康复护理方法对脑梗死偏瘫病人的护理要点探讨

目的探讨康复护理对脑梗死偏瘫患者的作用。方法选取180例脑梗死偏瘫患者为研究对象,根据护理方法分为康复护理组（90例）和常规护理组（90例）,比较两组治疗有效率。结果康复护理组中总治疗有效率为93．3％,明显高于常规护理组的73．3％（x2=12．960,P=0．0003〈0．05）。结论康复护理对脑梗死偏瘫患者具有较好的护理效果,值得推广研究。     

早期康复治疗对脑梗死偏瘫患者神经、运动功能及生活自理能力的影响

探讨不同时期康复治疗对脑梗死偏瘫患者神经、运动功能及生活自理能力的影响。方法 选取2019年10月—2020年12月广州市某医院收治的脑梗死偏瘫患者60例为研究对象。采用随机数字表法分为早期康复治疗组（30例）和晚期康复治疗组（30例）。早期康复治疗组患者在基础药物治疗的同时，于2周内实施早期康复治疗；晚期康复治疗组患者则在基础药物治疗4周后进行晚期康复治疗，2组患者均持续康复治疗2周。比较2组患者治疗前后Fugl Meyer运动功能评分、Barthel指数、美国国立研究脑卒中量表(NIHSS)评分和生活质量评分。结果 治疗后，早期康复治疗组患者Fugl Meyer运动功能评分、Barthel指数评分、生活质量评分均高于晚期康复治疗组，NIHSS评分低于晚期康复治疗组，差异均有统计学意义（P<0.05）。结论 早期康复治疗可有效减轻脑梗死偏瘫患者神经功能缺损程度，提高患者运动功能、日常生活自理能力和生活质量，值得在临床上推广使用。     

电动起立床在脑梗死患者中的实施及对偏瘫肢体的恢复效果

目的 分析电动起立床在脑梗死患者中的实施效果以及对患者偏瘫后肢体的康复影响效果.方法 将本院自2019年1月-2020年12月治疗的脑梗死后肢体偏瘫患者98例作为研究对象,分为观察组和对照组,对比分析两组患者分别训练后康复效果、下肢运动功能、平衡功能、躯干控制功能以及治疗前后BBS、FMA、QOL、ADL评分.结果 两...     

康复治疗脑梗死的临床疗效观察

目的探讨应用康复治疗(运动疗法、作业疗法等康复治疗方法对脑梗死偏瘫的影响。方法对发病1个月以内的以偏瘫为主要临床表现的80例脑梗死患者分为康复组与对照组,康复组以运动疗法及作业疗法以及适度的日常生活能力训练,治疗前后进行CSS评分及ADL分级。结果康复治疗组CSS评分减少较对照组减少P<0.01,有显著差异。结论脑梗死患者早期进行系统康复治疗对肢体功能有促进作用,改善预后。     

致作者

目的探讨脑梗死偏瘫的早期康复治疗的疗效。方法将94例脑梗死偏瘫患者随机分为康复组和对照组，康复组在药物治疗的基础上进行早期康复治疗，对照组为单纯药物治疗，采用临床神经功能缺损程度评分（NDS）和日常生活活动能力（ADL）评价的标准进行评分。结果康复组NDS及ADL评分明显优于对照组（P〈0．01）。结论早期进行康复治疗能明显促进脑梗死患者的患肢功能恢复，降低致残率，提高日常生活能力。     

早期针灸康复治疗急性脑梗死后偏瘫的临床效果分析

目的:分析早期针灸康复治疗急性脑梗死后偏瘫的临床效果。方法:选取我院2017年4月至2018年4月期间收治的60例急性脑梗死后偏瘫患者为研究观察对象,依据治疗方式的不同分为观察组和分析组,观察组用以往常规方式进行治疗,而分析组在常规疗法的基础上施行早期针灸康复治疗法,分别统计两组患者的治疗效果。结果:经统计和分析,两组患者治疗前的NIHSS分值和ADL分值都不具备统计学对比意义,P0.05;而治疗后两组患者的NIHSS分值和ADL分值具备统计学对比意义,数据有明显的差异,P0.05。结论:使用早期针灸康复治疗急性脑梗死后偏瘫具有更好的临床效果,有助于修复患者的神经系统,提高患者的预后质量,提升应对生活的能力,帮助患者康复,可以在临床中推广并进一步的深入研究。     

