目的 观察对比卒中单元早期康复护理对卒中偏瘫患者肢体功能恢复的效果。 方法 将2011年6月－12月期间住院的脑卒中偏瘫患者88例，按照发病时间分为试验组和对照组，发病5 d以内急性期入院者为试验组，5 d以上入院的超过急性期者为对照组。在规范治疗基础上予以相同的康复护理干预，对其日常生活活动能力采用改良的Rakin量表MRS评分来进行功能评定。 结果 试验组和对照组生活能自理人数分别占25%、13.6%，能部分自理的人数分别占56.8%、40.9%，试验组肢体功能恢复明显高于对照组（P＜0.05）。 结论 卒中单元早期康复护理对脑卒中偏瘫患者肢体功能恢复有重要意义。
Objective To explorer the application value of the inferior vena cava filter (IVCF) implantation in the prevention of recurrent pulmonary embolism (PE). Methods Clinical data of 265 inpatients with PE admitted from November 2014 to November 2016 were retrospectively analyzed. The patients were divided into an IVCF treatment group (55 cases) and an anticoagulant therapy group (210 cases) according to treatment measure. All patients were followed up for 3 months to 2 years through regular review. The one-year PE and deep vein thrombosis (DVT) recurrence rates, one-year mortality and two-year mortality were compared between two groups. Results The PE and DVT recurrence rates were 9.1% and 21.8% in the IVCF treatment group, and were 18.6% and 11.0% in the anticoagulant therapy group, respectively. The PE recurrence rate was lower and the DVT recurrence rate was higher in the IVCF treatment group compared with the anticoagulant therapy group, the differences were statistically significant (P<0.05). The one-year mortality (29.1% vs. 12.9%) and two-year mortality (34.5% vs. 14.8%) were significantly higher in the IVCF treatment group than those in the anticoagulant therapy group (P<0.05). Conclusions IVCF without anticoagulation can reduce incidence of pulmonary embolism caused by the lower extremity DVT, but will increase DVT recurrence rate. It may be an alternative option for prevention of PE in patients with contraindications to anticoagulant therapy or recurrent PE patients after regular anticoagulant therapy.
Pusher syndrome (PS) is a postural control disorder that occurs after stroke, which is mainly manifested as a balance dysfunction that is difficult to correct, leading to a significant decline in activity safety of stroke patients and hindering the process of rehabilitation treatment. Proper interventions are needed as soon as possible. Based on the research results of PS both domestic and foreign, this paper firstly summarizes the foundations of the mechanism of PS occurrence, and elaborates the existing disputes. Secondly, this paper systematically introduces the current mainstream assessment and treatment methods of PS, summarizes the problems in relevant clinical practice, and on this basis, gives some suggestions on the possible research directions in the future. The purpose is to provide reference for clinical application and future research directions.
ObjectiveTo explore and verify the effectiveness of task-oriented circuit therapy (TOCT) in rehabilitation training for stroke patients’ walking ability.MethodsSixty patients with stroke were selected from the Department of Neurology and Department of Rehabilitation Medicine of West China Hospital of Sichuan University from September 2019 to December 2020. By envelope method, the patients were randomly divided into the trial group and the control group, with 30 cases in each group. Both groups received routine rehabilitation treatment. The patients in the control group received conventional one-to-one rehabilitation therapy, and the patients in the trial group received TOCT training. The training lasted for 4 weeks. The patients were followed up 3 months after the training. Motor Assessment Scale (MAS) and Functional Ambulation Category Scale (FAC) were used to evaluate the walking ability of the patients before training, at the end of 4 weeks of training (after training) and at the follow-up. SF-36 health survey short form was used to evaluate the quality of life of patients before training and during follow-up.ResultsBefore training, there was no significant difference in gender, age, course of disease, stroke location, walking ability score or SF-36 score between the two groups (P>0.05). After training and at follow-up, the walking ability related scores of the two groups were improved. The trial group was better than the control group (MAS: Z=−3.220, P=0.001; Z=−4.703, P<0.001. FAC: Z=−2.447, P=0.014; Z=−3.249, P=0.001). SF-36 scores of the two groups were improved after 3 months of follow-up. The trial group was better than the control group (Z=−6.674, P<0.001). During the study period, there were no complications or adverse reactions related to rehabilitation training.ConclusionsTOCT has a significant effect on rehabilitation training of lower limb function of stroke patients. It has more advantages than conventional rehabilitation training in improving the walking ability and the quality of life of patients.