脊髓损伤术后间歇导尿患者家属的健康教育

目的 探讨对脊髓损伤术后间歇导尿患者家属实施健康教育的效果.方法 将60例脊髓损伤需行间歇导尿的患者随机分成观察组和对照组各30例.两组患者入院后均给予常规护理,依据医院拟定的健康教育手册进行健康教育.观察组在此基础上对家属进行膀胱功能训练及间歇导尿相关知识的健康教育,包括记日记、观看多媒体视频、床旁练习等.结果 干预4周后,观察组家属对间歇导尿知识的掌握情况显著好于对照组(均P＜0.01);观察组患者白细胞尿发生率显著低于对照组(P＜0.01);两组干预2周、4周时真性菌尿的发生率比较,差异无统计学意义(均P＞0.05).结论 对实施间歇导尿的脊髓损伤患者家属进行健康教育,可以提高家属的护理能力和专业技能,降低患者泌尿系感染的风险.     

脊髓损伤术后间歇导尿患者家属的健康教育

目的探讨对脊髓损伤术后间歇导尿患者家属实施健康教育的效果。方法将60例脊髓损伤需行间歇导尿的患者随机分成观察组和对照组各30例。两组患者入院后均给予常规护理,依据医院拟定的健康教育手册进行健康教育。观察组在此基础上对家属进行膀胱功能训练及间歇导尿相关知识的健康教育,包括记日记、观看多媒体视频、床旁练习等。结果干预4周后,观察组家属对间歇导尿知识的掌握情况显著好于对照组（均P〈0.01）;观察组患者白细胞尿发生率显著低于对照组（P〈0.01）;两组干预2周、4周时真性菌尿的发生率比较,差异无统计学意义（均P〉0.05）。结论对实施间歇导尿的脊髓损伤患者家属进行健康教育,可以提高家属的护理能力和专业技能,降低患者泌尿系感染的风险。     

脊髓血管畸形患者亲属对出院健康教育需求的调查

目的了解脊髓血管畸形患者家属对出院健康教育的需求及其掌握情况，使护士能够有针对性地进行健康教育，促进患者的院外康复。方法采用自行设计问卷对40名住院患者家属就其出院健康需求进行调查。结果患者家属对康复护理知识的需求程度最高；对患者出院后生活方式及饮食注意事项的需求次之；对疾病知识（疾病复发的应对及并发症的预防方法）的需求居第三；对于心理护理知识及复诊知识需求程度及掌握程度最低。患者家属的文化程度、经济水平影响其对健康知识的需求程度（均P〈0．05）；其年龄、对知识的掌握程度与健康知识需求相关（均P〈0．01）。结论依据脊髓血管畸形患者家属对出院健康教育的需求状况，重视健康教育的内容设计，针对不同情况的患者亲属进行不同内容、不同程度、不同形式的健康教育，提高其健康科学观念,可促进患者的院外康复。     

自护模式对脊髓损伤患者焦虑状况及并发症的影响

目的探讨实施自护模式对脊髓损伤患者心理状况及并发症发生率的影响。方法将40例患者随机均分为实验组及对照组各20例,实验组实施自护模式的康复护理,对照组从患者入院即进行常规康复护理。于干预1个月后评价两组焦虑状况及并发症发生率。结果实验组SAS评分显著低于本组干预前和对照组干预后(均P0.01),实验组并发症发生率低于对照组,两组肌肉萎缩的发生率比较,差异有统计学意义(P0.05)。结论对脊髓损伤患者实施自我护理模式能显著改善患者的心理状况,减少并发症的发生,促进患者尽快回归家庭和社会,提高生存质量。     

鼻咽癌患者及家属同期健康教育对患者生活质量的影响

目的探讨对鼻咽癌患者及其家属同时进行健康教育对改善患者生活质量的影响。方法将110例鼻咽癌患者随机分为两组，对照组（53例）接受常规健康教育，观察组（57例）及其家属同时接受健康教育。在入院时、出院前及出院后6个月，采用生活质量核心量表（EORTC QLQ-C30）分别对两组患者的生活质量进行评分比较。结果入院时两组生活质量评分比较，差异无显著性意义（均P〉0．05）。出院前及出院后6个月观察组患者的生活质量评分显著高于对照组（均P〈0．01），且出院6个月时观察组放疗不良反应发生率显著低于对照组（均P〈0．01）。结论鼻咽癌患者和家属同时接受健康教育，可以有效地改善患者的生活质量。     

