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Objective@#To study the application effect of graded nursing intervention for ICU patients combined with the Pre-Deliric prediction model.@*Methods@#A total of 288 ICU patients were elected and divided into the control group (141 cases from May 2017 to October 2017) and the intervention group (147 cases from November 2017 to April 2018) according to hospitalization time. The control group received conventional delirium prevention measures. The intervention group was assessed within 24 h following admission with Pre-Deliric prediction model to screen the risk of delirium, and then they received grading prevention care based on the assessment results of delirium risks. The data of this study were collected by Numeric Rating Scale, Critical-Care Pain Observation Tool, Richmond Agitation and Sedation Scale, Confusion Assessment Method for the ICU. The incidence and duration of delirium, 28d survival rate, ICU length of stay of the two groups were statistically analyzed.@*Results@#Compared with the control group, we detected that the incidence of delirium in the intervention group was significantly lower (χ2=5.043, P<0.05), 21.7%(32/147) vs. 35.5%(50/141). Compared with the control group, we found that the duration of delirium in the intervention group was significantly shorter,(1.68±1.24) vs.(2.82±1.60)d, the ICU length of stay in the intervention group were significantly shorter than the control group(t=4.45, P<0.01), (3.42±3.02)d vs (6.21±4.56)d. There was no significant difference in the 28-day ICU survival rate between the two groups (P>0.05).@*Conclusions@#the risk assessment and grading nursing care combined with Pre-Deliric prediction model could effectively prevent the occurrence and shorten the duration of delirium, and also shorten the ICU length of stay.It was significant for improve the quality of nursing.
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Objective To study the application effect of graded nursing intervention for ICU patients combined with the Pre-Deliric prediction model. Methods A total of 288 ICU patients were elected and divided into the control group (141 cases from May 2017 to October 2017) and the intervention group (147 cases from November 2017 to April 2018) according to hospitalization time. The control group received conventional delirium prevention measures. The intervention group was assessed within 24 h following admission with Pre-Deliric prediction model to screen the risk of delirium, and then they received grading prevention care based on the assessment results of delirium risks. The data of this study were collected by Numeric Rating Scale, Critical-Care Pain Observation Tool, Richmond Agitation and Sedation Scale, Confusion Assessment Method for the ICU. The incidence and duration of delirium, 28d survival rate, ICU length of stay of the two groups were statistically analyzed. Results Compared with the control group, we detected that the incidence of delirium in the intervention group was significantly lower (χ2=5.043, P<0.05), 21.7%(32/147) vs. 35.5%(50/141). Compared with the control group, we found that the duration of delirium in the intervention group was significantly shorter,(1.68 ± 1.24) vs.( 2.82 ± 1.60)d, the ICU length of stay in the intervention group were significantly shorter than the control group(t=4.45﹐P<0.01), (3.42±3.02)d vs (6.21± 4.56)d. There was no significant difference in the 28-day ICU survival rate between the two groups (P>0.05). Conclusions the risk assessment and grading nursing care combined with Pre-Deliric prediction model could effectively prevent the occurrence and shorten the duration of delirium, and also shorten the ICU length of stay. It was significant for improve the quality of nursing.
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Objective To assess and compare the predicted abilities of PRE- DELIRIC and E-PRE-DELIRIC two delirium prediction models in ICU patients. Methods From January 2017 to April 2017, 265 critically ill patients who met the inclusion criteria were included in this study. The clinical data of all the included patients, respectively calculated the scores with both PRE-DELIRIC and E-PRE-DELIRIC rating software were collected. Forecasting performance of two different models of discrimination and calibration were assessed. 2 medical staff assessed 20 patients with the Chinese version PRE-DELIRIC and E-PRE-DELIRIC,while the intraclass correlation coefficients were accumulated to evaluate the inter-rater reliability. Results The average scores of PRE-DELIRIC were46.41 ± 14.05in delirium group and20.08 ± 9.96 in patients without delirium, the difference between scores was statistically significant (t=14.34, P<0.05). The average scores of E-PRE-DELIRIC were36.23±13.34in delirium group and14.45±9.56 in patients without delirium, the difference between scores was statistically significant (t=14.59, P<0.05). The AUROCC and its 95％CI of the PRE-DELIRIC and E-PRE-DELIRIC for prediction of delirium were 0.928(0.891-0.965) and 0.904(0.861-0.947) respectively in all patients. Discrimination was generally good for two models. The PRE-DELIRIC and E-PRE-DELIRIC sensitivity were 0.841, 0.812, specificity was 0.939, 0.913, the threshold values of PRE-DELIRIC model was 36.5％and E-PRE-DELIRIC model was 30.5％. The Youden′s index of PRE–DELIRIC model was 0.779, which better than 0.725 of E-PRE-PREDIRIC model. Conclusions The PRE-DELIRIC and E-PRE-DELIRIC models both have high accuracy in predicting delirium of patients in intensive care unit. PRE-DELIRIC does better performance than E-PRE-DELIRIC, but has imitation in terms of time. E-PRE-DELIRIC model can be used in ICU patients who develop delirium within 24 h following admission.
