基于时间护理的呼吸训练与排痰管理对肺癌手术患者康复的影响分析

目的观察基于时间护理的呼吸训练与排痰管理对肺癌手术患者康复的影响效果。方法选择2018年1-12月于我院行手术治疗的92例肺癌患者为研究对象,入住偶数病室患者纳入对照组(46例),入住奇数病室患者纳入观察组(46例)。对照组接受常规护理,术后由护理人员依经验开展呼吸训练与排痰管理,观察组接受时间护理植入式呼吸训练与排痰管理,对两组干预后的各观察指标进行比较。结果观察组干预后呼吸训练与排痰管理掌握度评分、术后2周血氧饱和度及肺活量高于对照组,呼吸系统并发症总发生率显著低于对照组,康复进度各时间评价指标优于对照组(P<0.05)。结论采用时间护理植入式呼吸训练与排痰管理对肺癌患者施以康复管理,可显著提升肺癌手术患者呼吸训练与排痰管理知识技能掌握度,降低术后呼吸系统并发症风险,推动康复进度,改善肺功能。     

中国运动康复专业人才培养体系的构建

目的 分析运动康复人才培养政策背景,探讨我国运动康复专业培养目标、学科知识以及课程原则,构建中国运动康复专业人才培养体系。 方法 依据«世界残疾报告»行动建议,参照世界卫生组织康复指南«健康服务体系中的康复»的相关要求,以«国际功能、残疾和健康分类»(ICF)的理论体系为指导,分析康复发展政策背景,探讨我国运动康复专业的理论架构与方法体系。 结果 康复是国家健康服务体系的重要组成部分,是实现联合国2030可持续发展目标三“健康全覆盖”的重要手段之一,而运动康复人才的培养是建立和完善康复服务体系的重要保障。运动康复专业的培养目标是构建针对全人群和全生命周期的健康知识体系,运动康复人才学习“体医融合”知识与技能,并在健康服务体系中从事“体医融合”的相关工作。基于ICF理论架构,运动康复专业是综合性交叉学科,包括体育、生物、心理、社会和环境等多学科因素;学科可以分为与基础学科相对应的通识教育和学科基础知识,与应用学科相对应的专业基础知识,与康复专门学科相对应的康复知识和技能。基于ICF构建现代运动康复科学课程体系原则,开发与国际接轨的健康相关通识教育课程,根据康复科学和体育科学的规律强化运动康复学科基础课程,从健康科学和康复科学视角发展专业基础课程,以康复服务业的从业要求为导向发展职业相关的技能。 结论 运用ICF理论,依据«健康服务体系中的康复»的要求和«世界残疾报告»的行动建议,提出了我国运动康复专业人才培养的目标、理论框架、方法体系、学科知识以及课程体系,为进一步推动我国运动康复的专业发展,提高运动康复人才培养体系的科学化和规范化水平,提供理论基础和科学依据。     

舟曲救灾官兵体育锻炼与业务能力、心理创伤和自尊研究

目的了解参与舟曲救灾官兵的体育锻炼及其对心理创伤、业务能力和自尊的影响。方法采用事件冲击量表修订版（ISE-R）、自尊量表（SES）和自编体育锻炼情况调查表,对160名舟曲救灾官兵进行调查。结果①舟曲救灾官兵的体育锻炼次数较多且锻炼时间较长;并与其业务能力（r=0.255）、自尊（r=0.249）呈正相关;②舟曲救灾官兵的心理创伤程度较重,与其体育锻炼水平相关（t=-2.06,P=0.04）;③舟曲救灾官兵的心理创伤程度与其业务能力无关（r=-0.111,P=0.288）,但不同自尊水平官兵的心理创伤水平（t=-3.08,P=0.003）差别显著。结论体育锻炼能够降低心理创伤,自尊可以直接预测心理创伤水平。     

Evidence for single-limb exercises on exercise capacity,quality of life,and dyspnea in patients with chronic obstructive pulmonary disease or chronic heart failure

Abstract

Background: Although single-limb exercise (SLE) has been used for patients with chronic obstructive pulmonary disease (COPD) and for patients with chronic heart failure (CHF), the evidence for SLE has not been evaluated systematically and remains unclear.

Objectives: Determine the evidence for the effect of SLE compared to any comparator on outcome measurements for exercise capacity, quality of life (QoL) or dyspnea in patients with COPD or CHF.

Methods: PubMed, PEDro, and CENTRAL databases were searched from inception until 31 May 2011. Searches started 1 April 2011. English language randomized controlled trials (RCTs) were included. Extraction of data was performed by two review authors. Data and evidence for SLE were summarized in accordance with grading of recommendations assessment, development and evaluation (GRADE) guidelines. Authors of included studies were contacted for missing data.

Results: Six RCTs (two COPD and four CHF) were included. Low to very low-quality evidence indicates that SLE significantly improved exercise capacity, but not dyspnea, in patients with COPD, and significantly improved exercise capacity outcomes compared to a control in patients with CHF. However, when SLE was compared to non-SLE regimes in patients with CHF, positive effects were found irrespective of training regime regarding exercise capacity and QoL.

Conclusions: SLE appears to be effective in both conditions especially regarding exercise capacity, and might be included in exercise programs in patients with COPD or CHF. However, the evidence is low to very low according to GRADE and more clinical studies of high quality are required.     