脊髓损伤患者后期并发症及其相关因素探讨

目的:统计脊髓损伤患者后期并发症发生情况并探讨其相关因素。方法:对318例脊髓损伤患者进行3~15年跟踪随访,内容包括泌尿系并发症、呼吸系并发症、压疮、慢性顽固性肢体疼痛等,统计并发症发生情况、死亡原因,分析并发症与脊髓损伤程度、是否行手术治疗及损伤节段等的关系。结果:脊髓损伤患者后期主要并发症是泌尿系并发症,发生率为82.4%,其中泌尿系感染52.8%、慢性肾功能衰竭14.5%、肾盂积水10.5%、尿路结石5.0%;其次为慢性顽固性肢体疼痛,为64.2%;压疮为47.5%;呼吸系感染为34.3%,其它并发症有关节僵硬变形、异位骨化等。完全性脊髓损伤患者并发症发生率高于不完全性脊髓损伤患者(P<0.05),手术治疗组与非手术治疗组相近(P>0.05)。胸腰段脊髓损伤患者的泌尿系感染、压疮及肢体疼痛的发生率较其它节段损伤者高(P<0.05)。死亡28例,占8.8%,死亡主要原因是慢性肾功能衰竭,占46.4%,压疮合并感染占21.4%,呼吸系感染占14.3%。结论:脊髓损伤后期并发症发生率仍然很高,其发生率与外科手术无关。提高康复意识与水平以及全社会的支持是预防并发症、提高患者生存质量与延长寿命的关键。     

脊髓损伤的并发症及治疗体会

脊髓损伤的并发症是该病死亡的主要原因之一。我院从1993年5月至1995年2月共收治脊髓损伤的病人共23例。出现并发症9例。呼吸系统的并发症3例；循环系统并发症2例；泌尿系统并发症2例；深静脉栓塞1例应激性溃疡出血1例。现总结如下。临床资料本组9例病人，男7例，女2例；年龄最大69岁；最小16岁；颈段脊髓损伤5例；胸段脊髓损伤3例；腰段脊髓损伤1例。并发症的发生及治疗。1、呼吸系统并发症最常见。本组3例。颈段脊髓损伤2例，胸段脊髓损伤1例。均在一周内发生。1例为肺不张；2例为肺部感染，均在右肺。治疗关键是加强抗感染，同时帮助病人…     

脊柱脊髓损伤术后早期并发症预防及护理特点

目的：通过对脊柱脊髓损伤患者的护理，分析术后早期并发症预防及护理特点，减少并发症的发生。方法：对26例患者术后早期及时施行各种相关护理措施。结果：无褥疮、泌尿系感染、应急性溃疡等并发症的发生，截瘫得到了不同程度的恢复。结论：术后通过适当的康复护理，可以预防或减少并发症的发生，加快截瘫患者的早期康复。     

家居环境改造对脊髓损伤患者日常生活能力及并发症的影响

目的探讨家居环境改造对脊髓损伤患者日常生活能力(ADL)及并发症的影响。方法将54例脊髓损伤患者分为观察组(28例)和对照组(26例)。对照组出院后按常规定期进行康复指导及康复训练;观察组在此基础上,与装修公司技术人员合作指导患者进行家居环境改造。结果观察组出院3个月、6个月ADL评分高于对照组,两组比较,干预主效应P<0.05;出院6个月两组肌肉萎缩的发生率比较,差异有统计学意义(P<0.01)。结论对脊髓损伤患者进行预见性家庭环境改造,能最大限度地利用其残存功能,提高日常生活能力,减少并发症的发生。     

脊髓血管畸形患者亲属对出院健康教育需求的调查

目的 了解脊髓血管畸形患者家属对出院健康教育的需求及其掌握情况,使护士能够有针对性地进行健康教育,促进患者的院外康复.方法 采用自行设计问卷对40名住院患者家属就其出院健康需求进行调查.结果 患者家属对康复护理知识的需求程度最高;对患者出院后生活方式及饮食注意事项的需求次之;对疾病知识(疾病复发的应对及并发症的预防方法)的需求居第三;对于心理护理知识及复诊知识需求程度及掌握程度最低.患者家属的文化程度、经济水平影响其对健康知识的需求程度(均P＜0.05);其年龄、对知识的掌握程度与健康知识需求相关(均P＜0.01).结论 依据脊髓血管畸形患者家属对出院健康教育的需求状况,重视健康教育的内容设计,针对不同情况的患者亲属进行不同内容、不同程度、不同形式的健康教育,提高其健康科学观念,可促进患者的院外康复.     

