Chronic kidney diseases (CKD) with long duration and a variety of complications have caused great physical and psychological problems for patients, and the overall quality of life of patients is low. Taijiquan, as a traditional Chinese techniques project, is beneficial to improving cardiopulmonary function, enhancing lower limb muscle strength, and reducing cardiovascular and cerebrovascular risks. We summarized the latest progress in clinical research concerning taijiquan as exercise rehabilitation for patients with CKD, aiming to promote the clinical application of taijiquan and other traditional exercises in the rehabilitation process of CKD patients and improve the overall quality of life of CKD patients.
High-voltage electric burns is refractory with high rate of amputation (46%) in early stage and unfavorable functional recovery in later stage. Little breakthrough has so far been made in this respect. From Jan. 1985 to Jan. 1996, ninety-six cases with high-voltage burns were treated in our department. Seventy-one cases of various tissue flap grafting were applied to treat early electric burns, among which sixty-four cases were successful. The amputation rate was reduced to 30%. Postoperatively, a long-term rehabilitation training at home was carried out. Most of them achieved a good appearance of the wounded sites and limbs and satisfactory ability to work or self-care. It was suggested that early thorough debridement of necrosis tissue, careful reservation of living tissue, appropriate choice of tissue flap and postoperative rehabilitation training were of great importance to achieve a good prognosis.
Objective To investigate the status quo and influencing factors of depression and anxiety in postoperative patients with thoracic neoplasms. Methods The general information questionnaire and Huaxi emotional-distress index scale (HEI) were adopted to survey 70 patients after surgery of thoracic neoplasms at the thoracic nursing outpatients from September to November 2016. There were 43 males and 27 females with age of 18-78 (56.20±11.34) years. Results The prevalence rate of depression and anxiety among postoperative patients with thoracic neoplasms was 50.0%, and moderate to severe negative emotions predominated. There was significant difference in educational levels, postoperative hospitalization and postoperative complications (P<0.05), while no significant difference in age, gender, disease types, complicated diseases, surgical procedures, pathological stages and hospitalization expenditures between patients with unhealthy emotions and normal emotions (P>0.05). Conclusion There is a high prevalence rate of negative emotion among postoperative patients with thoracic neoplasms. Educational levels, postoperative hospitalization and postoperative complications are important factors for negative emotion.
ObjectiveTo investigate the clinical safety and feasibility of thoracic sympathectomy in the treatment of palmar hyperhidrosis based on ambulatory surgery.MethodsA retrospective analysis of 74 patients who underwent thoracoscopic sympathectomy in the Department of Thoracic Surgery of the First People's Hospital of Yunnan Province from January 2017 to April 2021 was performed, including 35 males and 39 females aged 12-38 (21.32±4.13) years. Patients were divided into two groups according to different treatments. There were 34 patients in a control group (adopting traditional surgery), and 40 patients in an observation group (adopting ambulatory surgery). The clinical effects of the two groups were compared.ResultsNo massive bleeding, conversion to thoracotomy, postoperative pneumothorax or severe pneumonia occured in all patients. Univariate analysis of intraoperative indexes showed that the two groups had no statistical difference in total hospitalization cost, operation time, anesthesia time or postoperative waiting time (P>0.05). The amount of intraoperative blood loss in the observation group was less than that in the control group (P<0.05). The time of postoperative out of bed and recovery of walking capacity and the incidence of electrolyte disturbance in the observation group were shorter or lower than those in the control group (P<0.05). There was no statistical difference in white blood count, neutrophils count or postoperative 24 h pulse oxygen saturation fluctuation peak between the two groups (P>0.05).ConclusionBased on the optimized diagnosis and treatment model, thoracoscopic sympathectomy with laryngeal mask airway which is performed during ambulatory surgery, is feasible and worth popularizing in thoracic surgery.
