出院患者医护联动电话随访的实践

目的探讨对出院患者实施医护联动电话随访的方法和效果。方法选取2013年6～7月出院患者9411例作为对照组，采取常规护士电话随访。选取2013年8～9月出院患者9648例作为观察组，实施医护联动电话随访，即患者出院时医生填写“电话随访需求表”，责任护士据此在患者出院1周内进行电话随访，随访后遴选需要医生随访的患者，医生再次电话随访。结果观察组患者对护士了解病情程度和电话随访的满意度显著高于对照组（均P〈0．01）。结论医护联动电话随访提高了护士素质，达到电话随访的针对性和个性化，提高了患者对护士电话随访的满意度。     

出院患者医护联动电话随访的实践

目的探讨对出院患者实施医护联动电话随访的方法和效果。方法选取2013年6~7月出院患者9411例作为对照组,采取常规护士电话随访。选取2013年8~9月出院患者9648例作为观察组,实施医护联动电话随访,即患者出院时医生填写"电话随访需求表",责任护士据此在患者出院1周内进行电话随访,随访后遴选需要医生随访的患者,医生再次电话随访。结果观察组患者对护士了解病情程度和电话随访的满意度显著高于对照组(均P0.01)。结论医护联动电话随访提高了护士素质,达到电话随访的针对性和个性化,提高了患者对护士电话随访的满意度。     

电话随访在出院患者延续护理中的研究进展

阐述了电话随访的概念及内容,出院患者延续护理中电话随访的主要实施者为护士,也可以是主治医师,同时需要多学科团队的支持;电话随访的实施应选择在一个适宜的时间,并且在护理过程中实施强度应由最初较强逐渐减弱。实施电话随访可以控制症状及预防并发症,提高依从性,改善自护行为,激发积极情绪,增加患者满意度,有效利用卫生保健资源。     

藏药浴治疗类风湿性关节炎患者的护理

对60例类风湿性关节炎患者采用藏药浴进行治疗并加强心理护理和对症护理。结果显效44例，有效13例，总有效率为95．0％。提示进行藏药浴前加强护患沟通。浴后及时予以对症护理，可使患者获得满意疗效。     

类风湿性关节炎的心理护理

目的:通过对类风湿性关节炎患者的心理护理,调动其主观能动性发挥机体的代偿功能,使其丧失的功能和社会适应能力获得恢复和改善并增强其对未来生活充满自信心.     

补肾法对类风湿性关节炎患者血液流变学的影响

目的：探讨补肾中药对类风湿性关节炎患者血液流变学的影响。方法：采用补肾中药青娥丸加味片对46例类风湿性关节炎患者进行为期1个月的治疗，检测患者治疗前后血液流变学指标，并观察其变化。结果：患者治疗后症状及体征有明显改善，与治疗前比较有显著差异。全血粘度、血浆粘度、红细胞压积、红细胞电泳时间、血沉等较治疗前也明显降低。结论：补肾中药通过改善类风湿性关节炎患者的微循环而达到在一定程度治疗该病的目的。     

藏药浴治疗类风湿性关节炎患者的护理

对60例类风湿性关节炎患者采用藏药浴进行治疗并加强心理护理和对症护理.结果显效44例,有效13例,总有效率为95.0%.提示进行藏药浴前加强护患沟通,浴后及时予以对症护理,可使患者获得满意疗效.     

对5588例出院患者护理满意度的电话随访与分析

目的:找出护理管理中的薄弱环节,更好地满足患者的需求。方法:对2004年1-8月出院的5588例患者电话随访其对住院期间的护理满意度和意见,并进行分析总结。均在患者出院1个月内进行电话追踪,在随访过程中由专职人员采用开放式的交流方法,随访内容包括治疗效果、病区环境以及与护理有关的病区管理、技术、服务态度、沟通、责任心、服务主动性和护士长管理水平等内容。结果:患者提出有关护理技术等意见共89件,归纳为病区管理混乱、护理技术差、服务态度生硬、护患沟通欠缺、不执行制度、责任心不强、主动服务意识差、护士长管理问题8大类。结论:随着医疗费用的不断增长,患者对住院环境、有效的护患沟通和人性化的服务要求也在不断增加。     

