中风又称脑血管意外,临床以昏迷不醒、半身不遂、口眼歪斜、失语等为主要症状.患者可有运动障碍、言语障碍、二便障碍、心理障碍等后遗症,这与中风恢复期护理、康复治疗不足等密切相关.而尿失禁是脑血管意外后常见的并发症,发病率达32％～79％[1],尿失禁不仅可导致泌尿系感染、皮肤损伤、褥疮等情况,甚至会对患者的生活生存质量和康复进展造成重大影响[2].笔者采用隔姜灸治疗中风后尿失禁收到满意疗效,现报道如下.

目的 观察压灸百会穴对脑卒中后失眠患者的临床治疗效果.方法 2016年4月~12月我科住院的脑卒中后失眠患者65例,按随机数字表法将患者分为治疗组32例和对照组33例.对照组接受原发病基础治疗和常规综合护理.治疗组在对照组的基础上采用压灸百会穴治疗.隔日1次,10天为1个疗程,共2个疗程,疗程结束后进行相关临床疗效比较.结果 治疗组治疗后总有效率为90.63%,对照组总有效率为72.73%,两组比较差异有统计学意义(P<0.05),两组治疗后PSQI评分均较治疗前降低,差异有统计学意义(P<0.01),且治疗组低于对照组(P<0.01).结论 在常规综合护理的基础上采用压灸百会穴治疗,可提高临床疗效,有效改善卒中后患者睡眠情况,是一种安全有效的护理技术,可应用于临床.

目的:探讨康复护理结合隔附子饼灸治疗中风后肩手综合征的疗效.方法:将60例中风后肩手综合征患者随机分为观察组和对照组各30例,在常规治疗的基础上,观察组采用康复护理结合隔附子饼灸法,对照组给予常规护理及艾灸法,观察2组治疗前后Fugl-Meyer上肢运动功能评分(FMA)、肩手综合征评分(SHS),评定临床疗效.结果:总有效率治疗组为93.33％,对照组为80.00％,2组比较,差异具有统计学意义(P＜0.05).2组治疗前后FMA、SHS评分组内比较及治疗后组间比较,差异均有统计学意义(均P ＜0.05).结论:康复护理结合隔附子饼灸法能有效改善中风后肩手综合征患者的患肢功能,提高临床疗效.

Objective:To explore the effect of evidence-based nursing on preventing falling for elderly inpatients. Methods:Selected 461 cases of elderly in-patients over the age of 65 hospitalized in neurology department from November 2013 to November 2014 as the observation group. Referring to evidence-based nursing procedure,raised questions,inspected application evidence,organically combined the nursing evidence and personal skills of nurses with actu-al conditions and willingness of patients to formulate the perfect nursing measures,and then compared it with the control group of 428 cases of elderly inpa-tients selected from November 2012 to October 2013. Results:The inpatients of observation group had not tumbled during the hospital stay,and 6 out of 428 cases of control group had tumbled during the hospital stay. The difference was of statistic significance (P<0. 05). Conclusion:The application of evidence-based nursing can effectively prevent elderly inpatients from tumbling, improving inpatients'security as well as nursing quality.

目的:探讨连续性小组层级岗位责任制排班在护士分层次管理中的实践效果.方法:(1)采用问卷调查法对206名病人及368名医护人员进行护理工作现状调查;(2)建立APN连续性小组层级岗位责任制排班模式;(3)小组层级责任制排班运行有效率统计;(4)新、旧排班护士日工作时数、月休息日数的比较.结果:APN连续性小组层级岗位责任制排班模式雏形(运行有效率大于70％);护理工作现状调查对比存在问题得到改善(P＜0.05),护士对实施护理排班改革的意愿增强(P＜0.01);新排班模式护士每天工时数减少、每月总休息天数增加(P＜0.01).结论:推行APN连续性小组层级岗位责任制排班模式,在护士分层级管理实践中充分体现了岗位责任制,践行了"以人为本"的科学发展观.此项护理岗位工作模式改革,经过8年的临床实践取得了显著的推行效果.

目的：观察氟西汀对脑梗死患者治疗1年内不同时期运动功能及认知功能障碍的影响。方法选取发病72 h内住院的急性脑梗死患者230例，随机分为治疗组及对照组，治疗组在住院48 h内常规二级预防的基础上加用氟西汀治疗，观察时间1年。截取住院48 h内，即氟西汀治疗前、脑梗死后1 w、1个月、3个月、1年5个时间点分别对两组患者进行NIHSS及MoCA量表检测及一般情况评定，并进行比较。同时比较1年内两组患者脑梗死复发情况。结果脑卒中后3个月、1年MoCA评分两组比较有统计学差异（ P＜0.05），1 w、1个月MoCA 评分两组比较无明显统计学差异（P＞0.05）。脑卒中后3个月，1年治疗组NIHSS评分与对照组比较具有明显的统计学意义（P＜0.001），脑卒中后1 w、1个月 NIHSS评分两组比较无明显统计学差异。结论氟西汀治疗能显著改善脑梗死后1年的运动功能及认知功能。

Objective To explore the effects of fluoxetine on motor functional deficits and cognitive functional deficits at different time points after acute cerebrovascular diseases.Methods This was a 3 months randomized,controlled trial.202 cases were enrolled in our study.They were randomly assigned to receive either conventional therapy or induceing fluoxetine based traditional treatment.Four follow up visits were occurred to test scores of National Institutes of Health Stroke Scale(NIHSS) and Montreal cognitive assessment(MoCA)within the 3 months after stroke to assess difference between two groups.Results At 3 months,scores were obviously decrease in NIHSS tests and were greatly increase in MoCA tests in test group.There was no significant difference between two groups at 7 days and 1 months either on motor functional deficits or cognitive functional deficits.Changes of MoCA scores were significant at 48 hours after admission and in 3 months.Conclusion 3 months fluoxetine usage exhibited obvious effects on improving motor function as well as cognitive function with acute cerebrovascular diseases.

Objective To determine the alterations of IGF-1 levels in newborns with HIE at acute stages.Methods Radioimmunoassay was performed to detect the IGF-1 levels in serum isolated from 48cases of normal controls and 46 cases of HIE newborns at acute and recovery period.Results The IGF-1 levels in HIE newborns were significantly lower than those in controls(P0.01).Conclusion Decreasing IGF-1 in HIE newborns is correlated with the pathophysiological procedure of HIE,which could be taken as an index of diagnosis about HIE,or as a target molecule in therapeutic strategy.

Objective To determine the alterations of IGF-1 levels in newborns with HIE at variant stages.Meth- ods Radioinmmunoassay was performed to detect the IGF-1 levels in serum isolated from 30 cases of normal controls and 45 cases of HIE newborns at acute and recovery period,among which the mild,moderate and severe HIE group had 15 cases. Results The IGF-1 levels in HIE newborns at both acute and recovery period were significantly lower than those in controls (P<0.01),whereas IGF-1 increased obviously at recovery period compared with those at acute(P<0.01).The IGF- 1 levels in mild,moderate trod severn HIE newborns were different to each other(P<0.01).More severe HIE leaded to more decrease of IGF-1.Conclusion Decreasing IGF-1 in HIE newborns is correlated with the pathophysiological proce- dure of HIE,which could be taken as an index of severity for clinical monitoring or as a target molecule in therapeutic strate- gy.