康复医学人才培养的思考

我国的康复医学起步较晚,康复医学教育比较滞后,师资力量不足,教材使用不规范等因素直接影响了康复医学的发展.为了适应社会的进步与医学科学的发展,康复医学人才培养成为当务之急.为此人才的培养应做到:建立正确的康复观念,强化专业技能的学习,重视师资投入,加强基地建设,规范教材编写,培养团队意识,增强自主学习能力等.     

骨科患者的基础护理及健康教育

骨科病人大多由意外事故急诊入院,缺乏足够的心理准备及相关的疾病知识,而且病人年龄跨度大,多需卧床休息或有自理能力下降,住院期间需协助其生活护理及培养自理能力又由于骨科的病种多,手术方案不一,特别是近年来新技术、新器械的应用层出不穷,因此针对这些特点,我们采取了多种方法相结合,从病人入院至出院实施全程的健康教育,增加了疗效提高了病人的自我保健能力及康复锻炼技巧.基础护理工作对骨科病人尤为重要,通过加强护士职业道德教育,全体护士进一步提高了对骨科老年病人、危重病人基础护理工作重要性的认识,对骨科住院病人进行了全程监控,通过及时有效的基础护理质量管理、使基础护理合格率上升,达到了满意效果,并发症的发生率降到最低.骨科病人的基础护理不同于其它科病人,由于创伤、多发骨折、复合伤、截瘫病人,加之老年病人股骨颈、粗隆间骨折,因疼痛原因限制,给骨科基础护理工作带来一定难度,易发生并发症,因此我院从基础护理质量管理入手,进一步加强和提高了对基础护理工作的重视,加大督促检查力度取得了明显效果,病人基础护理合格率明显上升,最大限度的降低了骨科病人并发症的发生.     

中国国内康复发展趋势

我国康复医学的发展是现代科技整体突破的大课题,是有影响的学科创新壮举,要进一步明确康复医学的内涵、发展其独特的技术、手段和方法、最大程度的提高康复医学的学术水平,走中西医结合路线取长补短,不断总结创新,创造出一个全新的、自立于世界医学之林的中国现代康复医学体系.     

中医院校康复治疗学专业分化之探讨

总结经验,探讨在中医院校背景下康复治疗学专业分化的教学模式,首先在前两年完成医学基础课程后,在后期分化为物理治疗和作业治疗方向,课程的侧重点有所不同.其次,在重视学习现代康复医学的基础上,同时也要发挥中医特色,突出以针灸推拿为主要特色的技能学习,吸收中国传统康复的理论和技术精华,指导中西医结合康复的教育建设.     

健康教育在骨科手术患者康复中的应用

目的:观察健康教育对骨科手术患者术后康复时间治疗效果的影响.方法:选择骨科手术患者114例,随机分为例数相等的两组,观察组从入院起、手术前、手术后、恢复期进行系统性健康教育;对照组未进行系统性健康教育.记录两组患者术后康复时间、治疗效果并进行比较.结果:观察组患者术后康复时间明显缩短,患肢功能恢复显著优于对照组,组间比较差异(p<0.05)具有统计学意义.结论:进行系统性健康教育缩短了骨科手术患者术后康复时间,提升治疗效果,具有重要的临床应用意义.     

医疗、心理护理与疾病康复的关系

随着现代医学的发展及医学模式的转变,医疗、心理护理越来越受到医学界的高度重视,要求医护人员不但要掌握丰富的医疗、护理知识,还要全面了解病人的心理状态,要有机智敏锐的观察力,掌握不同病人的心理特征.所谓心理是指人的内心世界,是人的感觉,思维,情感,能力,性格等心理现象的总称.病人来自不同的社会环境,有不同的性格和心理需求,因此,医护人员了解不同病人的心理活动,施以精心恰当的心理护理,对促进疾病康复是非常必要的,要做好心理护理工作,首先要了解病人的心理特点.     

骨科卧床病人便秘的预防及辨证施护

总结了60例骨科卧床病人的预防方法和辨证施护,主要通过情志护理、饮食护理、功能锻炼、中药热敷等预防便秘,辨析急证便秘、实证便秘、虚证便秘并采取相应护理措施.认为骨科卧床病人便秘的预防及辨证施护可促进病人舒适与康复.     

骨科患者的康复护理分析

目的:探讨对骨科患者的康复护理措施和效果.方法:对我院2009年6月至2010年12月进行康复护理的49例骨科患者的临床资料进行了收集和分析.结果:患者平均住院时间为41.5天,患者出院后对患者的日常生活自理能力进行评估:生活完全自理者26例(53.06%),生活部分自理者21例(42.86%),生活不能自理者2例(4.08%),生活自理率95.92%,其中,有5例发生了并发症.结论:通过对患者饮食、锻炼、心理等方面精心科学的护理,对患者术后的肢体功能的恢复和并发症的防治都起到的积极的促进作用,值得以后临床应用.     

颅脑外伤病人早期康复功能训练及护理

目的:颅脑外伤病人早期介入康复功能训练及护理的意义.方法:选择90例颅脑外伤病人进行随机分两组:45例早期训练组,45例康复才进行训练.观察两组患者意识状态,运动功能,认知综合功能进行比较.结论:早期介入康复功能训练及护理可使病人康复时间缩短,神经功能完善,并发症减少,值得临床应用.     

