护理干预对髌骨骨折术后膝关节功能恢复的影响

目的探讨护理干预对髌骨骨折术后膝关节功能恢复的影响。方法将102例髌骨骨折术患者分成2组,对照组51例予常规护理,观察组51例加用康复护理干预,观察比较护理后膝关节功能康复情况。结果治疗后观察组在治愈率和总有效率上优于对照组(P<0.05);2组护理后2周在肿胀程度、疼痛视觉模拟评分、HSS评分较护理后3天显著好转(P<0.05);观察组护理后3天和护理后2周在肿胀程度、疼痛视觉模拟评分、HSS评分上显著优于对照组(P<0.05);观察组在疼痛、晨僵、关节功能和总分上低于对照组(P<0.05)。结论护理干预有助于髌骨骨折术后膝关节功能恢复,能提高患者生活质量。     

快速活检枪用于58例肝脏活检的临床分析

目的:探讨应用快速活检枪进行肝活检的可行性以及对临床诊疗工作的意义。方法:选择符合穿刺指征的58例患者在超声引导下利用快速活检枪进行肝脏穿刺活检。结果:58例均穿刺成功,作出病理诊断。术后2例出现穿刺部位明显疼痛,另2例出现一过性休克,所有患者均未出现严重并发症。结论:在超声引导下利用快速活检枪进行肝活检安全可行,并发症少,对临床诊疗工作具有重要指导意义。     

强制性运动疗法对脑损伤性偏瘫患者上肢运动功能康复的疗效

目的 探讨脑损伤性偏瘫患者上肢运动功能康复的护理干预措施.方法 将50例脑损伤性偏瘫患者随机分为干预组和对照组,干预组在常规康复护理的基础上,加用强制性运动疗法等护理干预措施,对照组给予常规康复护理.比较两组在康复治疗3周末的疗效.结果 干预组显效率、有效率及总有效率均明显高于对照组,两组显效率比较(P＜0.05)、有效率比较(P＜0.05)、总有效率比较(P＜0.01)统计学检验有显著性差异.结论 对改善脑损伤性偏瘫患者上肢运动功能采用常规康复护理加强制性运动疗法,其疗效明显优于常规康复护理组.     

Systematic review of the QoR-15 score,a patient- reported outcome measure measuring quality of recovery after surgery and anaesthesia

Background

The QoR-15 is a patient-reported outcome questionnaire that measures the quality of recovery after surgery and anaesthesia. We aimed to perform a systematic review and meta-analysis of the measurement properties of the QoR-15.

甲状腺癌根治术不常规放置颈部引流管的可行性

目的:评价甲状腺癌根治术不常规放置颈部引流管的可行性及其临床意义。方法:回顾性分析2017年9月至2018年9月我科行择期甲状腺癌根治术314例患者临床资料,其中111例未放置颈部引流管,其余203例放置颈部引流管,比较两组患者基线资料[包括年龄、性别、体重指数(BMI)、手术方式、病理类型、淋巴结转移情况]、术后住院日、术后疼痛评分、术后换药次数及并发症发生率。结果:两组患者在平均年龄、性别构成、BMI指数、手术方式、术后病理分型等方面差异均无统计学意义,无引流组较引流组术后住院日明显缩短[(1.51±0.60)d vs(2.75±0.87)d,P<0.001],术后疼痛明显减轻(VAS评分:2.34±1.12 vs 2.78±1.52,P<0.01],术后换药次数明显减少(1.68±0.81 vs 2.52±1.85,P<0.001),二者在并发症发生率方面差异无统计学意义。结论:甲状腺癌根治术后不放置引流管可加快患者康复,且并不增加并发症发生率,故需严格把握引流管放置指征,不建议常规预防性放置颈部引流管。     

Rapid evidence assessment of approaches to community neurological nursing care for people with neurological conditions post‐discharge from acute care hospital

