脊髓损伤的康复护理

目的提高脊髓损伤致截瘫患者的生存率、生活能力和生活质量,增强生活的自信心,减少和预防并发症的发生.方法做好患者心理康复指导,鼓励和协助患者进行系统性康复功能训练,积极做好并发症的预防和康复护理.结果通过一系列的康复功能训练,提高了患者生活自理能力(进食、洗漱、排泄等)和生活质量,减轻了家庭和社会的负担.结论脊髓损伤患者通过心理康复指导,肢体早期康复功能训练,最大限度使用尚有运动功能的肌肉,来代偿已丧失的功能,消除和减轻患者功能上的障碍,还能促进肢体关节残存功能的恢复和重建,预防和减少了并发症的发生,达到了最大限度的适应独立生活和参与社会的能力,有着较大的社会效益和经济效益.     

脊髓损伤康复护理进展

脊髓损伤是一种较常见的严重致残性损伤,严重影响患者的生命安全和生存质量。脊髓损伤后的心理康复、膀胱功能、肠道功能、肢体功能、自我护理功能等康复护理,以及延伸护理康复可降低患者伤残程度和促进功能康复。本文就脊髓损伤后的康复护理措施进行综述。     

脊髓损伤病人康复护理体会

目的 探讨脊髓损伤截瘫患者康复期功能锻炼与预防二次伤残的有效护理方案。方法 193例脊髓损伤截瘫患者针对不同类型和不同阶段施以不同的护理及护理对策。结果 经过有效地康复护理,均缩短了患者的住院时间,取得了满意的临床效果。结论 有效地康复护理措施可明显提高患者的生活质量,降低脊髓损伤后各系统并发症的发生。     

康复护理对脊髓损伤患者生存质量的影响

目的探讨康复护理对脊髓损伤患者生存质量的影响。方法选择我院2009年5月至2011年5月脊髓损伤患者62例,实施康复护理干预,比较康复护理前后患者肌力和日常生活活动能力变化情况。结果经康复护理后患者ASIA评分明显高于护理前（P〈0.01）,Barthel指数、FIM评分明显优于护理前（P〈0.01）。结论康复护理能明显改善患者肌力,增强日常生活活动能力,提高生存质量。     

脊髓损伤患者的早期康复护理体会

脊髓损伤后可引起患者肢体不同程度的瘫痪，若护理不当可加重病情，发生各种并发症，延缓患者康复，故早期康复护理是非常重要的。     

浅谈脊柱脊髓损伤患者的护理

当前医疗卫生行业处于多元化发展时期，特别是中国入世后医疗卫生服务质量又将提升到一个新的台阶。随着医疗系统与世界的接轨，突发伤员的救治及护理显得日趋频繁，这对医疗护理工作者提出一个实质性的问题——怎样才能及时有效的护理好伤员的常见损伤？尤其是对脊柱脊髓损伤伤员的护理显得更为重要，该病致残性严重，有不同程度的截瘫或四肢瘫，目前有增加趋势。脊柱脊髓损伤患者大多是青壮年，伤病的困扰给自身和家庭造成残酷的打击，     

康复护理对脊髓损伤患者生活质量的影响

目的：探讨康复护理对脊髓损伤（spinalcordinjury,SCI）患者生活质量的影响。方法：依据WHOQOL-100量表设计SCI患者生活质量调查表,对60例SCI住院患者采取有针对性的提高生活质量的系统康复护理,执行周期为16周,然后进行统计评分。结果：经过4周和16周的系统康复护理,发现60例SCI患者的生存质量评分由入院时的（4．95±0．75）好转到（2．35±0．42）,生活质量由很糟、苦恼提高到大致满意或还可以;其中改善生活质量最关键的护理措施是膀胱功能重建技术,使导尿管拔率由人院时的10％提高到康复护理16周时的90％。结论：康复护理对SCI患者生活质量提高效果明显;膀胱功能重建的康复护理是改善SCI患者生存质量的关键因素,也是SCI康复护理的临床突破之一。     

