羟考酮缓释片单用或联合氟伏沙明对中重度癌痛合并抑郁患者的疗效

目的探讨羟考酮缓释片单用或联合氟伏沙明对中重度癌痛合并抑郁患者的疗效。方法将本院于2016年1月～2019年1月期间收治的102例中重度癌痛合并抑郁患者随机分为对照组和观察组,各51例,分别采用羟考酮缓释片单用治疗、羟考酮缓释片联合氟伏沙明治疗,观察两组疼痛程度、抑郁状态及生活质量改善情况,并观察两组用药不良反应发生情况。结果治疗前两组患者疼痛程度评分、抑郁状态评分及生活质量评分无明显差异,P0.05;治疗2周、4周时,观察组患者疼痛程度评分、抑郁状态评分及生活质量评分逐渐降低,且与同时间段对照组比较优势明显,P0.05;观察组便秘发生率低于对照组,而恶心呕吐则高于对照组,P0.05。结论羟考酮缓释片联合氟伏沙明可以使中重度癌痛合并抑郁患者的疼痛程度明显减轻,改善他们的抑郁状态及生活质量,而且不明显增加药物不良反应。     

加巴喷丁联合盐酸羟考酮缓释片对癌性神经痛患者疼痛介质的影响

目的研究加巴喷丁联合盐酸羟考酮缓释片对癌性神经痛患者疼痛介质的影响。方法选取我院2014-07—2015-07收治的癌性神经痛患者70例,抽签随机分为观察组与对照组各35例,对照组给予盐酸羟考酮缓释片治疗,观察组给予加巴喷丁联合盐酸羟考酮缓释片治疗。比较2组临床疗效、治疗前后视觉模拟评分法(VAS)评分,比较2组去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)含量变化情况及不良反应发生率。结果观察组临床总有效率为82.86%,较对照组的60%显著较高(P0.05);观察组VAS评分(1.72±1.02)分,显著低于对照组的(2.83±1.04)分(P0.05);观察组5-HT水平(706.51±147.48)ng/g,显著低于对照组的(812.18±178.62)ng/g(P0.05)。结论加巴喷丁联合盐酸羟考酮缓释片治疗癌性神经痛疗效显著,能显著降低患者体内疼痛介质水平,是一种安全可靠的治疗方法,值得临床应用推广。     

度洛西汀联合盐酸羟考酮缓释片对晚期癌痛伴抑郁患者生活质量、睡眠障碍的影响

目的 探讨晚期癌痛伴抑郁患者治疗应用盐酸羟考酮缓释片联合度洛西汀对心理状态、睡眠质量及生活质量的影响。方法 回顾性分析2021年3月～2023年3月区间医院接受的84例晚期癌痛伴抑郁患者的临床资料,根据治疗方法的不同分组各42例,划分为对照组（接受盐酸羟考酮缓释片治疗）与观察组（接受盐酸羟考酮缓释片+度洛西汀）;观察对比两组心理状态、睡眠质量、生活质量。结果 治疗后,两组焦虑自评量表（Self-Rating Anxiety Scale,SAS）、抑郁自评量表（Self-rating depression scale,SDS）评分均降低,且观察组较对照组显著低（P<0.05）;治疗后,两组匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index,PSQI）评分均呈不同程度降幅,且观察组降幅更明显（P<0.05）;治疗后,两组生活质量（Quality of life,QOL）评分均呈不同程度的升幅,且观察组升幅更大（P<0.05）。结论 应用盐酸羟考酮缓释片与度洛西汀联用可有效缓解晚期肿瘤患者癌痛症状,同时减轻焦虑抑郁,维持良好心理状态,并提高睡眠...     

