康复护理对小儿脑瘫患儿运动功能、康复效果的影响分析

目的分析康复护理对小儿脑瘫患儿运动功能、康复效果的影响。方法选取我院2018年1月～2019年3月收治的小儿脑瘫患儿110例,参照盲选法原则分为对照组和观察组各55例。对照组应用常规护理方案,观察组应用康复护理方案,对比两组患儿护理前后的运动功能、生活质量及康复效果。结果观察组康复总有效率高于对照组,差异有统计学意义(P<0.05);护理前,两组患儿ADL评分、FMA评分比较,差异无统计学意义(P>0.05),护理后,两组ADL评分、FMA评分较护理前均有改善,且观察组改善情况优于对照组,差异有统计学意义(P<0.05)。结论针对小儿脑瘫患儿采取康复护理效果尤为显著,能够有效改善患儿的运动能力,促进身体快速康复,进而提高生活质量,在临床上具有应用价值。     

脑梗死致患者瘫痪肢体的康复护理效果观察

探讨脑梗死致患者瘫痪肢体的康复护理效果。回顾性分析我院收治的120例脑梗死致肢体瘫痪的患者临床资料,将采用常规护理的60例患者分为对照组,采用康复护理的60例患者分为观察组。观察对比两组患者肢体运动功能评分、生活自理能力评分、护理满意度。护理前,两组患者瘫痪肢体运动功能评分无明显差异(P0.05);护理后,观察组患者运动功能评分明显高于对照组(P0.05)。护理前,两组患者生活自理能力评分无明显差别(P0.05);护理后,观察组患者自理能力评分明显高于对照组(P0.05)。观察组护理总满意率明显高于对照组(P0.05)。符合临床实际的康复护理措施对脑梗死患者具有积极影响,不仅能改善患者瘫痪肢体的运动功能,还能调节患者负性心理,提高临床护理效果,可推荐应用。     

早期康复护理对脑卒中偏瘫患者的影响

目的：探讨早期康复护理对脑卒中患者肢体功能恢复的影响。方法将100例脑卒中患者随机分为对照组和观察组各50例,2组患者给予神经内科常规治疗护理,观察组在此基础上同时实施早期康复护理1个月。于康复前及康复后应用Barthel指数评定日常生活活动能力（ ADL）,Fugl-Meyer（ FMA）评分法评定肢体运动功能,并对2组患者及家属对护理工作满意度比较。结果2组患者康复前后ADL、FMA评分均有一定程度改善,观察组优于对照组（P＆lt;0.05）。观察组患者及家属对护理工作满意度好于对照组（P＆lt;0.05）。结论早期康复护理可有效改善脑卒中患者肢体运动功能、提高患者日常生活活动能力和患者及家属满意度。     

脑瘫患儿应用引导式教育训练的疗效观察

目的:观察引导式教育训练对脑瘫患儿运动功能和生活自理能力的康复疗效。方法:将93例脑瘫患儿按照是否坚持引导式教育训练分为观察组63例和对照组30例,2组均进行综合康复治疗,观察组同时坚持3个月以上引导式教育训练,对照组未能坚持引导式教育训练。引导式教育训练前后2组均采用粗大运动功能量表88项(GMFM-88)和日常生活活动能力(ADL)评分评估康复疗效。结果:2组训练后GMFM-88及ADL评分均有明显升高(P0.01,P0.05);训练后观察组GMFM-88及ADL评分均明显高于对照组(P0.01);观察组中低龄段(3~4岁)GMFM-88和ADL评分训练前后差值均显著高于高龄段(4~7.5岁)(P0.01)。结论:引导式教育训练配合综合康复治疗能提高脑瘫患儿的运动功能和生活自理能力,疗效优于单纯综合康复治疗。引导式教育训练配合综合康复治疗对低龄脑瘫患儿的运动功能和生活自理能力疗效均优于高龄脑瘫患儿。     

早期康复护理在颅脑损伤患者中的应用

目的 探讨早期康复护理对颅脑损伤患者康复的作用.方法 选取颅脑损伤患者92例,随机分为观察组和对照组,每组46例.对照组给予常规护理,观察组在常规护理的基础上给予早期康复护理.观察两组患者治疗前后肢体残损程度及日常生活活动能力(ADL).结果 两组患者治疗后FMA评分及ADL评分均明显高于治疗前(P＜0.01);并且观察组治疗后FMA及ADL评分明显高于对照组(P＜0.05).结论 早期康复护理能明显改善颅脑损伤患者的神经功能、肢体运动功能及日常生活能力,对提高患者生存质量、促进康复有积极意义.     

