急性脑卒中患者三级康复治疗6个月综合功能恢复的临床分析

目的:探讨急性脑卒中患者进行三级康复治疗6个月综合功能的恢复。方法:196例急性脑卒中偏瘫患者随机分成两组,康复组和对照组,按照三级康复方案,一级康复(<28d).两组均住院进行早期康复治疗;二级康复(>28d),康复组在康复机构或医院继续治疗,对照组自行在家训练;三级康复(>3个月),康复组在家或社区进行康复治疗。结果:康复组治疗后6个月临床神经功能缺损、运动功能评分及改良巴氏指数评分均优于治疗前及对照组(P<0.01,P<0.05)。结论:急性脑卒中患者三级康复治疗综合功能恢复明显,可明显降低患者的依赖程度,提高生存质量。     

康复指导对脑卒中偏瘫患者运动功能恢复的影响

偏瘫是脑卒中引起的最常见的功能障碍,致残率在其存活者中高达80%以上[1],脑卒中偏瘫患者在病情稳定后尽早进行康复干预,对整体日常生活活动能力的改善有利[2].我们对脑卒中偏瘫患者住院期间进行早期康复指导及出院后继续进行维持性康复指导治疗,3个月后对偏瘫患者的肢体运动功能及日常生活活动能力恢复的影响进行了临床评估,现报告如下.     

早期康复干预管理模式对急性脑卒中患者神经功能恢复的影响

目的探讨早期康复干预管理模式对急性脑卒中患者神经功能恢复的影响。方法将80例急性脑卒中偏瘫患者随机分成2组,即早期康复干预组40例,患者生命体征平稳48 h即在神经内科病房开始执行康复干预,行床边康复治疗,30 d后转至康复科行常规康复训练30 d;对照组40例,也在神经内科接受神经内科常规治疗及护理,30 d后转至康复科行常规康复训练30 d。所有患者均在生命体征平稳48 h（入选时）及康复系统训练30 d（转到康复科时）及转至康复科30 d给予神经功能评测,即采用简式Fugl—Meyer运动功能评测法及改良Barthel指数（MBI）以评定患者的运动功能及ADL评分。结果两组患者在康复系统训练30和60 d后运动功能及ADL评分均有明显改善,早期康复干预组的治疗效果明显优于对照组（P〈0.01）。结论早期康复干预可促进急性脑卒中患者运动功能的康复,提高日常生活活动能力及生存质量。     

早期综合治疗脑卒中后抑郁临床对比观察

脑卒中后抑郁(PSD)是脑卒中后的一种常见并发症,脑卒中后抑郁发生率约为60%[1],严重影响脑卒中患者急性期的治疗,延缓患者的神经功能和认知功能恢复,影响患者后期的生活能力和生活质量。随着对PSD认识的提高,临床神经内科医师意识到抑郁状态是影响脑卒中患者康复的主要障碍之一,对脑卒中患者抑郁的治疗直接关系到病人的预后,因而早期诊断和治疗抑郁在脑血管病治疗中愈来愈重要。     

急性脑卒中患者的早期康复治疗分析

目的探讨早期康复对急性脑卒中患者功能预后的影响。方法在患者生命体征稳定后,选择80例急性脑卒中患者,随机分为早期康复组和对照组,进行日常生活活动能力的(ADL)评价,40例进行早期康复治疗,30d后再次评价。结果早期康复治疗组ADL评分较对照组改善程度更大(P<0.05)。结论早期康复可促进功能恢复,对脑卒中患者预后有优良的影响。     

急性脑卒中患者的早期康复治疗分析

目的探讨早期康复对急性脑卒中患者功能预后的影响。方法在患者生命体征稳定后，选择80例急性脑卒中患者，随机分为早期康复组和对照组，进行日常生活活动能力的（ADL）评价，40例进行早期康复治疗，30d后再次评价。结果早期康复治疗组ADL评分较对照组改善程度更大（P〈0．05）。结论早期康复可促进功能恢复，对脑卒中患者预后有优良的影响。     

脑卒中后抑郁临床研究进展

脑卒中后抑郁是影响脑卒中患者生存和功能恢复的严重并发症,患病率约30%,多发生于脑卒中1年内,尤其是脑卒中3个月内。其危险因素主要包括脑卒中后病残、脑卒中前抑郁病史、脑卒中严重程度、认知功能障碍和焦虑症状等。治疗方法主要有药物治疗、心理治疗、康复治疗和物理治疗等,其中康复治疗可以显著减少脑卒中后抑郁发生率,改善预后。进一步深入研究脑卒中后抑郁发生机制、优化康复治疗方案,对改善预后具有重要意义。     

早期康复对脑卒中患者治疗的影响

目的 探讨早期康复治疗对脑血管病偏瘫患者肢体功能恢复及日常生活活动(ADL)能力的作用.方法 选择急性脑血管病偏瘫患者210例,均为首次发病,随机分为康复治疗组及对照组.康复治疗组患者在神经科常规治疗基础上给予简单常规的康复治疗,以运动疗法为主;对照组给予神经科常规治疗.每例患者在治疗前,治疗后2周、1个月及半年时分别用Fugl-Meyer运动功能(FMA)量表测试运动功能、改良Barthel指数量表(MBI)测试ADL能力和神经功能缺损评分.结果 康复治疗组患者1个月及半年时ADL运动功能恢复均明显优于对照组.结论 早期的康复治疗对脑卒中偏瘫患者运动功能和日常生活活动能力具有良好的促进作用,可提高其生活质量,减少日后并发症.     

