随着关节镜技术的日趋成熟,其创伤小、并发症少、恢复快的特点已被大部分医生、患者所认可.关节镜诊断结果已作为关节疾病诊断的金标准[1].关节镜手术患者被认为是血栓发生的低风险人群.目前术后静脉血栓栓塞(venous thromboembolism,VTE )的发生尚未引起学者的广泛关注,因而对于膝关节镜术后VTE的预防尚未给予足够的重视,对于关节镜手术患者VTE的防治存在很大争议[2-3].

目的 旨在分析脑卒中康复期患者心理弹性与创伤后应激障碍(PTSD)相关性.方法 选取我院神经内科于2016年1月～2017年4月期间收治124例康复期脑卒中患者作为观察对象.分别使用一般情况自制调查问卷、心理弹性量表和创伤后应激障碍问卷调查患者一般情况、家庭情感支持和创伤后应激障碍.结果 康复期脑卒中患者心理弹性量总分(61.19±8.62)分,创伤后应激障碍总分(40.54±10.81)分.患者心理弹性与创伤后应激障碍呈现显著负相关性(P＜0.01).结论 脑卒中康复期患者具有较高的PTSD的发生率,且心理弹性较差.患者的心理弹性程度与PTSD严重程度有负相关,临床中应重视对此类患者及早的予以心理干预.

Objective To explore the correlation between social support and social avoidance distress in patients with mild aphasia. Methods 236 mild stroke aphasia patients were randomly selected as the research object from our hospital during January 2015 to January 2017. Social support were evaluated using Social Support Rating Scale (SRRS), and social avoidance distress were evaluated using Social Avoidance and Distress Scale (SADS). The association between social support and social avoidance and social distress were analyzed using pearson correlation. Results The social support score of male stroke patients with mild aphasia was significantly higher than that of female patients (P<0.05). The social avoidance and distress score of male stroke patients with mild aphasia was significantly lower than that of female patients (P<0.05). Social support score was significantly decreased with the increase of age. The social avoidance and distress score was significantly increased with age growth (P<0.05). The higher level of education was associated with higher social support and lower social avoidance and distress (P<0.05). The social support score of urban patients was significantly higher than that of rural patients (P<0.05). The social avoidance and distress score of urban patients was significantly lower than that of patients in rural areas (P<0.05). There was a negative correlation between social support and social avoidance and distress in patients with mild aphasia (P<0.05). Conclusion The nursing staff should effectively guide social support to the patients with mild aphasia, improve their self-confidence to communicate with others, and be optimistic about the ability of daily life.

Objective To analysis correlation of quality of social relationships a nd emotional symptoms in stroke hemiplegia patients.Methods 72 cases of stroke hemiplegia patients were selected as the observation object in the Department of Neurology of our hospital's from January 2016 ～ December 2016.Social relationship quality scale (SRQS)assessment of patients with quality of social relations.17 item Hamilton Depression Rating Scale (HAM D-17),14Hamilton Anxiety Scale (HAMA) and Beck-rafaelsdn Mania Rating Scale (BRMS) were used to measure the emotional symptoms.Pearson correlation analysis between social relationship and emotion symptoms.Results In these stroke hemiplegia patients,the total score of Social Relational Quality Scale (SRQS) is 32.8 ± 7.4.For the subscale analysis,Family Intimacy score is 13.8 ± 4.9;Family Commitment score is 10.2 ± 3.8,and Friendships score is 9.7 ± 2.9.For the emotion symptoms,the HAMD score is 54.8 ± 6.6,HAMA score is 48.1 ± 5.2,and BRMS score is 38.4 ± 4.5.Pearson correlation analysis showed that the total SRQS is negative associated depression,anxiety and mania symptoms in stroke hemiplegia patients (P＜ 0.01).The three subscale score of SRQS (Family Intimacy,Family Commitment and Friendships) were also negative associated depression,anxiety and mania symptoms in stroke hemiplegia patients (P ＜ 0.01).Conclusion There is a negative correlation between the quality of social relationship and emotion symptoms in stroke hemiplegia patients.Increasing the quality of social relationship may weaken the emotion symptoms.

总结改良McLaughlin手术治疗18例肱骨小结节骨折合并锁定性肩关节后脱位患者的术后护理.护理重点为体位护理,伤口渗血的观察及引流管护理,外固定支具的护理,术后疼痛护理,同时指导患者进行循序渐进的康复功能锻炼,避免关节粘连,加强出院指导.18例患者术后获12~60(36±16)个月随访.最终肩关节活动度前屈上举90°~170°,平均148°±25°;体侧外旋0°~72°,平均46°±20°;体侧内旋达到T10~L3水平.

目的 探讨预见性护理对脑梗死继发抑郁症患者的临床效果.方法 选取2014年1月至2015年10月期间,我院住院治疗的脑梗死后继发抑郁症患者96例,按照随机数字表法平均分为观察组与对照组,每组48例.对照组患者予以常规护理1个月,观察组在予以常规护理的基础上予以预见性护理1个月.对比两组护理干预前后汉密尔顿抑郁量表评分(HAMD)、神经功能缺损量表评分(NIHSS)、生活活动能力量表(ADL)评分以及护理满意度量表评分的差异.结果 两组患者护理前HAMD、NIHSS、ADL评分对比均无明显差异(P＞0.05);两组患者护理后HAMD、NIHSS评分均明显低于护理前,ADL评分明显高于护理前(P＜0.05);且护理后观察组HAMD评分及NIHSS评分均显著低于对照组(P＜0.05),ADL评分显著高于对照组(P＜0.05);观察组的护理满意度为95.83％,显著高于对照组的85.42％(P＜0.05).结论 在常规护理的基础上,对脑梗死继发抑郁症患者实施预见性护理能够更有效地改善患者的抑郁症状及神经功能,提高日常生活能力,提高患者对护理的满意度,值得临床推广应用.

用移植皮瓣修复皮肤缺损在国内外已广泛应用.腹部皮瓣互换术是将手部瘢痕切除时形成一瘢痕瓣,在腹部形成皮瓣后两个皮瓣的蒂部均位于创面的同一侧,供区用瘢痕瓣覆盖,受区用新形成的皮瓣覆盖[1].

2002年6月～2009年10月,我们利用椎管内残留的神经移植修复损伤的臂丛神经下干,效果较好.现将围手术期的护理方法介绍如下. 临床资料:本组18例患者中,男12例、女6例,年龄3～56岁,均为全臂丛神经损伤,且伴有同侧膈神经及副神经损伤.

[目的]评价舒适护理对预防断指再植病人鼻出血的作用。[方法]选择2005年5月—2009年5月断指再植病人120例,随机分为实验组和对照组各60例,对照组采用常规护理,实验组在此基础上实施舒适护理,比较两组病人鼻出血发生情况。[结果]实验组鼻出血发生率显著低于对照组(P<0.05)。[结论]断指再植术后病人在常规护理基础上实施舒适护理,可以预防鼻出血的发生。

总结了26例断指再植患者术后发生鼻衄的预防和护理要点。包括对26例断指再植术后发生鼻衄的患者进行局部指压、明胶海绵鼻腔内填塞、调整抗凝药剂量和使用时间、烤灯与面部置遮挡物、增加空气湿度和调整饮食等措施。认为心理护理,保持空气湿润以及观察抗凝药物的副作用是护理的关键环节。