骨科择期手术患者围术期的营养教育

营养是生命物质基础,饮食是生命活动的表现,也是治疗疾病的保证."医食同源,药食同根",在医学模式发生变化的今天,营养饮食的治疗作用越来越突出.合理的饮食营养对提高患者的手术耐受力,减少术后并发症,促使其早日康复有积极作用,但路兰等[1]调查表示,在骨科住院患者健康教育需求中,营养与饮食知识需求偏低,为26.39%.这说明饮食与营养对治疗和康复的重要性还不被患者重视.笔者在临床工作中也发现,大多数患者存在重治疗轻护理、重药物轻营养的现象.     

老年脑卒中恢复期吞咽障碍的康复治疗

目的:观察老年脑卒中恢复期吞咽功能训练对吞咽障碍的疗效.方法:20例老年脑卒中恢复期吞咽障碍患者在接受吞咽功能训练后进行才藤吞咽障碍7级评定.结果:老年脑卒中恢复期吞咽障碍患者在接受吞咽功能训练后功能明显改善,治疗前、后比较有差异(P<0.01).结论:老年吞咽障碍患者经吞咽功能训练能明显提高吞咽功能,恢复了经口摄食,促进自立能力,达到援助患者生活的目的.     

中风恢复期患者的家庭康复护理体会

中风的学名是急性脑血管疾病,具有致残率高的特点.因此,减轻不同程度的后遗症,帮助患者恢复自理能力是患者和社会共同关注的话题,尤其是出院后的家庭康复更是不可缺少.我院采用出院指导、定期随访、家庭康复护理相结合的办法,取得了较好的效果.     

Anaesthetic complications in the recovery room

INTRODUCTION: The immediate post-operative period in the recovery room is a known period of high risk for anaesthetic complications to occur. AIMS: We wanted to know the incidence and nature of our recovery room patients in the main-theatre complex of Hospital Kuala Lumpur. METHOD: A prospective study was conducted over a two-month period on all patients receiving either regional and/or general anaesthesia by an anaesthetic doctor admitted to this recovery room. Complications were documented according to predefined criteria. RESULTS: Out of a total of 1,995 patients, 50(2.5%) had some form of anaesthetic complication. Fifteen patients had more than one complication. The most common was pain (23 patients) followed closely by nausea and vomiting (21 patients). There were 32 patients with CNS problems (including the 23 with pain), 21 with GIT, 10 with CVS, 2 with respiratory and 3 with other problems. CONCLUSION: Our recovery room complication rate is acceptably low. Knowing the type and frequency of problems (in this case, mainly pain and nausea and vomiting) can further improve the figure. The role of anaesthesiologists has expanded as they are not only expected to ascertain the safety but also the comfort of patients post-operatively.     

Psychotherapy and the recovery from neurosis.

"Available evidence suggests that psychotherapy can be effective in alleviating minor maladjustments characterized by such objective states as 'unhappiness,' 'anxiety,' and tension' that often accompany neurosis. But the evidence does not yet support the view that psychotherapy is effective in relieving those gross and persistent maladjustments (neuroses) that are characterized by definite, palpable symptoms. Whether it has any effect on these is a question which only future research can settle." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dichloroacetate enhanced myocardial functional recovery post-ischemia : ATP and NADH recovery

This study was undertaken to determine the effect of dichloroacetate (DCA) on myocardial functional and metabolic recovery following global ischemia. Isolated rabbit hearts were subjected to 120 min of mildly hypothermic (34 degrees C), cardioplegic arrest with multidose, modified St. Thomas' cardioplegia. Hearts were reperfused with either physiologic salt solution (PSS) as controls, (CON, n = 10) or PSS containing DCA (DCA, n = 6) at a concentration of 1 mM. Functional and metabolic indices were determined at baseline and at 15, 30, and 45 min of reperfusion. In four DCA and four CON hearts, myocardial biopsies were taken at baseline, end-ischemia, 15 and 45 min for nucleotide levels. Functional recovery was significantly better in hearts reperfused with DCA as demonstrated by recovery of baseline developed pressure (DCA = 69 +/- 5%, CON = 45 +/- 9%) and dP/dt (DCA = 64% +/- 10% versus CON = 48% +/- 10%). Coronary blood flow was not different between groups either at baseline or during reperfusion, but myocardial oxygen consumption (MVO2) was increased in the DCA versus CON hearts (79% +/- 20% of baseline vs 50% +/- 18%). Recovery of myocardial adenylate energy status was improved in the DCA versus CON hearts (ATP recovered to 45% +/- 20% versus 8% +/- 6% of baseline). Coronary sinus lactate concentration was decreased in DCA perfused hearts at 45 min of reperfusion. Percent of baseline NADH values was similar at 15 min of reperfusion, but at 45 min, DCA hearts showed a decrease in NADH levels, while CON hearts showed an increase (DCA = 48%; CON = 121%). The enhanced myocardial function and improved metabolic status noted with DCA may result from increased oxidative phosphorylation due to altered pyruvate dehydrogenase (PDH) activity.