康复干预对脊髓损伤患者早期康复的影响

目的观察康复护理对脊髓损伤患者早期康复的影响。方法对60例脊髓损伤患者实施早期康复干预,随机分为对照组和康复干预组各30例。对照组行常规护理和非系统的功能锻炼;康复干预组除行常规护理外,还实施早期康复干预。观察并比较两组患者并发症发生率和生活质量评分。结果两组患者并发症发生率及生活质量评分比较,均有统计学意义(均P<0.05),其中康复组并发症发生率低于对照组,生活质量评分较对照组提高。结论做好脊髓损伤患者的早期康复干预,能有效控制并发症发生,促进功能恢复及尽量利用残存功能,达到生活自理或半自理,提高患者的生活质量,减轻社会和家庭负担。     

脊髓损伤后膀胱功能的康复护理

膀胱功能障碍是脊髓损伤(spinal cord injury,SCI)后最常见的并发症,其中尿潴留、尿路感染和慢性肾功能衰竭对患者的生活质量影响最大,甚至是引起截瘫患者死亡的重要原因[1]。加强脊髓损伤后膀胱的康复护理的目的就是预防泌尿系统并发症,保护肾脏与膀胱的功能,促进患者排尿功能的恢复。1病因外伤、血管性疾病、先天性疾病和医源性损伤等多种病因均可导致脊髓受损[2]。     

脊髓损伤住院病人的医疗和非医疗费用调查分析

目的调查脊髓损伤住院病人的医疗和非医疗费用的支付情况及其主要影响因素.对损伤后疾病负担做出基本估计,为残疾预防,促进与维护健康提供有价值的参考依据.方法以1998-2001年脊髓损伤康复科出院患者的原始资料为依据,自行设计费用调查问卷.资料应用SPSS完成.结果111例脊髓损伤住院病人医疗费用占总费用占58.03%,非医疗费用占41.97%.康复训练费用仅占医疗费用的12.86%.脊髓不完全性损伤费用多,康复治疗效果明显,患者的期望值高,因此住院时间较长.费用来源于公费、肇事责任方的患者平均住院日及费用无明显差异,自费患者住院天数、医疗费用明显减少.在脊髓损伤后非医疗费用中,陪护费占34.26%.结论遏止交通事故,工业伤害,减轻社会的总体负担;要逐步降低康复医院的药品费用的比重,提高康复训练中技术服务价值:应将脊髓损伤纳入重大疾病预防控制工作.     

急性脊椎损伤病人应用固定器的方法和护理

介绍了不同脊椎固定器的作用和使用方法，佛山市中医院急诊科于2006年4-9月对诊治的219例急性脊椎损伤病人应用固定器，取得了较好的护理效果。     

康复期颈髓损伤高位截瘫患者系统化护理的疗效评价研究

目的：研究并探讨康复期颈髓损伤高位截瘫患者系统化护理的疗效评价研究。方法：选取2012年10月-20／4年3月本院收治的60例高位截瘫患者进行临床回顾性分析,根据护理方式的不同将患者分为两组。对照组30例采用常规方式护理,试验组30例采用系统化护理的方式护理,比较两组的护理效果。结果：试验组康复期并发症低于对照组,且总体有效率高于对照组,差异均有统计学意义（P〈0．05）;试验组护理后较前SAS分明显降低,且低于对照组护理后（P〈0．05）。结论：采用系统化护理对康复期颈髓损伤高位截瘫患者的康复效果较好,对于患者的生活质量有一定的提高,值得临床上大力推广。     

The Experience of Military Sexual Trauma and Rehabilitation for Individuals with Spinal Cord Injury/Dysfunction

It has been well documented that spinal cord injury injury/dysfunction (SCI/D) can have a substantial impact upon psychological functioning. The complications that are produced by such an event include an array of physical issues (e.g., incontinence, impotence) to social difficulties (e.g., social resource access). Originally, the rehabilitation treatment focused on the physical impairment and psychological effects on the individual. For example, literature on sexuality after injury has examined the areas of the sexual response cycle, reproductive functioning, sexual behavior, and adjustment. Today, as the professional's awareness of the incidence of sexual trauma increases, assessing the impact of trauma history is an important healthcare consideration. Within the VA Healthcare System, military sexual trauma history is routinely screened. The complexities of working with individuals with SCI/D and sexual trauma can be challenging as some may lack effective verbal and social skills necessary for resolving interpersonal conflicts and advocacy. A pragmatic clinical model to utilize social skills deficit training is described in conjunction with specific sexual trauma treatment, as a way of increasing effective working relationships to maximize rehabilitation potential. Reprinted with permission from AASCIPSW, SCI Psychosocial Process.     

