依达拉奉治疗急性脑梗死临床疗效观察

目的 评价依达拉奉注射液治疗急性脑梗死(ACI)的疗效.方法 选择发病48 h内的急性脑梗死患者123例,随机分为依达拉奉组(66例)及对照组(57例).对患者治疗前及治疗后1个月的临床疗效、中国脑卒中临床神经功能缺损程度评分量表(CSS)和Barthel指数(BI)进行比较.结果 依达拉奉组总有效率达90.9%,显效率为75.6%,而对照组分别为77.2%和45.6%,两组比较有显著性差异(P＜0.05或P＜0.01).治疗后30 d依达拉奉组CSS评分较对照组降低明显,依达拉奉组BI评分较对照组升高,差异具有统计学意义(P＜0.01).结论 依达拉奉是一种治疗急性缺血性脑卒中有效的神经保护剂.     

血通联合依达拉奉提高急性缺血性卒中患者神经功能缺损的临床研究

目的观察血通注射液联合依达拉奉对急性缺血性卒中进行治疗的临床疗效。方法将100例患者急性缺血性卒中患者随机分为胞二磷胆碱组和血通注射液联合依达拉奉组,胞二磷胆碱组给予胞二磷胆碱治疗,血通注射液联合依达拉奉组给予血通注射液联合依达拉奉进行治疗,28d后评价疗效,分别于患者入院当天和患者入院第10天采用波士顿汉语失语症测试(ICATB)、MMSE法对患者的认知功能进行评价,采用Barthel指数与美国国立卫生院神经功能缺损得分(NIHSS)评价患者日常生活活动能力及神经功能缺损程度进行得分。结果血通注射液联合依达拉奉组的总有效率高达98%,胞二磷胆碱组为76%,血通注射液联合依达拉奉组高于胞二磷胆碱组,差异有统计学意义(P0.05);治疗后血通注射液联合依达拉奉组病人NIHSS优于胞二磷胆碱组,差异有统计学意义(P0.01)。血通注射液联合依达拉奉组入院当天ICATB得分与胞二磷胆碱组入院当天得分差异无统计学意义(P0.05),血通注射液联合依达拉奉组患者入院第10d ICATB得分高于胞二磷胆碱组,差异有统计学意义(P0.05);治疗后血通注射液联合依达拉奉组1个月、3个月、6个月、12个月每个组患者平均MMSE得分较治疗前有显著下降,差异有统计学意义(P0.05),各个时间点血通注射液联合依达拉奉组MMSE得分均低于胞二磷胆碱组,差异有统计学意义(P0.05);血通注射液联合依达拉奉组在治疗后的NIHSS得分均显著低于胞二磷胆碱组,Barthel指数高于胞二磷胆碱组,差异有统计学意义(P0.05)。结论血通注射液联合依达拉奉对急性缺血性卒中利于患者的语言康复和神经功能的恢复,提高治疗后的认知能力,治疗安全有效。     

依达拉奉治疗急性脑出血的临床观察

目的 观察依达拉奉对急性脑出血的治疗效果.方法 将64例脑出血患者随机分为治疗组和对照组各32例.对照组按脑出血常规方法治疗,治疗组在常规治疗基础上加用依达拉奉治疗.两组于治疗前、治疗第21天分别进行中国卒中量表(CSS)与巴氏指数(BI)评分及疗效评定,并观察脑水肿程度改变及依达拉奉治疗期间的不良反应.结果 两组治疗第21天CSS和BI评分均有所改善,但治疗组明显优于对照组,CSS(10.6±5.2)分vs(13.5±5.9)分,BI(52.5±6.2)分vs(42.2±6.9)分(P＜0.05);治疗组的显效率和有效率分别为71.9%和87.5%,显著高于对照组的34.4%和62.5%(P＜0.05);治疗组第14天时中重度(2～3级)脑水肿发生率12.5%(4/32),明显低于对照组的34.4%(11/32)(P＜0.05).依达拉奉治疗期间无明显不良反应发生.结论 依达拉奉可促进脑出血患者的神经功能康复.     

依达拉奉联合银杏达莫对血管性认知功能障碍患者治疗作用的研究

目的评价依达拉奉联合银杏达莫注射液在缺血性患者治疗中的有效性及安全性。方法选取符合入选标准的72例血管性认知功能损害(VCI)患者,随机分为2组,常规对照组(34例)给予胞磷胆碱注射液静脉滴注,共14 d;联合治疗组(38例)在常规治疗基础上加用依达拉奉、银杏达莫注射液静脉滴注。比较2组治疗后简易精神状态量表(MMSE)评分变化及副反应,初步探讨蒙特利尔认知量表(MoCA)在筛查非痴呆性血管性认知障碍(VCIND)的作用。结果 VCI患者应用依达拉奉联合银杏达莫注射液治疗后MMSE评分与治疗前比较,差异有统计学意义(P<0.05),与对照组治疗后比较,差异也有统计学意义(P<0.05);副作用:轻度头昏、头胀痛或上腹不适感。结论依达拉奉联合银杏达莫治疗VCI患者安全有效,改善脑缺血产生的症状和记忆功能,MoCA显示出比MMSE更能识别出轻微的认知功能障碍。     

