Післяопераційна реабілітація пацієнтів із синдромом латеральної гіперпресії надколінка

Background Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a surgical treatment to reduce the “off” state motor symptoms of Parkinson's disease (PD). Postural instability is one of the major impairments, which induces disabilities of activities of daily living (ADLs). The effectiveness of STN-DBS for postural instability is unclear, and the effect of rehabilitation following STN-DBS has remained uncertain. Objective The purpose of this study was to examine changes in balance ability, gait function, motor performance, and ADLs following 2 weeks of postoperative rehabilitation in PD patients treated with STN-DBS. Methods Sixteen patients were reviewed retrospectively from February 2016 to March 2017. All patients were tested in their “on” medication state for balance and gait performance using the Mini-Balance Evaluation Systems Test (Mini-BESTest) and the Timed “Up and Go” (TUG) test before the operation, after the operation, and during the discharge period. The UPDRS motor score (UPDRS-III) and Barthel Index (BI) were assessed before the operation and during the discharge period. Rehabilitation focused on muscle strengthening with stretching and proactive balance training. Friedman's test and the post hoc Wilcoxon's signed-rank test were used to analyze the balance assessments, and ANOVA and the post hoc Tukey's test were used to analyze gait performance. The significance level was p < 0.05. Results During the discharge period, the Mini-BESTest and TUG were significantly improved compared with the preoperative and postoperative periods (p < 0.05). There were no differences between preoperative and postoperative periods in the Mini-BESTest (p=0.12) and TUG (p=0.91). The BI and motor sections of the UPDRS did not differ significantly between the preoperative and postoperative periods (p=0.45, p=0.22). Conclusion The results of this study suggest that postoperative rehabilitation improves balance and gait ability in patients with PD treated with STN-DBS.

Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms. Surgical intervention constitutes a critical therapeutic approach for this condition. Nonetheless, postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided. To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer. In this study, a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients. The subjects were selected as subjects and divided into two groups based on differing nursing interventions, with each group comprising 30 patients. The control group received standard nutritional support and care, whereas the experimental group received individualized nutritional support and nursing strategies. The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices, nutritional status, quality of life (QoL), and complication rates between the two groups. The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery, and the average liver function recovery index of the experimental group was 85. significantly higher than that of the control group (73.67 ± 7.19). In terms of nutritional status, the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group, which were 42.33 ± 2.4 g/L and 93.3%, respectively, compared with 36.01 ± 3.85 g/L and 76.7% of the control group. In addition, the average QoL score of the experimental group was 84.66 ± 3.7 points, which was significantly higher than that of the control group (70.92 ± 4.28 points). At the psychological level, the average anxiety score of the experimental group was 1.17 ± 0.29, and the average depression score was 1.47 ± 0.4, which were significantly lower than the 2.26 ± 0.42 and 2.57 ± 0.45 of the control group. This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy. More importantly, the complication rate in the experimental group was only 10%, much lower than the 33.3% in the control group. Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients. Consequently, it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.

Objective To explore the effects of family involvement and online extended nursing for postoperative rehabilitation in patients with cervical spinal cord injury (CSCI) . Methods Totally 60 CSCI patients who were admitted and received surgery in Honghui Hospital, Xi'an Jiaotong University from October 2013 to July 2016 and their major caregivers after being discharged from hospital were equally divided into an observation group (n=30) and a control group (n=30) according to the random number table. Patients in the control group received conventional instructions 1 day before being discharged from hospital and telephone follow-ups in Week 1, Month 1, Month 3 and Month 6 after being discharged from hospital, while patients in the observation group received extended nursing via WeChat groups on this basis. The quality of life, incidence of complications and compliance of rehabilitation exercise six months after surgery were compared between the patients in the two groups. Results The patients in the two groups showed higher scores in various dimensions indicating the quality of life six months after surgery than they did at discharge, and the patients in the observation group showed higher scores than the patients in the control group (P 0.05) . The patients in the observation group showed higher compliance of rehabilitation exercise than the patients in the control group (P<0.05) . Conclusions Family involvement and WeChat extended nursing helps to build a long-term service system for CSCI patients and accelerate their postoperative rehabilitation, thus worthy of expansion and application. Key words: Rehabilitation nursing; Cervical spinal cord injury; Extended nursing; Family members; WeChat

