Risk factors of acute kindey injury in critical patients in emergency department / 中华急诊医学杂志

Objective:To investigate the incidence and risk factors of acute kidney injury in patients admitted to the resuscitation room of the Emergency Department.Methods:Patients were enrolled from the resuscitation room of our hospital from September to December 2018 by a retrospective cohort study. Patients were divided into AKI group and non-AKI group according to whether AKI occurred within seven days after admission. Demographic characteristics, APACHEⅡ score, whether to use nephrotoxic drugs,24-hour fluid volume, and patients survival time were collected. Multivariate regression analysis was used to explore the risk factors for AKI. Cox regression was used to study the effect of the occurrence of AKI on survival and to analyze the influence of AKI severity on the death risk of patients in the resuscitation room.Results:Among 238 critical patients who were finally included, 108 patients developed AKI(45.4%), 83 patients were in AKI stage 1 (34.9%), and 25 patients were in AKI stage 2-3 ( 10.5%).APACHEⅡ score>13( OR=1.11, 95% CI (1.08-1.16), P <0.01), vasoactive drugs ( OR=2.20, c95% CI (1.08-4.49), P=0.03), diabetes mellitus ( OR=2.33, 95% CI (1.23-4.42), P=0.01), and fluid load> 3 L( OR=3.10, 95% CI (1.17-8.25). P=0.02) were independent risk factors for AKI. After adjustment for APACHEⅡ score and age by multivariate COX regression, AKI remained an independent risk factor for death in emergency patients, and the severity of AKI significantly increased the risk of death in these patients(AKI 1: HR=1.45, 95% CI (1.08-2.03), P =0.04; AKI 2~3: HR=3.15, 95% CI (1.49-4.81), P=0.03). Conclusions:AKI occurred commonly in the resuscitation room of the emergency department. APACHE Ⅱ score>13, vasoactive drugs, diabetes, and fluid load>3 L were independent risk factors for AKI. The risk of death increased with the aggravation of AKI severity.

Effects of community nursing interventions on rehabilitation of stroke patients with attention disorders / 中华全科医师杂志

Objective To study the effects of community nursing interventions on stroke patients with attention disorders.Methods A total of 60 stroke patients fulfilling eligibility were divided randomly into two groups.Their data were collected between December 2010 and February 2012.The intervention group was treated by community nurses while the control group trained by family members.Attention was assessed by simple reaction time (SRT) and number cancellation test (NCT).Modified Barthel index was used to assess the activities of daily living (ADL).Both groups were evaluated before and after a 2-month intervention.Results Before treatment,the control group had(0.71 ± 0.25),(662.8 ± 152.7) and(31 ±8)scores at SRT,NCT and MBI respectively.And the intervention group yielded(0.69 ± 0.19),(652.7 ±131.0) and (30 ± 8)scores at SRT,NCT and MBI respectively.There were no significant differences in average value of SRT,NCT and MBI between training and control groups at pre-treatment (P ＞ 0.05).After 2 months,the control group had (0.68 ± 0.20),(637.4 ± 151.7) and (33 ± 8) scores at SRT,NCT and MBI respectively.And the intervention group yielded (0.56 ± 0.16),(540.3 ± 125.9) and(37 ± 8) scores at SRT,NCT and MBI respectively.Very significant difference existed in attention scale scores at Month 2 (P ＜ 0.01) and the difference in ADL scale scores was also significant (P ＜ 0.05).Conclusion For stroke patients with attention disorders,strengthening community nursing interventions may help to improve attention and boost activity of daily living.

心理康复对急性期脑卒中患者的疗效 / 中国康复理论与实践

@#目的观察脑卒中急性期接受心理康复程序治疗对患者心理障碍的疗效。方法271例脑卒中病患者随机分治疗组和对照组。两组患者均接受一般的药物治疗和功能锻炼。治疗组还接受心理康复程序治疗。结果治疗组患者各种心理障碍得到明显改善;临床疗效评定显效率和总有效率明显优于对照组。结论脑卒中急性期心理康复应和药物治疗、功能康复同步进行,并贯穿全康复过程。