脑卒中后抑郁状态的相关因素分析

Theconcomitantdepressionafterstrokecaninfluencethestateofillnessandrecoveryoffunctiondisorder．Itsmechanismisnotclearnow．Wetookaclinicalstudyon１２１strokepatientsfromJanuary２００１toDecember２００１，reportedasfollowed．１Subjectsandmethods１．１SubjectsAllthe１２１patientswerein－patientpatientsofdepartmentofneurologyofourhospital，including７４malesand４７females，＜４０yearsold：４cases，４１～５０yearsold：１５cases，５１～６０yearsold：４５cases，６１～７０yearsold：３２cases，７１～…     

Analysis of bony density of 3100 outpatients

Detectingofbonydensity，chooseandevaluationofthee－quipmentswereinitiallyreportedtheseyears．Quantitativeultra－soundskeletondensity（QUS）wascertifiedasafemethodwithnoradianinjuryindiagnosisofosteoporosis．３１００outpatientsweredetectedwithQUSfromNovemberof１９９８toJuneof２００１．１Subjectsandmethods１．１SubjectsOutpatientsofvarieddepartmentswhowerevol－unteersintroducedbydoctors．８２５malesand２２７５femalesweredividedinto６groupsaccordingtotheages：２０～２９yearsold，１８０；３０…     

Synthetic rehabilitation effects analysis of severe burn patients

Background：Appearanceandfunctiondamageafterburnarecausedbyscarhyperplasiaafterwoundrepair．Somaintaskofburnrehabilitationispreventionandtreatmentofhypertrophicscar．Pressuretherapycanpromotescarmaturation；decreaseitching，consistencyandthickofscar．Objective：Toinvestigatesyntheticrehabilitationeffectofse－vereburnpatients．Unit：FirstPeople＇sHospitalofFoshan．Subject：１１２severeburnpatientsfromFebruary１９９８toFebruary２００１，including８５malesand３０females，aged２～７６yearsold…     

Analysis of atypical symptoms in 30 cases of senile subarachnoid hemorrhage

CLINICALDATASubjectscamefrom３０patientswithsenilesubarachnoidhemrrhagetreatedinourhospitalfromJanuary１９９９toDecember２００１in－cluding１２malesand１８femalesaged６０－７８（mean：６５）yearsold．２４patientspresentedwithonsetinaction，６patientsatrest；２６casespresentedwithacuteonsetand４casessubacuteonset．Acuteheadacheasfirstsymptomwasin１３cases；painatneck，waist，sacralasfirstsymptomin７cases．３patientssearchedmedicalser－viceforheadachewithin１week；２patientsforseverepainofb…     

Rehabilitation exercises after closed reduction internal fixation of fracture of patella under arthroscope

INTRODUCTIONClosedreductioninternalfixationunderarthroscopeisperformedfromAugust，２０００toApril，２００１andadvanceddomesticandfor－eignrehabilitationprogramsarecombinedtotreatfractureofpatellacomprehensively，satisfyingeffectsareachieved．MATERIALSANDMETHODSMaterials１６casesoftransverseorlongitudinalfractureofpatellawerestudiedwith１２malesand４femalesincludedaged２２－４７（mean：３３）yearsold．９casesliedatleftknee，７casesatrightknee；１１casesweretransversefracture，５case…     

骨水泥型人工髋关节置换治疗老年股骨颈骨折术后近期行走功能随访

１Materialsandmethod１．１MaterialsIn１８casesofthisgroup，１０malesand８femalesagedfrom６０～９３yearsoldandmeanageof７５．２yearsold．Lefthip：６cases；Righthip：１２cases．Importedprothesis：７cases；Nativeprothesis：１１cases．Completehipreplacement：１２casesinwhichimportedandnativeprothesiswereusedin６casesrespectively．Di－polarartificialthighbonereplacement：６casesincluding１caseofimportedprothesisand５casesofnativeprothesis．Following－upduration：３～２３months，mean：１５．７mont…     

Block therapy of ganglion stellatum in 1 case of obstinate facial pain

１CaseabstractPatient，male，６８yearsold，gotobstinatefacialpain１０yearsagoafternerveblockduetotrigeminalneuralgia．Painresultedinfollowingdysfunction：facialasymmetry，atrophicleftfacialmusclewas１／２sizeofright；Myodynamydecreased，onlysoftandsemiliq－uidfoodcouldbetakenandcompensationofrightmusclewasneeded；Pselaphesiaandthalposiswerelostandtherewasonfeelingtowaterat４０℃．Continuousfacialpainledtounstablemood，dietdecreasing，badsleepness，lightweight，badfacialimpressionsandmentaldis…     