引导式教育理念在脑瘫患儿康复治疗中的应用分析

目的观察分析引导式教育在脑瘫患儿康复中的应用效果。方法选取自2014年6月~2015年6月于本院进行康复治疗的脑瘫患儿84例作为研究对象,按照随机数字表法将其平均分为观察组和对照组,每组各42例。其中对照组行常规康复疗法,观察组在此基础上加用引导式教育疗法。观察比较两组护理干预前以及干预后粗大运动功能评分(GMFCS)、日常生活活动能力评分(ADL)、韦氏儿童智力量表评分(C-WISC)的变化。结果两组组内比较,康复前、后GMFCS评分、ADL评分与C-WISC评分差异具有统计学意义(P0.05)。组间比较,两组治疗前GMFCS评分、ADL评分与C-WISC评分差异无统计学意义(P0.05);治疗后,观察组的GMFCS评分、ADL评分与C-WISC评分明显优于对照组,两组差异具有统计学意义(P0.05)。结论在传统康复治疗的基础上应用引导式教育方法可以更加有效地改善患儿的粗大运动功能、智力水平和自理能力,提高脑瘫患儿的生活质量,对促进脑瘫患儿融入社会具有积极意义,可以在临床工作中推广应用。     

强化前馈控制结合躯干训练对小儿脑瘫运动功能及日常生活活动能力的影响

目的:观察前馈控制结合躯干训练对小儿脑瘫运动功能及日常生活活动能力(ADL)的影响。方法:40例小儿脑瘫患者随机分成2组各20例,对照组给予常规躯干控制训练,训练组在此基础上结合基于强化前馈控制的躯干训练。在治疗8周后采用Berg平衡量表(BBS)评定2组患儿平衡功能,采用粗大运动功能评估量表(GMFM)评定患儿粗大运动功能,采用Fugl-Meyer运动功能评定量表(FMA)来评定患儿肢体运动功能,采用改良Barthel指数(MBI)评定患儿ADL能力。结果:治疗8周后,2组患儿的BBS,GMFM,FMA及MBI评分均明显高于治疗前水平(P0.05),且训练组高于对照组(P0.05)。结论:强化前馈控制结合躯干训练可以明显改善小儿脑瘫运动功能及日常生活活动能力。     

探析康复护理在小儿脑瘫护理中的应用效果

目的研究脑瘫患儿实施早期康复护理措施的临床效果。方法选取我院于2014年8月~2015年8月收治的34例脑瘫患儿。按照入院先后顺序分为常规组和干预组各17例。常规组接受脑瘫常规院内治疗与护理干预措施,干预组在常规组基础上实施早期康复护理,观察对比两组患儿肢体运动恢复情况及自理能力及家长满意率。结果常规组患儿机体恢复有效率为70.59%,干预组为88.24%,差异有统计学意义(P0.05)。干预前,两组自理能力评分比较无显著性差异(P0.05);干预后,干预组患儿自理能力指标评分均高于常规组,差异有统计学意义(P0.05)。干预组患儿家长满意度为94.12%,显著优于常规组的76.47%,差异有统计学意义(P0.05)。结论脑瘫患儿实施康复护理措施,能显著提高患儿肢体运动功能及自理能力,家长满意度较高。     

脑卒中偏瘫病人早期康复护理效果观察

为探讨脑卒中偏瘫病人早期康复护理的临床效果，将180例初发脑卒中病人随机分为康复护理组和对照组，康复护理包括运动功能和生活自理能力训练，康复护理前后用Fugl-Meyer量表（FMA）评定运动功能，用Barthel指数（BI）评定生活自理能力。 结果显示：两组总治疗时间无统计学差异（P＞0．05），康复护理后两组病人运动功能及生活自理能力均有所改善，神经功能缺损程度有所下降，但康复护理组FMA和BI改善程度与对照组比较有统计学意义（P＜0．01），且康复护理组神经功能缺损程度较对照组显著降低（P＜0．01）。提示，早期康复护理可明显改善初发脑卒中偏瘫病人的肢体运动功能，提高生活自理能力，降低神经功能缺损程度。     

社区康复对脑卒中患者肢体功能和日常生活活动能力的影响

目的探讨社区康复对脑卒中患者肢体运动功能和日常生活活动（ADL）能力的影响。 方法60例脑卒中患者分成康复组和对照组,每组30例。康复组由同一康复医师进行评估并制定康复治疗计划,同时指导患者进行系统、规范的社区康复训练,对照组给予常规健康教育。2组均于入组后第1天（治疗前）和治疗3个月后（治疗后）采用简化Fugl-Meyer运动功能量表（FMA）和改良巴氏指数（MBI）评定患者的肢体运动功能和ADL能力。 结果治疗前,2组患者的FMA评分和MBI评分差异均无统计学意义（P＞0.05）;治疗后,2组患者的FMA评分和MBI评分与本组治疗前比较,均有明显改善（P＜0.05）,且康复组的FMA评分和MBI评分较对照组治疗后改善更为显著,差异均有统计学意义（P＜0.05）。 结论社区康复训练对脑卒中患者肢体的运动功能和ADL能力具有良好的促进作用。     

