High-voltage electric burns is refractory with high rate of amputation (46%) in early stage and unfavorable functional recovery in later stage. Little breakthrough has so far been made in this respect. From Jan. 1985 to Jan. 1996, ninety-six cases with high-voltage burns were treated in our department. Seventy-one cases of various tissue flap grafting were applied to treat early electric burns, among which sixty-four cases were successful. The amputation rate was reduced to 30%. Postoperatively, a long-term rehabilitation training at home was carried out. Most of them achieved a good appearance of the wounded sites and limbs and satisfactory ability to work or self-care. It was suggested that early thorough debridement of necrosis tissue, careful reservation of living tissue, appropriate choice of tissue flap and postoperative rehabilitation training were of great importance to achieve a good prognosis.
Objective To observe the effect of comprehensive rehabilitation in patients with peripheral nerve injuries after the Wenchuan earthquake. Methods A total of 24 cases of peripheral nerve injuries who were admitted to the Rehabilitation Center for Earthquake Victims of West China Hospital of Sichuan University were treated with comprehensive rehabilitation, including exercise therapy, acupuncture therapy, functional electrical stimulation, and occupational therapy (mainly sensory training and wearing orthosis). After 30 treatment sessions, patient motor and sensory function, upper limb functional activity, and electrodiagnostic parameters were evaluated. Meanwhile, concomitant injuries were also recorded. Results As for the recovery of motor and sensory functions, the effective rate was 41.66%. The difference in the scores of upper limb functional activities was statistically significant before and after treatment (Plt;0.01). As assessed by electromyogram and nerve conduction velocity, the response rate was 87.50%. Patients with more concomitant injuries were likely to have slower recovery. Conclusion Comprehensive rehabilitation is appropriate and effective for patients with peripheral nerve injuries after the Wenchuan earthquake.
ObjectiveTo explore the effects of rehabilitation therapy on postoperative pulmonary function and exercise capacity of patients with lung cancer during the hospitalization in the setting of enhanced recovery after surgery (ERAS) protocols.MethodsA total of 110 lung cancer patients undergoing thoracoscopic lobectomy in the Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from September 2017 to December 2018 were randomly divided into the rehabilitation treatment group (the trial group, n=54) and the non-rehabilitation treatment group (the control group, n=56). The trial group got out of bed within 24 hours after surgery and performed respiratory rehabilitation training. The control group did not receive rehabilitation after surgery. Pulmonary function and 6-minute walking distance (6MWD) were evaluated preoperatively and prior to discharge in both groups to compare the differences in pulmonary function and exercise capacity between the two groups.ResultsThe preoperative forced vital capacity (FVC) in the trial group and the control group were (2.45±0.57) and (2.47±0.61) L, respectively; the forced expiratory volume in the first second (FEV1) were (2.29±0.55) and (2.22±0.55) L, respectively; 6MWD were (592±51) and (576±57) m, respectively; the differences between the two groups were not statistically significant (P>0.05). Prior to discharge, the FVC in the trial group and the control group were (1.43±0.36) and (1.19±0.33) L, respectively; FEV1 were (1.28±0.32) and (1.06±0.61) L, respectively; 6MWD were (264±43) and (218±37) m, respectively. The results of pre-discharge evaluation were significantly lower than those of preoperative evaluation (P<0.01). The pre-discharge FVC, FEV1, and 6MWD in the trial group were significantly superior to those in the control group (P<0.01).ConclusionIn the setting of ERAS protocols, postoperative rehabilitation therapy during hospitalizations can improve pulmonary function and promote the recovery of exercise capacity in lung cancer patients more effectively.
