急性脑卒中患者早期的康复护理

目的探讨早期康复护理对急性脑卒中患者肢体功能和生活能力的影响。方法对35名急性脑卒中患者进行早期康复干预,分别于治疗前、后进行两次评定。日常生活能力采用Barthal指数,肌张力采用Ashwarth评分法进行评定,并对数据进行相关分析。结果观察组与常规组康复前后Barthal指数比较差异显著(p<0.01);观察组康复前后肌张力比较差异显著(p<0.05),常规组康复前后肌张力比较差异无显著性(p>0.05),两组康复前肌张力比较无显著性差异(p>0.05),两组康复后肌张力比较有显著性差异(p<0.05)。结论早期康复护理干预能有效降低急性脑卒中并发症发生率和功能障碍,提高康复效果。     

早期康复护理对脑卒中患者功能恢复的影响

目的探讨早期康复护理对脑卒中患者功能恢复的影响。方法将108例脑卒中患者随机分成早期康复组和对照组,早期康复组早期在常规治疗和护理的基础上,进行有针对性的康复护理。结果早期康复组入院4周和出院4月时,Barthel指数和Fegl-Meyer运动功能积分均显著优于对照组(P<0.05)。结论早期康复护理能促进脑卒中患者的运动功能和日常生活能力的恢复,提高老年患者的生活质量。     

早期康复治疗及护理对脑卒中患者肢体功能恢复的影响

目的探讨早期进行康复治疗及护理对脑卒中患者肢体功能恢复的影响。方法 2009年1月至2010年1月收治的脑卒中患者245例依据康复进行时间分为早期康复组125例,常规组120例;2组病例均于治疗前和治疗4周后对肢体运动功能评定采用Fugl-Meyer运动功能评分法,日常生活活动能力(ADL)评定采用Barthel(指数BI)评分法评定。结果经统计学分析,2组评价内容治疗前比较P>0.05无显著差异性。2组评价内容治疗治疗后比较P<0.01有显著差异性。结论早期进行康复治疗及护理对脑卒中患者肢体功能恢复有着非常重要的意义,可以明显改善肢体功能,降低残废率,提高患者的生存质量。     

癌症患者康复期的心理护理

本文主要是从心理护理的角度分析本院附属医院收治的74例癌症患者,总结癌症患者康复期的心理护理方法,使癌症患者在康复期最大限度地减少心理障碍等消极因素,提高病人的生活质量和康复机会。     

中医综合护理对脑卒中偏瘫患者康复作用探析

目的探讨中医综合护理在促进脑卒中偏瘫患者康复进程中的的具体效果。方法通过对本院46例脑卒中偏瘫患者的临床资料回顾和跟踪治疗,分析中医综合护理在促进偏瘫患者康复方面的效果。结果观察组患者的治疗总有效率为95.7%,对照组患者的治疗总有效率为78.3%,2组比较差异显著(P<0.05)。结论中医综合护理对脑卒中偏瘫患者有显著的促进康复效果,能够加速身体机能的恢复,值得在临床上推广。     

脑卒中后吞咽障碍的康复护理

目的观察脑卒中合并吞咽障碍患者的吞咽训练康复护理疗效。方法脑卒中合并吞咽障碍患者60例,随机分为A、B2组各30例,2组均给予常规护理及留置胃管护理,B组添加吞咽功能训练、摄食训练等综合康复护理措施。结果 B组患者吞咽障碍的恢复明显优于A组。结论对脑卒中吞咽障碍的患者应及时进行吞咽功能的康复训练。     

脑卒中鼻饲患者并发吸入性肺炎的护理

脑卒中病人常伴有意识丧失或吞咽障碍,致患者不能自行进食。临床上一般禁食48～72h后需鼻饲,以保证维生素的摄入及能量供给。但长期鼻饲会出现一些相应的并发症,吸入性肺炎是最常见的一种。通过对我院2005年1月至2008年12月收治的53例脑卒中鼻饲患者进行回顾性分析,提出相应的预防、护理措施,现报道如下。     

吞咽理疗仪对老年脑卒中患者吞咽困难的护理

对脑卒中吞咽障碍的患者进行吞咽治疗仪和常规康复护理合用,吞咽障碍的恢复率明显提高。     

基层医院脑卒中后偏瘫早期康复的现状分析及对策

脑卒中急性期若得不到及时、有效的早期治疗,会在存活患者中留有不同程度的功能障碍,导致永久性残疾,严重影响患者的生存质量。如何使脑卒中残疾率降低,使患者早日康复,是人们普遍关心的问题。偏瘫患者康复治疗越早,病人恢复越好,大医院在这方面已有了很多经验,但在基层二级医院中康复治疗工作早期开展比较少。     

