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.
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.
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。
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.
The comprehensive rehabilitative treatment was used in 58 cases(194 finger)for functional impairment after eplantation. After the treatment the overall increase of flexion-extension range of motion was 30 to 130 degrees respectively. From the assessment of 10 items of daily activities, the patients could accomplish three-fourth of them. the average time taken for the treatment was 3 months with an excellent-good rate about 87.4%. Through the early comprehensive rehabilititive treatment patients could achieve better results.
Thirsty wrists of quite similar nature of injuries, 12 of them were treated by conventional method of operation and followed by no or irregular physiotherapy, and the other 18 cases received meticulous procedures by mierosurgery to repair various tissue damages and followed by regular rehabilitation. The patients in the two groups were followed up from 3 months to 2 years. In the conventional treatment group the excellent-good results only rated 8.3% and 67% in the group treated by mierosurgery and followed by regular rchabillitation.
Objective?To evaluate Mental Imagery on rehabilitation of functions in patients with stroke. Methods?Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMbase, PEDro (www.pedro.org.au), OpenSIGLE, National Technical Information Service (NTIS), CNKI, VIP, Wanfang Data, and CBM were searched for the Randomized controlled trials (RCTs) of Mental Imagery on rehabilitation of functions in patients with stroke from the date of establishment of the databases to October 2010. The bibliographies of the included studies were searched, too. Three independent researchers evaluated the included studies using GRADE. The extracted data were analyzed by RevMan 5.0.25 and GRAEDprofiler 3.2.2. Results?A total 16 trials were discovered. Meta-analyses showed that at the end of 4th, 6th, and 8th, compared with conventional rehabilitation, the mental practice increased the score measured by FMA (WMD=7.81, 95%CI 1.96 to 13.65; WMD=13.89, 95%CI 4.53 to 23.25; and WMD=9.45, 95%CI 3.67 to 15.23, respectively) and ARAT (WMD=5.70, 95%CI 3.17 to 8.22, P=0.30). The 4 outcomes were all of low quality in the GRADE system. Conclusion?The current evidence shows mental practice could improve the upper limb function in patients after stroke, and the side effects of mental practice are not found in meta-analyses. Compared with other rehabilitative therapies, it is simper, of lower input costs, and of low operating costs. The clinicians should recommend it. Due to the limitations of the included studies, more large-sample, high-quality RCTs are required.
Objective To investigate the assessment and treatment methods for unilateral spatial agnosia as well as its influence on the functional recovery of patients after stroke, so as to comprehensively understand unilateral spatial agnosia and formulate an effective treatment plan to improve the effect of rehabilitation for stroke patients. Methods A total of 86 patients with unilateral spatial agnosia were analyzed and a pre-treatment and post-treatment comparison was done. Results Of the 86 patients, 21% suffered from unilateral spatial agnosia. The occurrence of unilateral spatial agnosia was related to the location of the stroke lesion. The treatment group witnessed significant improvement after rehabilitation training of correcting unilateral spatial agnosia (Plt;0.05). Conclusion The correct rehabilitation method is beneficial for an early improvement in a patient’s cognitive ability. This also lays a foundation for the recovery of function in their limbs.
目的：探讨综合康复治疗体系对54例地震致下肢骨折患者功能恢复的影响。方法：采用综合康复治疗方法治疗“5·12”汶川大地震所致54例下肢骨折患者，临床观察患者伤口的愈合情况和骨折的复位情况，有无骨折并发症，分析比较治疗前后患者下肢功能恢复情况及日常生活活动能力的改善。结果：康复治疗后关节活动度明显改善，由入院时的平均218.61°增加至出院时的237.5°（P＜0.001）。Barthel指数由入院时的平均55.4增加至出院时的70.8（P＜0.001），日常生活活动能力有较大幅度提高。结论：综合康复治疗体系对于地震伤致下肢骨折患者的功能恢复至关重要，一套完善的体系应包括：①康复治疗早期介入，功能锻炼长期坚持；②发挥大型综合性医院的优势，多学科交叉，多部门合作；③功能康复和心理康复并重；④专业人士与社会团体共同参与。
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。