论著

集体呼吸操对慢阻肺稳定期患者的执行率影响研究

Study on the effect of collective breathing exercises on the execution rate of patients with stable COPD

:77-80
 
目的 研究集体呼吸操对慢阻肺稳定期患者的执行率影响效果。方法 选取连州市人民医院呼吸内科、ICU 2019年6月—2020年6月收治的120例慢阻肺稳定期患者为研究对象,以随机数字表法分为试验组与对照组,每组各60例,对照组采取一对一训练,试验组采取集体呼吸操,对两组执行率、肺功能、六分钟步行距、圣乔治呼吸问卷(St. George's Respiratory Questionnaire Application,SGRQ)评分进行对比。结果 试验组执行率90.00%,与对照组75.00%相比较,差异有统计学意义(P<0.05);护理前两组肺功能、六分钟步行距离、SGRQ评分相比较,差异无统计学意义(P>0.05),护理后4周、护理后8周与护理前相比较,差异有统计学意义(P<0.05); 试验组护理后4周、护理后8周肺功能、六分钟步行距、SGRQ评分与对照组相比较,差异有统计学意义(P<0.05)。结论 集体呼吸操有助于提高慢阻肺稳定期患者执行率,进一步改善其肺功能以及运动耐力水平,值得在今后护理工作中推广使用。
Objective To study the effect of collective breathing exercises on the execution rate of patients with stable COPD. Methods A total of 120 patients with stable chronic obstructive pulmonary disease admitted to the department of respiratory medicine and ICU of Lianzhou People's Hospital from June 2019 to June 2020 were selected as the research objects. They were divided into the experimental group and the control group by a random number table. For 60 cases, the control group took one-to-one training, and the test group took collective breathing exercises. The performance rate, lung function, six-minute walk distance, and St. George's Respiratory Questionnaire Application (SGRQ) scores were compared between the two groups. Results The execution rate of the experimental group was 90.00%, compared with 75.00% of the control group, the difference was statistically significant (P<0.05); there was no statistically differences in lung function, six-minute walking distance, and SGRQ score between the two groups before nursing ( P>0.05), 4 weeks after nursing, 8 weeks after nursing, and before nursing, the difference was statistically significant (P<0.05); in the experimental group, 4 weeks after nursing, 8 weeks after nursing, lung function, six-minute walking distance, SGRQ score was compared with the control group, the difference was statistically significant (P<0.05). Conclusion Group breathing exercises may help improve the performance rate of patients with chronic obstructive pulmonary disease in stable phase, and further improve their lung function and exercise endurance. It is worth popularizing in future nursing work.
论著

平板运动试验阳性者冠脉造影结果预警冠心病

Results of coronary angiography in patients with positive treadmill exercise test give early warning of coronary heart disease

:28-31
 
目的 分析平板运动试验阳性患者行冠脉造影检查后结果阳性者与冠心病的高危因素的关联性,从而预警冠心病。方法 选取浙江大学医学院附属第二医院2016年3月—2019年3月行平板运动试验的阳性患者经冠脉造影结果为阳性,且资料完整者280例患者为研究对象,筛选出影响冠心病的独立危险因素。结果 性别、体质量指数(BMI)、高甘油三酯、平板恢复1、2 min心率是影响冠心病的独立危险因素。结论 对于男性、BMI>24、高甘油三酯、平板恢复1、2 min心率异常的患者,当其平板运动试验为阳性时,应建议其进一步行冠脉造影检查。
Objective To analyze the correlation between coronary angiography and the risk factors of coronary heart disease in patients with positive treadmill exercise test, so as to give early warning of coronary heart disease. Methods A total of 280 patients who underwent treadmill exercise tests from March 2016 to March 2019 in the Second Affiliated Hospital of Medical College of Zhejiang University were selected as the study subjects with positive coronary angiography results and complete data to screen out independent risk factors for coronary heart disease. Results Gender, body mass index, high triglycerides, high cholesterol, heart rate after 1 or 2 minutes of tablet recovery were the risk factors for positive coronary angiography. Conclusion For men, patients with BMI>24, high triglycerides, and abnormal heart rate after 1 or 2 minutes of tablet recovery, when the treadmill exercise test is positive, further coronary angiography should be recommended.
论著

凯格尔(kegel)锻炼法结合生物反馈电刺激对产后盆底康复管理效果的影响

Effect of Kegel exercise combined with biofeedback electric stimulation on the management of postpartum pelvic floor rehabilitation

