Objective To explore the effectiveness of detailed physiotherapy in perioperative rehabilitation of patients undergoing thyroid cancer surgery with lymph node dissection. Methods A total of 97 patients with thyroid malignancy who underwent surgical treatment in West China Hospital of Sichuan University between February and June 2021 were selected and randomly divided into the trial group (n=50) and the control group (n=47). The patients in the trial group received detailed physiotherapy, and the patients in the control group received routine perioperative rehabilitation. The degree of pain within the operation area and the degree of neck and shoulder discomfort associated with surgery within 4 weeks, and the scores of Neck Dissection Impairment Index 4 weeks after surgery were compared between the two groups. The pain score, which was non-normally distributed, was described by median (lower quartile, upper quartile) and compared by generalized estimation equation; the discomfort score and score of Neck Dissection Impairment Index, which were normally distributed, were described by mean ± standard deviation, and the former was compared by multivariate analysis of variance, and the latter was compared by Student’s t-test. Results In the 1st, 2nd, 3rd, and 4th week after surgery, the pain scores within the operation area were 2.2 (1.7, 3.3), 1.5 (1.0, 2.2), 1.5 (0.0, 2.3), and 0.0 (0.0, 1.2), respectively in the trial group, and 3.4 (2.7, 5.2), 2.6 (1.5, 3.5), 2.4 (1.1, 3.4), and 1.5 (1.1, 2.0), respectively in the control group; the surgery-related neck and shoulder discomfort scores were 8.72±4.14, 5.28±2.98, 5.89±2.78, and 3.57±1.83, respectively in the trial group, and 10.56±5.30, 7.54±4.51, 7.37±3.49, and 5.05±2.59, respectively in the control group. Within 4 weeks after operation, the surgical-area pain scores and surgery-related neck and shoulder discomfort scores in the trial group were lower than those in the control group, and the differences were statistically significant (Wald χ2=28.826, P<0.001; F=7.695, P=0.007). In the post-operative week 4, the Neck Dissection Impairment Index in the trial group was higher than that in the control group, and the difference was statistically significant (75.23±20.40 vs. 63.83±19.52; t=2.809, P=0.006). Conclusion For patients undergoing thyroid cancer surgery with lymph node dissection, detailed physiotherapy intervention is more effective than routine perioperative rehabilitation.
As an innovative training method, blood flow restrictive exercise has gradually received extensive attention and application in rehabilitation medicine in recent years. Blood flow restrictive exercise can be combined with low-load, low-intensity training to promote individual muscle hypertrophy and enhance muscle strength to prevent muscle atrophy, which provides an alternative for those who cannot perform high-load, high-intensity training. However, the clinical use strategy and clinical application effect of blood flow restriction exercise are still unclear. This article will mainly introduce the operation methods, use risks, and application methods of blood flow restrictive exercise, in order to provide a reference for the clinical application and research of blood flow restrictive exercise.
Objective Peri pheral nerve injury is a common cl inical disease, to study the effects of the physical therapy on the regeneration of the injured sciatic nerve, and provide a reference for cl inical treatment. Methods Sixty-four female adult Wistar rats (weighing 252-365 g) were chosen and randomly divided into 4 groups (n=16): group A, group B, groupC, and group D. The experimental model of sciatic nerve defect was establ ished by crushing the right sciatic nerve in groups B, C, and D; group A served as the control group without crushing. At 2 days after injury, no treatment was given in group B, electrical stimulation in group C, and combined physical therapies (decimeter and infrared ray) in group D. At 0, 7, 14, and 30 days after treatment, the sciatic nerve function index (SFI) and the motor nerve conduction velocity (MNCV) were measured, and morphological and transmission electron microscopy (TEM) examinations were done; at 30 days after treatment, the morphological evaluation analysis of axons was performed. Results At 0 and 7 days after treatment, the SFI values of groups B, C, and D were significantly higher than that of group A (P lt; 0.05); at 14 and 30 days after treatment, the SFI value of group D decreased significantly, no significant difference was observed between group D and group A (P gt; 0.05) at 30 days; whereas the SFI values of groups B and C decreased, showing significant difference when compared with the value of group A (P lt; 0.05). At 0, 7, and 14 days after treatment, the MNCV values of groups B, C, and D were significantly lower than that of group A (P lt; 0.05), and there were significantly differences between group B and groups C, D (P lt; 0.05); at 14 days, the MNCV value of group D was significantly higher than that of group C (P lt; 0.05); and at 30 days, the MNCV values of groups B and C were significantly lower than that of group A (P lt; 0.05), but there was no significant difference between group D and group A (P gt; 0.05). At 0 and 7 days, only collagen and l i pid were observed by TEM; at 14 and 30 days, many Schwann cells and perineurial cells in regeneration axon were observed in groups B, C, and D, especially in group D. Automated image analysis of axons showed that there was no significant difference in the number of myelinated nerve fibers, axon diameter, and myelin sheath thickness between group D and group A (P gt; 0.05), and the number of myelinated nerve fibers and axon diameter of group D were significantly higher than those of groups B and C (P lt; 0.05). Conclusion Physical therapy can improve the regeneration of the injured sciatic nerve of rats.