氨酚羟考酮片治疗老年带状疱疹后神经痛疗效及安全性观察

氨酚羟考酮片为羟考酮5mg对乙酰氨基酚325mg组成的复方镇痛药,是由美国最大的麻醉药品生产企业马林克罗公司独家生产.羟考酮为阿片受体激动剂,可与对乙酰氨基酚、阿司匹林等联合用药,在许多国家广泛用于中重要疼痛治疗,我们对2008-01～2009-02应用氨酚羟考酮片治疗老年带状疱疹后神经疼进行统计,回顾分析其镇痛疗效和不良反应,现报告如下.     

骨水泥成形辅以放射治疗应用于恶性肿瘤骨转移癌：可为临床首选方案

背景：骨水泥成形具有即刻止痛和稳定骨折的作用，可明显提高肿瘤患者的生活质量，但其用于临床时间尚短，许多学者认为这种技术缺乏远期随访资料和更多病例验证，对复杂部位转移灶的治疗仍值得深入分析。 目的：回顾性分析单纯放射治疗及骨水泥成形辅以放射治疗恶性肿瘤骨转移癌患者的效果。 方法：2006-09/2009-02上海市第六人民医院收治的60例恶性肿瘤骨转移癌患者，随机分成2组，单纯放射治疗组30例，采用6 MV X射线，照射剂量2 Gy/次，5次/周，照射4周，总照射剂量40 Gy；联合组30例，采用骨水泥成形治疗，并辅以放射治疗。采用VRS法疼痛程度分级和目测类比评分法相结合的方式进行骨痛评分，测定起效时间。 结果与结论：治疗前两组患者骨痛评分基本相似(P > 0.05)；治疗后与单纯放射治疗组比较，联合组痛程度显著缓解，骨痛评分明显降低(P < 0.05)。单纯放射治疗组共13例患者治疗无效，联合组共8例患者治疗无效，单纯放射治疗组患者的起效时间迟于联合组。在10个月的随访期内，单纯放射治疗组共有25例患者死亡，联合组共有21例患者死亡，不同随访时间段内联合组生存患者多于单纯放射治疗组。全部死亡病例中均未发现与骨水泥有关的证据，提示应用骨水泥成形辅以放射治疗骨转移瘤比单纯行放射疗法对疼痛的缓解更为有效，可作为骨转移癌首选的治疗方式。 关键词：放射治疗；骨转移癌；经皮穿刺椎体成形术；疼痛缓解；骨水泥；生物材料 doi:10.3969/j.issn.1673-8225.2010.08.037     

强弱阿片类药物对神经病理性疼痛的干预作用

目的研究强弱阿片类药物对神经病理性疼痛的干预效果。方法抽选2013-05—2014-06我院收治的神经病理性疼痛患者86例,随机法分为强药组(n=43)和弱药组(n=43),强药组给予盐酸羟考酮缓释片治疗;弱药组给予盐酸曲马多片治疗,比较2组用药前后疼痛程度及睡眠质量改善率,比较不良反应发生情况。结果强药组用药1周后及用药2月后疼痛程度(3.2±1.5)分、(3.4±1.2)分较对照组(4.1±2.0)分、(4.3±1.8)分显著较低(P0.05);2组睡眠质量总改善率比较无统计学差异(P0.05);强药组便秘发生率76.7%与弱药组55.8%比较显著增高(P0.05);其他不良反应发生率比较无统计学差异(P0.05)。结论强阿片类药物比弱阿片类药物对神经病理性疼痛患者疼痛改善效果略好,但不良反应相对较高,临床用药可根据患者病情及既往用药史酌情选择。     

20例晚期癌痛病人应用芬太尼贴剂的护理

目的 观察芬太尼贴剂治疗晚期癌痛的效果、不良反应是护理重点.方法 使用芬太尼贴剂对20例晚期癌症病人疼痛进行治疗观察.结果 病人的癌痛显效13例,有效7例,总有效率为100%.结论 芬太尼贴剂治疗,可使晚期癌症病人的疼痛得以缓解,并在精心的临床护理下减轻病人的不良反应,提高病人的生活质量.     