目的：探讨5·12汶川地震致脊髓损伤患者神经源膀胱的康复治疗方法。方法：通过对35例脊髓损伤患者神经源膀胱康复治疗的总结回顾，观察采用制定饮水计划，间歇性导尿，药物治疗，膀胱功能训练，手术治疗等方法治疗神经源膀胱的疗效。结果：经过综合治疗，35例患者的神经源膀胱都得到了不同程度的改善。结论：地震致脊髓损伤发生率高，而神经源膀胱是其重大并发症之一，危害患者生命，重建脊髓损伤后患者的膀胱功能对于提高截瘫患者的生活质量，降低死亡率具有十分重要的意义。
Objective To explore the effect of early rehabilitation treatment on complications and prognosis of elderly patients with sever pneumonia undergoing mechanical ventilation. Methods The patients who meeting the inclusion criteria were randomly divided into an early rehabilitation group and a control group, with 35 cases in each group. On basis of same routine treatment, the early rehabilitation group was treated with early rehabilitation. The early rehabilitation methods included exercise therapy, electrical stimulation therapy, swallowing therapy, cough training and wheelchair-bed transfer training, etc. The patients received individual training methods according to their conditions. The difference of two groups were observed in the rates of ICU-acquired weakness (ICU-AW), ventilator-associate pneumonia (VAP), the incidence of delirium, the mechanical ventilation time, ICU-hospital time, total hospital time, 30-day hospital mortality, extubation fail rate and tracheotomy rate. Results Compare with the control group, the incidence of ICU-AW (14.28% vs. 37.14%), VAP (8.57% vs. 28.57%), and delirium (40.00% vs. 65.71%) in the early rehabilitation group were significantly reduced (all P<0.05). The duration of delirium [(3.50±1.31) dvs. (6.40±1.47) d], the ventilation time [(6.32±2.19) d vs. (9.40±4.43) d], ICU hospitalization time [(10.80±3.64) d vs. (15.31±3.85) d] and total hospitalization time [(22.52±7.56) d vs. (30.22±11.54) d] of the early rehabilitation group were significantly lower than the control group (all P<0.001). The tracheotomy rate and 30-day hospital mortality of the early rehabilitation group were significantly lower than the control group (25.71%vs. 51.42% and 28.57% vs. 54.28%, both P<0.05). There was no significant difference in extubation fail rate (5.71%vs. 11.42%, P>0.05). In the early rehabilitation group, there were no complications such as pipe prolapse, limb injury or serious arrhythmia. Conclusion Early rehabilitation can reduce the incidence of ICU-AW, VAP, delirium in elderly patients with severe pneumonia, help to shorten the mechanical ventilation time, ICU hospitalization time and total hospitalization time, reduce extubation failure rate and tracheotomy rate, so it is safe and effective, and worthy of being popularized and applied.
目的:探讨以5E为核心的康复治疗对改善血液透析患者抑郁的作用。方法:50例维持性血液透析大于3个月患者纳入本研究,使用汉密顿抑郁量表(HAMD)分别在研究开始、研究结束时评估患者的抑郁症状,对患者实施以5E为核心的康复干预,主要内容包括鼓励、教育、锻炼、工作及评估。随访6个月观察患者抑郁症状的变化。结果:50例患者完成随访研究,研究终末时具有具有抑郁症状患者由开始时的28例减少到11例。患者在研究开始与随访6月时患者抑郁症状的发生率与抑郁评分分别为(56%比22%,χ2=37,Plt;005)与［(67±51)比(50±47),t=273,Plt;005］。患者在随访终末时抑郁症状的发生率及抑郁评分较研究开始时均显著降低。结论:本研究表明以5E为核心的康复治疗能明显改善维持性血液透析患者的精神症状。
目的：通过观察神经肌电促通仪结合常规康复治疗对肌力恢复的影响，指导术后康复治疗的方式。方法:单纯上/下肢骨折术后患者80例，随机分为治疗组43例（神经肌电促通仪加常规康复治疗）和对照组37例（仅常规康复治疗）。通过徒手肌力评定法（manual muscle test,MMT）对治疗前后的肌力变化进行观察和记录。结果:根据徒手肌力评定（MMT）标准，按6级法记录，治疗组骨折区的伸、屈肌肌力均能达到5级者15例，部分伸、屈肌能达到5级或肌力在原基础提高3级以上者19例，骨折区的伸、屈肌肌力增加1～2级者9例；对照组骨折区的伸、屈肌肌力均能达到5级者7例，部分伸、屈肌能达到5级或肌力在原基础提高3级以上者14例，骨折区的伸、屈肌肌力增加1～2级者16例。两组比较临床显效率的差异有统计学意义（P＜0.05）。结论：神经肌电促通仪结合康复治疗对肢体骨折术后患者肌力的恢复优于常规康复治疗。
A 7.0 Ms earthquake hit Lushan country at Ya’an city of Sichuan province at 8:02 am, on April 20th, 2013. Rehabilitation medicine department of the West China Hospital, a regional state-level hospital arrived at stricken area, and super early rehabilitation rescue was organized at the second day after Lushan earthquake. On the third day after Lushan earthquake, patients receiving super early rehabilitation intervention were moved forward to orthopedics, neurosurgery, thoracic surgery, pediatric surgery and ICU for super early rehabilitation intervention. Up to 6 pm, 14 days after the earthquake, 69 wounded in total were admitted in early rehabilitation. The experiences of Wenchuan earthquake has been applied, improved and sublimated more rapidly, more appropriately, more effectively in the Lushan earthquake rehabilitation rescue.