For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein th...For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.展开更多
目的:评价重症监护室(ICU)患儿开展早期康复训练的效果。方法:检索Cochrane Library、Embase、PubMed、Web of Science、中国知网(CNKI)、维普数据库(VIP)、万方数据知识服务平台(WanFang Data)和中国生物医学文献数据库(CBM)中关于早...目的:评价重症监护室(ICU)患儿开展早期康复训练的效果。方法:检索Cochrane Library、Embase、PubMed、Web of Science、中国知网(CNKI)、维普数据库(VIP)、万方数据知识服务平台(WanFang Data)和中国生物医学文献数据库(CBM)中关于早期康复训练干预对ICU患儿康复影响的随机对照试验和类实验研究,检索时间为2012—2022年。纳入文献按照Cochrane评价手册和JBI类实验性研究真实性评价工具进行质量评价,采用RevMan 5.4软件进行Meta分析。结果:最终共纳入14篇文献,样本量1296例。Meta分析结果显示,早期康复训练可缩短机械通气时间[MD=-1.93,95%CI(-3.45,-0.41),P=0.01],缩短总住院时间[MD=-6.36,95%CI(-9.45,-3.28),P<0.0001],改善心肺功能[MD=37.39,95%CI(24.00,50.78),P<0.00001]和运动功能[SMD=3.25,95%CI(1.42,5.08),P=0.0005],提高生活质量[MD=3.16,95%CI(1.40,4.92),P=0.0004]。结论:早期康复训练在ICU患儿中应用可缩短机械通气时间和总住院时间,改善患儿运动和心肺功能,提高患儿生活质量。展开更多
BACKGROUND Mechanical ventilation is a common resuscitation method in the intensive care unit(ICU).Unfortunately,this treatment process prolongs the ICU stay of patients with an increased incidence of delirium,which u...BACKGROUND Mechanical ventilation is a common resuscitation method in the intensive care unit(ICU).Unfortunately,this treatment process prolongs the ICU stay of patients with an increased incidence of delirium,which ultimately affects the prognosis.AIM To evaluate the effect of progressive early rehabilitation training on treatment and prognosis of patients with mechanical ventilation in ICU.METHODS The convenience sampling method selected 190 patients with mechanical ventilation admitted to the Fourth Hospital of Hebei Medical University from March 2020 to March 2021.According to the random number table method,they were divided into the control and intervention groups.The control group received routine nursing and rehabilitation measures,whereas the intervention group received progressive early rehabilitation training.In addition,the incidence and duration of delirium were compared for the two groups along with mechanical ventilation time,ICU hospitalization time,functional independence measure(FIM)score,Barthel index,and the incidence of complications(deep venous thrombosis,pressure sores,and acquired muscle weakness).RESULTS In the intervention group,the incidence of delirium was significantly lower than in the control group(28%vs 52%,P<0.001).In the intervention group,the duration of delirium,mechanical ventilation time,and ICU stay were shorter than in the control group(P<0.001).The FIM and Barthel index scores were significantly higher in the intervention group than the control group(P<0.001).The total incidence of complications in the intervention group was 3.15%,which was lower than 17.89%in the control group(P<0.001).CONCLUSION Progressive early rehabilitation training reduced the incidence of delirium and complications in ICU patients with mechanical ventilation,which improved prognosis and quality of life.展开更多
基金supported by Hong Kong Spinal Cord Injury Fund (HKSCIF),China (to HZ)。
文摘For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.
文摘BACKGROUND Mechanical ventilation is a common resuscitation method in the intensive care unit(ICU).Unfortunately,this treatment process prolongs the ICU stay of patients with an increased incidence of delirium,which ultimately affects the prognosis.AIM To evaluate the effect of progressive early rehabilitation training on treatment and prognosis of patients with mechanical ventilation in ICU.METHODS The convenience sampling method selected 190 patients with mechanical ventilation admitted to the Fourth Hospital of Hebei Medical University from March 2020 to March 2021.According to the random number table method,they were divided into the control and intervention groups.The control group received routine nursing and rehabilitation measures,whereas the intervention group received progressive early rehabilitation training.In addition,the incidence and duration of delirium were compared for the two groups along with mechanical ventilation time,ICU hospitalization time,functional independence measure(FIM)score,Barthel index,and the incidence of complications(deep venous thrombosis,pressure sores,and acquired muscle weakness).RESULTS In the intervention group,the incidence of delirium was significantly lower than in the control group(28%vs 52%,P<0.001).In the intervention group,the duration of delirium,mechanical ventilation time,and ICU stay were shorter than in the control group(P<0.001).The FIM and Barthel index scores were significantly higher in the intervention group than the control group(P<0.001).The total incidence of complications in the intervention group was 3.15%,which was lower than 17.89%in the control group(P<0.001).CONCLUSION Progressive early rehabilitation training reduced the incidence of delirium and complications in ICU patients with mechanical ventilation,which improved prognosis and quality of life.