中医康复护理对脑梗死偏瘫病人早期功能恢复的影响

目的：分析在脑梗死偏瘫病人临床护理中，中医康复护理对患者早期功能恢复的影响。方法：选取我院于2015年1月至2016年1月收治的60例脑梗死偏瘫患者为对象，将所选患者随机均分为对照组与实验组，对照组患者接受常规护理，实验组患者则在此基础上接受中医康复护理，对比两组患者的运动功能评分。结果：实验组患者的运动功能评分明显高于对照组患者，两组患者数据对比存在统计学差异（P＜0.05）。结论：在脑梗死偏瘫患者早期功能恢复中，中医康复护理的应用效果较好，值得推广。     

初发与再发脑梗死偏瘫患者社区康复疗效的对照分析

目的探讨初发与再发脑梗死偏瘫患者社区康复治疗的疗效。方法 2008年1月至2009年12月住院病人,其中初发脑梗死偏瘫患者31例,再发脑梗死偏瘫患者31例,两组患者均在发病后病情稳定,无明显进展恶化后除药物治疗外开始康复治疗,两组治疗1个月、3个月及6个月后,观察其肢体运动功能及日常生活自理能力的变化,采用功能综合评定量表(FCA)进行评估。结果经社区康复治疗后,两组评分与入院时比较都有明显提高(P均<0.01),且初发组明显优于再发组(治疗3个月P<0.05;治疗6个月P<0.01)。结论社区康复治疗可明显改善初发脑梗死与再次脑梗死偏瘫患者的肢体运动功能,对提高日常生活质量非常重要;与此同时,预防脑梗死的再次发生也相当重要。     

空气波压力治疗急性脑梗死偏瘫患者疗效

目的：探讨气压治疗急性脑梗死致偏瘫患者的效果。方法：选择急性脑梗死致偏瘫病人60例,随机分成两组,对照组病人采用常规药物治疗加康复护理,观察组是在对照组基础上加用气压治疗。采用简式Fuel-Meyer评分法、日常生活能力评分（ADL）测评患肢康复护理前后患肢功能及日常生活活动能力。结果：2组患者的肢体功能及日常生活活动能力均有改善,观察组较对照组有显著优势,2组差异具有统计学意义。结论：气压联合常规药物治疗及康复护理对急性脑梗死偏瘫病人患肢功能恢复有明显改善。     

对比分析针灸与康复治疗脑梗死后偏瘫的临床效果

目的:探究针灸与康复治疗脑梗死后偏瘫的临床效果.方法:在本次研究中选择2016年3月-2017年1月我院收治的98例脑梗死后偏瘫患者作为研究对象,随机分为甲组和乙组,分别给予针灸以及针灸联合康复法治疗,对效果分析.结果:在本次研究中对甲组和乙组的治疗效果分析,实践证明,乙组的总有效率明显高于甲组.对甲组和乙组的NIHSS评分、BI评分对比,实践证明,乙组的各项评分高于甲组,乙组的恢复能力高于甲组.结论:对脑梗死后偏瘫患者采用针灸和康复法治疗,其效果明显,能改善中风偏瘫不良反应,值得推广和应用.     

系统康复指导对脑卒中偏瘫患者功能锻炼依从性的影响

目的 探讨系统康复指导对卒中偏瘫患者功能锻炼依从性的影响.方法 将88例脑卒中患者,随机分为实验组和对照组,对照组给予常规康复护理,实验组给予系统的康复指导.分别比较两组住院后15天、30天时的自理能力以及肢体功能锻炼依从性.结果 实验组的依从性显著高于对照组(P＜0.05).入院后15天时自理能力得分实验组除个人卫生外,其余均高于对照组(P＜0.05)；入院后30天自理能力实验组各项得分与总得分均高于对照组(P＜0.05).结论 系统康复指导有助于提高脑卒中偏瘫患者功能锻炼依从性,从而有利于自理能力的恢复.     

