影响急性脑卒中后吞咽障碍康复的相关因素分析

目的 探讨影响急性脑卒中后吞咽障碍康复的相关因素.方法 收集经规范康复治疗的吞咽障碍患者的临床资料,对年龄、性别、病变部位、症状、体征和吞咽障碍等指标与患者的预后进行相关性分析.结果 年龄、发病次数、病变部位、认知障碍、感觉性失语、视听觉障碍、康复介入时间、是否合作、吞咽障碍程度与患者的预后明显相关(P均<0.05),而与性别、血脂异常、高血压、糖尿病、肺炎、病灶数、侧别、脑出血或梗死无相关性(JP均>0.05).结论 根据脑卒中患者发病及入院时资料可协助判断吞咽障碍的预后,为患者制定科学合理的康复措施.     

社区康复对脑卒中偏瘫患者预后的影响

脑卒中患者经急性期抢救治疗后,有许多患者由于经济原因不能得到住院康复治疗.为探索行之有效且经济的康复方法,我们对92例因经济原因不能受到住院康复治疗的患者进行了研究,进一步验证和探讨社区康复对脑卒中偏瘫患者预后的影响.     

乙型肝炎肝窦病变的体视学定量研究

乙型肝炎(HB)病变中,肝窦病变与肝血管病变及肝纤维化和预后密切相关[1-7].研究肝窦病变的量化指标与HB及肝硬变的关系,对了解肝内微循环状况及其病理机制、实施治疗、判断预后皆有重要的意义.     

超早期气管插管支持下中西医康复治疗重型颅脑损伤65例疗效分析

重型颅脑损伤保持呼吸道通畅是治疗的关键措施之一.而给予超早期气管插管对于维持正常的呼吸功能,争取积极治疗具有重要意义.中西医康复治疗对疾病的预后及提高生活质量有积极影响.本文对我科2000年6月至2010年6月期间收治的重型颅脑损伤患者进行回顾性分析,探讨超早期气管插管及中西医康复治疗对患者预后的影响.     

食管癌放射治疗85例

目的:探讨食管癌放射治疗的疗效及其影响预后的相关因素.方法:收集2004-04/2009-04采用非手术综合治疗的食管癌患者85例进行预后分析,探讨影响预后的临床因素.生存率采用Kaplan-Meier法进行计算,并采用对数秩和检验(Log-rank test法)进行单因素分析,采用Cox比例风险模型对可能影响其预后的因素进行多因素回归分析.结果:随访率100%,1、3年生存率分别为65.9%、29.4%.单因素分析影响食管癌预后的因素有年龄、病变部位、病变长度、临床分期、治疗方式、放疗技术和近期疗效,而性别、放疗剂量大小与预后无关.Cox比例风险回归模型进行多因素分析显示治疗方式、临床分期和近期疗效为影响预后的独立因素.结论:食管癌放疗后总体生存率仍然较低,治疗方式、临床分期和近期疗效是影响食管癌预后的主要因素.     

基底动脉尖综合征32例临床观察及短期预后分析

目的 分析基底动脉尖综合征(TOBS)的临床及影像学特征,并探讨其短期预后的相关性因素.方法 收集32例诊断明确的TOBS患者临床资料,治疗30 d预后不良的相关性因素.结果 临床表现以意识障碍、瞳孔异常、眼球运动障碍为主; 磁共振弥散加权扫描( DWI) 能准确显示TOBS 梗死病灶部位及数目,磁共振血管成像(MRA)能直接反应椎动脉、基底动脉及大脑后动脉情况.受累病变的数量与预后不良相关.结论 TOBS临床表现多样,早诊断、早治疗对预后至关重要;受累病变的数量与预后密切相关.     

心电图aVR导联ST段变化的临床意义

心电图aVR导联ST段的抬高或压低,往往提示病人存在严重的冠状动脉左主干病变、前降支近段病变或三支病变,病人的预后较差,需要及时的干预治疗.     

