Objective To explore the common rehabilitation techniques involved in early rehabilitation, early rehabilitation period, and the access conditions of medical institutions for early rehabilitation on the basis of the early rehabilitation data of Chengdu, investigation on some domestic rehabilitation institutions, and expert consultation opinions, to provide a scientific basis for the early rehabilitation of relevant medical institutions. Methods We extracted the data of 130 medical insurance designated institutions in Chengdu for the whole year of 2014 (from January 1st to December 31st), and used the investigation method to study eight common types of clinical rehabilitation diseases (except stroke); went out to investigate the data of eight common types of clinical rehabilitation diseases (except burns) of five hospitals; using expert consultation method, collected 15 experts’ opinions on the early treatment of common clinical rehabilitation, intervention time, rehabilitation costs and so on. Results Common techniques for early rehabilitation included: rehabilitation assessment, acupuncture/electroacupuncture treatment, low-intermediate frequency pulse electrotherapy, pneumatic limb blood circulation promotion treatment, joint loosening training, other massage training, aerobic training, exercise therapy, and occupational therapy. In addition, each disease type also corresponded to special rehabilitation techniques. The early rehabilitation period was 13–14 days for persistent vegetative state (hypoxic ischemic encephalopathy), 11–18 days for fractures, 12–14 days for joint and soft tissue injury, 31–47 days for spinal cord injury, 11–18 days for brain injury, 14–19 days for burn (chemical, electric shock), 10–12 days for hand injury, 9–20 days for peripheral nerve injury, and 13–21 days for stroke. The access conditions for early rehabilitation included: general hospitals above the second level, with independent rehabilitation treatment rooms and rehabilitation wards, with early rehabilitation equipment, qualified full-time rehabilitation physicians and therapists. Conclusions In the common technical aspects of early rehabilitation, each disease has a common technology and also corresponds to special rehabilitation techniques. The early rehabilitation period for most diseases is 2–3 weeks. In order to ensure the quality and safety of early rehabilitation, it is recommended to include the hospital level and professional rehabilitation talent qualifications into the access conditions for early rehabilitation.
Objective To investigate the impact of complete video-assisted thoracoscopic lobectomy and open lobectomy on perioperative heart rate (HR) and blood oxygen saturation (SO2) of lung cancer patients,and explore whether minimally invasive surgery can enhance postoperative recovery of lung cancer patients. Methods A total of 138 lung cancer patients were chosen from 161 consecutive patients with pulmonary diseases who were admitted to West China Hospital of Sichuan University between September 2010 and December 2011. According to different surgical approach,all the 138 lung cancer patients were divided into routine thoracotomy group (thoracotomy group,70 patients including 53 males and 17 females with their average age of 56.1±9.7 years) and complete video-assisted thoracoscopic lobectomy group (VATS group,68 patients including 46 males and 22 females with their average age of 53.4±6.5 years). There was no statistical difference in preoperative clinical characteristics between the 2 groups. Preoperative and postoperative (1st,3rd,7th and 30th day) numeric pain rating scale (NPRS),HR and SO2 were compared between the 2 groups. Results (1) There was no statistical difference in NPRS on the 1st and 3rd postoperative day between the 2 groups (3.83±0.79 vs. 3.93±0.67, 2.88±0.59 vs. 3.03±0.71,P>0.05),but on the 7th and 30th postoperative day,NPRS of the thoracotomy group was signi- ficantly higher than that of VAST group (1.61±0.33 vs. 1.22±0.12,1.58±0.26 vs. 1.19±0.31,P<0.05). (2) Postop- erative sedentary HR of both VATS group and thoracotomy group were significantly higher than preoperative levels [(84.13±17.21) / minute vs. (73.67±10.32)/minute, (86.13 ±19.67) / minute vs. (72.24±14.21) / minute, P<0.05]. Postoperative HR of VATS group decreased to preoperative level on the 3rd postoperative day,while postoperative HR of the thoracotomy group decreased to preoperative level on the 7th postoperative day. (3) There was no statistical difference between preoperative and postoperative (all the time points) sedentary SO2 of both VATS group and thoracotomy group (96.34 %±2.11% vs. 97.12%±2.31%,95.33%±4.13% vs. 94.93% ±4.31%,P>0.05).(4) The changes of HR and SO2 before and after exercise of VATS group were significantly smaller than those of the thoracotomy group on the 3rd postoperative day [(11.11±4.81)/minute vs. (18.23±6.17)/minute,3.1%±1.2% vs. 7.4 %±2.7%,P<0.05] . Conclusion The impact of complete video-assisted thoracoscopic lobectomy on cardiopulmonary function is comparatively smaller,which is helpful for postoperative fast-track recovery of lung cancer patients.
With the continuous development of critical care medicine, the survival rate of critical ill patients continues to increase. However, the residual dysfunction will have a far-reaching impact on the burden on patients, families, and health-care systems, and will significantly increase the demand of the follow-up rehabilitation treatment. Critical illness rehabilitation intervenes patients who are still in the intensive care unit (ICU). It can prevent complications, functional deterioration and dysfunction, improve functional activity and quality of life, shorten the time of mechanical ventilation, the length of ICU stay and hospital stay, and also reduce medical expenses. Experts at home and abroad believe that early rehabilitation of critical ill patients is safe and effective. So rehabilitation should be involved in critical ill patients as early as possible. However, the promotion of this model is still limited by the setting of safety parameters, the ICU culture, the lack of critical rehabilitation professionals, and the physiological and mental cognitive status of patients. Rehabilitation treatment in ICU is constantly being practiced at home and abroad.