Neurological conditions represent leading causes of non‐fatal burden of disease that will consume a large proportion of projected healthcare expenditure. Inconsistent access to integrated healthcare and other services for people with long‐term neurological conditions stresses acute care services. The purpose of this rapid evidence assessment, conducted February–June 2016, was to review the evidence supporting community neurological nursing approaches for patients with neurological conditions post‐discharge from acute care hospitals. CINAHL Plus with Full Text and MEDLINE were searched for English‐language studies published January 2000 to June 2016. Data were extracted using a purpose‐designed protocol. Studies describing community neurological nursing care services post‐discharge for adults with stroke, dementia, Alzheimer's disease, Parkinson's disease, multiple sclerosis or motor neurone disease were included and their quality was assessed. Two qualitative and three quantitative studies were reviewed. Two themes were identified in the narrative summary of findings: (i) continuity of care and self‐management and (ii) variable impact on clinical or impairment outcomes. There was low quality evidence of patient satisfaction, improved patient social activity, depression scores, stroke knowledge and lifestyle modification associated with post‐discharge care by neurological nurses as an intervention. There were few studies and weak evidence supporting the use of neurology‐generalist nurses to promote continuity of care for people with long‐term or progressive, long‐term neurological conditions post‐discharge from acute care hospital. Further research is needed to provide role clarity to facilitate comparative studies and evaluations of the effectiveness of community neurological nursing models of care.     

Additive manufacturing of poly[(R)‐3‐hydroxybutyrate‐co‐(R)‐3‐hydroxyhexanoate] scaffolds for engineered bone development

A wide range of poly(hydroxyalkanoate)s (PHAs), a class of biodegradable polyesters produced by various bacteria grown under unbalanced conditions, have been proposed for the fabrication of tissue‐engineering scaffolds. In this study, the manufacture of poly[(R)‐3‐hydroxybutyrate‐co‐(R)‐3‐hydroxyhexanoate] (or PHBHHx) scaffolds, by means of an additive manufacturing technique based on a computer‐controlled wet‐spinning system, was investigated. By optimizing the processing parameters, three‐dimensional scaffolds with different internal architectures were fabricated, based on a layer‐by‐layer approach. The resulting scaffolds were characterized by scanning electron microscopy, which showed good control over the fibre alignment and a fully interconnected porous network, with porosity in the range 79–88%, fibre diameter 47–76 µm and pore size 123–789 µm. Moreover, the resulting fibres presented an internal porosity connected to the external fibre surface as a consequence of the phase‐inversion process governing the solidification of the polymer solution. Scaffold compressive modulus and yield stress and strain could be varied in a certain range by changing the architectural parameters. Cell‐culture experiments employing the MC3T3‐E1 murine pre‐osteoblast cell line showed good cell proliferation after 21 days of culture. The PHBHHx scaffolds demonstrated promising results in terms of cell differentiation towards an osteoblast phenotype. Copyright © 2014 John Wiley & Sons, Ltd.     

益气活血法治疗缺血性脑卒中恢复期患者的临床疗效及对hs-CRP、Fg、HCY水平的影响

目的探讨益气活血法治疗缺血性脑卒中恢复期患者的临床疗效及其对血清超敏C反应蛋白(hs-CRP),血浆纤维蛋白原(Fg)、血浆同型半胱氨酸(HCY)。方法选取缺血性脑卒中恢复期患者125例,随机分为观察组62例和对照组63例,对照组给予常规治疗,恢复期给予常规康复训练。观察组在对照组的基础上加用益气活血通络方。均以4周为1个疗程。观察2组治疗前后神经功能缺损程度评分、Barthel指数评分、中医血瘀证症状积分,及临床疗效和hs-CRP、Fg、HCY水平。结果2组患者治疗后神经功能缺损程度评分、血瘀证的症状积分均较治疗前显著降低(P0.05或P0.01),Barthel指数评分均较治疗前显著提高(P0.01)。治疗后,观察组神经功能缺损程度评分、血瘀证的症状积分均低于对照组,差异有统计学意义(P0.05或P0.01)。观察组临床总有效率为87.10%,高于对照组的66.67%,差异有统计学意义(P0.01)。在血瘀证症状疗效方面,观察组总有效率为72.58%,高于对照组的42.86%,差异有统计学意义(P0.01)。2组患者治疗后hs-CRP、Fg、HCY水平均较治疗前下降,差异有统计学意义(P0.05或P0.01),观察组治疗后hs-CRP、Fg、HCY水平低于对照组,差异有统计学意义(P0.05或P0.01)。结论益气活血法用于治疗缺血性脑卒中恢复期患者能提高临床疗效,改善神经功能。