针灸结合Bobath疗法综合治疗脑卒中后功能障碍的疗效评价

目的探讨针灸与Bobath疗法相结合的早期康复综合治疗方法对脑卒中后功能障碍者的恢复作用.方法将60例脑卒中后偏瘫病人随机分为早期康复综合组与对照组各30例.对照组采用常规药物治疗,早期康复综合组在常规药物治疗的同时接受早期康复综合疗法.两组病人分别在入院、出院时进行病类诊断积分及Barthel指数总分的评定并进行比较.结果病类诊断积分恢复程度和Barthel指数总分恢复程度,均表明早期康复综合组脑卒中患者的恢复较药物组更好(P＜0.01).结论针灸与Bobath疗法相结合的早期康复综合治疗方法对脑卒中患者的功能恢复有确切疗效.     

缺血性脑卒中后神经可塑性与运动功能恢复研究进展

卒中是导致死亡的第1位原因,也是导致成人致残的首要原因[1].在既往报道的大量缺血性脑卒中病例中,仅少数患者完全恢复,大多数患者残留有不同程度的永久性缺陷[2].然而,尽管卒中造成的功能损害很严重,但由于受损神经的重塑及相应部位的功能重组,受损功能仍能得以不断的恢复.本综述旨在介绍缺血性脑卒中后神经可塑性与运动功能的恢复的关系及其可能机制,为康复治疗提供有价值的资料.     

Mental illness in England,in Scotland and in Scots living in England

Summary Beginning from the observation that Scots living in England have much higher rates of mental hospital admission than do the English, several hypotheses are proposed to account for this. Much of the excess in rates of mental illness is accounted for by those diagnosed as having alcohol-related disorders and behaviour and personality problems. The results of an examination of offical statistics in the two countries enabled some explanations to be offered. It was found that rates of admissions to mental hospitals are higher in Scotland than in England but not as high as those found among Scots migrants who have a much higher rate of readmission to hospitals than either of the other groups. In fact, if first admissions only are considered the rates of admission in Scotland are not only higher than rates for English natives but also higher than for Scottish migrants. It seems that Scots living in England are somewhat less likely to become mental patients than Scots in Scotland but that once they do achieve this status they are very much more likely to be readmitted on subsequent occasions. It was concluded that there might be two fairly distinct groups of migrants from Scotland to England who have different backgrounds, different reasons for migrating and different psychological characteristics. On the one hand there are stable, economically motivated migrants who move south for definite employment related reasons and who show few psychological symptoms. While on the other hand there is a group of migrants who perhaps have psychological problems and who move more in hope than expectation without definite prospects and who account for the high rates of mental hospital admission found in Scottish migrants.     

Prostacyclin release in the coronary circulation during sustained stimulation in in vitro and in in vivo experimental systems

Prostacyclin release from rat isolated perfused hearts and from dog coronary circulation was studied by measuring immunoreactive 6-keto-PGF1 alpha (6-keto-PGF1a) in heart perfusate and in plasma obtained from the great cardiac vein respectively. Continuous infusion of arachidonic acid at constant concentration in isolated perfused hearts induced an increased prostacyclin release. This release showed a rapid peak within 10 min and a subsequent decrease. Low-flow ischemia induced an increased perfusate concentration of 6-keto-PGF1a but, considering the decreased flow, prostacyclin release was actually reduced. During the whole period of ischemia (60 min) prostacyclin release was constant. In open-chest anesthetized dogs 6-keto-PGF1a concentration in the great cardiac vein was increased after ligation of the left anterior descending coronary artery. A prolonged period of coronary occlusion (4.5 hours) resulted in a progressive rise of prostacyclin release. 6-keto-PGF1a determinations in the femoral vein and in the aorta did not show relevant variations during the observation period.     

Neuroimaging in epilepsy in tropics

Epilepsy is a major public health problem in many tropical countries. Also, some of the tropical diseases are major contributors to the higher prevalence of epilepsy in these countries. The etiologic factors responsible for epilepsy in these countries are quite different from those in the developed world. This article discusses the etiologic factors and neuroimaging of epilepsy in light of the conditions in these tropical countries.     

癫痫与抑郁关系的研究进展

抑郁是癫痫患者中常见的精神障碍,严重地影响了患者的生活质量。传统的观点认为癫痫患者因为存在着诸多社会学问题易出现抑郁倾向,癫痫和抑郁是单向的联系,但大量的研究已经证明癫痫和抑郁之间存在双向的联系,一种异常状态的存在可能易转化为另一种异常状态的发展。癫痫和抑郁存在着共同的发病机制。本文主要就癫痫和抑郁的双向联系以及抗抑郁药物在癫痫患者中的应用进行阐述。