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Objective To observe the clinical efficacy of extracorporeal shock wave (ESW) plus electroacupuncture in treating periarthritis of shoulder.Method Ninety patients with periarthritis of shoulder were randomized into an electroacupuncture (EA) group, an ESW group, and an ESW plus EA group, 30 cases in each group. The EA group was intervened by EA, the ESW group was treated with ESW, and the ESW plus EA group by ESW and EA. The three groups were treated once every 2 d, with successive 10 sessions as a treatment course. The Visual Analogue Scale (VAS) score and shoulder range of motion (ROM) score were evaluated before and after the treatment in the three groups. Result The VAS scores dropped significantly in the three groups after the intervention (P0.05); the VAS score in the ESW plus EA group was significantly different from that in the EA group and ESW group after the treatment (P0.05); the ROM score in the ESW plus EA group was significant different from that in the other two groups (P<0.05).Conclusion ESW plus EA can more significantly ease the pain and improve the shoulder ROM in treating periarthritis of shoulder compared with the two methods used separately.
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Objective To observe the clinical efficacy of Zhuang’s Moxibustion plus acupuncture in treating spastic paralysis due to craniocerebral injury.Method Ninety-two patients with spastic paralysis due to craniocerebral injury were randomized into a treatment group of 60 cases and a control group of 32 cases. The control group was intervened by conventional internal medicine and rehabilitation, while the treatment group was intervened by Zhuang’s moxibustion plus acupuncture in addition to the intervention given to the control group. The modified Ashworth Scale (MAS) was adopted to evaluate the clinical efficacy.Result The total effective rate was 75.0% in the treatment group versus 65.6% in the control group, and the between-group difference was statistically significant (P<0.01).Conclusion Zhuang’s moxibustion plus acupuncture is an effective approach in treating spastic paralysis due to craniocerebral injury.
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Objective To investigate the effect of acupuncture combined with antidepressant on behavioral changes and 5-hydroxytryptamine 1A and 2A receptor ( 5-HT1AR and 5-HT2AR) mRNA expression in nucleus raphes dorsalis (NRD) of sleep deprivation depression (SDD) rats. Methods Eight normal Sprague Dawley (SD) rats were caged together without any stimulus or treatment, serving as the normal group. Thirty-two SD rats were given solitary raise for 21 days, together with chronic unpredictable mild stress ( CUMS) and rapid eye movement ( REM) sleep deprivation to establish the model. Twenty-eight rats completed the modeling successfully, and were divided into model group, acupuncture group, medicine group, and combination group, 7 rats in each group. Rats in the model group were given modeling treatment but without any intervention. Rats in the acupuncture group were given acupuncture on acupoint Yintang, Shenting and bilateral Taichong, acupuncture stimulation lasting 15 s every 10 min and acupuncture retention for 20 min in each day. Rats in the medicine group were given gastric gavage of Zoloft solution (0.83 mg·kg-1·d-1) and Alprazolam solution (0.067 mg· kg-1·d-1) , and rats in the combination group were given both acupuncture and medicine intervention. The intervention for the three intervention groups lasted for 7 days. Results Compared with the normal group, body weight, Open-field scores and sucrose preference of the model rats were significantly decreased on modeling day 7, 14, 21 (P<0.05). On modeling day 28, body weight and Open-field scores of each intervention group were significantly increased compared with those of the model group (P<0.05), and Open-field scores of combination group differed from those of acupuncture group and medicine group ( P<0.05). Only sucrose preference of combination group was improved significantly compared with the model group (P<0.05). Compared with the model group, NRD 5-HT1AR mRNA expression level was increased in the combination group (P<0.05), and NRD 5-HT2AR mRNA expression level was down-regulated in all of the three intervention groups ( P<0.05). Conclusion Acupuncture and antidepressant treatment covering 7 days can evoke rapid effect on SDD rats, which can improve the slow effect of antidepressant.