综合护理干预对无痛人工流产术孕妇术后疼痛及焦虑情绪的影响

目的 探讨综合护理干预对无痛人工流产术孕妇术后疼痛及焦虑情绪的影响.方法 选取0015年8月至0017年10月在我院行无痛人工流产术的110例孕妇作为研究对象,随机分为两组各56例.对照组行常规护理干预,观察组在对照组基础上行综合护理干预.比较两组干预前后的疼痛程度(VAS评分)、焦虑情绪(SAS评分).结果 干预前,...     

Evaluation of anxiety and salivary chromogranin a secretion in women receiving breast conserving surgery followed by radiation therapy

We conducted a prospective study to assess the anxiety and salivary Chromogranin A (CgA), which is considered to be a biomarker of the stress response, in outpatients receiving breast conserving surgery followed by radiation therapy (RT) to the whole breast. Fifty consecutive patients who received whole-breast RT were enrolled in this study. The anxiety levels were measured by the State-Trait Anxiety Inventory (STAI) at the beginning of RT (baseline), 30 Gy, completion of RT, and 1 and 3 months after RT. Salivary CgA levels were also measured at the same time. The mean state anxiety score for all patients was 46.16 with a standard error (SE) of 1.57 at the beginning of RT (baseline) which continued to decline during and after RT. It reached its lowest score with 36.34 ± 1.56 at 3 months after RT (p < 0.0001). The mean trait anxiety score for all patients was 43.10 ± 1.54 at baseline and remained constant during RT but began to decline after completion of RT and reached a low level at 3 months after RT (p = 0.0021). The mean salivary CgA concentration for all patients demonstrated no consistent trends over time, but at 30 Gy the concentration showed a significant decreasing pattern (p = 0.0473). Salivary CgA concentrations and state anxiety and trait anxiety scores at all time points showed no correlation. The mean anxiety scores measured by STAI showed no positive correlation with salivary CgA concentration for breast cancer patients undergoing radiation therapy following breast conserving surgery.     

麦肯基疗法在腰椎间盘突出症社区康复护理中的应用

目的观察麦肯基疗法在社区康复护理中的作用。方法 80例腰椎间盘突出症患者被随机分为两组,试验组及对照组各40例。两组患者均接受包括腰椎牵引、物理因子治疗等的普通康复治疗,试验组在此基础上接受康复护理教育,进行麦肯基治疗性练习,并要求每日在家坚持练习20～30 min。所有患者每天进行治疗一次,每周5次,2周为一疗程。治疗前后对疼痛症状进行VAS问卷评分。结果治疗前VAS评定得分为:试验组6.15±1.16,对照组5.74±0.99;治疗后患者VAS评定得分为试验组3.86±0.93,对照组4.96±0.92,治疗后试验组患者VAS疼痛评分下降2.29±0.62,对照组VAS疼痛评分下降0.78±0.31(p<0.05),两组具有显著性差异。结论麦肯基疗法结合普通康复治疗能更有效改善腰椎间盘突出症患者的疼痛症状。     

肝胆外科择期手术患者术后痛感觉和痛情绪影响因素的研究

目的分析肝胆外科手术患者术后痛感以及痛情绪的影响因素。方法肝胆外科住院并择期手术的患者120例,分析其术后疼痛影响因素。结果不同年龄、职业、手术时间、精神质人格特征以及术前焦虑状态患者的术后VAS得分存在一定的差异,且PCIA镇痛患者的术后VAS得分显著低于对照组。结论患者的年龄、职业、镇痛方法、手术时间、精神质人格特征以及术前焦虑状态等均对其术后疼痛感具有影响。     

The application of Reiki in nurses diagnosed with Burnout Syndrome has beneficial effects on concentration of salivary IgA and blood pressure

This study aimed to investigate the immediate effects of the secretory immunoglobulin A (sIgA), α-amylase activity and blood pressure levels after the application of a Reiki session in nurses with Burnout Syndrome. A randomized, double-blind, placebo-controlled, crossover design was conducted to compare the immediate effects of Reiki versus control intervention (Hand-off sham intervention) in nurses with Burnout Syndrome. Sample was composed of eighteen nurses (aged 34-56 years) with burnout syndrome. Participants were randomly assigned to receive either a Reiki treatment or a placebo (sham Reiki) treatment, according to the established order in two different days. The ANOVA showed a significant interaction time x intervention for diastolic blood pressure (F=4.92, P=0.04) and sIgA concentration (F=4.71, P=0.04). A Reiki session can produce an immediate and statistically significant improvement in sIgA concentration and diastolic blood pressure in nurses with Burnout Syndrome.     