Analysis of 100 patients with dementia in geratic period

BACKGROUND：Seniledementiahasasevereeffectonworkandqualityoflifeofold－agedpeople．However，therearenospecialmethodsandindexesfordiagnosisofdementiaingeraticperiod．OBJECTIVE：Toanalyzethecharacteristicsofseniledementia．UNIT：DepartmentofNeurology，FirstHospitalofDandongCitySUBJECTS：Therewere１００patientsrecruitedfromSeptember１９９９toSeptember２００２．Therewere８９malesand１１females，agedfrom６２to８９yearsold，mean（７４±７）yearsold．Allthepatientsweremeasuredbyneurop…     

Effects of skin flap graft and sports training on degree Ⅲ burn of sole of foot

BACKGROUND：ToexploretheeffectsofskinflapgraftandsportstrainingondegreeⅢburnofsoleoffoot．UNIT：DepartmentofBurn，XijingHospital，FourthMilitaryMedicalUniversitySUBJECTS：１６patientswithdegreeⅢburnofsoleoffoottreatedinourhospitalfrom１９７８to２０００wereselectedincluding１２malesand４femalesaged２－７２yearsold．Completefootburn，３cases，５feet；completefootsoleburn，９cases，１４feet；partialsoleburn，４cases，７feet．INTERVENTION：Topatientswithcompletefootburn，incision…     

Effect of rehabilitation training after implantation and reduction peg-claw-rod system on recovery of nerve function

BACKGROUND：Implantationandreductionpeg－claw－rodsystemhasresolvedthereductionproblemsafterfractureofverte－brae，butsomerehabilitationmeasuresarenecessarytopostoperativecomplicationsandsequela．OBJECTIVE：Toobservetheeffectsofrehabilitationtrainingafterimplantationandreductionpeg－claw－rodsystemonrecoveryofnervefunction．UNIT：SecondDepartmentofSurgery，People＇sHospitalofMileCountySUBJECTS：９patientswereallmalesaged２１－５８yearsold．Affectedsegmentsincluded２casesofT１２…     

瞬目反射与面神经电图在儿童面神经炎中的应用

目的:探讨瞬目反射(BR)、面神经电图(ENoG)检测对面神经炎患儿的诊断价值。方法:20例面神经炎患儿在发病后7-30d分别行BR、ENoG检查。结果:患侧R1、R2及R2’波缺如2例,R1波缺如、R2及R2’波正常3例,R1、R2及R2’波潜伏期延长15例,阳性率100%。患侧面神经运动(M波)潜伏期缺如2例,M波延长、波幅低18例;近端损害8例,远端损害10例,远近端均受累2例。结论:BR检测是诊断儿童面神经炎的早期敏感指标,采用BR、ENoG综合检测可全面、客观地评价面神经损害的程度及部位。     

眨眼反射对早期周围性面神经麻痹的评估价值

目的研究眨眼反射(BR)对发病3日内早期周围性面神经麻痹的评估价值。方法对60名健康人及32例发病3d内的周围性面神经麻痹患者行BR检查并随访6个月观察预后。结果获得BR正常值。病例组3d内BR结果均异常,表现为潜伏期延迟、不规则波及无反应。BR表现与临床面瘫程度有显著性相关。3d内BR反应存在者均恢复良好,而BR反应消失者有部分恢复不良。结论BR是观察面神经损伤的敏感指标,能在周围性面神经麻痹发病3d内反映面瘫程度并对预后有一定评估价值。     

Bell''s麻痹患者的电生理检测

目的 :探讨Bell’s麻痹患者进行瞬目反射 (BR)、面神经电图 (ENG)、面肌肌电图 (EMG)检测的意义。方法 :6 0例Bell’s麻痹患者进行BR检测 ,同时进行ENG、EMG测定。结果 :患侧R1、R2 及R2 ’缺如者 35例 ,其余2 5例患侧较健侧R1、R2 及R2 ’波潜伏期延长 ,异常率 10 0 %。患侧面神经运动传导潜伏期延长、波幅降低 ,与健侧比较差异有显著性 (P <0 .0 5 ) ,早期异常率为 2 5 %。根据R1/M潜伏期比值测定结果提示 ,37例表现为近段 (茎乳孔内段 )损害 ,4例为远段 (茎乳孔外段 )损害 ,19例为较大范围损害。结论 :BR测定是诊断Bell’s麻痹的敏感指标 ,采用BR、ENG及EMG综合检测Bell’s麻痹患者 ,可全面、客观地评价面神经损害的程度及部位 ,对临床治疗及预后估计有一定的帮助。     