综合康复疗法对脑卒中患者的疗效观察

目的观察中西医结合并结合康复教育的综合治疗对脑卒中患者临床神经功能缺损程度(CNFD)和日常生活活动能力(ADL)的影响。方法选择2006年7月～2008年1月于我院就诊的脑卒中患者120例,随机分为综合康复组和简单康复组,于康复前后进行CNFD、ADL评定及临床疗效评定。结果治疗后综合康复组的CNFD和ADL评分与简单康复组相比,存在显著性差异(P<0.05),综合康复组疗效优于简单康复组。结论综合康复疗法能更快、更大程度地改善老年脑卒中患者的神经运动功能、提高患者的生活自理能力。     

老年冠心病伴抑郁症患者护理干预对策

目的了解冠心病患者的抑郁状态,为提出相应的护理措施提供依据。方法采用汉密尔顿抑郁量表(HAMD),通过交谈与观察的方式,对246例冠心病的患者进行调查。结果在246例中,存在抑郁症状者65例(占36.6%),其中轻度抑郁17例(占6.9%),中度抑郁38例(15.4%),重度抑郁35例(占14.2%)。不同类型冠心病患者抑郁症的患病率差异无统计学意义(P>0.05)。结论护理工作中要注意对冠心病患者的心理护理及精神支持,同时,改善患者社会支持及功能状态,减少冠心病患者抑郁状态的发生。     

肺结核患者的护理

目的探讨肺结核患者的护理措施。方法对我院2006年2月至2009年10月580例肺结核患者的护理措施进行回顾分析。结果580例肺结核患者经过精心的护理,460例临床治愈,120例好转。结论科学有效的护理措施,可提高肺结核的治疗效果,有利于促进肺结核患者早日康复。     

探讨老年病员药物性静脉炎的预防及护理

目的观察多源频谱仪照射预防老年病员药物性静脉炎的疗效。方法选择78例长期住院、反复外周静脉输液的老年病员,输注药物为血管刺激性较强的药物(前列地尔、奎诺酮类抗生素),随机平均分为A、B2组,A组采用传统的局部硫酸镁湿敷;B组采用MF-多源频谱治疗仪局部照射。结果B组病员药物性静脉炎发生率低,局部皮肤反应轻微,疗效明显优于A组(P<0.05),差异有显著性。结论反复外周静脉输入血管刺激性较强的药物,采用MF-多源频谱治疗仪局部照射可以预防老年病员药物性静脉炎,保护外周静脉血管,减轻病员痛苦,增强病员的治疗依从性,提高生活质量。     

老年髓部骨折患者术后护理干预研究

老年髓部骨折患者的心理抑郁和功能恢复之间存在着一种循环交互的复杂联系,持续性护理干预可有效改善老年髓部骨折患者术后髓关节功能和日常生活活动能力。本文对老年髓部骨折患者术后护理干预进行了研究。     

Selected Mediators of Inflammation in Patients with Acute Ischemic Stroke

During a stroke, a series of biochemical and metabolic changes occur which eventually lead to the death of cells by necrosis or apoptosis. This is a multi-stage process involving oxidative stress and an inflammatory response from the first signs of occlusion of a blood vessel until the late stages of regeneration and healing of ischemic tissues. The purpose of the research was to assess the concentration of pro-inflammatory cytokines IL-6 and TNF-α in the blood serum of patients with ischemic stroke (AIS) and to investigate their role as new markers in predicting functional prognosis after thrombolytic therapy. The researches have shown that the concentrations of the measured biomarkers were higher compared to the control group. Serum levels of IL-6 and THF-α before the initiation of intravenous thrombolysis were lower in the subgroup of patients with a favourable functional result (mRS: 0–2 pts) compared to the group of patients with an unfavourable functional result (mRS: 3–6 pts). A positive correlation was found between the concentration of IL-6 and TNF-α in patients with AIS during <4.5 h and on one day after the onset of stroke, which means that the concentration of IL-6 increases with the increase in TNF-α concentration. It has also been shown that higher levels of IL-6 in the acute phase of stroke and on the first and seventh days, and TNF-α during onset, were associated with poorer early and late prognosis in patients treated with intravenous thrombolysis. A relationship was found between the level of IL-6 and TNF-α in the subacute AIS and the severity of the neurological deficit. It has been shown that the investigated biomarkers may be a prognostic factor in the treatment of thrombolytic AIS.     