加巴喷丁联合氨酚羟考酮与阿米替林治疗带状疱疹后神经痛40例观察

目的观察加巴喷丁、氨酚羟考酮、阿米替林三种药物联合应用治疗带状疱疹后神经痛的疗效。方法选择带状疱疹后神经痛患者40例,采用三种药物联合应用,加巴喷丁低剂量起始逐渐加量。以视觉模拟评分(VAS)和睡眠质量评分(QS)综合评定治疗效果。结果治疗后第1～4周VAS评分和QS评分较治疗前显著降低(P<0.05)。显效90%(36/40),总有效率95%(38/40)。结论三种药物联合应用治疗带状疱疹后神经痛,能迅速缓解疼痛,改善睡眠,缩短起效时间,不良反应少,是目前较为理想的治疗方法。     

加巴喷丁联合硫酸吗啡控释片治疗癌性神经痛的效果及不良反应

目的分析加巴喷丁联合硫酸吗啡控释片治疗癌性神经痛的临床效果及不良反应。方法选取90例中晚期恶性肿瘤合并癌性神经痛患者,采取随机数字表法分为单独用药组与联合用药组各45例,单独用药组给予硫酸吗啡控释片治疗,联合用药组给予加巴喷丁联合硫酸吗啡控释片治疗,对比2组患者疼痛强度、不良反应及生活质量。结果单独用药组与联合用药组治疗前与治疗24h、48h、7d后的疼痛程度相比差异无统计学意义(t=1.34,P0.05;t=1.56,P0.05;t=1.71,P0.05;t=1.88,P0.05)。单独用药组治疗15d后与联合用药组治疗15d后疼痛程度相比差异有统计学意义(t=4.56,P0.05)。2组恶心呕吐、头晕、便秘、嗜睡发生率均明显降低(χ2=5.43,P0.05;χ2=5.12,P0.05;χ2=4.77,P0.05;χ2=4.98,P0.05)。2组治疗前与治疗24h、48h后的生活质量相比差异无统计学意义(t=1.56,P0.05;t=1.76,P0.05;t=1.59,P0.05)。单独用药组治疗15d后与联合用药组治疗7d、15d后生活质量相比差异有统计学意义(t=4.34,P0.05;t=5.24,P0.05)。结论加巴喷丁联合硫酸吗啡控释片治疗中晚期恶性肿瘤癌性神经痛疗效显著,不良反应较少,安全性较高,可有效改善患者的生活质量,值得推广应用。     

羟考酮与地佐辛对腹腔镜子宫切除术后镇痛效果比较

目的比较羟考酮与地佐辛用于腹腔镜子宫切除术后的镇痛效果。方法 76例择期在全麻下行腹腔镜子宫切除术患者随机分为2组,每组38例,观察组给予羟考酮1mg/kg复合托烷司琼0.1mg/kg加生理盐水稀100mL;对照组给予地佐辛0.6mg/kg复合托烷司琼0.1mg/kg加生理盐水稀释至100mL,行静脉自控镇痛(PICA)治疗。采用疼痛视觉模拟评分(VAS)和Ramsay镇静评分评估患者疼痛程度和镇静情况,同时记录不良反应发生情况。结果术后4h、12h、24h、48h观察组镇痛评分均低于对照组,镇静效果优于对照组,差异有统计学意义(P0.05),PCIA按压次数少于对照组。结论羟考酮用于腹腔镜子宫切除术术后PCIA,镇静镇痛效果好,患者满意度高。     

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。     

神经介入：回眸2022

<正>2022年,国际上公布了多项大型神经介入领域的随机对照试验（randomized controlled trial,RCT）结果,在血管内治疗（endovascular treatment,EVT）急性大血管闭塞（large vessel occlusion,LVO）适应证的扩展、药物治疗、管理,症状性颅内动脉粥样硬化性狭窄（symptomatic intracranial atherosclerotic stenosis,sICAS）治疗,无症状性颈动脉狭窄治疗,