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1.
目的 比较电疗术与周围关节松动术对卒中患者肩痛的治疗效果。方法 选择卒中后肩痛患者40例,卒中病程1~3个月,分为2组:电疗组(n=20)和手法组(n=20)。在治疗前和一个疗程后,通过目测类比法、Fugl-Meyer简式运动功能评定法及关节活动范围评定法对2组患者患肩的疼痛程度、上肢运动功能及关节活动范围进行评估。结果 治疗前后,电疗组只有疼痛程度明显减轻(P <0.05),而手法组的疼痛程度、上肢运动功能和关节活动范围均有显著改善(P <0.05),且治疗后两组之间比较差异均有统计学意义(P <0.05)。结论 手法治疗是临床上治疗卒中后肩痛的一种实用有效的治疗方法,但仍需多中心,大样本临床试验加以验证。  相似文献   

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1病例介绍患者男性,59岁,因“右侧肢体活动不利5个月,伴右肩疼痛2个月余”于2019年5月7日入院。患者曾于2018年11月10日突发右侧肢体活动不利就诊于上海长海医院。入院查体:无意识障碍、二便失禁、言语不能,右上肢肌力0级,右下肢肌力1级。当天急诊头颅CT提示:左侧基底节区出血。予脱水消肿、营养神经、预防癫痫发作等治疗,1个月后病情渐稳定。因遗留右侧肢体活动不利,随后于2018年12月6日入住本社区卫生服务中心病房行康复治疗6周,经治疗患者偏瘫侧肢体由软瘫期逐渐恢复至出现自主活动。  相似文献   

3.
目的 分析早期综合康复治疗对脑卒中偏瘫患者周围神经电生理学和形态学的影响。方法 全部病例资料来源于本院2017年7月-2018年2月康复科门诊、住院治疗的脑卒中偏瘫患者共100例,根据康复治疗方法不同分为康复组(n=65,早期综合康复治疗)和对照组(n=35,常规康复治疗),治疗前、治疗3个月后以肌电图诱发电位仪、彩超仪分别进行周围神经电生理学和形态学评估,并采用量表工具评定患者运动功能及日常生活活动能力恢复效果。结果 治疗3个月后与对照组比较,康复组偏瘫侧上肢正中神经、尺神经、桡神经、腋神经、肩胛上神经及下肢胫神经、腓神经波幅明显升高,即运动神经功能改善更明显(P<0.05); 同时偏瘫侧正中神经腕横纹上方6 cm、肱骨内上髁上4 cm、肱骨中点位置及尺神经肘管入口、肱骨中点位置CSA明显大,即神经形态改善更明显(P<0.05)。此外,治疗3个月后康复组Fugl-Meyer下肢运动功能评分(FMA)评分、日常生活能力评分(ADL)评分明显高于对照组(P<0.05)。结论 早期综合康复治疗有助于促进脑卒中偏瘫患者神经电生理指标及神经形态改善,继而可有效提高运动及日常生活活动能力。  相似文献   

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电生理技术具有客观、可量化、无创、易重复的优点,在卒中患者康复评定中具有不可替代的作用。表面肌电图在运动分析和肌肉功能评估中具有很好的应用价值;通过脑电图可以了解脑功能状况;诱发电位能够反映患者的运动、感觉和认知状态;经颅多普勒可用于检测卒中患者康复前后脑血流的变化。本文对电生理技术应用于卒中患者功能障碍评定、康复效果评估以及康复治疗方案制定中的临床价值及最新进展进行综述。  相似文献   

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糖尿病周围神经病变是糖尿病最常见的慢性并发症之一,由于诊断标准不同,献报道有50%~90%的糖尿病患可合并周围神经病变。其发病机制迄今尚未完全阐明,代谢障碍及血管损害被认为可能具有重要作用。糖尿病周围神经病变起病隐匿,主要为感觉神经受累,受累方式可分为大纤维型、小纤维型和混合型3种,临床上以小纤维型最为多见,疾病早期一般仅累及无髓和有髓小纤维神经。患主要表现为温度觉的减退或消失,而糖尿病交感神经病变的早期临床症状及体征常不明显,通过临床表现判断有时较为困难。目前,临床上对糖尿病周围神经病变的早期诊断需借助多种神经电生理检查技术,它们可为该病的早期诊断提供一定的客观依据,但各种技术的诊断和监测作用有所不同。  相似文献   