心脏康复对房颤影响的研究进展

房颤是一种常见的心律失常,与脑卒中、心力衰竭和心血管死亡风险的增加有关,严重危害人类健康.心脏康复治疗可改善患者的运动能力、生活质量和预后,故已被推荐用于冠心病、心力衰竭和其他慢性心脏疾病的综合治疗,但目前在房颤治疗中应用较少.本文系统回顾了心脏康复对房颤的作用及其研究进展.     

阻塞性肺气肿缓解期的治疗

阻塞性肺气肿的缓解期,是阻塞性肺气肿的稳定期,肺气肿的基本病变是气流不可逆阻塞.此期仍需进行包括药物、氧疗、呼吸康复等治疗.     

脑卒中的早期康复治疗进展

从脑卒中早期康复治疗的意义、治疗机制、开始时间、治疗方法、预后预测、早期康复治疗中需要注意的问题等方面对近10年来脑卒中后早期康复治疗现状进行综述。     

Comparative evaluation of different programs of physical rehabilitation in acute myocardial infarct]

The conducted randomized comparative study of 305 patients with acute myocardial infarction included into different programmes of physical rehabilitation has demonstrated that better results are achieved with fast rehabilitation in those with a relatively mild and moderate course of the disease, and with comparatively slower rehabilitation--in those with severe lesions. The regimen of motor activity has to be recommended on an individual basis to the infarction patients, with due regard of the severity of their state and its prognosis. A programme of rehabilitation is presented that prescribes the scope and tempo of motor activity extension depending on the severity and prognosis of the lesion determined mathematically on the basis of the described original technique.     

急性卒中患者瘫肢主动运动的预后价值和影响因素

肢体康复是卒中患者生活质量改善的关键问题之一.研究表明,卒中急性期患肢主动运动的保留或恢复对预后具有预测价值;责任病灶的部位和急性期康复训练町能是影响瘫痪上肢主动运动能力恢复的重要因素.但是,目前尚缺乏多中心大样本研究,需进一步开展相关研究.     

进展性缺血性脑卒中预后影响因素分析

目的探讨进展性缺血性脑卒中患者30天预后的影响因素,为临床诊治提供理论依据。方法预后据神经功能缺损评分分为好转(基本痊愈、显著进步和进步)和未好转(病情无变化、恶化和死亡),对经过综合治疗的219例进展性缺血性脑卒中患者的有关指标与30天预后的关系进行单因素和多因素分析。结果营养支持、康复治疗、梗死面积、梗死后出血、年龄、并发症及Barthel指数是影响进展性缺血性脑卒中预后的相关因素。结论积极营养支持、早期康复介入、改善缺血区供血以及防止并发症可能是改善预后的重要环节。     

La réadaptation cardiaque chez la femme coronarienne

Coronary artery disease (CAD) occurs later in life in women when compared to men (10 years later). The FAST-MI study has shown that the profile of women with CAD has changed in the past 15 years, they are younger, more obese, and usually smokers. Whatever the age at which CAD occurs in women, the prognosis tends to be worse than in men, despite a higher frequency of acute coronary syndrome (ACS) with angiographically normal coronary arteries in women. In women without significant lesion at coronary angiography, the WISE study has shown abnormalities of the coronary vasomotricy. Despite its beneficial effect on morbidity and mortality, cardiac rehabilitation is underused particularly in women. Indeed, several factors do not encourage a woman to follow a cardiac rehabilitation program, even after an ACS. These factors may be cultural, domestic, familial, orthopedic, or even the fear of exercising. Therefore, physicians have to be particularly convincing in women, in order to have them participating in rehabilitation programs. Physical capacity is lower in women when compared to men. However, the weaker the physical capacity, the better the benefit of cardiac rehabilitation. Physical endurance training continuously or in interval, associated to muscle strengthening can improve the physical capacity in women. Vascular risk factors correction is also an important step for the management of women with CAD. Therapeutic education and several available workshops help women to better understand their disease and to improve their self-management when they return home. Anxiety, depression, and sexual dysfunction frequently deteriorate the quality of life of our patients. Therefore, psychological management is also essential in our departments.     

