Clinical evaluation of pelvic floor rehabilitation training for patients with pelvic floor dysfunction after delivery via vagina / 中国基层医药

To observe the clinical effect of pelvic floor rehabilitation training on patients with pelvic floor dysfunction after delivery through vagina.Methods From January 2017 to December 2017,96 patients with pelvic floor dysfunction treated in the Maternal and Child Health Hospital of Lishui were randomly selected for clinical study.The patients were divided into observation group and control group by random number method ,with 48 cases in each group.The control group was given pelvic floor dysfunction knowledge education , psychological counseling and general treatment methods such as guiding patients to perform functional exercises .The observation group received pelvic floor rehabilitation training on the basis of the treatment plan of the control group .The symptoms related to pelvic floor dysfunction,pelvic floor contraction ability before and after treatment ,pelvic floor function and sexual quality of life were compared between the two groups.Results The incidence rates of clinical symptoms such as organ prolapse ,urinary incontinence ,asexuality and sexual intercourse pain in the observation group were 8.33%, 6.25%,8.33%and 10.42%,respectively,which were significantly lower than those in the control group (25.00%, 27.08%,22.92%and 27.08%) ( χ2 ＝4.800,P＝0.028;χ2 ＝7.500,P＝0.006;χ2 ＝3.872,P＝0.049;χ2 ＝4.376,P＝0.036).There was no statistically significant difference between the two groups in grade I -V before treat-ment(P＞0.05).After treatment,there were 2 cases,4 cases,8 cases,18 cases and 17 cases in the observation group with grade I-V,which were significantly better than those in the control group (8 cases,7 cases,10 cases,16 cases and 7 cases),and there was statistically significant difference (χ2 ＝8.102,P＝0.044).After treatment,the pelvic floor muscle tension of the observation group was higher than that of the control group [(4.16 ±0.33) grades vs. (3.84 ±0.27) grades],the difference was statistically significant ( t ＝5.200,P＝0.000).The sexual life quality score of the observation group was (87.33 ±10.24)points,which was significantly higher than (78.62 ±8.29)points in the control group(t＝4.580,P＝0.000).The total effective rate of the observation group was 95.83%,which was significantly higher than that of the control group (83.33%,χ2 ＝4.019,P＝0.048).Conclusion Pelvic floor rehabilitation training has good clinical effect on pelvic floor dysfunction after vaginal delivery .It can significantly improve pelvic floor function and sexual life ability ,improve pelvic floor muscle tension and reduce visceral prolapse. It has important clinical application value.

Comparison of the effects of early pelvic floor muscle rehabilitation on postpartum pelvic floor rehabilitation and sexual function in different delivery methods / 中国基层医药

Objective@#To observe the effect of early pelvic floor muscle rehabilitation on postpartum pelvic floor rehabilitation and sexual function in different delivery methods.@*Methods@#Ninety-three parturient women who admitted to the Department of Obstetrics and Gynecology in Taizhou Hospital from January 2018 to December 2018 were divided into cesarean section group (53 cases) and vaginal delivery group (40 cases) according to the mode of delivery.Early pelvic floor muscle rehabilitation was performed in both two groups.Maternal pelvic floor rehabilitation was assessed by pelvic floor muscle pressure and muscle fiber contraction, and maternal sexual function was assessed by sexual function status score.@*Results@#Before treatment, the sustained systolic blood pressure of type Ⅰ muscle fibers[(28.14±3.03)cmH2O vs.(27.66±3.14)cmH2O], the duration of type Ⅰ muscle fibers[(9.54±1.04)s vs.(9.66±1.00)s], the rapid systolic blood pressure of type Ⅱ muscle fibers[(48.14±3.03)cmH2O vs.(47.66±3.14)cmH2O], and the contraction of type Ⅱ muscle fibers[(2.54±1.04) vs.(2.66±1.00)] had no statistically significant differences between the two groups (t=0.401, 0.312, 2.401, 0.324, all P>0.05). After treatment, the sustained systolic blood pressure of type Ⅰ muscle fibers, duration of type Ⅰ muscle fibers, rapid systolic blood pressure of type Ⅱ muscle fibers, and the contraction of type Ⅱ muscle fibers had statistically significant differences between the two groups (t=10.642, 10.214, 10.672, 10.254, all P<0.05). There were no statistically significant differences in resting pressure and pelvic systolic pressure between the two groups before intervention (all P>0.05). After intervention, both two indicators were elevated, and the differences were statistically significant compared with before treatment (t=12.093, 14.152, all P<0.05). The resting pressure and pelvic systolic pressure in the cesarean section group were higher than those in the vaginal delivery group, the differences were statistically significant (t=11.642, 10.234, all P<0.05). Compared with before intervention, the indicators and total scores of sexual function in the cesarean section group were better than those in the vaginal delivery group, the differences were statistically significant (t=15.401, 17.312, 19.645, 19.401, 17.312, all P<0.05). After intervention, the maternal sexual function indicators and total score in the two groups were increased, and the differences between the two groups were not statistically significant (t=0.642, 1.214, 0.468, 0.668, 0.068, all P> 0.05).@*Conclusion@#Early pelvic floor rehabilitation is beneficial to the recovery of pelvic floor and sexual function.

