【摘要】 目的 探讨指导性强化作业疗法对脑卒中患者上肢运动功能障碍的疗效，旨在提高患者的生活质量。 方法 2007年6月-2009年6月将68例脑卒中偏瘫患者随机分成治疗组及对照组。治疗组进行指导性强化作业疗法，对照组采用传统康复训练。分别于治疗前、治疗后和治疗后1、3个月应用MAL和Bathel指数对其进行评定。 结果 两组MAL评分及Bathel指数在治疗后均有所提高，治疗组在治疗后1、3个月的MAL评分及Bathel指数较治疗前增加，有统计学意义（Plt;0.05）；对照组无差异。治疗后1、3个月，两组MAL评分及Bathel指数比较有统计学意义（Plt;0.05）。 结论 指导性强化作业疗法作为一种新型的康复治疗技术，能够改善患者上肢运动功能及日常生活能力，提高生活质量，具有较高的临床应用价值。【Abstract】 Objective To explore the efficacy of guiding intensified occupational therapy for ischemic stroke patients with upper motor dysfunction, aiming at improving the quality life of the patients. Methods From June 2007 to June 2009, sixty-eight patients with stroke were randomly divided into treatment group and control group. Treatment group was treated with guiding strengthen occupational therapy and control group with trandional therapy. The MAL and the Bathel index were used to evaluate before treatment, after treatment and 3 months after treatment respectively. Results The MAL score and Bathel index were improved after treatment. The MAL score and Bathel index of the treatment group immediately and in 3 months after treatment increased greatly, and there were statistical significance (Plt;0.05). There was no difference in the MAL score and Bathel index in the control group before and after treatment. The MAL score and Bathel index of two groups were statistically significant after 3 months treatment (Plt;0.05). Conclusion Guiding intensified occupational therapy as a new kind of rehabilitation techniques, can improve the function of upper movement and daily life, and improve the quality life. It had high value of clinical applications.
ObjectiveTo investigate the effect of behavior intervention through diets and exercises on blood glucose controlling in patients with gestational diabetes mellitus (GDM), and to provide the basis for GDM therapy. MethodsA total of 116 patients with GDM diagnosed and treated in the Sixth Affiliated Hospital of Sun Yat-sen University between March 2011 and December 2012 were taken as our study objects, including 72 patients in the study group and 44 patients in the control group, based on their will. For patients in the study group, we carried out behavior interventions through diets and exercises, including dietary guidance, giving pamphlet and formulating exercise plan, while for patients in the control group, we only gave them oral guidance and publicity materials. The same questionnaire was used to collect all the patients' information. Follow-up was done once in every 3 days, and rechecking was performed 2 weeks later. The results of oral glucose tolerance test and the rate of pathoglycemia were compared in these groups before and after intervention. ResultsThe fasting blood glucose, 1- and 2-hour blood glucose were lowered after the behavior intervention in the study group (P<0.05), which were also significantly lower than the control group (P<0.05). Fasting blood glucose, 1- and 2-hour pathoglycemia was significantly lower in the study group than that in the control group and that before intervention (P<0.05). ConclusionCombination of diets and exercises can control levels of blood glucose in GDM patients, and is an important therapy for GDM.
ObjectiveTo explore the current situation of the readiness for hospital discharge and the quality of discharge teaching in lung cancer patients based on enhanced recovery after surgery, and to analyze their correlation.MethodsWe conducted a cross-sectional study and 141 postoperative patients with lung cancer in our hospital from July to August 2018 were investigated by general information questionnaire, readiness for hospital discharge scale and quality of discharge teaching scale. There were 65 males and 76 females at age of 18-85 (55.35±12.15) years.ResultsTotally 88.65% of postoperative patients with lung cancer reported that they were ready for discharge, and the total score of readiness for hospital discharge was 78.36±16.48, and the total score of quality of discharge teaching was 90.94±18.62. There was a positive correlation between the readiness for hospital discharge and the quality of discharge teaching in postoperative patients with lung cancer (r=0.57, P<0.01).ConclusionThe readiness for hospital discharge of postoperative patients with lung cancer keeps in medium level, while the quality of discharge teaching is good, and the readiness for hospital discharge is positively correlated with the quality of discharge teaching. Medical staff should pay more attention to the cognitive level of lung cancer patients' disease-related information and their physical function recovery, and enrich the discharge guidance content, in order to improve the readiness of postoperative patients with lung cancer.
目的 探讨心脏机械瓣膜置换术后患者出院指导的综合方法，评价其效果。 方法 将2010年9月－2011年1月242例心脏机械瓣膜置换术患者按入院先后顺序随机分成试验组和对照组。试验组患者采用综合出院指导方案，对照组采用常规宣教方法，在6个月后对两组患者进行调查，评价综合指导方案的效果，并进行统计学分析。 结果 试验组患者均未出现不良并发症，对照组有1例出院后未遵医嘱服药及定期复查，死于血管栓塞；有2例出现血管栓塞，2例牙龈出血，经及时治疗后好转。 结论 对心脏机械瓣膜置换术患者出院时，发放健康教育资料及定期随访指导的综合出院指导方案，可以降低术后并发症，提高患者认知水平和满意度，帮助患者提高依从性，提高生存质量。
National Center for Medical Service Administration of National Health and Family Planning Commission of China was established at the beginning of 2015. It is mainly in charge of developing and managing standards of medical technology and organizing their implementation, and giving technical guidance and consulting for evaluation of medical institutions. The foundation of the center fills in the blank of lacking central administrative department of the guideline development and evaluation. This paper introduces the definition and the function of clinical practice guideline, and analyzes the current situation, problems and challenges of domestic guidelines, and proposes some potential suggestions on improving the quality of Chinese guidelines from national level for promoting the standardization, scientification and transparency of clinical practice guidelines in China.