ABSTRACT
Objective@#To investigate the application value of Information-Motivation-Behavioral Skill Model (IMB)-based continuing care on the recovery of nerve function and life quality in patients with stroke after thrombolytic therapy.@*Methods@#Stroke patients who underwent thrombolytic therapy were randomly assigned to IMB group(35 cases) and control group(35 cases) according to the method of random number table. The control group recieved routine thrombolysis nursing, IMB group was given IMB-based continuing care. After six months of intervention, nerve function was evaluated by National Institute of Health Stroke Scale(NIHSS) and Modified Rankin Scale(MRS), the active ability was performed by Fugl-Meyer Assessment Scale(FMA) and Barthel Index(BI), the quality of life was assessed by the item short from health survey(SF-36), respectively.@*Results@#Before intervention, the scores of NIHSS, MRS, FMA, BI, SF-36 between two groups was no significant difference (P>0.05). After three and six months of nursing, the NIHSS, MRS was (7.84±2.20), (5.00±1.60) points and (3.48±0.84), (3.07±0.69) points in IMB group, and (9.75±1.82), (8.21±1.37) points and (4.06±1.08), (3.91±0.71) points in control group, there was significant difference between two groups (t =2.417-8.647, P<0.01 or 0.05). After one, three and six months of intervention, FMA was (65.86±5.67), (76.41±8.47), (78.79±8.58) points, BI was (46.29±7.29), (58.09±10.20), (67.50±9.44) points, SF-36 was (33.13±4.64), (43.09±6.70), (49.83±8.56) points in IMB group, (58.53±8.92), (64.47±7.56), (71.81±8.90) points, (42.47±5.67), (48.74±5.39), (56.03±6.55) points and (29.63±4.06), (35.91±5.93), (41.02±9.05) points in control group, there was significant difference between two groups (t =2.333-5.972, P< 0.05). Moreover, in the repeated measures ANOVA showed the differences of NIHSS, MRS, FMA, BI, SF-36 were statistically significant for the group by time interaction(F=13.556-133.994, P<0.05).@*Conclusions@#IMB-based continuing care can promotes the recovery of nerve function and improves the quality of life in patients with stroke after thrombolytic therapy.
ABSTRACT
Objective To investigate the application value of Information-Motivation-Behavioral Skill Model (IMB)-based continuing care on the recovery of nerve function and life quality in patients with stroke after thrombolytic therapy. Methods Stroke patients who underwent thrombolytic therapy were randomly assigned to IMB group(35 cases) and control group(35 cases) according to the method of random number table. The control group recieved routine thrombolysis nursing, IMB group was given IMB-based continuing care. After six months of intervention, nerve function was evaluated by National Institute of Health Stroke Scale(NIHSS) and Modified Rankin Scale(MRS), the active ability was performed by Fugl-Meyer Assessment Scale(FMA) and Barthel Index(BI), the quality of life was assessed by the item short from health survey(SF-36), respectively. Results Before intervention, the scores of NIHSS, MRS, FMA, BI, SF-36 between two groups was no significant difference (P>0.05). After three and six months of nursing, the NIHSS, MRS was (7.84±2.20), (5.00±1.60) points and (3.48±0.84), (3.07±0.69) points in IMB group, and (9.75±1.82), (8.21±1.37) points and (4.06±1.08), (3.91±0.71) points in control group, there was significant difference between two groups (t=2.417-8.647, P<0.01 or 0.05). After one, three and six months of intervention, FMA was (65.86±5.67), (76.41±8.47), (78.79±8.58) points, BI was (46.29±7.29), (58.09±10.20), (67.50±9.44) points, SF-36 was (33.13±4.64), (43.09±6.70), (49.83±8.56) points in IMB group, (58.53±8.92), (64.47±7.56), (71.81±8.90) points, (42.47±5.67), (48.74±5.39), (56.03±6.55) points and (29.63 ± 4.06), (35.91 ± 5.93), (41.02 ± 9.05) points in control group, there was significant difference between two groups (t=2.333-5.972, P<0.05). Moreover, in the repeated measures ANOVA showed the differences of NIHSS, MRS, FMA, BI, SF-36 were statistically significant for the group by time interaction (F=13.556-133.994, P<0.05). Conclusions IMB-based continuing care can promotes the recovery of nerve function and improves the quality of life in patients with stroke after thrombolytic therapy.
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Objective: To investigate the preventive effect of alprostadil (prostaglandin E1) combining hydration therapy on contrast induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elder patients. Methods: A total of 175 patients with coronary artery disease (CAD) elder than 75 years received PCI in our hospital from 2011-03 to 2014-03 were retrospectively studied, those including 122/175 (69.71 %) with male gender. The patients were at the mean age of (74.7 ± 3.9) years and randomly allocated into 2 groups: Control group, based on routine treatment, the patients received regular hydration of intravenous normal saline 1 ml/(kg?h) at 6 hours prior and 12 hours after PCI,n=84 and Alprostadil+hydration group, based on routine treatment and regular hydration, the patients received intravenous alprostadil 10μg in 100ml normal saline twice a day at 1 day prior PCI and the 3rd day after PCI,n=91. The serum levels of creatinine (SCr) were examined prior PCI and 3 days continuously after PCI, creatinine clearance rates (Ccr) were calculated and the CIN occurrence rates were compared between 2 groups. Results: At the 3rd day after PCI, the mean SCr level in Alprostadil+hydration group (92.08 ± 21.65) μmol/L was lower than Control group (99.43 ± 22.77) μmol/L,P<0.05, the mean Ccr level in Alprostadil+hydration group (63.78 ± 20.58) ml/min was higher than Control group (57.09 ± 22.31) ml/min,P<0.05. The occurrence rate of CIN after PCI was higher in Control group (13.1%, 11/84 patients) than Alprostadil+hydration group (3.3%, 3/91 patients),P<0.05. Conclusion: Alprostadil combining hydration therapy may obviously protect renal function and reduce the incidence rate of CIN in elder CAD patients after PCI treatment.
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Objective: To observe the protective effect of ischemic post-conditioning on myocardial reperfusion injury with the potential mechanism in experimental rabbits. Methods: A total of 36 healthy New Zealand rabbits were divided into 6 groups:①Sham group,②Ischemic reperfusion control (CON) group,③Myocardial ischemic post-conditioning (MpostC) group,④Remote ischemic post-conditioning (RPostC) group,⑤MPostC+5-HD group,⑥RPostC+5-HD group.n=6 in each group. The ischemic reperfusion injury model was established by left ventricular descending artery occlusion for 45 min followed by reperfusion for 120 min. Bilateral external iliac artery was occluded for 5 min to induce the short skeletal muscle ischemia. The indexes of cardiac function and plasma CK , LDH activities were measured at baseline, end of ischemia and 1, 2 h after reperfusion respectively, the sizes of myocardial infarction (MI) were examined and compared among different groups. Results: ①Compared with CON group, the indexes of cardiac function were improved in MPostC and RPostC groups at 1, 2 h after reperfusion,P0.05. The MI ranges and areas in MPostC and RPostC groups were much less than that in CON group,P0.05. Conclusion: Classical ischemic post-conditioning and remote organ ischemic post-conditioning both have protective effect on myocardial reperfusion injury in experimental rabbit, which might be related to the activation of mitochondrial ATP-sensitive potassium channels.