特发性面神经麻痹的神经电生理研究

目的探讨特发性面神经麻痹患者神经电生理变化与预后的关系。方法对48例特发性面神经麻痹患者进行患侧与健侧面神经传导速度及肌电图检查。结果神经传导速度检测显示患侧面神经运动潜伏期延长,M波波幅降低,与健侧相比差异显著(P<0.05);肌电图检侧显示患侧面肌运动单位电位时限延长、多相波增多,募集电位减弱,并有自发电位出现。结论特发性面神经麻痹患者神经电生理变化与预后有关,患健侧M波波幅比值>50%面瘫恢复较好,<30%面瘫恢复较差。     

Usefulness of BFB/EMG in facial palsy rehabilitation

Objective. To analyze and to compare the recovery and the development of synkinesis in patients with idiopathic facial palsy (Bell's palsy) following treatment with two methods of rehabilitation, kinesitherapy (KT) and biofeedback/EMG (BFB/EMG).

Study design. Retrospective cases - series review.

Methods. Seventy-four patients with Bell' palsy were clinically evaluated within 1 month from onset of palsy and at 12 months after palsy (House scale and synkinesis evaluation). Electromyography (EMG) and Electroneurography (ENG) were performed about 4 weeks after palsy to better evaluate functional abnormalities due to facial nerve lesion. The patients followed two different protocols for rehabilitation: the first 32 patients were treated with therapeutic exercises performed by therapists (KT group), the latter 42 patients were treated using BFB/EMG methods (BFB group) with inhibition of synkinetic movement as the primary goal.

Results. KT and BFB patients were evaluated for clinical and neurophysiological characteristics before rehabilitative treatment. BFB patients showed better clinical recovery and minor synkinesis than KT patients.

Conclusions. BFB/EMG seems to be more useful than KT in Bell's palsy treatment. This could be due to the fact that BFB/EMG gives more accurate information than KT on muscle activation with better modulation in voluntary recruitment of motor unit.     

不同剂量的钙离子通道拮抗剂对面神经损害的保护作用

背景应用Ca2+通道拮抗剂对周围神经损害保护作用的实验研究较多,但在临床应用中其剂量大小对受损神经保护作用的效果差异尚需探讨.目的应用不同剂量Ca2+通道拮抗剂氟桂利嗪治疗面神经麻痹(简称面瘫),观察治疗1个月后电生理学量化评估结果.设计随机分组,空白对照,随访1个月.单位南京医科大学第一附属医院神经科.对象1999-11/2001-05南京医科大学第一附属医院神经内科门诊面瘫患者35例,男19例,女16例,年龄16～58岁,病程≤3 d,未经过任何治疗且瘫痪均为完全性.采用随机抽样方法将初诊患者分为对照组12例、治疗Ⅰ组10例,治疗Ⅱ组13例.方法对照组采用基础治疗,强的松1 mg/(kg·d),1次/d,晨服,最大剂量≤60 mg/d,每隔5 d减半量,1个疗程15 d,甲钴胺口服500μg,3次/d.呋喃硫胺口服25 mg,3次/d.超短波理疗,1次/d,治疗15 d.共治疗1个疗程.治疗Ⅰ组和治疗Ⅱ组在此基础上进行Ca2+通道拮抗剂治疗治疗Ⅰ组氟桂利嗪5 mg,1次/晚,治疗Ⅱ组氟桂利嗪10 mg,1次/晚.治疗前及治疗后1个月分别检测各组患者的Blink反射潜伏期及波幅的变化.主要观察指标各组患者治疗1个月后Blink反射潜伏期和波幅.结果按意向处理分析,35例患者均进入结果分析.①治疗前3组患者Blink反射均呈现面瘫侧传出型阻断,R1,R2均消失.②治疗后1个月Blink反射R1,R2出现,治疗Ⅱ组R1及R2的潜伏期恢复显著优于对照组[(9 608±0.575)ms,(31.869±2.934)ms,(11.208±1 490)ms,(37.583±5.408)ms,P＜0.01],而治疗Ⅰ组与对照组比较,R1,R2潜伏期恢复无差异.③治疗后1个月3组Blink反射同侧波幅变化比较无差异. 结论较大剂量(10 mg/d)氟桂嗪治疗1个月,可促进面瘫患者面神经功能的恢复,而日剂量5 mg时,氟桂嗪对周围神经的保护作用不优于常规治疗,其机制和最适剂量本文未做进一步观察.     