运动针疗法配合手法治疗中风后遗偏瘫128例疗效观察

目的探讨以运动针疗法为主配合手法治疗中风后遗症偏瘫的疗效。方法 128例中风后遗偏瘫患者,运用运动针疗法为主,配合手法治疗,每天治疗一次,每5天为一疗程,疗程间休息2天。观察治疗8个疗程后患者日常生活自理能力以及偏瘫疗效情况。同时与常规针刺疗法进行比较。结果经过8个疗程治疗后,治疗组总有效率达96.9%,对照组总有效率为73.3%。治疗组在日常生活能力Barthel指数评分提升上优于对照组,且有显著性差异。结论运动针疗法配合手法治疗对中风偏瘫疗效显著。     

慢性正己烷中毒的康复护理

目的探讨慢性正己烷中毒的临床观察及康复护理措施。方法通过实施康复治疗前的健康评估、心理治疗、早期康复干预和恢复期康复治疗,评价并总结其实际护理效果。结果通过一系列的康复功能训练,患者肢体运动和感觉功能恢复良好,改善了日常生活和工作能力,减轻了家庭和社会负担。结论慢性正己烷中毒康复训练护理模式,能促进肢体关节残存功能的恢复和重建,预防和减少并发症的发生,提高独立生活和参与社会的能力,有着较大的社会效益和经济效益。     

Evaluation of Self-Reported Work Ability and Usefulness of Interventions Among Sick-Listed Patients

Aim To describe the types of intervention offered, to investigate the relationship between the type of intervention given, patient-reported usefulness of interventions and the effect on self-reported work ability in a cohort of sick-listed patients with musculoskeletal disorders (MSD) or mental disorders (MD). Methods A prospective cohort study was performed including 810 newly sick-listed patients (MSD 62 % and MD 38 %). The baseline questionnaire included sociodemographic characteristics and measures of work ability. The 3-month follow-up questionnaire included measures of work ability, type of intervention received, and judgment of usefulness. Results Twenty-five percent received medical intervention modalities (MI) only, 45 % received a combination of medical and rehabilitative intervention modalities (CRI) and 31 % received work-related interventions combined with medical or rehabilitative intervention modalities (WI). Behavioural treatments were more common for patients with MD compared with MSD and exercise therapy were more common for patients with MSD. The most prevalent workplace interventions were adjustment of work tasks or the work environment. Among patients with MD, WI was found to be useful and improved work ability significantly more compared with only MI or CRI. For patients with MSD, no significant differences in improved work ability were found between interventions. Conclusions Patients with MD who received a combination of work-related and clinical interventions reported best usefulness and best improvement in work ability. There was no difference in improvements in work ability between rehabilitation methods in the MSD group. There seems to be a gap between scientific evidence and praxis behaviour in the rehabilitation process. Unimodal rehabilitation was widely applied in the early rehabilitation process, a multimodal treatment approach was rare and only one-third received work-related interventions. It remains a challenge to understand who needs what type of intervention.     

对慢性乙型肝炎住院患者实施行为和心理干预的效果观察

[目的]探讨对慢性乙型肝炎住院患者实施行为和心理干预的效果。[方法]对2006年8月至2008年7月在泰山医学院附属医院住院的162例慢性乙型肝炎患者进行调查,并对其中82例针对不良的生活方式和心理压力进行干预。[结果]具有不良饮食、保健知识缺乏、具有自身压力、具有周围压力、具有社会压力者所占比例,人院时干预组与对照组的差异均无统计学意义（P〉0．05）,出院时干预组明显低于对照组（P〈0．01）;出院时,知晓乙肝传播途径、消毒知识知晓与自我隔离、饮食保健、合理休息、自我保健信念建立者所占比例,干预组均高于对照组（P〈0．01）。[结论]所采取的行为和心理干预措施可以减轻慢性乙肝患者的心理压力,提高自我保健能力．     

Social supports as a determinant of community-based care utilization among rehabilitation patients.

