目的 探讨围手术康复干预对老年全髋关节置换术(total hip arthroplasty,THA)术后功能水平及运动耐力的影响.方法 选取2020年2月-2021年6月火箭军特色医学中心收治的40例老年全髋关节置换术后患者作为研究对象,用随机数字表法分为观察组和对照组,每组各20例.对照组行THA手术前采取常规健康教育,术后4周开始进行康复训练;观察组在健康教育的基础上,增加术前预康复训练及术后早期康复干预.分别于入院时、术前1天、术后第7天、4周、8周,采用髋关节功能评分量表(Harris Hip Score,HHS)、视觉模拟评分量表(visual analog scale,VAS)、6 min步行试验(6-minute walk test and daily life,6 MMT)及日常生活活动能力评分(activities of daily living,ADL)对2组的功能情况进行评价.结果 入院时,2组HHS评分、VAS评分,6 MWT及ADL评分差异无统计学意义(P＞0.05);经过术前预康复后,观察组的HHS评分、VAS评分,6 MWT及ADL评分结果优于对照组,差异具有统计学意义(P＜0.05).术后第7天,2组的相关指标差异无统计学意义(P＞0.05);经过8周治疗后,观察组的HHS评分、VAS评分,6 MWT及ADL评分结果优于对照组,差异有统计学意义(P＜0.05).结论 围手术康复干预有助于提升老年全髋关节置换术后功能水平及运动耐力的提升.

Objective To explore the effect of mindfulness-based stress reduction on adverse mood and quality of life of patients with complex spinal metastatic tumors undergoing arterial chemoembolization. Methods A total of 120 patients with complex spinal metastatic tumors treated by arterial chemoembolization in our hospital between March 2014 and August 2018 were selected as the study subjects. They were divided into control group and observation group according to random number table method, 60 cases in each group. Patients in the control group were given routine mental health instruction, while patients in the observation group were given mindfulness-based stress reduction intervention on the basis of the control group, once a week, for a total of six weeks. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Numeric Rating Scale-10(NRS-10) and Functional Assessment of Cancer Therapy-G (FACT-G) were applied to evaluate and compare the anxiety, depression, pain degree and quality of life of patients between the two groups before and after intervention. Results There was no difference in SAS, SDS and NRS-10 scores between the two groups before intervention (P>0.05). After intervention, the scores of the above mentioned decreased significantly in both groups (P<0.05), but they decreased greater in observation group than in control group (P<0.05). As for the FACT-G scores, there were no differences between the two groups before intervention in total scores as well as in physical, social/family, emotional and functional dimension (P>0.05). However, after intervention, the FACT-G scores of the two groups increased significantly in the five dimensions (P<0.05), and the increase of the observation group was more than that of the control group, with significant difference (P<0.05). Conclusion Mindfulness-based stress reduction can effectively relieve anxiety and depression, relieve pain and improve the quality of life in patients with complex spinal metastases undergoing arterial chemoembolization.

目的 介绍游离股薄肌移植重建屈肘屈指功能障碍的护理经验.方法 回顾分析15例臂丛神经损伤后屈肘屈指功能障碍患者的临床资料,采用游离股薄肌移植重建肢体功能,加强围手术期管理,注意肌皮瓣血液循环的观察、石膏护理及药物不良反应的观察.结果 肌皮瓣成活良好,经过1～2年的随访,15例患者屈肘屈指都有不同程度的恢复.结论 围手术期的精心护理,可以提高肌皮瓣的成活率,有助于术后屈肘屈指功能的恢复.

抢救护理记录是重要的法律依据,也是医疗事故技术鉴定最重要的基本材料.笔者设计了一种表格式抢救记录单,包括患者的一般信息、时间、用药、各项抢救措施和效果评估.护士只需在相应栏内填写数字、英文符号即可,与传统的纯手工记录相比,书写内容减少90%以上,使记录更为快捷、准确。

目的比较断肢再植术后应用半导体激光照射与否对患者康复的效果。方法随机抽取第二炮兵总医院骨科施行断肢再植手术的患者50例,分成试验组、对照组各25例。采用国产LHH-500IVB型半导体激光治疗仪局部外照射10 min,2次/d。临床疗效的观察指标为患肢的血循环、手术切口的愈合。结果试验组与对照组抽样的总体差异有统计学意义。结论断肢再植术后实施常规显微外科术后护理联合半导体激光照射患肢优于单纯实施常规显微外科术后护理。

随着医学的发展,婴幼儿臂丛神经损伤手术的开展逐年增加,年龄及手术范围不断扩大,手术风险性也随之增多.由于臂丛神经损伤可引起肩关节外展及屈肘功能障碍,导致患儿上肢完全或不完全瘫痪,且不能完全恢复正常,严重影响个人的生活自理能力,给家庭及社会带来沉重的负担.能否使婴幼儿臂丛神经损伤手术顺利进行并取得满意手术结果,术前、术后护理配合发挥重要的作用。