:42-46
 
目的 探讨凯格尔(Kegel)锻炼法结合生物反馈电刺激对产后盆底康复管理效果的影响。方法 选取2018年5月—2019年4月在我院妇产科阴道分娩的足月产妇200例,采用随机数字法分为对照组和观察组,每组各100例,对照组单纯给予Kegel锻炼法,观察组给予Kegel锻炼法结合生物反馈电刺激。干预2~3个月,比较两组患者盆底肌肉功能相关指标改善情况,并比较两组患者生活质量的改变。结果 干预后,观察组患者盆底肌Ⅰ类肌纤维肌力恢复正常率为86.0%(86/100),高于对照组的56.0%(56/100),观察组盆底肌Ⅱ类肌纤维肌力恢复正常率为83.0%(83/100),高于对照组的54.0%(54/100),差异均有统计学意义(P<0.05)。且干预后,观察组下腹不适、尿失禁、排尿异常、排便异常及阴道分泌物异常患者低于对照组(P<0.05),性生活质量评分高于对照组(P<0.05)。结论 Kegel锻炼结合生物反馈电刺激可促进盆底肌力,改善尿失禁、盆腔器官脱垂等盆底异常症状,提高患者生性生活质量。
Objective To explore the effect of Kegel exercise combined with biofeedback electric stimulation on the management of postpartum pelvic floor rehabilitation. Methods A total of 200 full-term pregnant women who delivered vaginally in our hospital from May 2018 to April 2019 were randomly divided into two groups: the control group and the observation group, with 100 cases in each group. The control group was only given Kegel exercise method, and the experimental group was given Kegel exercise method combined with biofeedback electrical stimulation. After 2~3 months of intervention, the improvement of pelvic floor muscle function and quality of life of the two groups were compared. Results After intervention, the recovery rate of pelvic floor muscle type I muscle strength in the observation group was 86.0% (86/100), higher than that in the control group (56/100), and the recovery rate of pelvic floor muscle type II muscle strength in the observation group was 83.0% (83/100), higher than that in the control group (54/100). The difference was statistically significant (P<0.05). After the intervention, the patients situations in the experimental group were lower than those in the control group (P<0.05) including abdominal discomfort, urinary incontinence, abnormal urination, abnormal defecation and abnormal vaginal secretion, and the score of sexual quality of life was higher than that in the control group (P<0.05). Conclusion Kegel exercise combined with biofeedback electrical stimulation may promote pelvic floor muscle strength, improve the symptoms of urinary incontinence, pelvic organ prolapse and other pelvic floor abnormalities, and improve the quality of life of patients.
论著

医院视角下新发传染病卫生应急演练工作探讨

Discussion on health emergency exercises of emerging infectious diseases from the perspective of healthcare facilities

:96-99
 
目的 开展卫生应急演练并总结经验,探讨演练在提高新发传染病应急处置能力中的作用。方法 以桌面演练和功能性演练为手段,在广州某三甲医疗机构开展演练活动,并对演练效果进行评价。结果 全院共51个科室开展新发传染病防控卫生应急演练,全院演练平均得分4.87。演练为新发传染病应急处置积累了实战经验,达到了锻炼队伍、提高能力的作用。结论 卫生应急演练是检验和提高新发传染病应急处置水平的重要手段,医疗机构通过推进演练活动的制度化、规范化和常态化,可促进新发传染病应急处置工作能力提升。
Objective To carry out health emergency exercises and summarize experiences, and to explore the role of exercises in improving emergency response capabilities for emerging infectious diseases. Methods Using tabletop exercises and functional exercises as means, the exercises were conducted in a tertiary class healthcare facilitie in Guangzhou, and the effects of the exercises were evaluated. Results A total of 51 departments in the hospital conducted health emergency exercises for the prevention and control of emerging infectious diseases, and the average score of the exercises was 4.87. The exercises accumulated actual combat experience for emergency treatment of emerging infectious diseases, and achieved the effect of training the team and improving the capabilities. Conclusion Health emergency exercise is an important mean to test and improve the emergency response capability of emerging infectious diseases. Healthcare facilities can promote the improvement of emergency response capabilities of emerging infectious diseases by promoting the institutionalization, standardization and normalization of exercise activities.
临床诊疗