系统化盆底康复锻炼在产后康复训练中的应用效果

目的探究系统化盆底康复锻炼在产后康复训练中的应用效果。方法选取产后康复训练患者242例作为研究对象,对所有的患者进行随机分组,分为观察组、哑铃组和对照组,观察组选择系统化的盆底康复锻炼方法,包括电刺激、生物反馈以及阴道康复器锻炼;对照组选择常规的产后治疗方法进行治疗,哑铃组选择阴道康复器进行锻炼,所有的患者均于产后的42d进行,治疗结束后对患者的盆底肌力水平、盆底功能障碍恢复效果以及流行病学问卷等指标进行比较和分析。结果对照组患者的Ⅰ、Ⅱ类肌纤维肌的疲劳程度显著高于观察组,肌纤维电压低于观察组,对照组患者的盆底肌力水平差于观察组,不同组患者的组间比较有显著的差异(P0.05);产后3个月各组患者的S+P发生率的组间比较无显著差异(P0.05);产后的3个月各组患者的SUI发生率以及产后的6个月各组患者的SUI、S+P发生率的组间比较均有显著差异(P0.05);各组产后患者指标比较,患者的SUI发生率3个月和6个月时间点哑铃组和观察组相比较无显著差异,但是均显著低于对照组,差异有统计学意义(P0.05);哑铃组患者和对照组患者产后6个月的S+P发生率均有显著高于观察组(P0.05),哑铃组患者和对照组患者产后6个月的S+P发生率比较无显著差异(P0.05)。结论系统性的盆底锻炼在产后康复训练中具有无创、无痛、方便锻炼、效果显著的特点,对恢复盆底肌的功能效果可靠,值得推广。     

产后综合康复护理对产妇产后抑郁及子宫康复的影响

目的：探究产后综合康复护理对产妇产后抑郁及子宫康复的影响。方法选取2013年1月至2014年1月在我院进行分娩的产妇120例作为研究对象,将产妇分为对照组和观察组,每组60例产妇,观察组产妇采用产后综合康复护理法进行护理,对照组产妇采用常规的护理法进行产后护理。观察两组护理方法对产妇产后抑郁及子宫康复情况的影响。结果对采用不同方法进行护理产妇产后抑郁和子宫康复情况进行比较,对照组产妇的抑郁率（70．00％）明显高于观察组产妇的抑郁率（30．00％）,两组比较差异具有统计学意义（P＜0．05）,观察组的子宫恢复良好率（70．00％）明显好于对照组的子宫恢复良好率（35．00％）,两组比较差异具有统计学意义（P＜0．05）。结论在对产妇进行产后护理时采用产后综合护理的方法可以降低产妇产后抑郁情况的发生,促进子宫的康复,能够提高产妇和婴儿的生活质量,值得在临床的护理工作中广泛推广应用。     

A comparison of a hospital-based and two home-based rehabilitation programmes

Purpose.?This paper compares the service models of three different types of rehabilitation programmes provided in Victoria, Australia: One hospital-based and two types of rehabilitation in the home (RITH).

Method.?Nine focus group interviews were conducted with multidisciplinary staff working in rehabilitation teams in one hospital-based and eight RITH programmes. Additional data were collected for 164 clients and 75 carers from eight of these programmes at admission, discharge and three months post discharge. Interviews were conducted with 32 clients and 14 carers.

Results.?The criteria for admission and model of rehabilitation adopted in the three programmes were similar. There were differences in programme aims, characteristics of the clients admitted and the type and level of therapy clients received, both between hospital and home-based programmes and between the three programmes. In general, staff and clients saw the home as providing a relevant context that enabled individualized, goal directed therapy for medically stable rehabilitation clients. The hospital offered an opportunity to socialize with others and specialized equipment.

Conclusions.?Results of this study suggest clients and carers require a mix of hospital and home-based rehabilitation that is able to respond to their needs and preferences at each phase of the rehabilitation continuum.     

A comparison of a hospital-based and two home-based rehabilitation programmes

Purpose. This paper compares the service models of three different types of rehabilitation programmes provided in Victoria, Australia: One hospital-based and two types of rehabilitation in the home (RITH).

Method. Nine focus group interviews were conducted with multidisciplinary staff working in rehabilitation teams in one hospital-based and eight RITH programmes. Additional data were collected for 164 clients and 75 carers from eight of these programmes at admission, discharge and three months post discharge. Interviews were conducted with 32 clients and 14 carers.

Results. The criteria for admission and model of rehabilitation adopted in the three programmes were similar. There were differences in programme aims, characteristics of the clients admitted and the type and level of therapy clients received, both between hospital and home-based programmes and between the three programmes. In general, staff and clients saw the home as providing a relevant context that enabled individualized, goal directed therapy for medically stable rehabilitation clients. The hospital offered an opportunity to socialize with others and specialized equipment.