6.
面向21世纪的精神电生理学研究陈兴时张明岛今天,人类已来到21世纪的门口。现对近15年来精神电生理学作一回顾,并对下一个世纪初期如何适应形势,以及应采取的措施作些考虑。一、十五年工作1.应用1948年南京神经精神病防治院首次引进脑电图仪,并于1951...  相似文献   

7.
目的观察用中西医结合的方法综合治疗卒中后肩痛的临床疗效。方法对120例诊断为脑卒中后肩痛患者分2组,治疗组60例采用中西医结合治疗;对照组60例康复及基础治疗治疗,比较2组的临床疗效。结果治疗后,治疗组总有效率为93.3%,对照组为76.7%,差异有极显著性意义(P<0.01)。结论中西医结合可最大限度地改善脑卒中后肩痛临床症状,提高患者生活质量。  相似文献   

8.
偏瘫性肩痛(hemiplegic shoulder pain,HSP)又称卒中后肩痛,指在脑卒中后2~3个月发生的肩部疼痛症状,是脑卒中后的常见并发症。HSP病因复杂,治疗方法也要根据病因进行选择。药物治疗、神经电刺激、肩胛上神经阻滞、肉毒毒素注射和重复经颅磁刺激主要用于神经因素引起的疼痛;肌内效贴、矫形器和吊带主要用于机械因素引起的疼痛;针灸主要通过疏经活络、活血化瘀增加肌肉局部的血流量,从而改善疼痛症状。对于多病因造成的HSP,推荐联合治疗以达最佳效果。  相似文献   

9.
本介绍脑电生理技术在精神科的应用情况。  相似文献   

10.
目的 建立适用于动眼神经损伤后神经再生及功能修复电生理研究的动物模型.方法 20只Beagle犬随机均分为单纯损伤组及损伤+刺激组.行右侧动眼神经海绵窦后段压榨损伤、颅内动眼神经刺激电极植入及右侧下斜肌记录电极植入.结果 实验手术均被所有实验犬耐受,下斜肌记录电极和颅内刺激电极成功植入,可用于记录运动单位电位(MUPs)及混合肌肉动作电位(CMAPs).结论 应用于动眼神经再生修复电生理研究的动物模型已经建立,此模型具有良好的可行性及可重复性.  相似文献   

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目的 分析卒中后患者上肢体感诱发电位(somatosensoryevokedpotentials,SEP)、周围神经电生理特征与运动功能的相关性。方法 此前瞻性研究连续纳入2018年6月—2022年3月康复科收治的亚急性期卒中患者,采用自身健患侧进行对比,进行双侧上肢SEP和周围神经电生理检查并对患侧上肢运动功能进行评分。分析患侧SEPP15、N20、P25、N13及N9潜伏期、感觉神经传导参数、运动神经传导参数与上肢运动功能等指标的相关性。结果 本研究共纳入卒中后亚急性期偏瘫患者102例,平均(68.76±11.33)岁,男性78例。患者偏瘫侧上肢SEPP15[(16.90±1.67)ms vs.(16.27±1.50)ms,P<0.001]、N20[(20.13±1.49)ms vs.(19.42±1.60)ms,P<0.001]、P25[(24.39±1.75)ms vs.(23.70±1.50)ms,P<0.001]、N13[(14.05±1.25)ms vs.(13.42±1.26)ms,P<0.001]及N9[(9.25±0.96)ms vs.(8....  相似文献   

16.

Objective

In order to develop a novel nerve guidance channel using porcine small intestinal submucosa (SIS) for nerve regeneration, we investigated the possibility of SIS, a tissue consisting of acellular collagen material without cellular immunogenicity, and containing many kinds of growth factors, as a natural material with a new bioactive functionality.

Methods

Left sciatic nerves were cut 5 mm in length, in 14 Sprague-Dawley rats. Grafts between the cut nerve ends were performed with a silicone tube (Silicon group, n=7) and rolled porcine SIS (SIS group, n=7). All rats underwent a motor function test and an electromyography (EMG) study on 4 and 10 weeks after grafting. After last EMG studies, the grafts, including proximal and distal nerve segments, were retrieved for histological analysis.

Results

Foot ulcers, due to hypesthesia, were fewer in SIS group than in Silicon group. The run time tests for motor function study were 2.67 seconds in Silicon group and 5.92 seconds in SIS group. Rats in SIS group showed a better EMG response for distal motor latency and amplitude than in Silicon group. Histologically, all grafts contained some axons and myelination. However, the number of axons and the degree of myelination were significantly higher in SIS group than Silicon group.