孕妇妊娠期运动现状及其影响因素分析

Current situation and influence factor analysis of exercise during pregnancy

:87-91
 
目的 了解孕妇妊娠期运动现状及其影响因素,为优化妊娠期运动方案提供依据。方法 采用便利抽样法,使用自编《孕妇妊娠期运动现状及影响因素调查问卷》对广州市某三级甲等妇幼保健院214名孕周>37周的孕妇进行调查。结果 妊娠期每次运动时长集中在30min~1 h的孕妇占43.0%;91.6%的孕妇选择散步和爬楼梯,仅有8.4%的孕妇接触过孕妇体操和瑜伽等其他运动形式;妊娠合并糖尿病与无合并症孕妇运动量相比,差异无统计学意义(P>0.05);家人朋友为孕妇主要获取妊娠期运动信息来源。认为妊娠期运动不重要、缺乏安全感、家庭及社会支持为妊娠期运动的主要影响因素。结论 孕妇运动量总体处于较低水平,运动形式单一,受认知、心理、生理、社会因素影响;孕妇尤其是患有妊娠合并糖尿病的孕妇对妊娠期运动的重要性和必要性没有给予足够的重视;医护人员对于妊娠期运动的引导作用较弱。
论著

功能锻炼和心理护理对中风后肩手综合征老年患者功能康复的分析

Analysis on functional exercise and psychological nursing for the elderly patients with post-stroke shoulder hand syndrome

:68-70
 
目的 观察和研究功能锻炼和心理护理对中风后肩手综合征老年患者功能康复的影响,以及对运动功能、日常生活活动能力的影响。方法 选取2015年6月—2017年2月收治的中风后肩手综合征老年患者60例为研究对象,随机法分为干预组与对照组,各30例。干预组在给予内科常规治疗及护理的同时,采用功能锻炼心理干预等方法进行处理;对照组仅进行内科的常规治疗及护理。运动功能则采用Fugl-Meyer评分法(FMA)进行评分,而日常生活活动能力采用改良Barthel指数(MBI)进行评分。并比较两组患者干预前后焦虑、抑郁水平。结果 干预组FMA评分以及MBI评分均高于对照组,差异有统计学意义(P<0.05)。干预后干预组患者焦虑、抑郁评分低于对照组,两组比较差异有统计学意义(P<0.01)。结论 采用功能锻炼和心理护理能提高中风后偏瘫患者的运动功能以及日常生活活动能力,缓解或消除患者焦虑抑郁等负性情绪,效果明显,值得推广应用。
Objective To observe and study of functional exercise and psychological nursing for stroke shoulder hand syndrome after the influence of the elderly patients with functional rehabilitation, and the influence on motor function and ability of daily life activities. Methods 60 cases of elderly patients with apoplexy after apoplexy were selected from June 2015 to February 2017. They randomly were divided into two groups: intervention group and control group, each with 30 cases. The intervention group was treated with functional exercise psychological intervention with giving routine treatment and nursing care as the same time. The control group only conducted routine treatment and nursing care. The exercise function was rated by the Fugl-Meyer scoring method (FMA), while the improved Barthel index (MBI) was used to score the daily activities. The anxiety and depression levels were compared between the two groups. Results The FMA score of the intervention group and MBI score were higher than that of the control group, and the difference was statistically significant(P<0.05). The anxiety and depression scores of the intervention group were lower than those in the control group, and the difference between the two groups was statistically significant(P<0.01). Conclusion The functional exercise and psychological care may improve movement function in patients with hemiplegia after stroke, and daily life activities ability, alleviate or eliminate negative emotions, including anxiety depression. It is worth promoting.
论著

八段锦联合呼吸训练对社区慢性阻塞性肺疾病患者疗效研究

Study on the effect of Baduanjin exercise combined with breathing training on patients with chronic obstructive pulmonary disease in community

:29-32
 
目的 探讨八段锦联合呼吸训练对社区慢性阻塞性肺疾病(COPD)患者的疗效研究。方法 选取本社区2016年6月—2017年4月期间收治的重度及极重度稳定期COPD患者70例。随机分为A组(25例)、B组(23例)和C组(22例)。A组患者采用八段锦联合呼吸训练治疗,B组患者仅采用呼吸锻炼,C组患者不采用锻炼方式。记录对比三组患者治疗前后的肺功能、六分钟步行距离和圣乔治呼吸评分。结果 A组和B组患者肺功能均比治疗前及比C组改善(P<0.05),且A组改善更明显(P<0.05);A组和B组步行距离均比治疗前及C组增加(P<0.05),且A组比B组增加程度更大(P<0.05);A组和B组圣乔治呼吸评分均比治疗前及C组降低(P<0.05),且A组比B组降低更多(P<0.05)。结论 对COPD患者,八段锦联合呼吸训练可改善患者肺功能和运动能力,缓解呼吸困难,对患者活动及生活各方面的影响。具有较好的临床效果,值得临床推广应用。
Objective To study the effect of Baduanjin exercise combined with breathing training on patients with chronic obstructive pulmonary disease (COPD) in community. Methods We selected 70 patients with severe and extremely severe COPD at stable period in the community from June 2016 to April 2017. The patients were randomly divided into group A (25 cases), group B (23 cases) and group C (22 cases). Patients in group A were treated with Baduanjin exercise combined breathing training, while group B patients only used breathing exercise, and group C patients did not have exercise. We recorded and compared the lung function, six-minute walking distance and St Georges breathing score before and after treatment in the three groups. Results The pulmonary function of patients in group A and group B had been improved more than that before the treatment and of group C (P<0.05), and group A had been improved (P<0.05); the walking distance in group A and group B increased more than that before the treatment and of group C (P<0.05), and group A increased a greater degree than that of group B (P<0.05); The St Georges breathing score in group A and group B decreased than before the treatment and of group C (P<0.05); and group A decreased more than that of group B (P<0.05). Conclusion The Baduanjin exercise combined with breathing training may improve the pulmonary function and athletic ability of the patients with COPD, relieve dyspnea, reduce the influence of the illness on the activities activities of daily living of the patients. It has good clinical effect and is worthy of clinical application.
论著