Conclusions. Results of this study suggest clients and carers require a mix of hospital and home-based rehabilitation that is able to respond to their needs and preferences at each phase of the rehabilitation continuum.     

上海市康复医疗资源调查报告

目的:上海对本地区现有的康复医疗资源现状进行调研,为卫生行政部门启动康复医疗服务体系的试点工作提供科学循证的决策依据.方法:采用问卷和实地走访的方式调研,各单位在完成《上海市康复医疗资源调查表》填写后需加盖单位公章确认.结果:上海市共有463家医疗机构,其中180家(38.88％)设有康复医学科,31家(6.7％)设有康复病床,康复医师585人,康复治疗师754人.康复医师具有研究生及以上学历者占26.32％,康复治疗师具有研究生及以上学历者占3.71％.结论:目前上海康复从业人员数量和专业质量都未达到卫生部对康复医学科设置的基本标准,尤其康复人才匮乏凸显.多种形式多种渠道,规范培养康复人员非常紧迫.     

时间康复护理方案对脑梗死后吞咽障碍患者功能康复的影响

目的探讨时间康复护理方案在促进脑梗死后吞咽障碍功能恢复中的应用。方法将60例脑梗死后吞咽障碍患者分为观察组和对照组,对照组采用常规方案护理,观察组采用时间康复护理方案,比较2组的吞咽功能恢复情况及生活质量。结果观察组与对照组的总疗效分别为93.3%、73.3%,差异有统计学意义(P0.05)。观察组护理后的藤氏吞咽障评分高于对照组,洼田饮水试验评分低于对照组,生活质量高于对照组,差异均有统计学意义(P0.05)。结论时间康复护理方案能够促进脑梗死后吞咽障碍的功能恢复,改善患者的生活质量,方法简便,值得推广。     

The work of rehabilitation

Purpose. To describe three years of activity of a rehabilitation unit and to make comparisons between clients who receive different levels of active rehabilitation.

Method. A retrospective study set in an inpatient rehabilitation facility located in Dunedin, New Zealand, examining 874 inpatient admissions over three financial years (2000 - 2002). Outcome measures include Functional Independence Scores (FIM) at admission and discharge, length of stay, weekly gains in FIM scores, and changes in FIM sub-scores.

Results. Assessment and rehabilitation patients made significant FIM gains in comparison to assessment only and social relief (respite care) patients. Assessment and rehabilitation patients showed greater gains in the Physical dimensions of the FIM in comparison to the Cognitive although this is probably a function of different scaling. Floor and ceiling effects were not present in the FIM.

Conclusions. The interdisciplinary rehabilitation program brings about real functional and cognitive gains in a range of patients as measured with the FIM. This adds to the considerable body of research which documents FIM gains and further provides evidence that physical and cognitive gains differ.     

The work of rehabilitation

Purpose.?To describe three years of activity of a rehabilitation unit and to make comparisons between clients who receive different levels of active rehabilitation.

Method.?A retrospective study set in an inpatient rehabilitation facility located in Dunedin, New Zealand, examining 874 inpatient admissions over three financial years (2000?–?2002). Outcome measures include Functional Independence Scores (FIM) at admission and discharge, length of stay, weekly gains in FIM scores, and changes in FIM sub-scores.

Results.?Assessment and rehabilitation patients made significant FIM gains in comparison to assessment only and social relief (respite care) patients. Assessment and rehabilitation patients showed greater gains in the Physical dimensions of the FIM in comparison to the Cognitive although this is probably a function of different scaling. Floor and ceiling effects were not present in the FIM.

Conclusions.?The interdisciplinary rehabilitation program brings about real functional and cognitive gains in a range of patients as measured with the FIM. This adds to the considerable body of research which documents FIM gains and further provides evidence that physical and cognitive gains differ.     

环境和康复

人类的工作和行为必然与环境相关,环境是人类全部活动的一部分,环境是人们通过活动达到目的的途径。如果个人活动不适应人类的生存环境,它将不会长久存在。反之,如果不断关注与自己相关的环境,将会更加容易地达到活动的目的。环境在康复领域中的影响,很早就被关注到。康复中的环境包含了人类个体外在的全部因素,其分类方式较多。在康复评定中,针对环境有部分常用的评定方法。在康复治疗中,通过环境干预可以治疗疾病。     

烧伤的康复治疗

目的 :本文阐述了烧伤康复的基本方法。方法 :报告了872例经系统康复治疗的患者。结果 :再次入院手术率及致残率均显著下降 ,对照组与康复组分别为25%、11.2 %和4 %、1.7%(P<0.001)。结论 :康复效果明显优于未经系统康复治疗组的患者