Clinical arterial infusion of calcium gluconate: The preferred method for treating hydrofluoric acid burns of distal human limbs

Objective

This study was designed to evaluate the efficiency and safety of arterial infusions of calcium gluconate to treat hydrofluoric (HF) acid burns of the distal human limbs.

Materials and Methods

Eligible patients with HF burn limbs, collected from January 2008 to October 2011, were given the arterial infusion of calcium gluconate into the injured limbs. The measures of pain were conducted before the infusion, immediately after the infusion, 4 h after the infusion, and 2 days after the infusion by the visual analogy score (VAS). If the VAS score was higher than 4.0 at the time point 4 h after the first infusion, the infusion was repeated. The time of wound healing, and the number and ratio of the cases receiving the surgical operation were also evaluated.

Results

A total of 118 patients, male (107 cases) and female (11 cases), were collected, including 64 cases of outpatients and 54 cases of inpatients. The age of the subjects ranged from 16 to 60 years, with the mean age of 37.6. The burn sites were located in the lateral limbs (28 cases) and in the unilateral limbs (90 cases). For 107 cases, the pain scores decreased quickly after the first infusion. The other 11 cases, with the VAS score higher than 4.0 at the time point 4 h after the first infusion, received the second infusion. The average time of wound healing and the ratio of the cases receiving the surgical operation were closely related to the interval from the injury to the reception of infusion.

Conclusions

Arterial infusion of calcium gluconate, effectively relieving the pain, blocking wound progressive deepening, and causing no adverse effects, could be the preferential method to treat hydrofluoric acid burns of the distal human limbs.     

高强度聚焦超声治疗对缓解胰腺癌疼痛的疗效观察

目的:观察高强度聚焦超声(HIFU)在胰腺癌疼痛治疗中的临床效果。方法:对本院确诊的11例胰腺癌伴癌痛患者进行HIFU治疗,观察视觉模拟评分(VAS)变化及并发症发生情况。结果:治疗前患者VAS分值平均为(7.1±2.2)分,治疗后患者VAS分值平均为(3.2±1.3)分,差异有统计学意义(P<0.05)。治疗过程中及治疗后所有患者均未出现皮肤损伤、胰腺炎、胃肠道穿孔、胰漏等并发症。结论:HIFU对胰腺癌治疗效果良好,疼痛明显缓解,治疗安全性高,可作为胰腺癌疼痛的优选治疗方法。     

Short time effects of a low-frequency,high intensity magnetic field in the treatment of chronic neck and low back pain

IntroductionNeck and back pain afflicts millions of people. Magnetotherapy has shown to have anti-inflammatory effects that could act on pain generation, but the literature lacks provide a precise therapeutic protocol.MethodsA high-intensity electromagnetic field with a dedicated applicator was administered to 38 patients with low-back pain and 30 patients with neck pain. The device provides 60 mT and a frequency of 50 Hz for 30 minutes, the session was repeated 4 times.ResultsThe mean VAS of the low-back pain group decreased from 6.56 to 4.54, with a significant reduction of 30.8%. The mean VAS of the neck pain group decreased from 6.51 to 1.96, with a significant reduction of 69.9%.DiscussionThe treatment used showed good results in both groups of the patient, without side effects. The therapeutic protocol adopted is safe, provide rapid relief from the pain and is not time demanding. This treatment could represent an effective non-pharmacologic physical therapy option in the treatment of low-back pain and cervical pain.     

吗啡PCA治疗晚期重度癌痛的临床观察

目的:观察患者自控镇痛(PCA)在晚期重度癌痛治疗中的临床效果。方法:对本院确诊的21例晚期重度癌痛患者进行吗啡PCA治疗,观察视觉模拟评分(VAS)变化及并发症发生情况。结果:治疗前患者VAS分值平均为(8.1±2.3)分,治疗后30min患者VAS分值平均为(3.3±1.4)分,治疗后24h患者VAS分值平均为(2.1±0.8)分,治疗后30min及治疗后24h患者VAS分值与治疗前有统计学差异(P<0.05)。治疗过程中出现恶心呕吐3例,便秘2例,未出现嗜睡、导管堵塞脱落、呼吸抑制、皮肤瘙痒、幻觉等情况。结论:吗啡PCA对晚期重度癌痛控制效果满意,治疗并发症少。     