Clinical evaluation of pelvic floor rehabilitation training for patients with pelvic floor dysfunction after delivery via vagina / 中国基层医药

Objective@#To observe the clinical effect of pelvic floor rehabilitation training on patients with pelvic floor dysfunction after delivery through vagina.@*Methods@#From January 2017 to December 2017, 96 patients with pelvic floor dysfunction treated in the Maternal and Child Health Hospital of Lishui were randomly selected for clinical study.The patients were divided into observation group and control group by random number method, with 48 cases in each group.The control group was given pelvic floor dysfunction knowledge education, psychological counseling and general treatment methods such as guiding patients to perform functional exercises.The observation group received pelvic floor rehabilitation training on the basis of the treatment plan of the control group.The symptoms related to pelvic floor dysfunction, pelvic floor contraction ability before and after treatment, pelvic floor function and sexual quality of life were compared between the two groups.@*Results@#The incidence rates of clinical symptoms such as organ prolapse, urinary incontinence, asexuality and sexual intercourse pain in the observation group were 8.33%, 6.25%, 8.33% and 10.42%, respectively, which were significantly lower than those in the control group (25.00%, 27.08%, 22.92% and 27.08%) (χ2=4.800, P=0.028; χ2=7.500, P=0.006; χ2=3.872, P=0.049; χ2=4.376, P=0.036). There was no statistically significant difference between the two groups in grade I-V before treatment(P>0.05). After treatment, there were 2 cases, 4 cases, 8 cases, 18 cases and 17 cases in the observation group with grade I-V, which were significantly better than those in the control group (8 cases, 7 cases, 10 cases, 16 cases and 7 cases), and there was statistically significant difference (χ2=8.102, P=0.044). After treatment, the pelvic floor muscle tension of the observation group was higher than that of the control group[(4.16±0.33)grades vs.(3.84±0.27)grades], the difference was statistically significant(t=5.200, P=0.000). The sexual life quality score of the observation group was (87.33±10.24)points, which was significantly higher than (78.62±8.29)points in the control group(t=4.580, P=0.000). The total effective rate of the observation group was 95.83%, which was significantly higher than that of the control group (83.33%, χ2=4.019, P=0.048).@*Conclusion@#Pelvic floor rehabilitation training has good clinical effect on pelvic floor dysfunction after vaginal delivery.It can significantly improve pelvic floor function and sexual life ability, improve pelvic floor muscle tension and reduce visceral prolapse.It has important clinical application value.

Comparison of the effects of early pelvic floor muscle rehabilitation on postpartum pelvic floor rehabilitation and sexual function in different delivery methods / 中国基层医药

Objective To observe the effect of early pelvic floor muscle rehabilitation on postpartum pelvic floor rehabilitation and sexual function in different delivery methods.Methods Ninety-three parturient women who admitted to the Department of Obstetrics and Gynecology in Taizhou Hospital from January 2018 to December 2018 were divided into cesarean section group (53 cases) and vaginal delivery group (40 cases) according to the mode of delivery.Early pelvic floor muscle rehabilitation was performed in both two groups.Maternal pelvic floor rehabilitation was assessed by pelvic floor muscle pressure and muscle fiber contraction ,and maternal sexual function was assessed by sexual function status score.Results Before treatment,the sustained systolic blood pressure of type Ⅰ muscle fibers[(28.14 ±3.03)cmH2 O vs.(27.66 ±3.14)cmH2 O],the duration of type Ⅰ muscle fibers[(9.54 ±1.04)s vs.(9.66 ±1.00) s], the rapid systolic blood pressure of type Ⅱ muscle fibers [( 48.14 ±3.03 ) cmH2 O vs. (47.66 ±3.14)cmH2 O],and the contraction of type Ⅱmuscle fibers[(2.54 ±1.04) vs.(2.66 ±1.00)] had no statistically significant differences between the two groups ( t ＝0.401,0.312,2.401,0.324,all P＞0.05).After treatment,the sustained systolic blood pressure of type Ⅰ muscle fibers, duration of type Ⅰ muscle fibers, rapid systolic blood pressure of type Ⅱmuscle fibers,and the contraction of type Ⅱmuscle fibers had statistically signifi-cant differences between the two groups (t＝10.642,10.214,10.672,10.254,all P＜0.05).There were no statisti-cally significant differences in resting pressure and pelvic systolic pressure between the two groups before intervention (all P＞0.05).After intervention,both two indicators were elevated ,and the differences were statistically significant compared with before treatment (t＝12.093,14.152,all P＜0.05).The resting pressure and pelvic systolic pressure in the cesarean section group were higher than those in the vaginal delivery group ,the differences were statistically significant (t＝11.642,10.234,all P＜0.05).Compared with before intervention ,the indicators and total scores of sexual function in the cesarean section group were better than those in the vaginal delivery group ,the differences were statistically significant (t＝15.401,17.312,19.645,19.401,17.312,all P＜0.05).After intervention,the maternal sexual function indicators and total score in the two groups were increased ,and the differences between the two groups were not statistically significant (t＝0.642,1.214,0.468,0.668,0.068,all P＞0.05).Conclusion Early pelvic floor rehabilitation is beneficial to the recovery of pelvic floor and sexual function .