Conclusion

These results show that the porcine SIS was an excellent option as a natural biomaterial for peripheral nerve regeneration since this material contains many kinds of nerve growth factors. Furthermore, it could be used as a biocompatible barrier covering neural tissue.  相似文献   

17.
Sural nerve biopsy specimens from affected and non-affected limbs of stroke patients were examined morphometrically. Two principle abnormalities of peripheral nerve were found in hemiparetic and hemiplegic limbs. First, the frequency of abnormal teased nerve fibers was significantly increased with abnormal internodes frequently "clustered" and showing a 50% or more reduction in myelin thickness. Second, the mean diameter of myelinated nerve fibers was reduced. These results suggest a primary atrophy of peripheral nerve fibers in the affected limbs of stroke patients with secondary demyelination. Possible aetiological factors include disuse, transynaptic degeneration, ischemia, pressure effect, and decreased axoplasmic flow. It would seem that the structural integrity of peripheral nerve is frequently compromised following a cerebral lesion.  相似文献   

18.
目的 探讨异种神经脱细胞移植物桥接大鼠坐骨神经缺损后的神经再生及其再生过程中免疫排斥反应。 方法 用脱细胞兔周围神经作为移植物桥接大鼠坐骨神经1cm缺损;术后3、5、8、11、15天检测血液中淋巴细胞占白细胞百分比;3个月后取移植物及腓肠肌,用甲苯胺蓝、乙酰胆碱酯酶(AchE)、琥珀酸脱氢酶(SDH)组化染色,光、电镜观察神经再生及腓肠肌运动终板的恢复情况。  结果 术后大鼠血液中淋巴细胞占白细胞的百分比与正常大鼠相比较无显著性差异,3个月后大鼠术侧下肢足趾能分开,行走时后蹬动作有力,针刺足底有逃避反应,桥接物内见有大量再生的坐骨神经纤维,腓肠肌肌纤维上见有呈AchE阳性的运动终板和神经纤维。  结论 异种神经脱细胞移植物桥接大鼠坐骨神经缺损具有促进其再生的作用。  相似文献   

19.
Two cases of chronic pelvic pain of unknown etiology with symptoms referable to the low abdominal wall are presented. These patients are often difficult to manage because of multiple causes and multiple pathways for pain transmission from the pelvis. In these cases, the patients’ complaints were refractory to medication management, as well as diagnostic and therapeutic nerve blockade. After careful evaluation, a successful trial of peripheral nerve stimulation was followed by permanent implantation of low abdominal subcutaneous leads and a pulse generator device. The patients reported excellent relief of their chronic pelvic pain. The use of neuromodulation via peripheral stimulation deserves further investigation as an alternative to spinal cord stimulation for chronic pelvic pain.  相似文献   

20.
ObjectiveOur aim was to evaluate the histopathological effects of tissue adhesives on peripheral nerve regeneration after experimental sciatic nerve transection in rats and to search whether these tissue adhesives may possess a therapeutic potential in peripheral nerve injuries.MethodsThis experimental study was performed using 42 female Wistar-Albino rats distributed in 6 groups subsequent to transection of right sciatic nerves. Group I underwent external circumferential neurolysis; Group II received suture repair; Group III had local polymeric hydrogel based tissue adhesive administration; Group IV received suture repair and polymeric hydrogel based tissue adhesive application together; Group V had gelatin based tissue adhesive application and Group VI had suture repair and gelatin based tissue adhesive together. After a 6-week follow-up period, biopsies were obtained from site of neural injury and groups were compared with respect to histopathological scoring based on inflammatory, degenerative, necrotic and fibrotic changes.ResultsThere were remarkable differences between control group and study groups with respect to inflammation (p=0.001), degeneration (p=0.002), necrosis (p=0.007), fibrosis (p<0.001) and vascularity (p=0.001). Histopathological scores were similar between study groups and the only noteworthy difference was that Group V displayed a lower score for necrosis and higher score in terms of vascularization.ConclusionOur results imply that tissue adhesives can be useful in repair of peripheral nerve injuries by decreasing the surgical trauma and shortening the duration of intervention. Results with gelatin based tissue adhesive are especially promising since more intense vascularity was observed in tissue after application. However, trials on larger series with longer durations of follow-up are essential for reaching more reliable conclusions.  相似文献   

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