Screening anxious-depressive symptoms and pain in medical inpatients

AIM: Several studies indicate a relationship among depression, anxiety, pain and hospitalization. Depression has a bidirectional relationship with cardiovascular disease, and it is observed in HIV-positive individuals, in cancer patients and it often complicates chronic pain. METHODS: In order to assess dimensionally depressive and anxious symptoms and pain in medical inpatients, 327 non-psychiatric inpatients were assessed using the Hospital Anxiety and Depression Scale (HADS) and Visual Analogical Scale (for pain, VAS). Inpatients were hospitalized for neurovascular disease, chronic medical illness, cancer, infectious disease, cardiovascular illness, orthopaedic surgery and general surgery. RESULTS: Very high anxiety levels were discovered in cardiovascular, general surgery, infectious and neurovascular patients, whereas depression levels were higher among cardiovascular and chronic patients. The highest levels of pain were found among patients admitted to the Oncology Unit and those suffering from chronic medical illness. A stronger, direct relationship was obtained between anxiety and depression than between pain and anxiety or depression. No statistical differences were found in men and women. Statistically speaking significant differences were found in wards. Pain is a significant predictive variable for anxiety and depression (P<0.001). CONCLUSION: Screening for anxiety and depression should be included in the clinical interview carried out by the nurse at the moment of admission to the ward.     

Potential Risk Factors Increasing the Severity of Sexual Dysfunction in Women with Fibromyalgia

The purpose of this study is to investigate the effect of clinical features including duration of FM and sexual partnership, and severity of pain, anxiety, and depression on the severity of sexual dysfunction in women with Fibromyalgia (FM). This cross-sectional study was conducted on 130 female patients with FM, who were admitted to Physical Therapy and Rehabilitation Polyclinic in August and September 2015, and 60 healthy controls. The data was collected with Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Women Sexual Function Index (FSFI), Fibromyalgia Impact Questionnaire (FIQ) and Visual Analogue Scale (VAS). Evaluating FM and control group according to the FSFI Score, it was found that 103 (84.4%) and 19 (15.6%) had sexual dysfunction, respectively. The median scores of FSFI scale and subscale, and VAS in the FM patients were significantly higher than those in the control group (p < 0.05). The mean scores of FIQ, BAI, and BDI in the FM patients were significantly higher than those in the control group (p < 0.05). The FSFI score was significantly predicted by FIQ, BAI, duration, and duration of partnership. FSFI score has a negative correlation with BAI score, disease duration and duration of partnership. This study supports that FM may affect all domains of sexual function. In our clinical settings, multiple regression analysis reveals that the duration and severity of FM and duration of sexual partnership, and severity of anxiety but not severity of pain and depression can increase the severity of sexual dysfunction. Knowledge about meaningful contributing factors of duration of FM and sexual partnership, and severity of FM and anxiety may be helpful for physicians for determining correct strategies for prevention and management of sexual dysfunction in FM.     

妇科手术患者及其亲属联合接受音乐认知治疗对患者术后疼痛的影响

目的 观察妇科手术患者及其亲属联合接受音乐认知治疗对患者术后疼痛的影响.方法 将60例于椎管内麻醉下行全子宫切除术患者及其60例亲属随机分成两组.音乐组亲属于术前接受音乐和认知治疗,患者于术中听音乐;对照组不进行干预.于干预前、术前和术后24 h均采用 Zung 焦虑自评量表对亲属进行评估,于术前、术后0 h和2 h检测患者血清皮质醇;记录术后24 h平均疼痛视觉模拟评分（VAS）和镇痛药用量.结果 音乐组亲属术前和术后的焦虑评分低于对照组（F1,17=31.688,P＜0.01）;音乐组患者术后的皮质醇水平（F1,17=5.356,P=0.033）和镇痛药用量（F1,17 =8.402,P＜0.01）低于对照组.结论椎管内麻醉下妇科手术患者及其亲属联合接受音乐认知治疗,可有效降低亲属的焦虑,并持续缓解患者的术后疼痛.     

