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1.
目的:探讨早期康复护理干预对胫骨平台骨折患者术后膝关节功能的影响。方法:将80例胫骨平台骨折手术患者随机分为观察组和对照组各40例,对照组患者实施常规治疗与护理,观察组在对照组基础上实施早期康复护理干预,比较两组护理效果。结果:观察组患者住院时间、骨折愈合时间和完全负重时间明显短于对照组(P0.05)。术后3、12个月观察组胫骨平台内翻角(TPA)和后倾角(PA)明显优于对照组(P0.05)。术后12个月观察组膝关节功能HSS评分、膝关节功能优良率均明显优于对照组(P0.05)。结论:早期康复护理干预在手术内固定治疗胫骨平台骨折术后康复过程中能够显著改善患者膝关节功能,促进患者康复。  相似文献   

2.
目的:探讨超激光治疗结合康复训练对全膝关节置换术(TKR)后疼痛、功能和生活质量的影响。方法:选取TKR术后患者52例,随机分为2组各26例。对照组患者给予常规康复治疗(包括术后良肢位摆放、关节活动度训练、肌力训练、转移训练、平衡功能训练、本体感觉训练和步行能力训练);观察组在此基础上,进行超激光治疗。分别于治疗前和治疗6周后进行评价,指标包括视觉模拟评分法(VAS),膝关节主动关节活动度(AROM),膝关节功能评分(HSS)和简版生活质量量表(SF-12)评价临床疗效。结果:治疗6周后,2组患者VAS评分均较治疗前明显下降(P0.05),且观察组低于对照组(P0.05);2组HSS膝关节功能评分及膝关节AROM屈曲、伸展角度均较治疗前明显提高(P0.05),且观察组高于对照组(P0.05);2组SF-12量表心理总得分(MCS)和生理总得分(PCS)及总分均较治疗前明显提高(P0.05),且观察组高于对照组(P0.05)。结论:对初次行TKR的术后患者进行超激光治疗结合康复训练临床疗效确切,可改善患者的膝关节功能、心理功能和缓解疼痛,疗效优于常规治疗组,而且显著提高患者的生活质量。  相似文献   

3.
目的:探讨本体感觉训练对膝关节周围骨折术后患膝主动活动范围、膝关节功能及患者平衡功能的影响.方法:将48例膝关节周围骨折术后患者随机分为治疗组(24例)和对照组(24例).对照组采用中药熏蒸、关节松动术、关节功能牵引、渐进性抗阻肌力训练等治疗.治疗组在对照组治疗的基础上应用PNF技术、Thera-band平衡垫及Moto-med智能运动训练系统进行本体感觉强化训练.治疗前及治疗8周后测量患膝的主动关节活动度、Lysholm膝关节功能评分及Berg平衡量表评分.结果:经过8周治疗后,两组患者各项指标较治疗前均有显著改善,且治疗组的改善程度明显优于对照组,差异具有显著性意义(P<0.05).结论:本体感觉训练能显著改善膝关节周围骨折术后患者患膝的主动关节活动范围、关节稳定性和运动控制能力,从而提高患者膝关节功能及平衡功能.  相似文献   

4.
水中PNF技术对膝关节损伤后功能障碍的治疗作用   总被引:1,自引:0,他引:1  
目的:观察水中神经肌肉本体促进技术(PNF)对膝关节损伤后功能障碍患者的疗效。方法:膝关节功能障碍患者80例,随机分为2组各40例,均进行系统综合康复治疗,包括肌力、关节活动度、站立及平衡训练,矫形器的应用、物理因子治疗、康复教育等。观察组另联合水中PNF治疗。治疗前后对患者膝部本体感觉、关节活动范围(ROM)、疼痛程度、主要肌群肌力、平衡功能、步行能力及ADL能力进行综合评价,并对其功能改善情况进行分析。结果:经过8周治疗后,2组患者与治疗前比较,膝部本体感觉偏差评分及疼痛评分明显降低,ROM、平衡及步行距离、ADL及肌力分级均明显提高,10m步行时间缩短(P〈0.05、0.01),且观察组均优于对照组(P〈0.01)。结论:配合水中PNF更能提高膝关节功能障碍患者的综合功能及ADL能力。  相似文献   

5.
目的 探讨本体感觉强化训练联合肌力训练对于促进全膝关节置换术后患者康复的效果.方法 以2019年10月至2020年10月于南通市第三人民医院骨科行全膝关节置换术的124例患者作为研究对象,将其随机分为观察组(n=62)与对照组(n=62).对照组接受常规肌力训练,观察组在此基础上联合本体感觉强化训练.比较两组患者患肢股四头肌肌力改善情况、膝关节功能、并发症发生率及SF-36生活质量评分.结果 干预8周后,观察组患者的患肢股四头肌肌力、膝关节功能评分及生活质量评分均高于对照组(P<0.05),并发症发生率低于对照组(P<0.05).结论 本体感觉强化训练联合肌力训练可有效提高全膝关节置换术患者的股四头肌肌力,促进其膝关节功能恢复,减少并发症发生,有助于提升患者术后生活质量.  相似文献   

