Objective To investigate the mental status of medical staffs in the orthopedics department during the earthquake, providing evidence for psychological intervention. Methods Choosing 104 staffs in the orthopedics department as eligible subject with convenient sampling; the research tool was Symptom Checklist-90. The questionnaire was done by the participants with the same instruction from psychological professionals; analyze the results. Results The score in somatization, anxiety and phobic anxiety of staffs in the orthopedics department was significantly higher than the national norm. Conclusion There exists disorder in mental health of medical staffs in orthopedics department, it is necessary to implement mental intervention.
目的:了解汶川地震老年伤员存在的身体结构与功能受损程度及活动、参与能力受限程度,明确其康复护理需求。方法:方便抽样的方法选取研究对象,采用自行设计的调查表由康复医师在征得其同意后对其完成资料的收集。结果:共选取研究对象40名。伤员存在多系统多器官的结构和功能受损,存在呼吸道感染者4例(10%),截肢者2例(5%),颅脑损伤导致瘫痪者1例(2.5%),骨折者28例(70%)。伤后早期即出现运动功能的下降,26例(65%)患者存在关节活动受限,26例(65%)肌力下降。疼痛是需要解决的一个重要问题,19例(47.5%)患者存在不同程度的疼痛问题。伤后老年伤员日常活动生活能力下降,生活能基本自理者仅13例(32.5%);参与能力受限也是一个不容忽视的问题,职业能力受限者36例(90%),休闲娱乐能力受限者33例(82.5%),社交能力受限者25例(62.5%)。结论:老年伤员的康复现状不容乐观,应该引起重视,康复治疗需要及早进行。
目的:了解汶川地震后截肢患者存在的功能障碍及康复需求情况。方法:选取我院骨科2008 年5 月12 日至2008 年6 月1 日收治的19 例截肢患者为研究对象,采用自行设计的调查表,由康复医师在征得研究对象同意的情况下完成资料的收集。结果:63.2%的患者存在肌力下降,36.8%的患者生活需要帮助,其中生活依赖明显占31.6%,完全依赖占5.3 ％,几乎所有患者存在参与功能障碍。 结论:大多数截肢患者存在不同程度的功能障碍,应该引起高度重视其康复锻炼。
Objective To evaluate the safety and efficacy of intermittent pneumatic compression in prevention of deep venous thrombosis after major orthopedic operation. Methods We searched MEDLINE (1966 to January 2008), The Cochrane Library (Issue 2, 2008), CBM (1996 to January 2008), CNKI (1998 to January 2008), VIP (1998 to January 2008), and retrieved clinical controlled trials (CCTs) or randomized controlled trials (RCTs) in which IPC was used as an intervention to prevent DVT, and all the trials were published in English or Chinese. The methodological quality of the included studies was assessed according to the standard of Cochrane systematic review. RevMan 4.2 software was used for meta-analysis. Results Seven RCTs and 1 CCT were included. Their methodological quality was poor. The results of Meta–analyses showed: (1) The incidence of DVT in the IPC group was lower than that in the control group (RR=0.20, 95%CI 0.11 to 0.35, Plt;0.000 01); (2) There was no difference in the incidence of DVT between the IPC group and the LMWH group (RR=0.70, 95%CI 0.28 to 1.74, P=0.44); (3) The incidence of DVT in the IPC plus LMWH group was lower than that in the LMWH-alone group (RR=0.23, 95%CI 0.10 to 0.52, P=0.000 4). Furthermore, the incidence of DVT in the IPC plus LMWH group was lower than that in the GCS plus LMWH group (Plt;0.000 1). No severe adverse reaction of IPC in DVT prevention was reported. Conclusion IPC shows an effective tendency in DVT prevention, but because of the low quality and the small sample of the included studies, this conclusion needs to be verified by protocols of more samples and high quality.
目的 探讨围手术期患者静脉血栓预防的分级护理方法，为静脉血栓的预防提供实证依据。 方法 2009年5月－2012年1月，以某市级乙等综合性医院各科室手术患者为对象，引入量化工具评估患者围手术期静脉血栓发生的危险，并根据评估结果采取分级护理方法进行防治，并在患者出院时用彩色多普勒超声判断是否存在静脉血栓，以验证分级护理防治效果。 结果 纳入的318患者经评估均存在发生静脉血栓的风险，其中低度危险患者65例，中度182例，高度危险71例。经分级护理治疗，出院时均未发生静脉血栓症状、肺栓塞。 结论 分级护理方法安全、简便，可操作性强，便于围手术期患者静脉血栓的早期、普遍预防，值得推广。
目的:总结分析25例地震伤致气性坏疽伤员的救治经验，探讨救治方案，为临床工作提高参考。方法:回顾性研究25例地震伤致气性坏疽伤员的早期临床表现，诊断方法，隔离措施、临床管理及其预后。结果:共收治25例气性坏疽伤员，无一例死亡。院外诊断7例，院内诊断18例。截肢18例，开放性截肢12例，非开放性截肢6例；扩创7例。发生急性肾功能衰竭2例，行血液透析治疗后肾功能恢复；无院内交叉感染的发生。结论:早期诊断、治疗、早期隔离及全面、系统护理可以提高临床救治水平，改善患者的预后，避免院内交叉感染的发生。