不孕症患者行门诊不麻醉宫腔镜检查疼痛影响因素分析

目的：探讨不孕症患者行门诊不麻醉宫腔镜检查时疼痛的影响因素,为临床中研究减轻患者疼痛的护理干预提供理论指导。方法：本研究采用问卷调查法对2016年6-9月北京大学第三医院生殖中心门诊进行不麻醉宫腔镜检查的不孕症患者进行调查。调查问卷包括患者一般资料、自评焦虑量表、自评抑郁量表、一般自我效能感量表、宫腔镜检查相关知识问卷和疼痛视觉模拟评分法（visual analogue scale,VAS）。被调查的125例宫腔镜检查患者均采用奥林巴斯的软管镜进行宫腔镜检查,在宫腔镜检查后取少量子宫内膜组织送病理,其中28例在患者知情同意下行子宫内膜息肉摘除术。结果：125例患者VAS评分为4.42（3,6）,经对数转换后为正态分布资料。多元线性回归分析显示,是否摘除息肉、家庭月总收入、抑郁得分、文化程度、知识得分进入回归方程（回归方程F=7.189,P=0.000）。摘除息肉、家庭月总收入高、文化程度高以及患者抑郁情绪得分高是不麻醉宫腔镜检查时疼痛程度的危险因素,宫腔镜检查相关知识得分高是保护因素。结论：临床工作中进行宫腔镜检查前应进行充分宫腔镜检查相关知识的宣教,尤其是对于存在子宫内膜息肉,以及家庭月总收入高、文化程度高和抑郁情绪较重的患者。     

胸椎骨质疏松椎体新鲜压缩骨折椎体成形术的临床研究

目的探讨胸椎骨质疏松新鲜压缩骨折椎体成形术的临床治疗效果和手术注意事项。方法在C型臂X线机监视引导下,对61例胸椎骨质疏松性新鲜椎体压缩骨折患者经皮穿刺椎体成形术(PVP)。共对93个椎体(61例)进行了PVP手术。术后第1天、1周、一月、三月、半年对疼痛缓解进行随访和评价。结果各椎体内骨水泥注射剂量2.5～4ml,术中未发生并发症,术后疼痛明显缓解或消失者54例。VAS术前评分8.42±1.96,术后2.76±1.64。术前与术后比较,统计学有显著性差异(P<0.01);术后各时间点VAS评分比较,统计学无显著性差异(P>0.05)。结论经皮穿刺椎体成形术是一种治疗胸椎骨质疏松新鲜椎体压缩骨折缓解疼痛快速、安全、有效的方法,但也是一种相对高风险的手术。     

综合护理干预在肿瘤患者癌性疼痛护理中的应用

目的探讨综合护理干预在肿瘤患者癌性疼痛护理中的应用效果。方法选取我院2018年1月到2019年8月间收治的120例伴有癌性疼痛的肿瘤患者作为研究对象,随机分为两组各60例。对照组给予常规护理干预,观察组在对照组基础上给予综合护理干预。比较两组护理干预前后的癌性疼痛评分,以及护理满意度。结果干预前,两组患者的VAS评分比较,差异无统计学意义(P>0.05);干预后,两组患者的VAS评分均显著降低(P<0.05),且观察组的VAS评分显著低于对照组(P<0.05)。观察组患者的护理满意度为91.7%,显著高于对照组的76.7%(P<0.05)。结论综合护理干预可有效缓解肿瘤患者的癌性疼痛,提高患者的护理满意度,值得临床推广应用。     

Use of aromatherapy with hospice patients to decrease pain,anxiety, and depression and to promote an increased sense of well-being

This study measured the responses of 17 cancer hospice patients to humidified essential lavender oil aromatherapy. Vital signs as well as levels of pain, anxiety, depression, and sense of well-being were measured (using 11-point verbal analogs). Each subject was measured on three different days before and after a 60-minute session consisting of (1) no treatment (control); (2) water humidification (control); or (3) 3-percent lavender aromatherapy. Results reflected a positive, yet small, change in blood pressure and pulse, pain, anxiety, depression, and sense of well-being after both the humidified water treatment and the lavender treatment. Following the control session (no treatment), there was also slight improvement in vital signs, depression, and sense of well-being, but not in pain or anxiety levels.     

Combining goal setting and achievement with occupational therapy to improve pain,psychological factors and physical activity in patients after high tibial osteotomy: A non-randomized controlled study

BackgroundPsychological factors contribute to chronic pain and may lead to physical inactivity and poor functional outcomes.PurposeWe conducted a non-randomized controlled study to evaluate the effectiveness of goal setting and achievement following occupational therapy (OT) intervention to improve pain, psychological factors, and physical activity among patients after high tibial osteotomy (HTO).MethodWe analyzed the data of 31 patients who underwent HTO, allocated into OT intervention and control groups. Goal achievement was encouraged through OT in the intervention groups; the control groups did not receive OT intervention. Outcome measures included the Canadian Occupational Performance Measure (COPM) score (before and after the OT intervention), walking pain, pain catastrophizing, anxiety, depression, pain self-efficacy, and physical activity level.ResultsOT significantly improved the COPM score, depression, and physical activity. At the final assessment, the depression score was lower while the step count and physical activity time were significantly higher in the intervention group than in the control group (p < 0.05).ConclusionEmbedding goal setting and achievement as part of an OT intervention improved the outcomes after HTO.     

