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Objective:To observe the effects of applying ultrasound-guided balloon dilatation in the treatment of post-stroke cyclopthyroid achalasia.Methods:Thirty-eight stroke survivors with cyclopneaful achalasia were divided into a control group ( n=19) and an experimental group ( n=19). All had been diagnosed with cycloparyngeal achalasia using videofluoroscopic swallowing study (VFSS). The controls were treated with conventional oral balloon dilatation, while the experimental group underwent ultrasound-guided oral balloon dilatation. The treatment was performed once every 2 days. During the treatment period, the durations and the number of expansions were recorded, and the patient′s comfort and throat pain were evaluated. The Kubota drinking water test (KDWT), standardized swallowing assessment (SSA) scoring and VFSS scoring were compared before and after the 2 weeks of treatment. Results:The average daily duration of expansions in the experimental group was significantly less than in the control group and their number was significantly greater. Comfort and larynx pain were also significantly better in the experimental group. The effective rate in the KDWT was 78.95% in the treatment group, significantly higher than the control group′s 31.58%. Significant differences were also found in the average SSA scores, VFSS pharyngeal phase scores and in the incidence of achalasia between the experimental and control groups.Conclusions:Using ultrasound to guide balloon dilatation can shorten the operation, reduce the throat pain involved and allow for more expansions, greater comfort and thus more effective treatment.
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Objective:To develop the questionnaire of nurses′ neurogenic bladder knowledge, attitude and behavior and test its reliability and validity.Methods:Based on the knowledge-attitude-behavior model,literature reviewing and expert consultation, the item pool was developed.A total of 286 clinical nurses from 4 hospitals in Zhejiang Province were surveyed. The different statistical analysis methods were used to select items and its reliability and validity was tested.Results:The final questionnaire consisted of 42 items: knowledge dimension with 18 items, attitude dimension with 11 items, and practice dimension with 13 items. The Cronbach α coefficient and test-retest reliability were 0.952 and 0.818 respectively. The item level content validity index ranged from 0.857 to 1.000, and the scale level content validity index was 0.993. Seven factors were identified by exploratory factor analysis, accounting for 69.839% of the total variance.Conclusions:The questionnaires reliable and valid,which could be applied to related clinical investigation.
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Objective To evaluate the effect of three different choices of indwelling urethral catheter clamping. Indwelling urethral catheter clamping choices included according to patients′complaints to clamp the catheter (Group A), released as schedule (Group B),and smooth passway of indwelling urinary catheter all the way (Group C). Methods We searched RCT about the effect of different choices of indwelling urethral catheter clamping from CNKI, VIP database,Wanfang database, PubMed on line. Literatures were searched from the database had been established till now. Two reviewers evaluate the literatures independently according to the RCT authentic assessment manual of Cochrane Collaboration. Other than different results, negotiation took as the measure to attach an agreement. No agreement reached, consult the opinion of the third person. RevMan5.2 was used to analyses the result of the study. Results Statistical difference between three clamping choice on the rate of successful in autonomous urination after catheter removed: both group A and group B preceded group C (Z=2.97, Z=4.34, P < 0.05), mean well group A preceded group B (Z=5.30, P < 0.05). Statistical difference did not found on the rate of urinary tract irritation after catheter removed between three choices. Conclusion Clamping indwelling urethral catheter according to patients′ complaints seems useful in bladder reconditioning before indwelling urethral catheter removal.
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Objective To explore the clinical efficacy of motor imagery therapy in treating neurogenic bladder dysfunction after traumatic spinal cord injury (SCI).Methods Seventy patients with neurogenic bladder control problems after SCI were randomly divided into an experimental group and a control group using a random number table.All patients of the two groups were given general bladder function intervention,including intermittent catheterization,inducing voiding by reflex detrusor contraction,Credé's maneuver urination,etc.Additionally,the patients in the experimental group were given supplemental motor imagery therapy.The times of urinary incontinence,average bladder capacity,maximum voided volume and residual urine volume of the two groups were measured before treatment and at 2 months after treatment.The two groups' outcomes were quantified using a quality of life (QOL) score.Results Incidents of urinary incontinence,average bladder capacity,residual urine volume,voided volume and the QOL score showed significant improvements in both groups,but the experimental group showed better improvements than the control group.The differences were statistically significant.Conclusion The combination of general bladder function intervention with motor imagery therapy can improve the voiding function of patients with neurogenic bladder disorders after SCI more significantly and enhance their QOL.
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Objective To explore quality of life (QOL) of spouses of spinal cord injury patients,as well as its influencing factors.Methods Sixty-eight spouses of spinal cord injury patients were recruited as an observation group.At the same time,another 70 healthy married people who had no serious chronic diseases in the family but were matched in gender,age,occupation and education were chosen as a control group.The QOL of all the subjects in both groups was investigated by way of a questionnaire survey.The results of both groups were compared and factors that influenced their QOL were explored.Results The QOL of spouses of spinal cord injury patients,including total QOL ( 3.22 ± 0.37 ),physiological function ( 60.57 ± 14.22 ),psychological state ( 60.09 ± 8.06 ),social relations (63.37 ± 8.10 ) and the living environment (66.86 ± 11.26 ) were significantly lower than in the control group (4.62 ± 0.75 ; 82.48 ± 10.92 ; 86.02 ± 8.75 ; 85.94 ± 10.13 and 83.23 ± 9.54,respectively).The QOL of spouses of spinal cord injury patients was closely related to the patient's injury type,injury position,the treatment protocol,as well as their own gender,vocation and education.Conclusion The QOL of spouses of spinal cord injury patients is significantly lower than that of normal people,and closely related with the patients' injury type,injury position and treatment,as well as their own gender,vocation and education.
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Objective To explore the effects of comprehensive rehabilitation on nutriture and medical costs in the treatment of patients with dysphagia following stroke. Methods Eighty-seven patients with dysphagia were divided into an intervention group (IG) and a control group (CG). Comprehensive rehabilitation therapy including deglutition training, electric neuromuscular stimulation and acupuncture were used with the IG patients, but not with those in the CG. Nutriture parameters included a biochemistry index and a body measurement index. Medical costs were observed before and after one month of treatment for both groups. Results After one month of treatment, average deglutition scores and nutriture indices were significantly higher in the IG than in the CG. Medical costs for the IG had decreased significantly compared with the CG. Conclusions Comprehensive rehabilitation therapy improved deglutition function and slowed nutriture deterioration, while decreasing medical costs in the treatment of patients with dysphagia following stroke.
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@#目的探讨干预性护理措施对预防和减少脊髓损伤(SCI)患者脊髓功能的进一步损害、防止并发症发生的作用。方法对65例SCI患者在入院后进行康复护理评定,并随机分为观察组 (29例)和对照组(36例)。对照组患者实行常规护理,观察组患者在常规护理的基础上针对康复期存在的或潜在的功能障碍和并发症,采取干预性护理措施,12周后评定两组的护理效果并进行统计学分析。结果观察组和对照组患者的常见功能障碍和并发症是相同的,但观察组患者的肺部感染和尿路感染率低于对照组患者(P<0.05),深静脉血栓、皮肤压疮和烫伤的发生率明显低于对照组(P<0.01)。结论干预性护理措施可降低康复期SCI患者的肺部感染和尿路感染率,并使深静脉血栓、皮肤损伤等并发症明显减少。