Efficacy and safety of enhanced recovery after surgery concept combined with precise hepatectomy for the treatment of hepatocellular carcinoma / 中华普通外科杂志

Objective To investigate the safety and efficiency of enhanced recovery after surgery (ERAS) concept combined with precise hepatectomy (EP) in the treatment of hepatocellular carcinoma (HCC).Methods 393 HCC patients admitted to the Affiliated Provincia Hospital of Anhui Medical University were divided into group EP (n =73),precise hepatectomy group P (n =55),group ERAS (n =118) and conventional hepatectomy group C (n =147).Outcome measures were postoperative length of stay (LOS),hospital charges,postoperative complication,numerical rating scale (NRS) on postoperative 24 h,48 h,time to ambulation and first passage of flatus,readmission rate,mortality.Results Compared to group P,patients in group EP had significantly shorter postoperative LOS (F =4.573,P ＜ 0.05),less hospital charges(F =3.090,P ＜ 0.05),lower NRS on postoperative 24 h,48 h (F =5.235,7.456,P ＜ 0.05),shorter time to ambulation (x2 =41.387,P ＜ 0.05) and first passage of flatus (F =0.387,P ＜ 0.05).Compared with the group ERAS,the group EP had significantly lower general postoperative complications (x2 =2.967,P ＜ 0.05).Conclusion ERAS concept combined with precise hepatectomy could optimize surgical treatment of patients with hepatocellular carcinoma.

Fast track surgery in laparoscopic liver resection / 中华普通外科杂志

Objective To evaluate the value of fast track surgery (FTS) in laparoscopic hepatectomy.Methods The clinical data of 142 patients undergoing laparoscopic liver resection from January 2014 to January 2016 were analyzed retrospectively.74 patients received fast track surgery treatment (FTS group) and 68 patients received traditional treatment methods (control group).Results Compared with control group,FTS group had a shorter operative time and less blood lose (t =2.279,t =2.432,P ＜0.05),quicker postoperative intestinal function recovery (t =3.548,P ＜ 0.05),a shorter postoperative hospitalization time (t =2.821,P ＜ 0.05),a lower hospitalization cost (t =2.507,P ＜ 0.05),a lower postoperative VAS scores (t =3.394,t =3.176,t =7.079,P ＜ 0.05) in 3 post-op successive days.There were 3 patients with major post-op complications in FTS group (4.05％,3/74) compared with 4 cases in control group (5.88％,4/68) (x2 =0.253,P ＞ 0.05).Conclusion The application of fast track surgery in laparoscopic liver resection is safe and effective,and helpful in reducing patients' inhospital cost.

The applications of enhanced recovery after surgery in laparoscopic hepatectomy: a retrospective cohort study / 中华普通外科杂志

Objective To investigate the safety and effectiveness during perioperative period in patients undergoing laparoscopic hepatectomy under ERAS program.Methods A retrospective study was carried out,in 40 patients under ERAS programs from Sep 2016 to Aug 2017 compared with 40 patients in control group from Sep 2015 to Aug 2016 in intraoperative central vein pressure,blood loss,postoperative stress indicators,the incidence of moderate to severe pain,exhaust time,oral feeding time,ambulation time,complications,hospital stays and costs and patient satisfaction.Results Compared with control group,the intraoperative blood loss was decreased by controlling central venous pressure (t =2.556,P =0.013),earlier exhaust,oral intake of food and ambulation (P ＜0.001),lower incidence rate of moderate to severe pain (x2 =11.314,P ＜ 0.001),and higher patient satisfaction (t =6.816,P ＜ 0.001) in ERAS group,though there were no significant differences in extubation time (t =0.336,P =0.738).The average hospital stays were 2.8 days shorter (16.6 ± 3.0 vs.19.4 ± 6.4,t =2.514,P =0.015),and hospital expenses were (￥)6 000 less than control group (5.4 ±0.7 vs.6.0± 1.5,t =2.338,P =0.023).Conclusion ERAS programs applied to patients undergoing laparoscopic hepatectomy can safely and effectively accelerate patient recovery.