6.
目的探究本体感觉训练结合持续性被动运动(CPM)机对膝关节周围骨折术后患者膝关节功能及生活质量的影响。方法选取某科97例膝关节周围骨折术后患者采用随机数字表分组。对照组48例给予CPM机训练,观察组49例增加本体感觉训练,对比疗效。结果训练后观察组疼痛视觉模拟评分(VAS)(3.45±1.12)分低于对照组(5.96±1.03)分、骨折愈合时间低于对照组,膝关节活动度(116.29±20.67)°高于对照组(90.22±15.12)°,膝关节功能评分(HSS)(87.35±10.27)分高于对照组(60.36±10.21)分,世界卫生组织生活质量测量表(WHOQOL-BREF)各项评分、优良率高于对照组,差异有统计学意义(P0.05)。结论本体感觉训练结合CPM机对膝关节周围骨折术后患者干预,可降低机体疼痛程度,缩短骨折愈合时间,提高膝关节功能、生活质量,提升临床疗效。  相似文献   

7.
胫骨平台骨折术后早期康复治疗对患膝功能恢复的作用   总被引:9,自引:0,他引:9  
目的:研究胫骨平台骨折术后早期康复治疗对膝关节功能恢复的作用。方法:胫骨平台骨折术后患者47例。对照组23例,术后采取固定等常规治疗;康复组24例,早期采取综合康复治疗。采用HSS膝关节功能评估系统分别评估术后6个月及12个月的膝关节功能。结果:按照HSS评分,康复组膝关节功能优良率于术后6、12个月分别是75.0%和87.5%,均显著高于对照组(P〈0.05)。结论:早期综合康复治疗对胫骨平台骨折术后膝关节功能恢复有效。  相似文献   

8.
目的:探讨全膝关节置换术前本体感觉训练对术后功能恢复的影响。方法:选取48例严重膝关节骨关节炎且拟行全膝关节置换术的患者,随机分为2组。训练组26例在行全膝关节置换术前6周进行本体感觉训练,包括膝屈曲位、双单腿、睁闭眼等的平板训练,固定自行车练习等。对照组22例未进行本体感觉训练。2组分别在行全膝关节置换术前后6周进行膝关节本体感觉测试(即膝关节主动复位误差角度值);术后6周进行膝关节功能评分(Hospital for Special Surgery,HSS);以Biodex 3等速系统测量2组患者双膝关节主动复位误差角度,以作为个体本体感觉能力优劣的代表。结果:术后6周训练组患膝关节主动复位误差角度值明显小于术前及对照组(P〈0.05)。HSS项目中的疼痛、行走功能、肌力及稳定性评分,训练组均明显高于对照组(P〈0.05)。结论:全膝关节置换术前进行本体感觉训练,可以提高患者术后本体感觉及肢体功能。  相似文献   

9.
目的探讨双髁胫骨平台骨折术后早期康复的方法及临床治疗效果。方法回顾性分析66例双髁胫骨平台骨折患者,依据术后开始康复的时机分为早期康复组(30例)和恢复期康复组(36例)。通过测定X线片胫骨平台内翻角及胫骨平台后倾角、关节活动度检查及美国特种外科医院(HSS)膝关节功能评分进行比较。结果两组末次随访与术后X线片胫骨平台内翻角及后倾角平均值的差异无统计学意义(P0.05);两组HSS评分、膝关节屈曲和伸直关节活动度(ROM)均值比较,差异均有统计学意义(P0.01或0.05);康复开始时间与总治疗次数呈显著正相关(P0.01),与膝关节屈曲ROM和HSS评分呈显著负相关(P0.01)。结论康复介入时机与双髁胫骨平台骨折术后膝关节功能恢复效果相关性显著,术后早期康复训练可有效提高患者预后功能。  相似文献   

10.
陈乙瑞  骆浩 《中国康复》2014,29(4):276-278
目的:探讨关节镜治疗胫骨平台骨折后早期康复的介入对膝关节功能恢复的影响。方法:胫骨平台骨折患者58例,分为观察组30例和对照组28例,对照组术后常规治疗,观察组术后在对照组基础上接受针对性的康复训练,治疗后半年和1年时进行随访,采用 HSS膝关节功能评分标准评定,并评价临床疗效。结果:6个月随访时,2组HSS总分及各分项评分较术前均明显提高(P<0.05),且观察组 HSS总分、分项评分及优良率均明显高于对照组(P<0.05)。1年时随访,2组HSS总分、分项评分及优良率较6个月时均明显提高(P<0.05),且观察组更高于对照组(P<0.05)。结论:早期康复介入能促进近期关节镜治疗胫骨平台骨折后患者的膝关节功能恢复。  相似文献   

11.
Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.  相似文献   

12.
Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.  相似文献   

13.
This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.  相似文献   

14.
ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.  相似文献   

15.
Ranganath C  Heller AS  Wilding EL 《NeuroImage》2007,35(4):1663-1673
Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.  相似文献   

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17.
The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.  相似文献   

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目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高<20%视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P<0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P<0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P<0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.  相似文献   

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