目的 探讨改道置管肛外引流术治疗直肠黏膜下脓肿的临床疗效。 方法 2007年5月－2012年5月，将76例直肠黏膜下脓肿患者分为改道置管肛外引流术（治疗组）和传统切开引流术（对照组）治疗，每组各38例，两组患者在年龄、性别比、病程等方面具有可比性。观察两组患者治愈时间、治愈率、随访3个月的复发情况以及肛门直肠压力测定，评价两组患者临床疗效及肛门功能保护情况。 结果 治疗组患者治愈时间为（21.3 ± 6.37）d，对照组为（29.5 ± 4.52）d，治疗组时间明显缩短（t=5.79，P＜0.01）；治疗组治愈率97.3%，对照组为73.6%，差异有统计学差异（χ2=6.81，P＜0. 01）；两组患者随访3个月的肛门功能比较，RRP治疗组为3.48 ± 0.61，对照组3.22 ± 0.79，差异无统计学意义（t=−1.61，P＞0.05）；ARP治疗组为19.05 ± 3.76，对照组为17.55 ± 3.31，差异无统计学意义（t=−1.85，P＞0.05）；ALCT治疗组为36.74 ± 4.70，对照组为37.13 ± 3.90，差异无统计学意义（t=−0.39，P＞0.05）；AMCP治疗组为24.03 ± 5.80，对照组为21.8 ± 4.91，差异无统计学意义（t=−1.61，P＞0.05）。 结论 改道置管肛外引流术治疗直肠黏膜下脓肿可缩短疗程，提高治愈率。
ObjectiveTo investigate the effect of continuous occupational therapy (OT) on the life satisfaction of patients with spinal cord injury (SCI). MethodsFifty-two SCI patients treated in Department of Rehabilitation at People’s Hospital of Mianzhu City between 2008 and 2010 were randomly assigned into two groups with 26 patients in each. Patients in the trial group received OT and rehabilitation nursing both in hospital and after being discharged from hospital, whereas patients in the control group only received treatment in hospital. Life satisfaction was assessed when patients were discharged from hospital and 21 months later. ResultsThe patients were treated for an average of 12 weeks in hospital before being discharged. Twenty-six questionnaires were given out to the patients when they were discharged from hospital, and another 26 were given 21 months later. All the questionnaires were retrieved, with a retrieval rate of 100%. The life satisfaction scores between the trial and control groups were not different from each other when the patients were discharged from hospital (P>0.05). The trial group was more satisfied with their life 21 months after being discharged from hospital (P<0.05). The life satisfaction scores of the control group were not changed (P>0.05). The trial group had higher life satisfaction than the control group 21 months after being discharged (P<0.05). ConclusionContinuous OT instruction on patients can increase their life satisfaction, and the rehabilitation effect of patients is better than rehabilitation intervention at a certain stage.
【摘要】 目的 探讨康复宣教与训练等干预手段对股骨干骨折患者围手术期的影响。 方法 2010年6月－2011年3月收治股骨干骨折患者90例，其中男48例，女42例；年龄17~58岁，平均38岁。开放性骨折28例，闭合性骨折62例。股骨骨折部位:上1/3骨折33例，中1/3骨折35例，下1/3骨折20例，多段骨折2例。横形骨折20例，斜形骨折30例，粉碎性骨折40例。将90例患者随机分为康复组（46例）和对照组（44例）。对照组采用骨科术前常规处理，康复组采用骨科术前常规处理加康复宣教与训练。 结果 康复组住院时间为（5.35±1.27） d，对照组为（7.67±1.85） d，两组比较差异有统计学意义（Plt;0.05）。 康复组治疗后发生并发症7例，对照组16例，康复组并发症发生率（15.2%）明显低于对照组（36.4%），差异有统计学意义（Plt;0.05）。治疗后5 d，康复组疗效获优35例，良6例，可3例，差2例，优良率89.1%；对照组获优25例，良5例，可12例，差2例，优良率68.2%；两组疗效比较差异有统计学意义（Plt;0.05）。 结论 康复宣教与训练能预防与改善股骨干骨折围手术期卧床引起的并发症，减轻患者腿部疼痛及肿胀，缩短围手术期时间，使患者能尽早手术，加快住院床位周转，提高患者生活质量。【Abstract】 Objective To explore the effects of rehabilitation education and training interventions on perioperative patients with femoral shaft fractures. Methods A total of 90 patients with femoral shaft fractures were selected from June 2010 to March 2011, including 48 males and 42 females aged from 17 to 58 years (mean 38 years). In these 90 patients, open fracture was in 28 and closed fracture was in 62. Fracture site: upper 1/3 fracture was in 33, middle 1/3 fracture was in 35, lower 1/3 fracture was in 20 and multiple fractures was in 2. There were transverse fractures in 20 patients, oblique fractures in 30 patients and comminuted fractures in 40 patients. All of the patients were randomly divided into experimental group (46 patients) and control group (44 patients). The patients in the control group underwent the routine treatment before the orthopedic surgery; besides the routine treatment, the patients in the experimental group were given the rehabilitation education and training before the orthopedic surgery. Results The hospital duration in the rehabilitation group was (5.35±1.27) days while in the control group was (7.67±1.85) days, the difference was statistically significant (Plt;0.05). There were 7 cases who had complications in rehabilitation group compared with 16 patients in the control group; the incidence of the complications in the rehabilitation group (15.2%) was significantly lower than that in the control group (36.4%) (Plt;0.05). After the treatment for 5 days, the therapeutic effect in rehabilitation group were excellent in 35 cases, good in 6 cases, middle in 3 cases and poor in 2 cases (with the good rate of 89.1%); while in the control group were excellent in 25 cases, good in 5 cases, middle in 12 cases and poor in 2 cases (with the good rate of 68.2%); the difference was significant between the two groups (Plt;0.05). Conclusion Rehabilitation education and training could prevent the perioperative complications in patients with femoral shaft fracture, decrease the pain and edema, speed up the turnover of hospital beds, and improve the patients’ quality of life.