社区护理干预对糖尿病患者的影响

目的探讨社区护理干预对糖尿病患者生活习惯及治疗效果的影响。方法随机将164例糖尿病病人分为实验组和对照组,实验组进行社区护理指导干预,并针对每例病人进行个体指导;对照组未进行系统的糖尿病健康教育。6个月后监测病人糖尿病生活习惯及血糖变化。结果实验组糖尿病患者生活习惯改变明显高于对照组(P<0.05),血糖控制率高于对照组,差异有统计学意义。结论社区护理干预能有效提高病人自我管理能力及疗效,提高生活质量。     

BDNF rs6265 Polymorphism and Its Methylation in Patients with Stroke Undergoing Rehabilitation

Brain-Derived Neurotrophic Factor (BDNF) and its rs6265 single nucleotide polymorphism (SNP) play an important role in post-stroke recovery. We investigated the correlation between BDNF rs6265 SNP and recovery outcome, measured by the modified Barthel index, in 49 patients with stroke hospitalized in our rehabilitation center at baseline (T0) and after 30 sessions of rehabilitation treatment (T1); moreover, we analyzed the methylation level of the CpG site created or abolished into BDNF rs6265 SNP. In total, 11 patients (22.4%) were heterozygous GA, and 32 (65.3%) and 6 (12.2%) patients were homozygous GG and AA, respectively. The univariate analysis showed a significant relationship between the BDNF rs6265 SNP and the modified Barthel index cut-off (χ²(1, N = 48) = 3.86, p = 0.049), considering patients divided for carrying (A+) or not carrying (A−) the A allele. A higher percentage of A− patients obtained a favorable outcome, as showed by the logistic regression model corrected by age and time since the stroke onset, compared with the A+ patients (OR: 5.59). At baseline (T0), the percentage of BDNF methylation was significantly different between GG (44.6 ± 1.1%), GA (39.5 ± 2.8%) and AA (28.5 ± 1.7%) alleles (p < 0.001). After rehabilitation (T1), only patients A− showed a significant increase in methylation percentages (mean change = 1.3, CI: 0.4–2.2, p = 0.007). This preliminary study deserves more investigation to confirm if BDNF rs6265 SNP and its methylation could be used as a biological marker of recovery in patients with stroke undergoing rehabilitation treatment.     

Early Rehabilitation Exercise after Stroke Improves Neurological Recovery through Enhancing Angiogenesis in Patients and Cerebral Ischemia Rat Model

Among cerebrovascular diseases, ischemic stroke is a leading cause of mortality and disability. Thrombolytic therapy with tissue plasminogen activator is the first choice for clinical treatment, but its use is limited due to the high requirements of patient characteristics. Therefore, the choice of neurological rehabilitation strategies after stroke is an important prevention and treatment strategy to promote the recovery of neurological function in patients. This study shows that rehabilitation exercise 24 h after stroke can significantly improve the neurological function (6.47 ± 1.589 vs. 3.21 ± 1.069 and 0.76 ± 0.852), exercise ability (15.68 ± 5.95 vs. 162.32 ± 9.286 and 91.18 ± 7.377), daily living ability (23.37 ± 5.196 vs. 66.95 ± 4.707 and 6.55 ± 2.873), and quality of life (114.39 ± 7.772 vs. 168.61 ± 6.323 and 215.95 ± 10.977) of patients after 1 month and 3 months, and its ability to promote rehabilitation is better than that of rehabilitation exercise administered to patients 72 h after stroke (p < 0.001). Animal experiments show that treadmill exercise 24 h after middle cerebral artery occlusion and reperfusion can inhibit neuronal apoptosis, reduce the volume of cerebral infarction on the third (15.04 ± 1.07% vs. 30.67 ± 3.06%) and fifth (8.33 ± 1.53% vs. 30.67 ± 3.06%) days, and promote the recovery of neurological function on the third (7.22 ± 1.478 vs. 8.28 ± 1.018) and fifth (4.44 ± 0.784 vs. 6.00 ± 0.767) days. Mechanistic studies have shown that treadmill exercise increases the density of microvessels, regulates angiogenesis, and promotes the recovery of nerve function by upregulating the expression of vascular endothelial growth factor and laminin. This study shows that rehabilitation exercise 24 h after stroke is conducive to promoting the recovery of patients’ neurological function, and provides a scientific reference for the clinical rehabilitation of stroke patients.     

老年人全口义齿修复临床分析

目的探讨老年人修复全口义齿的临床特点。方法对192例老年人全口义齿修复的临床特征进行回顾性分析。结论对重新修复全口义齿的老年患者,采取适当的措施可以达到满意修复效果。