目的：了解地震截肢伤员的伤情特点，为其康复提供依据。方法：2008年6月～2008年12月31日，华西医院康复中心收治33例地震伤截肢患者，观察分析其伤情特点和康复治疗变化。结果：男性15例（45.5%），女性18例（54.5%）；男性与女性的年龄相比无统计学意义（P＞0.05）；10～19岁青少年45.45%；学生51.52%，在职人员33.33%；重物砸伤占78.79%；膝上截肢占43.90%，上肢截肢21.95%，下肢78.05%；截肢合并症13种，肾功衰最多，占28.57%；手术次数平均2.55次；残端有2例愈合差，有14名培养出细菌；日常生活活动能力Barthel指数入院时50.92±16.76，出院时77.77±14.37。结论：地震截肢伤员伤情重，残端情况差，康复治疗效果明显。
Objective To explore the application of enhanced recovery after surgery (ERAS) in pain management after knee arthroplasty (TKA). Methods Doctor-nurse pain management team was established based on ERAS between June and July 2016, and the pain management was carried out after training the doctors and nurses. According to the formula of two-sample mean comparison and inclusion and exclusion criteria, 60 TKA patients admitted to the hospital from March to May 2016 were assigned into the control group (before intervention) and 60 TKA patients admitted from August to October 2016 were assigned into the trial group (after intervention). The patients in the control group received routine pain management. In the trial group, preventive analgesia was performed, pain health education paths were built and ISBAR communication mode was made preoperatively; anesthesia protocols were optimized intraoperatively; multimodal analgesia based on time-demand was used postoperatively; continuing analgesia program was provided at the discharge. The pain score, Hospital for Special Surgery (HSS) knee score, average length of stay (ALOS) and average hospitalization cost (excluding materials) were compared between the two groups. Results The pain scores between the two groups at the admission and 6 hours after surgery were not statistically different (P>0.05), and the pain scores in the trial group 24, 48, 72 hours after surgery were significantly lower than those in the control group (P<0.05). The HSS scores between the two groups at the admission were not statistically different (P>0.05), and the HSS scores in the trial group 3 days, 1 week, and 1 month after surgery were significantly higher than those in the control group (P<0.05). And ALOS and average hospitalization cost (excluding materials) in the trial group were significantly lower than those in the control group (P<0.05). Conclusion The application of ERAS in pain management after TKA can effectively alleviate the postoperative pain, improve the patients’ knee function, shorten the ALOS, and decrease the average hospitalization cost.
目的:探讨以5E为核心的康复治疗对改善血液透析患者抑郁的作用。方法:50例维持性血液透析大于3个月患者纳入本研究,使用汉密顿抑郁量表(HAMD)分别在研究开始、研究结束时评估患者的抑郁症状,对患者实施以5E为核心的康复干预,主要内容包括鼓励、教育、锻炼、工作及评估。随访6个月观察患者抑郁症状的变化。结果:50例患者完成随访研究,研究终末时具有具有抑郁症状患者由开始时的28例减少到11例。患者在研究开始与随访6月时患者抑郁症状的发生率与抑郁评分分别为(56%比22%,χ2=37,Plt;005)与［(67±51)比(50±47),t=273,Plt;005］。患者在随访终末时抑郁症状的发生率及抑郁评分较研究开始时均显著降低。结论:本研究表明以5E为核心的康复治疗能明显改善维持性血液透析患者的精神症状。
【摘要】 目的 观察综合康复治疗对汶川地震截肢伤员功能障碍的临床疗效。 方法 对5•12汶川大地震22例挤压伤截肢患者的24条截肢残端实施护理、摆放良肢位、运动治疗、残端塑形、紫外线疗法、红外线疗法、石蜡疗法、音频电疗法、经皮电刺激神经疗法、关节松动、按摩和拍打、超短波治疗、作业疗法和心理治疗等综合康复治疗，直至截肢伤员出院为止。视觉模拟评分法量表评定幻肢痛疼痛强度、测定膝关节和髋关节活动范围、Barthel指数评定日常活动。 结果 治疗前幻肢痛疼痛强度为2.95±1.33，治疗后为0.50±0.96；治疗前肘关节活动范围为（90.0±28.3）º，治疗后为（135.0±7.1）º；治疗前肩关节屈伸活动范围为（68.8±27.8）º，治疗后为（137.5±9.6）º；治疗前肩关节收展活动范围为（53.8±7.5）º，治疗后为（96.3±4.8）º；治疗前膝关节活动范围为（91.0±23.0）º，治疗后为（123.0±6.7）º；治疗前髋关节屈伸活动范围为（86.9±25.9）º，治疗后为（132.3±13.8）º；治疗前髋关节收展活动范围为（46.9±10.9）º，治疗后为（64.6±8.7）º；治疗前Barthel指数为57.05±18.69，治疗后为78.18±13.85，康复治疗前后均有统计学意义（Plt;0.05）。 结论 地震后截肢不良残肢发生率高，综合康复治疗能促进截肢残端伤口愈合和消除残肢疼痛，可明显改善残肢条件，有利于地震截肢患者功能恢复和日常生活能力的提高，为后期的假肢安装及步态训练创造了条件。