OBJECTIVE. We determine the extent to which noninstitutionalized long-term care patients receive assistance from family members and friends, and evaluate the effect of this assistance on use of outpatient rehabilitative and personal care services. DATA SOURCES AND STUDY SETTING. Over 12 months, primary data were collected from 289 patients in noninstitutional settings after inpatient rehabilitation at three Boston-area rehabilitation hospitals. Data on patients' acute and rehabilitative stays were obtained from medical record reviews. Patients provided primary data on sociodemographics, living arrangements, social supports, functional status, health behaviors, life events, and use of outpatient services during the study period. The latter was verified and service charge data obtained from the care providers. STUDY DESIGN. The study was longitudinal and observational. Patient-provided information was obtained at one, six, and twelve months postdischarge. ANALYTIC METHODS. Multivariate Tobit regression was used to evaluate the effect of social supports on patients' use of rehabilitative and personal care services, controlling for sociodemographics and functional status. Service use was measured as charges incurred during the 12-month study period. PRINCIPAL FINDINGS. Results confirm the primary role of family and friends in providing daily personal care and identify the availability of that support as a key determinant of expenditures on community-based personal care services. Social supports do not predict outpatient rehabilitative service use. CONCLUSIONS. Differing eligibility criteria seem appropriate for outpatient rehabilitative and personal care services. The current emphasis on functional status in determining rehabilitative service eligibility appears appropriate; but we find that considering patients' social supports would be both meaningful and appropriate in determining personal care service eligibility. This approach would avert the expense of making personal care services universally available, while facilitating assistance for patients whose functional and social status put them at increased risk of institutional placement.     

应用Peabody量表指导脑瘫患儿康复的效果观察

目的:探讨Peabody运动发育量表(PDMS-2)评估方法对脑瘫患儿各运动能区发育水平的判断,评价其配套训练方案在改善患儿运动技能中的应用价值。方法:选取0～6岁脑瘫患儿200例,随机分成两组,观察组和对照组,用PDMS-2量表进行运动发育水平评估,对照组采用常规康复治疗,包括运动疗法(主要是Bobath疗法)、理疗等,观察组采用在常规康复治疗的基础上,指导家长参与根据PDMS-2评估结果运用其配套训练方案对观察组进行干预,6个月后再次运用PDMS-2量表对两组患儿各运动能区发育水平进行评估。结果:干预前对照组粗大运动商(GMQ)、精细运动商(FMQ)和总运动商(TMQ)与干预组之间差异无统计学意义(P0.05);干预后评估显示两组患儿运动技能都有所提高,但观察组GMQ,FMQ和TMQ均显著大于对照组(P0.05)。结论:PDMS-2评估方法对脑瘫患儿各运动能区发育水平有很好的评估作用,其配套训练方案对提高患儿的运动技能很有价值。     

A Tailored Discharge Program Improves Frailty and Mood in Patients Undergoing Usual Rehabilitative Care: A Randomized Controlled Trial