心肌顿抑及运动的影响*☆

背景：随着体育科研领域研究的深入，运动对心脏的影响日益受到体育科研人员的关注和重视。 目的：系统综述心肌顿抑的研究历程、机制以及运动对顿抑心肌的影响。 方法：由第一作者检索PubMed数据库及维普数据库(1980-01/2010-01)的相关文章。英文检索词为“myocardial stunning; exercises;ischemia-reperfusion”，中文检索词为“心肌顿抑；运动；缺血再灌注”。计算机初步检索到83篇文献按纳入和排除标准筛选出36篇文献，从心肌顿抑的定义、特点、分类、机制以及运动对心肌顿抑影响等几方面出发进行归纳总结。 结果与结论：心肌顿抑在临床医学研究中越来越深入，心肌顿抑的定义、特点以及分类都很明确，并且也开始从分子生物学层面探索心肌顿抑的可能机制，然而剧烈运动持续时间过长，可引起运动员心肌灌流不足，导致心功降低和心肌损伤，由此可见，某种条件下，运动员可能出现心肌顿抑现象。     

Device-guided breathing in the home setting: Technology, performance and clinical outcomes

Routine practice of slow breathing is a major component of a variety of behavioral treatments of chronic conditions. The present paper addresses the challenge of using device-guided breathing (DGB) as a self-treatment tool in the home setting. The breathing patterns of hypertensive patients treated using DGB over 8 weeks in 15-min daily sessions were analyzed using minute-by-minute stored data. The relationship of breathing pattern with office blood pressure changes over the treatment period was evaluated. The treatment device operated to reduce breathing rate effortlessly while prolonging exhalation: patients were requested to synchronize breathing with the guiding tones, generated in response to the monitored breathing pattern. Breathing modification was highly individualized, repeatable over sessions, and unrelated to clinical or demographic characteristics; it also seemed to reflect behavioral aspects of device-patient interaction. Quality of breathing synchronization with the guiding tones and time spent in slow breathing displayed a relationship with the clinical outcomes. Different DGB methods are believed to share similar features. A possible physiological mechanism underlying the beneficial effect of slow and effortless breathing in chronic conditions is discussed in relation to restoring autonomic balance via lung reflexes.     

被动操与主被动操对儿童早期发展的影响

目的研究婴儿被动操与主被动操对儿童早期发展的影响。方法将自生后2个月起在儿保门诊进行检查的80名的婴儿随机分为实验组和对照组。实验组由儿保医生指导家长每日在家中训练,对照组仅给予常规的系统管理服务。记录两组儿童4、6、9、12个月时的生长发育指标,并于生后6、9、12个月用《0—6岁发育筛查测验》(DST)进行智力测试。结果对两组婴儿4、6、9、12个月时的体重、身长发育均值进行比较,仅6月龄时身长无差异(P>0.05),其余数据有显著性差异(P<0.05):DQ和MI比较,具有显著性差异(P<0.01);两组婴儿运动能力及社会适应能力比较存在明显差别。结论被动操与主被动操对婴儿的生长发育有促进作用。     

钢铁行业总粉尘与呼吸性粉尘浓度比值的研究

[目的]为探讨总粉尘与呼吸性粉尘浓度比值的关系。[方法]对某钢铁公司所属炼铁和采矿分公司的1504名接尘工人进行调查研究,通过进行矽肺病流行病学调查分析,把40年来的总粉尘浓度换算成呼吸性粉尘浓度。[结果]表明T/R比值在不同作业场所结果不一,配料和掘进两个工种呼吸性粉尘浓度较其他工种高,且患病率也高于其他工种。[结论]说明粉尘的生物学作用与呼吸性粉尘联系密切,进一步说明了呼吸性粉尘浓度比总粉尘浓度更能反映工人接尘的实际危害程度。     

初中生心理健康状况与运动关系的研究

目的评价初中生心理健康状况,并了解运动与心理健康的关系。方法采用《心理健康诊断测验》和运动干预研究,对313名初中学生进行测查。结果初中生心理健康状况呈现问题多、程度轻的状态;重点中学初中生情绪焦虑的发生率为44.30%,但程度重;普通中学初中生情绪焦虑的发生率为58.33%,但程度较轻。运动对于减轻心理问题的发生有显著作用,运动前后所测得分差异有统计学意义(p<0.05)。结论无论是普通中学还是重点中学的初中生焦虑问题不容忽视。体育锻炼有助于学生释放心理压力。     

Analysis of Breathing Pattern in Children with Asthma

The breathing pattern in children with asthma was studied, using respiratory inductive plethysmography. The subjects were 31 children with mild to moderate asthma (15 males, 16 females; aged 6∼15 years, average 11 years). The respiratory rate was 25.5±10.7/min. (mean ± S.D.) during asthma attacks and 18.4 ± 5.0/min. between attacks with a significant increase during attacks (P < 0.001). The expiratory time was 1.774 ± 0.833 second during attacks, and 2.125 ± 0.602 seconds between attacks. The expiratory time to total respiratory time ratio (T_E/T_TOT) was 0.631 ± 0.056 during attacks and 0.608 ± 0.035 between attacks. Thus there was a slight prolongation at the time of attack, but the difference was not significant. The tidal volume was increased slightly during mild and moderate attacks. V_T/T_I (mean inspiratory flow) was increased during attacks. The respiratory pattern was thoracic during attacks and changed to the abdominal pattern with improvement.