In patients with hip fracture, anemia may result as a direct consequence of the injury or surgery. Red blood cell transfusions are commonly administered to surgical patients in response to operative hemorrhage, and to treat anemia. However, the impact of transfusions on mortality and morbidity in patients with hip fracture is still unclear. A large observational study finds no beneficial effect of transfusion on mortality regardless of the presence of preexisting cardiovascular disease [1]. Other studies suggest that anemia decreases physical performance and postoperative rehabilitation in patients with hip fracture, and red blood cell transfusions improve short-term functional outcomes [2, 3]. To date, there are few randomized clinical trials (RCT) assessing the clinical impact of different transfusion thresholds. A large study involving patients in intensive care units shows that a restrictive strategy of redcell transfusion is at least as effective as and possibly superior to a liberal transfusion strategy in critically ill patients [4]. However, there are no RCTs evaluating the safety of withholding transfusion until symptoms of anemia develop in patients with hip fracture. Furthermore, the safety of symptomatic transfusion in patients with cardiovascular disease and the impact of a lower transfusion threshold on functional recovery after surgical hip repair have not been studied. Summary

Effects of early enteral nutrition on postoperative rehabilitation in patients with pancreaticoduodenectomy

Purpose The aim of this study was to evaluate work ability, activity limitations and physical activity in adults that had gone through major bone sarcoma resection and reconstruction surgery in hip and knee. Materials and methods Twenty patients, of 72 enrolled, and 20 controls were included in this cross-sectional study. Work Ability Index scores (general [0–10 points], physical and mental [1–5 points]), the Patient Specific Functional Scale (0–10 points), step counts and the International Physical Activity Questionnaire (IPAQ) were assessed. Adjusted and unadjusted general linear models were applied. Results The patients had a mean age of 43 (range, 20–71) years and were assessed 7 years (range, 2–12) after surgery (proximal femoral n = 9, distal femoral n = 7, proximal tibia n = 4). Compared with controls, patients had lower general work ability (mean difference [95%CI], −1.3 points [−2.1, −0.5]) and work ability in relation to physical demands at work (−1.4 points [−2.0, −0.8]). The patients reported higher severities of activity limitation (−6.7 points [−7.9, −5.4]). There were no between-group differences in step counts or IPAQ-scores. Conclusion Despite similar levels of physical activity, patients showed poorer work ability and severe activity limitation. Post-operative rehabilitation in patients of the working-age population should include assessments of work ability and activities important to the individual. IMPLICATIONS FOR REHABILITATION Adults that have gone through resection and reconstruction surgery following bone sarcoma in lower extremity show clinically relevant reductions in work ability and self-selected activities To tailor post-operative rehabilitation at short and long term, initial assessment and monitoring should include work ability and activities important to the individual patient.

Traditional nursing usually focuses on the rehabilitation of patients undergoing colorectal cancer surgery at the post-operative stage, but many clinical studies have found that early detection and adjustment or correction of risk factors affecting the post-operative rehabilitation of patients with colorectal cancer before operation can reduce postoperative complications, enhance recovery after surgeries and improve the patients' quality of life. This paper summarizes the research on the intervention applying the pre-rehabilitation concept on the colorectal cancer patients' preoperative motor ability, nutritional status, psychological status, history of tobacco and alcohol, anemia, in order to provide theoretical basis for the clinical practice of pre-rehabilitation concept. Key words: Colorectal neoplasms; Operation; Pre-rehabilitation; Enhanced recovery after surgery

Efficient pain management is essential for postoperative rehabilitation in patients undergoing a tumor resection with an immediate reconstructive surgery. Ultrasound-guided quadratus lumborum block has been described for abdominal or hip surgery, but not for concomitant surgery in the abdomen and the thigh. The paraspinous transmuscular approach has easy landmarks to perform this block. We present a case of a patient undergoing a resection of a sarcoma in the lower limb with an immediate reconstruction with a pedicled vertical designed deep inferior epigastric perforator flap, in whom a successful paraspinous transmuscular quadratus lumborum block for postoperative analgesia was performed.

