Objective:To explore the application effect of health education based on protective motivation theory(PMT) in rehabilitation exercise of patients after total knee arthroplasty.Methods:Seventy-two patients with knee osteoarthritis who underwent unilateral total knee arthroplasty in Guangdong Second Traditional Chinese Medicine Hospital from July 2021 to February 2022 were selected and randomized to control group and experimental group according to random number table, 36 patients in each group. The control group received routine health education, while the experimental group received health education based on PMT besides the routine health education. The rehabilitation self-efficacy score, rehabilitation exercise compliance score and knee joint function score of the two groups were compared. The independent sample t test was used for measurement data, and chi square test was used for counting data.Results:There was no significant difference in the scores of rehabilitation self-efficacy, rehabilitation exercise compliance or knee function between the two groups before intervention (all P>0.05). After intervention, the scores of all dimensions of rehabilitation self-efficacy, rehabilitation exercise compliance and knee joint function of patients in the experimental group were higher than those in the control group, and the difference was statistically significant (t=4.865, 3.984, 5.901, 5.514, 5.304, 4.183, all P<0.05).Conclusion:Health education based on PMT can improve the sense of rehabilitation self-efficacy and rehabilitation exercise compliance of patients after total knee arthroplasty, and effectively promote the recovery of knee joint function.

中医传统养生功法历史悠久,是中华民族养生文化的瑰宝.其与中国传统的特有的思维方式、价值导向、思想和导引术发展的主客体这些之间都存在着内在的联系,本文从古代医家对养生功法的认识,以及养生功法的发展过程进行归纳汇总,为今后中医传统养生功法的研究提供一些参考.

目的:探讨全膝关节置换术后病人本体感觉重建过程的心理体验及应对.方法:采用现象学研究方法对10例全膝关节置换术后病人进行半结构式访谈,以Colaizzi 7步分析法对资料进行分析.结果:提取出5个主题:①期望与信心,术后早期对康复结局保持着期待与信心;②害怕与担忧,行走时害怕跌倒而不敢下地行走参与基本的日常活动,康复阶段病人对关节假体稳定性及预后的担忧;③困惑与疑虑,对疼痛的恐惧及认识不足导致对康复锻炼的困惑以及对手术效果的疑虑;④健康需求及渴望沟通;⑤期待理解和支持,对恢复社会家庭角色的强烈期待及社会主体地位下降的失落心理.结论:全膝关节置换术后病人本体感觉重建阶段的心理体验总体是一个复杂交错、需要关注的过程.医护人员可根据研究结果进一步优化全膝关节置换术后延续护理方案,建立多维度支持系统,帮助病人有效应对,促进病人肢体功能的恢复及更好地融入社会家庭.

目的 分析呼吸功能训练对肺结核疗效影响及护理措施.方法 选取2017年1月至2018年12月68例肺结核患者,分为观察组和对照组,观察组34例,对照组34例.对照组应用常规护理,观察组应用呼吸功能训练,比较两组患者对呼吸功能训练方法的掌握程度、依从性及患者对护理工作的满意度.结果 观察组呼吸功能训练方法掌握率为94.12%,对照组为61.76%,观察组呼吸功能训练方法掌握率高于对照组,差异具有统计学意义(P＜0.05).观察组呼吸功能训练依从性为85.29%,对照组为58.82%,观察组呼吸功能训练依从性高于对照组,差异具有统计学意义(P＜0.05).观察组患者对护理工作满意度为97.06%,对照组为58.82%,观察组患者对护理工作满意度高于对照组,差异具有统计学意义(P＜0.05).结论 呼吸功能训练对肺结核疗效较好,加强对呼吸道和引流管等护理措施改善患者的运动耐力,进而提高患者对呼吸功能训练方法的掌握程度、依从性及患者对护理工作的满意度.