ObjectivesTo systematically review the efficacy of exercise therapy on functional and activity recovery after anterior cruciate ligament reconstruction (ACL).MethodsPubMed, EMbase, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise therapy on functional and activity recovery after ACL from inception to May 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 602 patients were included. The results of meta-analysis showed that: 1 week (MD=3.07, 95%CI 1.37 to 4.77, P=0.000 4) and 3 weeks (MD=4.53, 95%CI 2.34 to 6.71, P<0.000 1) conventional exercise training rehabilitation effects were better than natural recovery under orthopedic routine care in promoting knee joint function recovery. The recovery effects of over 6 months neuromuscular training was significantly increased compared with conventional rehabilitation (MD=11.48, 95%CI 8.25 to 14.71, P<0.000 01). In addition, there was significant difference between open and closed chain exercise rehabilitation after more than 6 months rehabilitation training (MD=6.77, 95%CI 0.86 to 12.68, P=0.02).ConclusionsThe current evidence shows that over 6 months neuromuscular training significantly enhance the recovery of motor function after anterior cruciate ligament reconstruction. According to different reconstruction methods, individualized rehabilitation program is developed to maximize the recovery of knee joint function. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusions.
Objective To investigate the status of health condition and activities of daily living of “50630” retired cadres in Mianzhu, and analyze the related factors affecting their activities of daily living. Methods According to the registration information of Mianzhu administration of elderly cadres in Sichuan, the method of cluster sampling was adopted in March 2019 to select retired cadres who participated in work between October 1st, 1949 and June 30th, 1950 in urban and rural areas respectively. The survey and analysis were carried out using the self-designed general condition questionnaire, Berg balance scale, Hoffer walking ability rating scale, and modified Barthel Index, to understand the activities of daily living ability of retired cadres and analyze the relevant factors affecting their self-care ability of daily life. Results A total of 64 “50630” retired cadres were investigated, with an average age of (86.39±3.37) years. 64.06% of the patients with poor balance function needed wheelchair, 10.94% could not walk, and 56.25% were heavily dependent on activities of daily living. Age (r=−0.421, P=0.001) and underlying diseases (r=−0.060, P=0.032) were negatively correlated with activities of daily living. Balance ability (r=0.658, P<0.001), walking ability (r=0.393, P=0.001), spouse status (r=0.669, P<0.001), care status (r=0.830, P<0.001), place of residence (r=0.706, P<0.001) were positively correlated with activities of daily living. Education level (r=0.096, P=0.380) and gender (r=0.122, P=0.265) had no correlation with activities of daily living. Multiple linear regression analysis showed that the main influencing factors of daily living activities of “50630” retired cadres in Mianzhu were balance function, walking ability, spouse or not and type of care. Conclusions There are many related factors affecting the activities of daily living of “50630” retired cadres, which can be intervened according to basic diseases, balance function and walking ability. Through multi-disciplinary and multi-sectoral cooperation, integrating community health service resources, providing all-round health care services, formulating personalized rehabilitation measures, and organizing community group activities, it is possible to improve their social participation, psychological status, and ability of daily living activities, and reduce the disability, so as to further improve the quality of life of veteran cadres.