Relationship among multifaceted factors including blood pressure at discharge and long-term clinical outcome in patients with cardiovascular diseases

The relationship among blood pressure (BP) levels at discharge, other multifaceted factors assessed in cardiac rehabilitation programs, and prognosis for up to 2 years was examined in 154 consecutive cases (132 patients; 69 males; 79 ± 12 years, mean ± SD). A total of 72 composite events occurred (58 rehospitalizations from cardiovascular causes and 14 all-cause death events). The relationship between the systolic BP (SBP) at discharge and the long-term prognosis formed a J-shaped curve, with the event rate being lowest in patients with SBP of 115–125 mmHg. This relationship was still significant after adjustment of multifaceted factors assessed in cardiac rehabilitation programs.     

卒中预后的影响因素

研究卒中预后的影响因素对于指导治疗、促进患者康复以及合理分配医疗资源都有着重要意义。文章对最近5年有关人口统计学、临床状态、实验室检查、影像学检查与卒中预后相关性的研究做了回顾。     

卒中预后的影响因素

研究卒中预后的影响因素对于指导治疗、促进患者康复以及合理分配医疗资源都有着重要意义。文章对最近5年有关人口统计学、临床状态、实验室检查、影像学检查与卒中预后相关性的研究做了回顾。     

Radiologic assessment of resectability and prognosis in esophageal carcinoma.

Utilizing double-contrast technique it is possible to detect the earliest malignant lesions of the esophagus even when the carcinoma is confined to the mucosa. In patients with carcinoma, it is also important to attempt to grade and classify the lesion in order to predict its resectability and prognosis. The resectability of a lesion is determined by the depth of invasion and by the presence or absence of lymph node metastases. The significant factors are the length of the lesion, its gross morphology, the character of its margins, and the depth of ulceration. Unfortunately, the depth of invasion is not necessarily directly related to the prognosis. In some carcinomas confined to the submucosa, lymph node metastases are already present, and these patients have a poor prognosis. The presence of lymph node metastases in early carcinoma can be suggested by the gross morphology of the lesion, its length, irregularity of the surface, and the presence of a complex lesion. Careful analysis of the radiographic features of the carcinoma can be valuable for the assessment of resectability and prognosis.     

早产儿脑白质损伤早期MRI-DWI的分类、演变及临床意义

目的结合常规MRI和弥散加权成像（DWI）探讨早产儿脑白质损伤（CWMD）的较客观分类方法,动态评价不同类型CWMD的变化规律及临床意义。方法 517例早产儿行常规MRI和DWI检查,确诊早产儿CWMD212例,对其中55例随访。结果随病变累及区域数目不同,异常信号有特征性分布及形态学改变,呈现一系列动态变化,并与神经发育结局有较好的相关性。根据早期CWMD类型可以预测后期发生脑室周围白质软化（PVL）的类型,反之根据PVL类型可以推测早期CWMD类型。早期（1周内）DWI能提早发现病变,在一定程度上预示预后。常规MRI晚期（3周左右）检查能高度预测患儿预后。结论常规MRI和DWI相结合可动态观察CWMD病变受累区域,与形态学相结合可较客观评价患者预后,并对高危早产儿进行早期合理康复。     

肺结核并发多器官功能障碍综合征53例临床分析

目的探讨影响肺结核并发MODS病死率的主要因素。方法回顾性分析53例肺结核并发MODS患者资料,对筛选出的与30 d病死率相关的各项因素进行单因素分析及Logistic多元回归统计分析。结果单因素分析结果表明APACHEⅡ评分、肺结核病灶范围、血清白蛋白含量、肺结核并发症为肺结核并发MODS的30 d病死率的危险因素。肺结核病灶范围、低血清白蛋白、衰竭器官数目及肝衰可以作为肺结核并发MODS的独立预后因素。结论肺结核病灶累及范围、低血清白蛋白、衰竭器官数目及肝功能衰竭在肺结核并发MODS的预后中起着重要的作用。