目的 探讨智能床旁护理系统在骨科患者健康教育中的应用效果,利用科技手段创新新的健康教育模式.方法 整群抽取骨关节科2018年5～11月入院的250例患者按时间段分为两组进行前瞻性研究,抽取2018年5～7月入院的125例患者设为对照组,采用传统模式进行健康教育;抽取2018年8～11月入院的125例患者设为观察组,采用智能床旁护理系统进行健康教育,评价对照组和观察组患者健康教育知晓率、依从性、满意度.结果 对照组患者对健康教育内容完全知晓者56例(44.8％),而观察组对健康教育内容完全知晓者为92例(73.6％);观察组健康教育知晓率、依从性明显优于对照组,两组比较差异均有显著统计学意义(P<0.01).结论 在骨科患者健康教育中应用智能床旁护理系统进行健康教育,可显著提高健康教育效果,有利于促进疾病康复,提高了护理工作效率,促进护理管理模式的不断创新,值得临床推广和使用.

目的:探讨雷火灸治疗腰椎间盘突出症的临床应用效果.方法:择取我院2015.01到2018.01时间段内诊疗的60例腰椎间盘突出症患者,以病历号奇偶数的不同分为对照组30例、综合组30例.即患者均执行雷火灸治疗,综合组在此基础上使用综合护理,比较患者总有效率、护理效果.结果:综合组总有效率为100.00％,对照组则为86.67％,各数据间比较有意义(P<0.05).对照组NRS评分、FPS评分、Barthel指数明显较差于综合组,各数据间比较有意义(P<0.05).结论:针对腰椎间盘突出症患者,在雷火灸的前提下联合综合护理模式,不仅可提高患者治疗疗效,还可改善其NRS评分、FPS评分、Barthel指数,值得推广.

目的 探讨循经穴位按摩预防关节置换术后下肢肿胀的临床效果.方法 选择髋膝骨关节置换术110例,采用随机数字表法分为实验组(55例)和对照组(55例).对照组接受术后常规护理:内容包括疼痛护理、术口护理、情志护理、饮食护理及功能锻炼指导等;实验组在常规护理的基础上采用下肢循经穴位按摩.两组患者分别在术前1天,术后1天、3天、6天,下肢静脉血流速度、血浆D-二聚体、疼痛、术肢周径,比较两组之间的差异.结果 髋膝骨关节置换术后3天实验组患者的疼痛、肿胀改善明显明显优于对照组(P＜0.05).结论 在关节置换患者术后实施下肢循经穴位按摩能够有效缓解患者的疼痛,减轻肿胀,降低其他并发症的发生率,缩短患者的住院时间,从而促进患者的康复和护理满意度的提高.本循经穴位按摩方法简单,值得临床推广应用.

Objective To observe the clinical effect of musculoskeletal stretching exercise created by Professor Xu Xuemeng on patients with lumbar disc herniation.Methods From October,2017 to October,2018,100 patients with lumbar disc herniation treated at our department were randomly divided into an observation group (50 cases) and a control group (50 cases) according to the random number table.The control group received physical therapy and appropriate bed rest;the observation group performed musculoskeletal stretching exercise on the basis of these measures,2 times/day,for 2 weeks.The scores of VAS and JOA were evaluated before and after the treatment.Results The VAS score was lower and the JOA score was higher in the observation group than in the control group [(2.04±1.00) vs.(2.74±1.61) and (20.18±2.49) vs.(16.72±2.56)],with statistical differences (t=2.6 and-6.859,P=0.01 and 0.00).The effective rate was higher in observation group than in the control group (92.00％ vs.78.00％),with a statistical difference (Z=-2.461,P=0.014).Conclusion Musculoskeletal stretching exercise can improve the muscle strength,maintain and strengthen the stability of the joint and the spine,restore the local mechanical balance,and improve the rehabilitation of patients with lumbar disc herniation.