【Abstract】 Objective To observe the efficiency of comprehensive rehabilitation therapy on amputation patients after Wenchuan earthquake. Methods Twenty-two amputation patients after Wenchuan earthquake with 24 stumps were treated with postoperative wound care, maintaining the correct position of the limbs, exercise therapy, stump shaping, ultraviolet therapy, infrared therapy, paraffin therapy, audio electrotherapy, transcutaneous electrical nerve stimulation therapy, joint mobilization, massage, beat, ultrashort wave therapy, occupational therapy and psychotherapy and so on until discharged. The results were measured from the following aspects: pain intensity using VAS, rangement of knee joint and hip joint, Barthel index of ADL before and after rehabilitation. Results Pain intensity of phantom limb pain were (2.94±1.53) before rehabilitation,and (0.44±1.03) after; the movement range of elbow was (90.0±28.3)º before and(135.0±7.1)º after; the movement range of shoulder flexion and extension was (68.8±27.8)º before and (137.5±9.6)º after; the movement range of shoulder abduction and adduction was (53.8±7.5)º before and (96.3±4.8)º after rehabilitation; the movement range of knee was (91.0±23.0)º before and (123.0±6.7)º after rahabiliation; the movement range of hip flexion and extension was (86.9±25.9)º before and (132.3±13.8)º after; the movement range of hip abduction and adduction was (46.9±10.9)º before and (64.6±8.7)º after; the score of Barthel index was 57.05±18.69 before and 78.18±13.85 after. The difference between before and after rehabilitation were statistically significant (Plt;0.05). Conclusion The incidence of adverse amputation stumps after the earthquake was high. Integrative rehabilitation has an positive effect on promoting wound healing, by eliminating stump pain and recovering lower limb function, improving daily living function and social ability, and creating conditions for installing prosthesis limbs and gait training in later period.
ObjectiveTo explore the feasibility and effectiveness of community-based rehabilitation for patients with cerebral infarction. MethodThe cerebral infarction patients (n=285) registered before March 2011 and newly involved in the research between March 2011 and September 2012 were randomly divided into rehabilitation group (n=142) and control group (n=143). The doctors in community hospitals were trained by specialist physicians in Neurology Department and Rehabilitation Department from second-grade hospitals. Community physicians were responsible for the patients' rehabilitation for one year. ResultsNo differences between the rehabilitation group and the control group in the time of enrollment situation (P>0.05). After six months of intervention, there were significant differences between the two groups of patients in neurological function, daily activity ability, anxiety and depression scale scores (P<0.05), and the difference was more significant after 12 months (P<0.01). The results of Kubota drinking experiment were significantly different between the two groups after six months of intervention (P<0.05). ConclusionsCommunity-based rehabilitation treatment can significantly reduce the degree of physical and mental disability. The cooperation between second-grade hospitals and community hospitals is an effective way to realize three-stage neurological rehabilitation, which can better improve patients' quality of life and is helpful for them return to the society.