SUMMARYThe gold standard for pertrochanteric fractures is closed reduction with traction and intramedullary osteosynthesis. A significant number of patients report knee pain after surgery, which could be associated with gonarthrosis and traction. In this research we wanted to determine if managing knee pain affects the rehabilitation of patients. There were three groups: the first group received a post-operative intra-articular (IA) injection containing methylprednisolone with lidocaine; the second group received the same combination periarticularly (PA); and the control group did not receive any form of injection. We measured the Visual Analogue Scale (VAS) score on the 3rd and 12th postoperative days, as well as six weeks after surgery. We measured knee range of motion (ROM) on the 12th postoperative day and six weeks after surgery. We calculated the Harris Hip Score (HHS) on the 3rd day and six weeks postoperatively. There were 27 patients. Preoperative Kellgren-Lawrence and VAS pain scores were similar. The IA group demonstrated the lowest VAS pain score after six weeks. ROM did not improve between groups on the 12th day and six weeks postoperatively. HHS was best in the IA group after 6 weeks. Injection of methylprednisolone with lidocaine into the knee improved postoperative rehabilitation in patients with knee osteoarthritis undergoing ipsilateral cephalomedullary fixation for a pertrochanteric fracture.

Objective:&amp;nbsp;To explore the clinical effect of combining traditional Chinese medicine techniques with psychological counseling on the postoperative rehabilitation of patients with mixed hemorrhoids.&amp;nbsp;Methods:&amp;nbsp;A total of 100 patients with mixed hemorrhoids who underwent surgical treatment at our hospital from January 2024 to December 2024 were randomly selected. According to a random number table, they were divided into two groups: 45 patients receiving routine care (control group), and 45 patients receiving routine care combined with traditional Chinese medicine techniques and psychological counseling (observation group). The nursing interventions included herbal hot compresses, herbal sitz baths, acupoint application, auricular acupuncture, and psychological counseling. The rehabilitation indicators, VAS (Visual Analog Scale) scores, anal heaviness scores, anal edema scores, bowel movement conditions, and complication rates were compared between the two groups.&amp;nbsp;Results: The wound healing time in the observation group was (12.97 &amp;plusmn; 3.15) days, the recovery time for wound edema was (4.62 &amp;plusmn; 1.15) days, and the time of postoperative bleeding after defecation was (5.92 &amp;plusmn; 0.86) days. In the control group, the corresponding times were (15.52 &amp;plusmn; 3.96) days, (5.45 &amp;plusmn; 1.59) days, and (7.12 &amp;plusmn; 1.24) days. The observation group showed significantly shorter times (P&amp;nbsp;&lt; 0.05). The VAS scores, anal heaviness scores, anal edema scores, difficulty in defecation, stool frequency, sensation of incomplete defecation, and stool characteristics at 3 days and 7 days postoperative were lower in the observation group compared to the control group (P&amp;nbsp;&lt; 0.05). The total complication rate in the observation group was lower than that in the control group (P&amp;nbsp;&lt; 0.05).&amp;nbsp;Conclusion:&amp;nbsp;The combination of traditional Chinese medicine techniques and psychological counseling helps promote early recovery and health restoration in patients with mixed hemorrhoids postoperatively, reduces wound healing time and edema recovery time, alleviates postoperative pain, and lowers the incidence of complications. This approach is worth adopting.

Surgical interventions in the nasal cavity are accompanied by reactive phenomena in the postoperative period. On their background the process of physiological regeneration is disorganized resulting in impaired physiological functions of the nasal cavity.The objective of the research was to study the recovery process of the main physiological functions of the nasal cavity in patients with aspirin-intolerant polypous rhinosinusitis in the postoperative period.Materials and methods. 80 patients with aspirin-intolerant polypous rhinosinusitis at the age of 24-57 years were operated on.All the patients were divided into 2 groups: the control group included 30 patients; the main group comprised 50 patients.Patients of the control group received nasal cavity cleaning, nasal mucosa anemisation, irrigation therapy since the first day of the postoperative period.Patients of the main group received an herbal drug BNO-101 additionally. The effectiveness was assessed on the 3rd, 7th and 10th days of treatment.Results. The postoperative rehabilitation with the inclusion of botanical preparation BNO-101 provided a significant improvement of nasal breathing, mucociliary transport rate and indicators of nasal peak flowmetry compared to the control group. Despite subjective improvement of nasal breathing the indicators of the peak expiratory flow rate in the main group were 34.2% lower than the norm while in the control group they were 54.7% lower than normal ones thereby justifying further treatment.Conclusions. The postoperative rehabilitation of patients with aspirin-intolerant polypous rhinosinusitis provided more rapid improvement of the main functions of the nasal cavity compared to the control group.