Objective To investigate the effect of Bone-Tendon-Muscle rehabilitation gymnastics on quality of life in patients with knee osteoarthritis. Methods 100 cases of knee osteoarthritis undergoing conservative treatment were divided into the experimental group and the control group with the random number table method, 50 cases in each group. The control group received routine comprehensive physical therapy and traditional functional exercise; on this basis the experimental group received Bone-Tendon-Muscle rehabilitation gymnastics designed by our hospital as functional exercise. The knee joint function and quality of life of the two groups were evaluated by the quality of life scale (SF-36) and Lequesne knee functional score before the functional exercise and after functional exercise for 3 months. Results There were statistically significant differences in the scores of each dimension of quality of life scale before the functional exercise and after functional exercise for 3 months in both two groups (P<0.01), the difference values of the scores of each dimension before and after the treatment in the experimental group were significantly more than those in the control group (P<0.01). Lequesne knee functional score in both two groups significantly decreased after the treatment (P<0.05), Lequesne knee functional score in the experimental group was significantly lower than that in the control group after the treatment (P<0.01). Conclusions The Bone-Tendon-Muscle rehabilitation gymnastics could improve the leg strength, maintain and strengthen the stability of knee joint, restore the local biomechanics balance, to make the life quality of patients with knee osteoarthritis more better, more thorough, and more stable. Bone-Tendon-Muscle rehabilitation gymnastics was easy to learn, so it was easy to accept and stick to, which is well worthy popularizing. Key words: Knee osteoarthritis; Life quality; Bone-Tendon-Muscle rehabilitation gymnastics

目的:探讨四子散药熨法联合超激光治疗仪治疗慢性咳嗽的临床疗效.方法:选取40例慢性咳嗽患者作为观察对象,应用四子散药熨法联合超激光治疗仪治疗,并参照中华医学会呼吸病学分会制定的《咳嗽的诊断和治疗指南(2009版)》进行疗效评价.结果:40例患者中,显效27例、有效10例、无效3例,总有效率为92.5%.结论:四子散药熨法联合超激光治疗仪治疗慢性咳嗽临床疗效优,能发挥协同作用,值得推广使用.

目的:研究舒适护理在慢性咳嗽中的应用价值.方法:收集2015年2月-2016年9月笔者所在科门诊接收的慢性咳嗽病例共46例,采用数字抽签原理分组所选病例,试验组与对照组,各23例.两组都予以常规护理,试验组同时辅以舒适护理.观察两组睡眠质量改善情况,比较生命质量等指标.结果:试验组护理后PSQI评分为(6.05±0.07)分,患者满意率为95.65%,对照组分别为(7.83±1.79)分、73.91%,差异有统计学意义(P<0.05).针对生命质量的改善程度,试验组明显优于对照组,差异有统计学意义(P<0.05).结论:于慢性咳嗽中合理引入舒适护理理念,可显著改善患者的睡眠及生命质量.

目的:探讨人工膝关节表面置换术术后采用冷疗垫冷敷的方法有效地减轻膝关节肿痛的疗效.方法:选择应用人工膝关节表面置换术术后的患者64例,随机分为治疗组31例、对照组33例,患肢均无感觉障碍,手术后24小时后均进行功能锻炼.治疗组采用布袋式冷疗垫冷疗装置在患者行人工膝关节表面置换术术后安置于其患侧膝部,间断冷敷治疗72小时,对照组予抬高患肢,观察伤口渗血并行常规换药及无菌清洁包扎.观察两组关节疼痛和肿胀程度及消肿率.结果:术后72h,两组患者的VAS评分较术后显著改善(P<0.01),且治疗组术后72h的VAS评分、周径显著优于对照组(P<0.01).结论:人工膝关节表面置换术术后采用冷疗垫冷疗能够有效地起到止痛消肿、减少出血的作用,适用于膝骨性关节炎人工膝关节表面置换术术后的患者.

功能性子宫出血(以下简称功血),是妇科常见病之一,由于内分泌功能紊乱,引起月经周期不规律,阴道大量出血,妇科检查找不到器质性病变者,它属祖国医学崩漏的范畴.笔者共治114例,取得满意效果,现报导如下: