objective of my thesis was to give a complete survey of interventional radiological methods used by a radiologist in liver examinations.
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