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Objective To explore the risk factors of lower extremity deep venous thrombosis (LEDVT) of neurosurgical patients, and to provide references for identifying the most susceptible population and taking preventive measures. Methods A total of 68 cases of neurosurgical patients with LEDVT in three general hospitals from August 2010 to August 2013 were collected. The design method of one to one matching case-control study was used controlling age, sex and neurosurgical disease. Univariate and multivariate analyses were performed to determine the probable risk factors among two groups. Results The univariate analysis showed that coma, paralysis and limb immobilization, infection, trauma and fracture, lower limbs central venous catheterization, trachea cannula or tracheotomy, mechanical ventilation, surgical operation, dehydration and blood transfusion were significantly related to the incidence of LEDVT ( Χ2=4.50-33.23, P<0.05 or 0.01). The Logistic multivariate regression analysis showed that coma (OR=9.410, 95%CI 1.689-52.423), paralysis and limb immobilization (OR=4.950, 95%CI 1.432-17.105), infection (OR=2.927, 95%CI 1.162-7.373) and lower limbs central venous catheterization (OR=6.072, 95%CI 2.187-16.858) were independent risk factors for the development of LEDVT. Conclusions We should pay attention to patients with high risk factors of LEDVT and take preventive measures early to avert the formation of LEDVT.
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@#Objective To explore the risk factors of dysphagia in the patients with traumatic brain injuries (TBI). Methods 141 TBI patients were assessed with Gugging Swallowing Screen, and divided into the dysphagia (n=36) and normal (n=105) groups. The related factors were compared between 2 groups. Results The frequency increased in severe brain injury, brain stem injury, bilateral brain injury, tracheotomy, nasal-gastric tube insertion and cognitive defect in the dysphagia group compared with those in the normal group (P<0.05). Conclusion The severe brain injury, brain stem injury, bilateral brain injury, tracheotomy, nasal-gastric tube insertion and cognitive defect may be related with the dysphagia post TBI.
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Objective To explore the risk factors of dysphagia in the patients with traumatic brain injuries (TBI). Methods 141 TBI pa-tients were assessed with Gugging Swallowing Screen, and divided into the dysphagia (n=36) and normal (n=105) groups. The related fac-tors were compared between 2 groups. Results The frequency increased in severe brain injury, brain stem injury, bilateral brain injury, tra-cheotomy, nasal-gastric tube insertion and cognitive defect in the dysphagia group compared with those in the normal group (P<0.05). Con-clusion The severe brain injury, brain stem injury, bilateral brain injury, tracheotomy, nasal-gastric tube insertion and cognitive defect may be related with the dysphagia post TBI.
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Objective To compare the difference between GUSS swallowing evaluation and traditional evaluation as a symbol of pulling out stomach tube.Methods 60 patients with cerebral hemorrhage combined with indwelling tube were divided into two groups,the GUSS group and the traditional group,according to the symbol of pulling out the gastric tube.Each group contained 30 cases.The GUSS score ≥ 15 points was used as the symbol of pulling out the gastric tube in the GUSS group,while being able to eat 200 ml liquid without any trouble in two days was used as the symbol in the traditional group.Then we compared the incidence of gastric tube reinsertion and aspiration pneumonitis between the two groups.Results No gastric tube reinsertion and aspiration pneumonitis occurred in the GUSS group,while 7 cases accepted gastric tube reinsertion and 3 cases diagnosed as aspiration pneumonitis in the traditional group.The incidence of gastric tube reinsertion and aspiration pneumonitis in the GUSS group were obviously lower than those in the traditional group.Conclusions GUSS evaluation score ≥ 15 points could be used as a symbol of pulling out gastric tube.
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Objective To observe the effect of cognitive rehabilitation training based on games on cognition of the traumatic brain injury (TBI) patients.Methods 60 cases of patients according with the inclusion and exclusion criteria were divided into the control group and the training group with 30 cases in each group.The Montreal cognitive assessment (MoCA) test scores of all patients were lower than 26 points.The training group accepted the cognitive rehabilitation training based on games such as exactly the same game,drum game and picture memory game,while the control group did not accept the training.After one month,all patients accepted the MoCA test again.Then we analyzed the differences of the cognition between the two groups.Results After 30 days of training,all items of the cognitive function increased except the sub-item of abstraction.While in the control group,only the scores of attention,delayed recall,orientation and the total score showed alleviation.And all the scores of the training group were higher than those of the control group except the sub-item of abstraction.Conclusions Cognitive rehabilitation training based on games can effectively improve the cognitive function of TBI patients.
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Objective To summarize the perioperative nursing of acute intracranial arterial occlusion treated with mechanical thrombectomy with Solitaire AB stent.Methods Fifty-three cases of acute intracranial arterial occlusion were treated with mechanical thrombectomy with Solitaire AB stent.Before the operation,emergency green passage was established and after the operation,the nursing measures included close observation of conditions,intensified basic nursing,control and management of blood pressure and medication,prevention from the complications by reperfusion injury and early rehabilitative training.Results The mechanical thrombectomy with Solitaire AB stent was successful for all the 53 patients.The occlusions in the blood vessels of 44 cases were fully removed and those in 9 cases were partially removed,3 treated with stent for stenosis.Conclusion The nursing points for acute intracranial arterial occlusion treated with mechanical thrombectomy with Solitaire AB stent include preoperative effective preparation, close observation of the disease conditions such as changes in their consciousness and blood pressure,prevention from reperfusion injury and early rehabilitative training.