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Objective:To evaluate and summarize the best evidence for early rehabilitation of adults with veno-venous extracorporeal membrane oxygenation (VV-ECMO).Methods:Evidence on early rehabilitation of adult VV-ECMO patients was searched by computer from 7 English literature databases [PubMed database, cumulative index to nursing and allied health literature (CINAHL), Embase database, Cochrane library database, UpToDate clinical consultant, BMJ best clinical practice, JBI database], 5 Chinese literature databases (China biomedical literature database, China Yimai Tong, China national knowledge infrastructure, Wanfang data, VIP database), 5 guideline networks [National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), China Guide Network] and 2 professional association websites [Extracorporeal Life Support Organization (ELSO), Chinese Association of Rehabilitation Medicine]. The search period is from January 2011 to December 2021. The appraisal of guidelines for research and evaluation Ⅱ (AGREE ) and JBI 2014 quality assessment tools were used to evaluate the quality of inclusion guidelines, systematic reviews, expert consensus and original studies, respectively, and to extract and summarize the best evidence for early rehabilitation of adults with VV-ECMO.Results:A total of 2 guidelines, 2 expert consensuses, 2 systematic reviews and 8 original studies [including 1 randomized controlled trial (RCT), 1 non-randomized controlled study, 3 cohort studies and 3 case reports] were included. The evidence was summarized from 9 aspects including the necessity of early rehabilitation, rehabilitation initiation time, rehabilitation location, pre-rehabilitation preparation, pre-rehabilitation assessment, rehabilitation method, rehabilitation frequency and duration, rehabilitation process monitoring and effect evaluation,and finally 24 pieces of the best evidence were summarized.Conclusion:Early rehabilitation of adults with VV-ECMO is safe and feasible. The summary of the best evidence can provide evidence-based guidance for clinical medical staff to reasonably carry out early rehabilitation.
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Objective@#To investigate the nursing effect of clinical treatment combined with early rehabilitation nursing intervention in patients with heart failure.@*Methods@#A total of 60 cases of patients with heart failure from January 2018 to May 2018 in Beijing Anzhen Hosipital, Capital Medical University were admitted. They were divided into control group (30 cases) and observation group (30 cases) by random digits table method. All patients in 2 groups were treated with clinical treatment, while those in control group were treated with conventional nursing and observation group combined with early rehabilitation nursing intervention. Echocardiogram, 6 min walking test (6MWT), body composition analyzer (measuring extracellular moisture ratio) and body mass index (BMI) was used to evaluate the changes of all indexes before and after nursing care in 2 groups.@*Results@#Using the receiver operating characteristic curve(ROC) of extracellular moisture ratio to predict heart failure, the area under the curve (AUC) of patients with heart failure was predicted to be 0.737(P<0.01). Analysis of the correlation between the decrease of extracellular moisture ratio after treatment and the increase of walking distance after 6 minutes of treatment showed a positive correlation. With the decrease of extracellular water ratio after treatment, the 6MWT distance increased continuously after treatment (r=0.164, P=0.032). In the observation group, the 6 minute walking distance, extracellular water ratio, the added value of BMI, added value of 6 minute walking distance after treatment, after treatment of extracellular water reducing ratio, and BMI lower values were (438.76±89.16) m, (0.380±0.021)%, (24.74±3.13) kg/m2, (129.20±18.62) m, 0.010±0.006, (2.71±0.89) kg/m2, respectively. The control group were (356.40±85.28) m, (0.384±0.014)%, (25.93±2.68) kg/m2, (60.25±8.43) m, 0.009±0.008, (1.37±0.85) kg/m2. The differences between the two groups were statistically significant (t=1.726-15.739, P<0.05).@*Conclusions@#The extracellular moisture ratio indicates the degree of heart failure. Clinical treatment combined with early rehabilitation nursing intervention is superior to conventional nursing in patients with heart failure, which can significantly increase the patient′s 6MWT and reduce the patient′s BMI, which is worth popularizing and applying.
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Objective To investigate the medication combined with early rehabilitation nursing intervention to reduce the disability rate of the patients with cerebral thrombosis. Methods 80 cases of acute cerebral thrombosis patients from January 2014 to December 2016 were selected as the research object. According to the principle of single blind random allocation, patients were randomly divided into two groups with 40 cases in each group. The control group received routine treatment and nursing intervention, and the observation group was given early rehabilitation nursing intervention on the basis of the control group. Neurological deficit scores, Barthel index, FMA limb function score, quality of life score and prognosis were compared between the two groups. Results After the intervention, the neurological deficit scores of the two groups were significantly decreased (P<0.05), and the scores of Barthel index and FMA were significantly increased (P<0.05), and the scores of the intervention group were better than those of the control group (P<0.05). The quality of life of the observation group was significantly higher than that of the control group (P<0.05). The prognosis was superior to the control group (P<0.05). Conclusion Early rehabilitation nursing intervention can effectively promote the neurological function, daily self-care ability and recovery of limb motor function in patients with acute cerebral thrombosis, which is beneficial to reduce morbidity and improve the quality of life and prognosis of patients.
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Objective To investigate the medication combined with early rehabilitation nursing intervention to reduce the disability rate of the patients with cerebral thrombosis. Methods 80 cases of acute cerebral thrombosis patients from January 2014 to December 2016 were selected as the research object. According to the principle of single blind random allocation, patients were randomly divided into two groups with 40 cases in each group. The control group received routine treatment and nursing intervention, and the observation group was given early rehabilitation nursing intervention on the basis of the control group. Neurological deficit scores, Barthel index, FMA limb function score, quality of life score and prognosis were compared between the two groups. Results After the intervention, the neurological deficit scores of the two groups were significantly decreased (P<0.05), and the scores of Barthel index and FMA were significantly increased (P<0.05), and the scores of the intervention group were better than those of the control group (P<0.05). The quality of life of the observation group was significantly higher than that of the control group (P<0.05). The prognosis was superior to the control group (P<0.05). Conclusion Early rehabilitation nursing intervention can effectively promote the neurological function, daily self-care ability and recovery of limb motor function in patients with acute cerebral thrombosis, which is beneficial to reduce morbidity and improve the quality of life and prognosis of patients.
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Objective To investigate the clinical treatment of neonatal bilirubin encephalopathy (ABE)and the specif-ic care measures. Methods Selected 168 cases of ABE in our hospital,and 78 cases of children admitted from January 2011 to January 2012,implementation of routine care for all children,set C2 group(control group); 90 cases of chil-dren admitted. C1 group (observation group)was from January 2012 to January 2013. Given children with early reha-bilitation nursing intervention. After clinical condition was stable in C1 group of children, caregivers for children with auditory stimuli implemented, visual stimulation and olfactory stimuli, such as a series of measures to care for the children. C1 and C2 group of children with MDI,PDI and intelligent case of children were compared. Results C1 group of children in each time period PDI and MDI,and C2 groups of children were compared,both showed significant im-provement(P<0.05);In mental abnormality rate,C1 group was lower than the C2 group(P<0.05). Conclusion ABE for neonatal patients given early rehabilitation nursing intervention can significantly promote children's motor development and mental development,improve the quality of clinical outcomes in patients with significant effect.
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@#The traumatic brain injury(TBI)is the main cause of death and disability after earthquake.The rehabilitation should intervene as earlier as possible.This paper would introduce some rehabilitation approaches practically.
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@#The traumatic brain injury(TBI)is the main cause of death and disability after earthquake.The rehabilitation should intervene as earlier as possible.This paper would introduce some rehabilitation approaches practically.