Sexual Satisfaction in People with Spinal Cord Injury

The objective of this study is to extend knowledge regarding sexual satisfaction, comparing the findings among pre- and post-lesion periods and a control group. From Brazil, the participants were 90 men, of whom 40 had a spinal cord injury (SCI) and 50 had no physical disability. The instrument used was a structured open and closed–ended questionnaire. Of the 40 men with SCI, 29 had paraplegia and 11 had tetraplegia. The participants were asked about their level of sexual satisfaction: 72% of the control group declared themselves to be very satisfied; 80% of the men with SCI in the pre-lesion period also reported being very satisfied, while in the postlesion period this number fell to 47.5%. In the pre-lesion period and in the control group sexual satisfaction exhibited positive correlations with: sexual frequency; sexual stimulation; sexual desire and intensity of orgasm. Meanwhile, in the post-lesion period there were correlations between variables that are modified by the SCI: erection sufficient for penetration; reaching orgasm; achieving penetration and finding sex possible without penetration. Noteworthy, the study found that there are changes in the sexual satisfaction of men with SCI. In many cases this change results from the difficulty in maintaining a sex life similar to that experienced pre-lesion. Furthermore, new correlations with sexual satisfaction appear in the post-lesion period.     

Semen Quality in Males with Spinal Cord Injury: Medical and Psychological Aspect

Lower paraplegia is an important medical condition that presents a significant life challenge. One important concern in male with lower paraplegia is the complications in reproductive function. Indeed, sexual function is confirmed for the interrelationship between sexual function and autonomic dysreflexia. Sexual and genital prognosis in adult paraplegics is a present focus and will be presented in this article.     

Sexuality and Women with Spinal Cord Injury

Women with spinal cord injury (SCI) have unique concerns and problems related to their sexuality. The purpose of this study is to assess sexual issues in women with SCI, for better management and rehabilitation of such patients. Consequently, 40 such women were interviewed based on a standardized questionnaire. Evaluation of sexual activity, medical problems most significantly interfering with sexual activity, menstruation, pregnancy, child bearing and relationships was done. Interest in sex and importance of sex in lives did not change significantly after SCI. The key concerns after SCI were sexual, bladder and bowel dysfunctions, bed sores, pain, spasticity and satisfaction of partner and cultural taboos. Only, 30% women had received information on sexual matters, that too to isolated problems. There is a distinctive need for clinical attention, education, research and development around gynaecological/reproductive, sexual and urogenital issues unique to women with SCI in India.     

胶质细胞源性神经营养因子促进脊髓损伤后轴突再生的实验研究

目的探讨胶质细胞源性神经营养因子（GDNF）对轴突生长的促进作用。方法在体外培养胚胎大鼠脊神经后根神经节,随机分为两组,实验纽加入GDNF,对照纽只添加培养液,3天后用免疫荧光染色方法鉴定神经节轴突生长情况。在体内试验方面,36只成年SD大鼠建立脊髓半切损伤模型,随机分为两组,实验组移植含有GDNF的雪旺细胞微管．对照组仅移植雪旺细胞微管。移植术后2周、4周、6周取材,测量再生神经束的大小。结果GDNF处理3天后,实验组脊髓后根神经节新生轴突的长度明显长于对照组,而且新生轴突的覆盖面积显著大于对照组。雪旺细胞微管移植后不同时间,含有GDNF的微管内再生神经柬的截面积均显著大于对照组。结论GDNF在体内外对轴突的生长都有显著的促进作用,有望成为治疗脊髓损伤的可选方法之一。