ObjectiveTo investigate whether a tailored intersectoral discharge program (TIDP) impacts on multidimensional frailty, rehospitalization days, and patient-related outcome measures in older in-patients undergoing acute care and usual rehabilitative care.DesignRandomized controlled trial of TIDP vs usual rehabilitative care with a 6-month follow-up, 2019–2020, and historical control with a 6-month follow-up, 2016–2019.Setting and ParticipantsGeriatric co-managed internal medicine ward of a metropolitan university hospital. One hundred-twelve multimorbid patients older than age 60 years were consecutively assessed for eligibility and inclusion (age ≥60 years, multimorbidity, admitted for treatment of acute disease, at least 2 geriatric syndromes requiring usual rehabilitative care, and able to consent) and signed informed consent, with 110 recruited and randomized to either TIDP or usual rehabilitative care. At discharge, 104 patients were alive in the intention-to-treat group, the 6-month follow-up was completed for 91 patients. A historical control group of 468 patients was included for comparison.InterventionTIDP as intervention included contact with treating general practitioner to discuss the further treatment plan, a structured medical and lifestyle counseling to patients and caregivers at admission as well as a discharge program with internist, geriatrician, and general practitioner in shared decision making with patients.MethodsFifty-four patients underwent TIDP, 53 patients underwent usual rehabilitative care only. Rehospitalization days at follow-up as primary endpoint; multidimensional frailty and prognosis (Multidimensional Prognostic Index, Geriatric Depression Scale, Rosenberg Self-Esteem Scale, quality of life, falls, mortality, home care service need, and need of long-term care at 1-, 3- and 6-month follow-up as secondary endpoints.ResultsTIDP (median age 76.0 years, 56% female) showed significantly improved Multidimensional Prognostic Index scores at discharge compared with usual rehabilitative care (median age 78.5 years, 58% female) (0.43 vs 0.49, P = .011). Compared with usual rehabilitative care, TIDP improved self-confidence (Rosenberg Self-Esteem Scale 13.9 vs 12.4, P = .009) and mood (Geriatric Depression Scale 4 vs 5, P = .027) at follow-up. Compared with historical control (median age 77.0 years, 39 % female), usual rehabilitative care patients showed significantly lower rehospitalization rates (53% vs 70%, P = .002) and lower mortality rates (13% vs 32%, P < .001).Conclusions and ImplicationsA feasible TIDP improves frailty and mood in advanced age. In older patients undergoing potentially disabling acute treatments, usual rehabilitative care significantly reduces rehospitalization rates. Therefore, implementing geriatric treatment in general is useful to improve outcomes in older in-patients and a tailored discharge program can further increase the benefit for this frail population.     

超早期小骨窗手术治疗高血压脑出血的临床分析

目的：探讨小骨窗手术治疗基底节脑出血的疗效。方法：对60例符合纳入标准的高血压基底节区脑出血患者采用超早期小骨窗手术清除血肿。结果：60例患者术后24h内死亡2例,术后24h复查头颅CT,36例完全清除,6例大部分清除,12例少量残存,再出血4例。56例患者半年后随访,按日常生活活动能力量表ADL分级,Ⅰ级27例,Ⅱ级14例,Ⅲ级10例,Ⅳ级3例,Ⅴ级2例。结论：超早期小骨窗手术入路清除高血压基底节区脑出血创伤小,时间短,易操作,能显著改善高血压脑出血病人的预后。     

心理干预对冠心病患者康复的影响研究

目的探讨心理干预对冠心病患者康复的影响。方法将120名冠心病住院患者分为干预组和对照组各60例,对照组只给予临床常规药物治疗,干预组同时进行心理干预,运用自测健康评定量表和西雅图心绞痛调查量表分别于心理干预前及结束时对两组患者进行评定。结果两组患者在实施心理干预前SRHMS评分和SAQ评分差异无统计学意义(P0.05)。实施心理干预后,干预组在自测健康的生理健康(t=2.772,P0.01)、心理健康(t=7.779,P0.01)、社会健康(t=6.403,P0.01)3个维度和总分(t=7.035,P0.01)上的干预前后差值及在心绞痛发作状态(t=4.015,P0.01)、治疗满意度(t=8.774,P0.01)和疾病认识程度(t=6.771,P0.01)3个维度及西雅图总分(t=9.972,P0.01)上的干预前后差值都高于对照组。干预组和对照组的临床疗效差别有统计学意义(χ2=16.536,P0.01)。结论心理干预不仅能够提高冠心病患者自身健康水平和生活质量,而且能够提高冠心病患者的疗效,有效促进其临床康复。