类风湿性腕关节炎镜下滑膜切除术的中期随访结果

本文作者报告了３１便４７个类风湿性腕关节炎的镜下滑膜切除术的中期随访结果。术后平均随３。５年，疗效属优者占３０％，可３０％，差１２。４％。作者提出病期和病型是影响滑膜切除具有创伤小，并发症很少等优点。作者认为镜下滑膜切除术是早期类风湿性腕关节炎经内科治疗无效者的较为理想的外科治疗方法。     

膝关节骨性关节炎与类风湿性关节炎患者骨小梁的显微结构分析

[目的]通过显微计算机断层扫描(micro-computed tomography,Micro-CT)检测胫骨平台软骨下骨小梁显微结构,分析膝关节骨性关节炎(osteoarthritis,OA)与类风湿性关节炎(rheumatoid arthritis,RA)患者骨小梁的显微结构。[方法]收集人工全膝关节置换术(total knee arthroplasty,TKA)中截取的OA及RA患者胫骨平台,用Micro-CT扫描标本的内、外侧胫骨平台软骨下骨小梁,获得显微结构参数进行分析比较。[结果]膝关节骨性关节炎患者内侧胫骨平台软骨下骨小梁的骨体积分数(BV/TV)、骨小梁厚度(Tb.Th)、骨小梁数目(Tb.N)大于类风湿性关节炎内侧胫骨平台软骨下骨小梁,骨表面积体积比(BS/BV)、骨小梁间隔(Tb.Sp)、结构模型指数(SMI)、各项异性的程度(DA)则小于类风湿性关节炎内侧胫骨平台软骨下骨小梁;而外侧胫骨平台软骨下骨小梁,骨性关节炎的BS/BV、Tb.Th、Tb.N大于类风湿性关节炎,Tb.Sp和DA则相反。膝关节骨性关节炎内侧胫骨平台软骨下骨小梁的BV/TV、Tb.Th、Tb.N大于其外侧,BS/BV、Tb.Sp、SMI小于其外侧。而类风湿性关节炎内侧胫骨平台软骨下骨小梁的BV/TV、Tb.Th小于其外侧。BS/BV、SMI、DA与其他显微结构参数间存在着相关关系。[结论]膝关节骨性关节炎与类风湿性关节炎及两种疾病的内、外侧胫骨平台软骨下骨小梁显微结构存在差异,这对人工膝关节假体的力学环境分析有一定的指导作用。     

Long-term follow-up on 33 TPR ankle joint replacements in 26 patients with rheumatoid arthritis

BackgroundThere exist very few long-term follow-up studies, on total ankle replacement (TAR). In the present study a cohort of rheumatoid arthritic (RA) were followed for up to 23 years.MethodsThirty-three TAR were performed in 26 RA patients from 1980 to 1993. Removal of the prostheses and radiolucency was considered endpoints. All patients were followed to prosthesis failure or until death of the patients or until January 2008.ResultsTwo patients with 3 prostheses were still alive with their prosthesis in place. Eighteen patients with 23 prostheses had died with their prosthesis in place. Two patients had their ipsilateral leg amputated 12 and 14 years after operation of unrelated causes. Five prostheses in 4 patients had been removed. The 10 years prosthesis survival was 85%, when removal is the endpoint.ConclusionsThe long-term survival of this first generation type of TAR adds some optimism to the development of TAR.     

15-year follow-up study of total knee arthroplasty in patients with rheumatoid arthritis

In 25 patients with rheumatoid arthritis, 36 cases of cemented Kinematic total knee arthroplasty were reviewed clinically and radiographically at 13 to 19 years after surgery. The mean age at the time of surgery was 51.6 +/- 8.9 years. According to the follow-up results evaluated with the Hospital for Special Surgery knee scoring system, 28 knees (77.7%) were classified as good or excellent. The mean flexion angle at follow-up evaluation was 99 degrees +/- 24 degrees (10 degrees -140 degrees ). At the tibial or femoral bone-cement interfaces, a radiolucent line was seen in 10 of 36 knees (27.8%) at follow-up evaluation. The survival rate of prostheses with revision as the endpoint was estimated to be 93.7% at 15 years. Kinematic total knee arthroplasty in rheumatoid arthritis patients provided a good long-term outcome.     