ERAS in the treatment of cholecystolithiasis complicating extrahepatic bile duct stones by combination of laparoscopy and choledochoscopy / 中华普通外科杂志

Objective To evaluate enhanced recovery after surgery (ERAS) in the treatment of cholecystolithiasis complicated with extra hepaticbile duct stones by laparoscopy and choledochoscopy.Methods Patients were divided into ERAS and control groups according to the inclusion and exclusion criteria.Patients in ERAS group received perioperative management according to enhanced recovery rehabilitation program.Clinical and laboratory results were compared between the two groups.Results 46 patients were enrolled into ERAS group and 40 patients into control group.The ERAS group had shorter time of first postoperative exhaust,first postoperative oral intake,getting out of bed,removal of abdominal drainage tube,postoperative hospital stay (respectively t =-3.658,-15.552,-8.864,-6.673,-6.036,all P ＜ 0.05),less pain in 6,12,24 and 48 hours after operation (F =8.284,P =0.000),and lower complication rate (x2 =4.172,P =0.043),lower C-reactive protein (CRP) level from pre-operation to postoperative day 1,3 and 5 (F =6.692,P =0.013),higher level of prealbumin (PA) from preoperation to postoperative day 1,3 and 5 (F =21.191,P =0.000),lower hospitalization costs (t =-0.592,P =0.004).Conclusion The application of ERAS in the treatment of cholecystolithiasis complicated with extrahepatic bile duct stones by laparoscopy combined with choledochoscopy is conducive to rapid postoperative recovery of patients.

The value of enhanced recovery after surgery (ERAS) in laparoscopic precise liver resection / 中华普通外科杂志

Objective To explore the value of enhanced recovery after surgery (ERAS) in laparoscopic precise liver resection.Methods A total of 62 patients receiving laparoscopic precise liver resection in our hospital from January 2014 to June 2016 were devided into ERAS group (n =31) and control group (n =31).Postoperative recoveries were compared between the 2 groups of patients.Result Compared with control group,off bed time,eating time,postoperative exhaust time,postoperative hospitalization time in ERAS group were significantly shorter than those in control group (P ＜ 0.05),there were lower numerical scale (NRS) 24,48 h postoperative,and CRP levels on postoperative day 1,3 (P ＜ 0.05).All patients were followed up (range,3-33 months),there were no difference in tumor recurrence and metastasis,hepatic dysfunction,death rate at the end of follow-up (P ＞ 0.05).Conclusion ERAS management improved postoperative recovery,and decreased complications.

Effect of sensory integration training on motor function of cerebral palsy children / 中国基层医药

Objective To observe the effect of sensory integration training on motor function of cerebral palsy children.Methods 42 children with cerebral palsy were divided into two groups,with 22 cases in observation group,20 cases in control group.All children were treated with mainly Bobath technique based rehabilitation therapy,while those of observation group were added sensory integration training for 3 months.We used GMFM-88 to estimate the gross motor function of the two groups.Results After treatment,the scores of GMFM-88 significantly improved in both groups,GMFM scores of the observation group were more effective than thoes of the control group(t =2.481,P =0.018).Conclusion Sensory integration training based on tradition neural movement therapy can improve gross motor function in children with cerebral palsy,can significantly improve the curative effect of rehabilitation.

Rehabilitation effect research of electro-acupuncture combined with computer aided training on brain injury patients with cognitive deficits / 中华全科医师杂志

A total of 60 brain injury patients with cognitive impairment were randomly divided into electro-acupuncture,computer and combination groups (n =20 each).The electro-acupuncture group received electroacupuncture,computer group cognitive rehabilitation training with specialized equipment and combination group both regimens.The treatment lasted for 2 months.Before training,Loewenstein occupational therapy cognitive assessment (LOTCA) test was not statistically significant among all groups (P 8 0.05).After 1 month,the combination group scored higher than pre-training (P ＜ 0.05).After 2 months,the scores of all groups were higher than pre-training(P ＜ 0.05).After 1 and 2-month training,the combination group scored higher than the other two groups in aspects of consciousness,optomotor tissue,attention,thinking and aggregate score (P ＜ 0.05).However,the orientation scores of all groups changed insignificantly after 1-month training (P 8 0.05),the combination group scored higher than the other two groups in improved orientation after 2 months (P ＜ 0.05).