目的:探讨急性胰腺炎(AP)并发胰腺假性囊肿(PPC)的早期诊断、早期治疗方法及疗效观察。方法:急性胰腺炎患者给予常规治疗,每周复查B型超声,必要时复查上腹部CT,一旦检查诊断为胰腺假性囊肿形成,即给予TDP(CQ型特定电磁波治疗器)烤腹部相应囊肿部位皮肤,烤后再以适量黄冰解毒消肿软膏外敷腹部相应囊肿部位皮肤,每周复查B超1次,直致囊肿消失。结果: 63例胰腺假性囊肿56例胰腺假性囊肿经保守治疗后完全消失,有效率8889%(56/63),平均68周时间,最短时间2周,最长时间12周。7例囊肿未消失,其中2例囊肿有缩小,5例无效。结论: 胰腺假性囊肿形成早期诊断,早期联合物理治疗和中药外敷疗效显著,不失为一种安全、有效、经济的治疗方法。
Objective To explore the preventive effectiveness of early physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer. Methods A total of 206 patients who underwent modified radical mastectomy for breast cancer in The First Affiliated Hospital of Henan University from June 2014 to June 2016, enrolled in this randomized controlled clinical trial. Then these patients were randomly divided into intervention group and control group equally. Patients in the control group received routine treatment, and the patients in the intervention group began to use the air pressure pump combined with the microwave physiotherapy on the second day after the radical surgery. The incidences of limb lymphedema in 6 months and 1 year after operation between the 2 groups were compared, and the influencing factors of arm lymphedema were explored. Results The clinical data of 195 patients were analyzed at end, including 99 patients of the intervention group and 96 patients of the control group. ① There were statistical significance in the incidences of arm lymphedema in 6 months and 1 year after operation between the 2 groups (P<0.05), that incidences of arm lymphedema in the intervention group were both lower than those of the control group at the2 time points [6 months after operation: 2.0% (2/99)vs. 9.4% (9/96); 1 year after operation: 5.1% (5/99) vs. 17.7% (17/96)]. ② The results of non-conditional logistic regression analysis shown that, age (OR=1.45, P=0.008), tumor location (OR=1.72, P<0.001), TNM stage (OR=2.01, P=0.033), the number of invasive axillary lymph nodes (OR=1.15, P=0.005), and postoperative radiotherapy (OR=1.23, P=0.016) were the influencing factors of arm lymphedema after modified radical mastectomy for breast cancer, patients with age older than 60 years, tumor position at the outside area, stage Ⅲ of TNM, the number of invasive axillary lymph nodes >5, and patients received radiotherapy after operation had high risk of arm lymphedema. Conclusion Early physiotherapy can effectively prevent the occurrence of arm lymphedema after modified radical mastectomy for breast cancer, and early physiotherapy should be performed for patients with high risk of arm lymphedema.
This paper briefly introduces the basic concepts, development history, basic principles, main treatment and evaluation technologies, development status, existing problems and development trends of aquatic therapeutic exercise, and summarizes the new progress of aquatic therapeutic exercise in basic medical research and evidence-based medical research through literature analysis. It aims to provide a reference for clinical treatment, scientific research and medical education for practitioners in rehabilitation medicine and related fields by systematically analyzing the scientific principles, technical systems, application fields and evidence-based foundation of aquatic therapeutic exercise, and improve the awareness rate and application rate of aquatic therapeutic exercise in the fields of rehabilitation medicine, sports medicine, geriatrics, etc., promote the standardized development of aquatic rehabilitation.
【摘要】目的探讨腹腔镜联合盆腔理疗对输卵管性不孕症的治疗效果,旨在提高术后的受孕率。方法将2007年1月2008年12月进行诊治的不孕者86例随机分为干预组与对照组,每组43例。干预组腹腔镜手术治疗,术后进行理疗;对照组不进行理疗。调查并比较两组的治疗效果和患者满意度。结果干预组43例中13例再次宫内妊娠,受孕率为30.23%;对照组再次宫内妊娠,8例(18.60%)两组比较差异具有统计学意义(Plt;0.05)。干预组总有效率86.05%,明显优于对照组67.44%,且差异亦具有统计学意义(Plt;0.05)。患者满意率干预组为90.67%(39/43),对照组为76.74%(33/43)。两组差异具有统计学意义(Plt;0.05)。结论腹腔镜联合盆腔理疗可以有效改善治疗效果,提高再次受孕率,值得在临床实践中推广应用。