The coactivation (Co-A) of shoulder muscles that contribute to humeral head depression can lead to mechanical unloading of the subacromial structures during abduction and thus can be beneficial for patients with arthroscopic rotator cuff repair (ARCR). The present study aims to examine the effectiveness of humeral head depressor muscle Co-A (DM-Co-A) training on clinical outcomes in a sample of patients with ARCR. We hypothesized that DM-Co-A training with medioinferior vector during glenohumeral exercises can improve clinical results in the rehabilitation of ARCR. Randomized controlled single-blind study. Level 1B. A total of 27 patients who underwent ARCR after a medium-sized rotator cuff tear and completed their Phase 1 training with ≥80% compliance were included. Together with 14 weeks of conservative treatment (6 weeks of Phase 2 training and 8 weeks of Phase 3 training), synchronized "DM-Co-A Training" was applied to the treatment group with an electromyography (EMG) biofeedback (EMG-BF) device. Patients in the treatment group were asked to voluntarily activate the humeral head depressor muscles guided by visual and auditory feedback of the EMG-BF device during the Phase 2 and Phase 3 conservative treatment exercises performed by the control group. Demographic characteristics of the participants were recorded. Visual analog scale and universal goniometer were used to assess pre- and posttreatment pain severity and joint range of motion, respectively. The Disabilities of Arm, Shoulder and Hand Questionnaire, Revised Oxford Shoulder Score, Modified Constant-Murley Shoulder Score, and the Western-Ontario Rotator Cuff Index were used to assess functionality. There was a clinically meaningful improvement in pain severity, active ROM excluding internal rotation, and functionality in the treatment group compared with the control group (P < 0.05). A 14-week duration DM-Co-A with EMG may be beneficial in the postoperative rehabilitation of patients after ARCR.

Value of Fast Recovery Nursing and Diet Intervention in Postoperative Rehabilitation of Patients with Colorectal Cancer after Radical Operation

BackgroundBu-Shen-Huo-Xue (BSHX) decoction has been used in the postoperative rehabilitation of patients with spinal cord injury in China. In the present study, we aim to reveal the bioactive compounds in BSHX decoction and comprehensively explore the effects of BSHX decoction and the underlying mechanism in spinal cord injury recovery.MethodsThe main chemical constituents in BSHX decoction were determined by UPLC–MS/MS. SCI mice were induced by a pneumatic impact device at T9–T10 level of the vertebra, and treated with BSHX decoction. Basso–Beattie–Bresnahan (BBB) score, footprint analysis, hematoxylin–eosin (H&E) staining, Nissl staining and a series of immunofluorescence staining were performed to investigate the functional recovery, glial scar formation and axon regeneration after BSHX treatment. Immunofluorescent staining of bromodeoxyuridine (BrdU), neuronal nuclei (NeuN) and glial fibrillary acidic protein (GFAP) was performed to evaluate the effect of BSHX decoction on neural stem cells (NSCs) proliferation and differentiation.ResultsWe found that the main compounds in BSHX decoction were Gallic acid, 3,4-Dihydroxybenzaldehyde, (+)-Catechin, Paeoniflorin, Rosmarinic acid, and Diosmetin. BSHX decoction improved the pathological findings in SCI mice through invigorating blood circulation and cleaning blood stasis in the lesion site. In addition, it reduced tissue damage and neuron loss by inhibiting astrocytes activation, and promoting the polarization of microglia towards M2 phenotype. The functional recovery test revealed that BSHX treatment improved the motor function recovery post SCI.ConclusionsOur study provided evidence that BSHX treatment could improve the microenvironment of the injured spinal cord to promote axonal regeneration and functional recovery in SCI mice.

Clinical Analysis of Individualized Nursing Intervention in Postoperative Rehabilitation of Patients with Gynecological Minimally Invasive Surgery