Gastrointestinal Complications of Chronic Spinal Cord Injury

ABSTRACT

Gastrointestinal problems are important in the chronic stage of spinal cord injury. We review the literature on problems of specific segments of the alimentary tract in this setting and add observations based on clinical experience. Emphasis is placed on the colon and rectum, where most clincially apparent problems occur. While bowel management programs are often successful in the near-term, long-term dysfunctions are common and difficult to treat. Studies to determine colonic transit time and rectal physiologic responses are useful to provide scientific basis of management of such patients. More information is needed on the relative roles of extrinsic and intrinsic nervous system in Gl function. (J Amer Paraplegia Soc 1991;14: 175–81)     

Information Needs of People With Spinal Cord Injuries

Abstract

Background/Objective: To determine the information needs, level of Internet access, and current and preferred formats and sources of information of adults with spinal cord injuries (SCIs). Individuals with SCIs have a high lifetime risk for medical complications and other health conditions secondary to their injury. Many secondary conditions can be prevented or mitigated through appropriate self-care and/or self-management. People with SCIs need timely, high-quality information about health and medical issues after discharge and throughout their lifetime to improve self-care and maximize quality of life.

Methods: A survey was administered as part of the third time point of a longitudinal research study on individuals with SCI.

Results: A total of 80.2% of the 277 respondents reported having Internet access. The most frequently selected format used currently and preferred by respondents for receiving SCI information was "Web pages/Internet." The top-ranked current and preferred source of SCI information was from a "Physician: SCI Expert/Rehabilitation Specialist." Respondents reported needing information on medical issues the most. Significantly higher percentages of individuals identified as "white" and with higher education levels had access to the Internet and ranked the selection of Web pages/Internet as their top choice.

Conclusions: Results confirm that, although people with SCI prefer to receive SCI information from SCI experts, the Internet is a more accessible and more currently used source. Educational level and race predicted current and preferred use of the Internet for obtaining SCI information, suggesting that Internet distribution of SCI information will exclude subgroups.     

Information Needs of People With Spinal Cord Injuries

Background/Objective:

To determine the information needs, level of Internet access, and current and preferred formats and sources of information of adults with spinal cord injuries (SCIs). Individuals with SCIs have a high lifetime risk for medical complications and other health conditions secondary to their injury. Many secondary conditions can be prevented or mitigated through appropriate self-care and/or self-management. People with SCIs need timely, high-quality information about health and medical issues after discharge and throughout their lifetime to improve self-care and maximize quality of life.

Methods:

A survey was administered as part of the third time point of a longitudinal research study on individuals with SCI.

Results:

A total of 80.2% of the 277 respondents reported having Internet access. The most frequently selected format used currently and preferred by respondents for receiving SCI information was “Web pages/Internet.” The top-ranked current and preferred source of SCI information was from a “Physician: SCI Expert/ Rehabilitation Specialist.” Respondents reported needing information on medical issues the most. Significantly higher percentages of individuals identified as “white” and with higher education levels had access to the Internet and ranked the selection of Web pages/Internet as their top choice.

Conclusions:

Results confirm that, although people with SCI prefer to receive SCI information from SCI experts, the Internet is a more accessible and more currently used source. Educational level and race predicted current and preferred use of the Internet for obtaining SCI information, suggesting that Internet distribution of SCI information will exclude subgroups.     

Spinal Cord Injuries in the 21st Century

ABSTRACT

We investigated dorsal penile stimulation for control of incontinence in nine spinal cord impaired (SCI) patients, using a battery-powered home-use stimulator connected to surface electrodes (Unipatch). The efficacy of the penile stimulation was assessed by urodynamic evaluation (NL-2, Life Tech) and surface electrodes (Unipatch); baseline and repeat cystometries (CMG) with and without stimulation were done. Stimulation for home use was begun at threshold parameters for inducing perineal contractions and, after two weeks, was adjusted based upon results.

Two subjects successfully completed the study and became continent. One of these patient's CMG demonstrated hyperreflexia and his volume increased from 110 ml to 150 ml after the stimulation protocol. The most effective stimulating parameters were 5 pps, 250 microsec. pulse width and 40 ma current. The other patient also had a hyperreflexic bladder and improved on the protocol.

The remaining seven patients did not complete the study for several reasons. Three patients had CMG's that demonstrated areflexia. Stimulation did not alter their bladder function and they dropped out of the program. Three other subjects withdrew because of bothersome sensations even at subthreshold levels and they complained that the technique was cumbersome. Finally, one patient with significant hyperreflexia and incontinence withdrew after trying unsuccessfully and diligently for 10 days.

Our encouraging results in two patients with hyperreflexic bladders and decreased sensation suggest that this modality may be effective in this patient group.