关节松动术联合运动疗法对颞下颌关节慢性不可复性盘前移位的疗效观察

Effectiveness of joint mobilization combined with therapeutic exercise in patients with chronic anterior disc displacement without reduction of temporomandibular joints

:22-24
 
目的 评估关节松动联合运动疗法对颞下颌关节慢性不可复性盘前移位患者的疗效。方法 采用随机对照方法,将46例慢性不可复性盘前移位患者随机分为联合治疗组(n=24)及对照组(n=22), 对照组仅接受传统治疗(包括超短波、超声波、软组织按摩及健康教育),治疗组在传统治疗的基础上应用关节松动联合运动疗法。在治疗前和治疗后2周采用最大张口度(maximal interincisal opening,MIO)、目测类比法(visual analog scale,VAS)、口腔健康影响程度量表(health impact profile-14,HIP-14)评价疗效。结果 治疗前两组患者一般情况类似。治疗后两组颞下颌关节MIO、VAS、HIP-14得分较治疗前改善(P<0.05),组间比较,治疗组在MIO、VAS、HIP-14评分比对照组改善(P<0.05)。结论 关节松动联合运动疗法治疗颞下颌关节慢性不可复性盘前移位疗效明显,值得推广。
Objective To evaluate the effectiveness of joint mobilization combined with therapeutic exercise in patients with chronic anterior disc displacement without reduction of temporomandibular joints. Methods 46 patients with chronic anterior disc displacement without reduction were randomly divided into two groups. The treatment group of 24 cases received joint mobilization combined with therapeutic exercise and conventional therapy (ultrashort-wave diathermy, ultrasound therapy, soft tissue massage, health education), 22 cases in the control group received conventional treatment.The treatment was administered for 2 weeks. The baseline and endpoint outcome assessment measures were maximal interincisal opening (MIO),visual analogue scale(VAS)score and oral health impact profile (HIP-14). Results After the treatment, significant improvements were observed in the two groups of all the outcome measurements (P<0.05).Maximal interincisal opening, visual analogue scale and oral health impact profile were improved significantly in the treatment group than in the control group (P<0.05). Conclusion Joint mobilization combined with therapeutic exercise can improve the symptoms of chronic anterior disc displacement without reduction.
医学教育

BOPPPS 模式下模块化教学结合模拟演练在创伤急救培训中的应用

Application of modular teaching combined with simulation exercise in trauma first aid training under BOPPPS model