瞬目反射和面神经电图在Bell’s麻痹中的应用

目的探讨Bell’s麻痹患者行瞬目反射（blink reflex，BR）、面神经电图（electroneurogram，ENG）检测的意义。方法36例Bell’s麻痹患者在发病1周内行BR和ENG测定。结果患侧R1、R2及R2’缺如者23例，其余13例患侧较健侧R1、R2及R2’波潜伏期延长，异常率100％；患侧面神经运动传导潜伏期延长、波幅降低，与健侧比较差异有显著性（P＜0．05），早期异常率为63．9％。结论BR测定是诊断Bell’s麻痹的敏感指标，同时结合ENG可全面、客观地评价面神经损害的程度和预后。     

贝尔麻痹患者的面肌功能评分与预后

背景贝尔麻痹原因不明,且由于不同的病因和病程可导致病情轻重不同的结果,目前临床上对面肌功能测定和预后还没有取得一致的意见.目的探讨贝尔麻痹的定位诊断、瞬目反射(Blink reflex,BR)和神经电图(electroneurography,ENoG)测试结果与预后的关系,并进一步探讨治疗时机的选择.设计前后对照研究.单位广西壮族自治区北海市人民医院耳鼻咽喉科.对象1989-01/1999-12北海市人民医院耳鼻咽喉科住院符合诊断标准的贝尔麻痹患者42例,其中把资料完整的36例进行统计分析.方法对36例贝尔麻痹患者均进行定位诊断、BR和ENoG测试,并对面肌功能进行评分.结果对定位诊断其病变在D段、面肌功能评分在11分以下者,BR和ENoG测试显示面肌功能差的患者,保守治疗效果亦差,而行面神经减压术后可望提高疗效,发病1个月内检查结果与预后一致(P＞0.05).在发病后40 d手术的2例,均能完全恢复;2个月行2例,1例完全恢复,1例部分恢复;3个月与4个月分别各行1例,都能部分恢复.结论对临床上定位诊断病变在D段以下,面肌功能评分在11分以上,发病后1个月内BR测试R1波存在,ENoG测试面肌纤维损失＜90%的患者,保守治疗可完全恢复.反之,效果就差,对保守治疗无效者,必须行面神经减压术.     

面神经电图和瞬目反射在面神经炎中的应用

目的:探讨面神经电图和瞬目反射对面神经炎的诊断和预后评估的价值。方法:对42例面神经炎患者在发病10 d内进行面神经电图和瞬目反射的检测,并在治疗3个月后对24例患者进行复查。结果:瞬目反射患侧R1、R2和R2’缺如12例,R1、R2和R2’潜伏期延长30例,异常率100%。患侧面神经运动潜伏期延长及波幅降低28例,缺如1例,异常率为69.1%。瞬目反射异常率明显高于面神经电图(P<0.01)。复查时,R1瞬目反射各波缺如的8例患者中2例可检出波形,好转率为25%;原来R1延长的16例患者中10例恢复正常,好转率为62.5%;后一类患者的好转率明显高于前一类患者(P<0.05)。结论:瞬目反射可以作为面神经炎早期诊断的客观指标,对判断面神经受损程度和预后评估有重要作用。     

Usefulness of BFB/EMG in facial palsy rehabilitation

Objective.?To analyze and to compare the recovery and the development of synkinesis in patients with idiopathic facial palsy (Bell's palsy) following treatment with two methods of rehabilitation, kinesitherapy (KT) and biofeedback/EMG (BFB/EMG).

Study design.?Retrospective cases?–?series review.

Methods.?Seventy-four patients with Bell’ palsy were clinically evaluated within 1 month from onset of palsy and at 12 months after palsy (House scale and synkinesis evaluation). Electromyography (EMG) and Electroneurography (ENG) were performed about 4 weeks after palsy to better evaluate functional abnormalities due to facial nerve lesion. The patients followed two different protocols for rehabilitation: the first 32 patients were treated with therapeutic exercises performed by therapists (KT group), the latter 42 patients were treated using BFB/EMG methods (BFB group) with inhibition of synkinetic movement as the primary goal.

Results.?KT and BFB patients were evaluated for clinical and neurophysiological characteristics before rehabilitative treatment. BFB patients showed better clinical recovery and minor synkinesis than KT patients.

Conclusions.?BFB/EMG seems to be more useful than KT in Bell's palsy treatment. This could be due to the fact that BFB/EMG gives more accurate information than KT on muscle activation with better modulation in voluntary recruitment of motor unit.