Septic arthritis in patients with rheumatoid arthritis

There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article.     

Average 10.1-year follow-up of cementless total knee arthroplasty in patients with rheumatoid arthritis

Background

Total knee arthroplasty (TKA) using a cemented technique has been recommended in patients with rheumatoid arthritis owing to the initial stability of the fixation and long-term durability of the components; however, similar long-term follow-up results have been reported in patients who have undergone cementless TKA. The purpose of this study was to evaluate the radiologic and clinical outcomes of cementless TKA in patients with rheumatoid arthritis.

Methods

We enrolled patients undergoing cementless TKA from March 1990 to February 2000. Clinical and radiologic evaluations were performed using the Knee Society clinical rating system and radiographic evaluation and scoring system.

Results

We included the cases of 112 patients who underwent 179 cementless TKA procedures in our analysis. Their mean age was 62.3 years, and the mean follow-up period was 10.1 years. The final survival rate was 0.968 at the 15.5-year follow-up. Regarding radiologic results after surgery, the mean total valgus angle was 6.7°, the mean femoral flexion angle was 97.5° and the mean tibial angle was 89.2° on the anteroposterior radiographs. On the lateral films, the mean femoral flexion angle was 1.6° and the mean tibial angle was 89.2°. At the last follow-up, the mean total valgus angle was 6.5°, the mean femoral flexion angle was 97.4° and the mean tibial angle was 89.1°, as seen on the anteroposterior view. On the lateral views, the mean femoral flexion angle was 1.4° and the mean tibial angle was 89.0°. Regarding the clinical outcome, the mean knee score and function score on the Knee Society clinical rating system were also enhanced from 47.5 and 43.6, respectively, before the operation to 91.2 and 82.3, respectively, at the last follow-up.

Conclusion

On radiologic and clinical follow-up of cementless TKA for patients with rheumatoid arthritis, there were no serious complications, and the results of the operation were satisfactory with improvement in range of motion and clinical symptoms.     

Kudo total elbow arthroplasty in patients with rheumatoid arthritis: a long-term follow-up study.

BACKGROUND: Improvements in the design of total elbow prostheses over the last two decades have led to better and more consistent results. The type-3 Kudo total elbow prosthesis was developed in 1980. The long-term results of use of this implant have not been reported. Because it is an unlinked prosthesis, it is not known whether preservation of the anterior oblique component of the ulnar collateral ligament at the time of implantation is important. METHODS: A type-3 Kudo total elbow arthroplasty with cement was performed in forty-seven patients (fifty elbows) with rheumatoid arthritis. Revision rates, clinical symptoms, postoperative complications, and radiographic changes were assessed eleven to sixteen years (mean, thirteen years) postoperatively. RESULTS: The overall survival rate of the prosthesis was 90% at sixteen years. The mean Mayo elbow performance scores were all poor (mean overall score, 43 points) initially. The overall score was substantially improved at both the intermediate follow-up examination (four to six years after the operation) and the late follow-up examination (eleven to sixteen years after the operation), to 81 and 77 points, respectively. The overall rate of radiolucency about the humeral component was 45% at the intermediate follow-up examination and 100% at the long-term follow-up examination. The rate of radiolucency about the ulnar component at the intermediate and late follow-up examinations was 4.3% and 8.9%, respectively. No great differences in results were found with preservation of the anterior oblique component of the ulnar collateral ligament. CONCLUSIONS: This long-term follow-up study showed acceptable results of the type-3 Kudo total elbow arthroplasty in patients with rheumatoid arthritis. Preservation of the ulnar collateral ligament does not seem to be necessary when performing this procedure.