:422-428
 
       目的   探讨BOPPPS[(导引(B),目标(O),课前测试(P),参与式学习(P),课后测试(P),总结(S)]模式下模块化教学结合模拟演练在创伤急救培训中的应用效果。方法   选取福建省泉州市正骨医院急诊科2022年8月—2024年2月90名护士,随机分为对照组和干预组,每组45名护士。对照组采用传统授课模式进行教学培训;干预组采用BOPPPS模式下模块化教学结合模拟演练进行教学培训。培训结束对两组学员的创伤急救综合理论及单项技能、创伤急救救护综合能力、培训效果满意度进行统计分析。结果   干预组的综合理论成绩为(80.74±6.87)分、单项技能成绩为(92.13±2.26)分,相较于对照组均提高(P<0.05)。干预组对创伤急救课程的总体满意度:非常同意23例、同意20例,比例均高于对照组(P<0.05)。干预组的创伤急救救护综合能力如病情评估预判能力,优秀26例、良好15例;护理计划分析实施能力,优秀25例、良好13例;团队协作与资源管理能力,优秀27例、良好15例;情景感知与应变能力,优秀30例、良好11例;综合救护能力,优秀36例、良好5例。显著优于对照组(P<0.05)。结论  BOPPPS模式下模块化教学结合模拟演练能够提高急诊科护士的综合创伤救护能力,且取得了较高的满意度,值得进一步推广应用。
       Objective  To explore the application effect of modular teaching combined with simulation exercise in trauma 
first aid training under BOPPPS model.Methods  A total of 90 nurses in the emergency department from August 2022 to February 2024 were randomly divided into control group(n=45) and intervention group(n=45).The control group was trained  by traditional teaching mode.The intervention group was trained by BOPPPS modular teaching combined with simulation exercise.After the training,the comprehensive theory of trauma first aid,individual skills,comprehensive ability of trauma first aid and satisfaction degree of training effect of the two groups of nurses were statistically analyzed.Results  The comprehensive theoretical scores and single skill scores of the intervention group were significantly improved compared with the control group(P<0.05).The satisfaction degree of trauma first aid training in the intervention group was significantly higher than that in the control group(P<0.05).The comprehensive ability of trauma first aid in the intervention group was significantly better than that in the control group(P<0.05).Conclusions  The combination of modular teaching and  simulation exercise in BOPPPS model can improve the comprehensive trauma rescue ability of nurses in emergencydepartment,and has obtained a high degree of satisfaction,which is worthy of further popularization and application.
论著

运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响

The effect of exercise intervention combined with therapeutic listening on social communication function inchildren with autism spectrum disorder

:403-409
 
       目的   探讨运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响。方法   选取黄河三门峡医院2020年1月—2023年10月收治的100例孤独症患儿,应用随机数字表法分为两组,各50例。对照组患儿实施常规护理,观察组在对照组基础上增加运动干预联合治疗性聆听。分别在干预前及干预6个月后采用孤独症治疗评价量表(ATEC)、儿童感觉统合发展评定量表、格塞尔发育量表(GDS)及中国韦氏儿童智力量表(WISC-R)评价两组患儿社会交往能力、感觉统合发展水平、神经发育水平及智力水平变化。结果   干预后两组患儿的ATEC各部分评分,包括健康/生理/行为、感知/认知能力、社交能力、语言表达/沟通能力及ATEC总分均降低,观察组低于对照组(P<0.05);干预后两组患儿学习能力发展、本体感觉、触觉防御、前庭功能及儿童感觉统合发展评定量表总分均升高,观察组高于对照组P<0.05);干预后两组患儿动作能、应物能、言语能、应人能相关神经发育情况评分均升高,观察组高于对照组(P<0.05);干预后两组患儿言语智商、操作智商、总智商相关WISC-R评分均升高,观察组高于对照组(P<0.05)。  运动干预联合治疗性聆听对孤独症谱系障碍儿童应用效果显著,可提升其社会交往能力,促进感觉统合发展,进而促进其神经发育及智力水平提升。
       Objective  To  explore the  effect  of  exercise intervention  combined with therapeutic listening  on  social communication function in children with autism spectrum disorder.Methods  A total of 100 autistic children who were admitted to our hospital from January 2020 to October 2023 were selected and divided into two groups by random number table method,with 50 children each.The control group received routine care,while the observation group  received exercise intervention combined with therapeutic listening in addition to routine care.The Autism Treatment Evaluation Scale (ATEC),Children’s Sensory Integration Development Scale,Gesell Development Scale,and Wechsler Intelligence Scale for Children-Revised by China (WISC-R)were used before and 6 months after the intervention to evaluate the social communication ability,sensory integration development level,neural development level,and intellectual level changes of the two groups of children.Results  After intervention,the score of every dimension in ATEC including the health/physiology/behavior,perception/cognitive ability,social ability,language expression/communication ability,and total ATEC score of the two groups of children decreased,and the observation group was lower than the control group (P<0.05).After intervention,the total scores of the learning ability development insufficient,proprioceptive dysfunction,excessive tactile defense,vestibular dysfunction,and children’s sensory integration development assessment scale in both groups of children increased,with the observation group being higher than the control group (P<0.05).After intervention,the neurological development scores related to motor,adapt,language,and social ability in both groups of children increased,and the observation group was higher than the control group (P<0.05).After intervention,the WISC-R scores related to verbal intelligence,operational intelligence,and total intelligence in both groups of children increased,and the observation group was higher than the control group (P<0.05).Conclusions  The combination of exercise intervention and therapeutic listening has asignificant effect on children with autism spectrum disorder,which can enhance their social communication ability,promote sensory integration development,and ultimately promote their neural development and intellectual level improvement.
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