3种方法对带状疱疹神经痛的疗效对比研究

摘要:目的　对比观察加巴喷丁、皮质激素、神经阻滞法治疗带状疱疹神经痛的效果。方法　随机选取在某院就诊的胸部或背部带状疱疹伴急性期神经痛病人共90例,分成3组,即观察A组（30例）、观察B组（30例）和观察C组（30例）,所有患者均采用常规治疗,包括抗病毒药物更昔洛韦、甲钴胺等,观察A组加用加巴喷丁治疗,观察B组联合皮质激素治疗,观察C组联用肋间神经阻滞法治疗。根据VAS量表得分,对比研究各组治疗后1周、治疗后3周疼痛的改善情况、治疗效果及不良反应的发生率。结果　3组在治疗后1周与治疗后3周的VAS均比治疗前有明显的减少,且治疗后3周时比治疗后1周时也有较大减少,差异均有统计学意义,P＜0.05。而3组治疗后组间两两比较,治疗后1周与治疗后3周3组VAS得分差异有统计学意义,进一步进行两两比较后发现,观察A组与B组、观察A组与C组间治疗后的得分差异有统计学意义,观察B组及观察C组治疗后1周及治疗后3周的得分低于观察A组,而观察B组与观察C组间无统计学差异（P＞0.05）。治疗3周后,观察A组治疗总有效率为83.3%（25/30）,虽低于其他2组的90.0%（27/30）,但差异无统计学意义（χ2＝0.162,P＞0.05）。3组患者均未出现明显不良反应,加巴喷丁组1例患者自述头晕,并有一过性轻度嗜睡,自行缓解。结论　加巴喷丁、皮质激素、神经阻滞法均能较为有效地治疗带状疱疹神经痛,其中皮质激素、神经阻滞法较加巴喷丁改善患者神经痛的效果更为明显。     

Health-related Quality of Life, Depression and Anxiety in Thyroid Cancer Patients

Objectives: We examined the relationships among physical complaints, health-related quality of life (HRQL), anxiety and depression in differentiated thyroid cancer (DTC) patients under short-term hypothyroidism. Methods: We conducted a cross-sectional study in 136 patients hypothyroid on thyroid hormone withdrawal (THW) hospitalized for radioiodine administration. Patients were assessed using Short Form SF-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Beck Depression Inventory (BDI), and physical complaints. Results: Compared to the German general population, hypothyroid patients had significantly impaired HRQL. Surprisingly, the prevalence of anxiety (62.5%), but not depression (17.9%) was much higher in hypothyroid DTC patients than in the general population. In multivariate analysis, depression and age were independently associated with the physical health score (R² = 0.21), but only psychological variables (depression, mood disturbance, and anxiety) were associated with the mental health score (R² = 0.43), on the SF-36 HRQL instrument. Conclusions: HRQL is severely impaired in DTC patients under short-term hypothyroidism. As potential predictors of generic HRQL impairment, depression, anxiety, and mood disturbance could be used to preselect the patients most needing psychiatric care. The high frequency of anxiety should be considered in the aftercare of thyroid cancer patients.     

Pain control for intrauterine device insertion: a randomized trial of 1% lidocaine paracervical block

BackgroundThis study was conducted to investigate the effects of a 1% lidocaine paracervical block on perceived patient pain during intrauterine device (IUD) insertion.Study DesignWe randomized 50 women undergoing IUD insertion to receive either a 10-mL 1% lidocaine paracervical block or no local anesthetic before IUD insertion. Women marked their pain on a 100-mm visual analogue scale (VAS) (0 mm = no pain, 100 mm = worst pain possible) at various points of the procedure (speculum insertion, tenaculum placement, paracervical block administration, IUD insertion and 5 min postprocedure).ResultsTwenty-six women received the paracervical block before IUD insertion, and 24 received no local anesthesia. Groups were similar in age, parity, ethnicity, education and complications. Women who received the paracervical block reported a median VAS score of 24.0 mm with IUD insertion, and women who did not receive local anesthetic reported a median VAS score of 62.0 mm with IUD insertion; p=.09.ConclusionCompared with no anesthetic, a 1% lidocaine paracervical block did not result in a statistically significant decrease in perceived pain with IUD insertion.