2型糖尿病患者脑梗死急性期应用丁苯酞、 依达拉奉的临床疗效比较

目的:比较2型糖尿病患者脑梗死急性期应用丁苯酞、依达拉奉的临床疗效。方法:糖尿病并发急性脑梗死患者105例,随机分为对照组,丁苯酞组、丁苯酞联合依达拉奉组(联合组),各35例。对照组给予常规治疗;丁苯酞组在对照组的基础上,加用丁苯酞注射液治疗;联合组在丁苯酞组的基础上,加用依达拉奉注射液治疗;3组均连续治疗14 d。于治疗前、治疗后第8天和第15天对患者进行美国国立卫生院脑卒中量表(NIHSS)及Barthel指数(BI)评分;治疗后第15天评价临床疗效。观察并记录治疗后不良反应情况。结果:治疗后,3组NIHSS评分均降低,且丁苯酞组和联合组NIHSS评分低于对照组(P0.05),丁苯酞组和联合组间评分差异无统计学意义(P0.05);治疗后,3组BI均升高,治疗后8 d时,联合组的BI高于对照组(P0.05),其他各时间点组间评分差异无统计学意义(P0.05)。治疗后第15天,丁苯酞组和联合组有效率高于对照组(均P0.05),丁苯酞组和联合组间有效率差异无统计学意义(P0.05)。治疗过程中未见不良反应。结论:丁苯酞或丁苯酞联合依达拉奉治疗糖尿病患者急性脑梗死疗效显著,但二者联合使用并没有提高临床效果。     

依达拉奉联合血塞通注射液治疗急性脑梗死疗效观察

目的 比较应用依达拉奉联合血塞通注射液与单用血塞通注射液治疗急性脑梗死患者的临床疗效.方法 将周口市川汇区中医院内科2007-06-2010-06期间住院治疗的124例急性脑梗死患者随机分为治疗组(依达拉奉联合血塞通组)62例和对照组(血塞通组)62例,比较两组患者治疗14 d后的疗效.结果 两组的治疗结果对比,治疗组总有效率88.7％,对照组总有效率66.1％,依达拉奉联合血塞通组总有效率明显高于单一血塞通组,两组比较差异有统计学意义(P＜0.05).结论 依达拉奉联合血塞通注射液治疗急性脑梗死比单用血塞通注射液效果更理想,能有效改善急性脑梗死患者的神经功能缺损.     

依达拉奉治疗急性脑梗死疗效分析

目的 观察依达拉奉治疗急性脑梗死的临床疗效.方法 选择发病在48 h内的急性脑梗死患者60例,随机分成观察组30例,时照组30例.对照组:灯盏花素40 mg+0.9%盐水250 ml或5%葡萄糖250 ml静脉滴注,1次/d;奥扎格雷钠80 mg+0.9%盐水250 nd静脉滴注,1次/d,连用14 d.观察组:在对照组治疗基础上予依达拉奉30 mg+0.9%盐水100 ml静脉滴注,每12小时1次,连用14 d.结果 治疗组患者神经功能缺损评分为(15.90±1.60)分,对照组(17.53±2.45)分,2组比较差异有统计学意义(P<0.05);治疗组显效率达90.00%(27/30),对照组66.67%(20/30),2组比较差异有统计学意义(P<0.05).结论依达拉奉是治疗急性脑梗死疗效肯定,值得临床推广应用.     

依达拉奉治疗急性脑梗死疗效评估

目的探讨依达拉奉治疗急性脑梗死的疗效。方法选取2015年3月23日~2017年3月23日我院收治的100例急性脑梗死患者,随机分为观察组和对照组各50例,对照组采用常规治疗,观察组在常规治疗的基础上加用依达拉奉治疗。结果观察组患者的治疗后7d NIHSS评分15.32±1.02分、治疗后14d NIHSS评分10.02±1.35分;治疗后7d BI评分76.85±5.41分、治疗后14d BI评分89.52±3.21分;TNF-α(0.21±0.05)mg/L、hs-CRP(2.16±2.54)ng/ml、脑梗死面积(7.31±1.54)cm2、不良事件发生率均优于对照组(P0.05)。结论急性脑梗死患者加用依达拉奉治疗,能有效促进神经功能恢复,增强治疗效果。     

依达拉奉联合丁苯酞氯化钠注射液治疗急性脑梗死疗效分析

目的探讨依达拉奉联合丁苯酞氯化钠注射液治疗急性脑梗死的临床疗效。方法选取2018年5月至2018年11月急性脑梗死患者共48例,依据用药方案将其分为观察组和对照组,每组24例。对照组患者接受依达拉奉联合阿司匹林治疗,观察组患者接受依达拉奉联合丁苯酞氯化钠注射液治疗。结果治疗前,两组超敏C-反应蛋白(hs-CRP)、超氧化物歧化酶(SOD)、美国国立卫生院神经功能缺损评分(NIHSS评分)、巴氏指数评分(BI评分)比较,差异未见统计学意义(P 0. 05)。治疗后,观察组hs-CRP、NIHSS评分明显低于对照组,SOD、BI评分明显高于对照组,差异有统计学意义(P 0. 05)。结论依达拉奉联合丁苯酞氯化钠可对患者神经组织提供更好的保护,降低其炎性反应,值得临床推广。     

丁苯酞氯化钠注射液联合依达拉奉注射液治疗急性进展性脑梗死临床疗效观察

目的:观察丁苯酞氯化钠注射液联合依达拉奉注射液治疗急性进展性脑梗死的临床疗效。方法:选取2015年10月～2018年6月在我院就诊的32例急性进展性脑梗死患者作为研究对象,采用随机数字表法分为对照组和观察组,每组16例。对照组给予常规治疗,观察组在对照组的基础上加用丁苯酞氯化钠注射液联合依达拉奉注射液治疗。比较两组治疗前后的血液流变学指标、神经功能缺损程度、认知功能和同型半胱氨酸(Hcy)水平。结果:治疗前,两组纤维蛋白酶原、血浆黏度、红细胞压积和血沉等指标相比较,差异均无统计学意义,P0.05;治疗后,观察组的纤维蛋白酶原、血浆黏度、红细胞压积和血沉等指标均明显低于对照组,差异均有统计学意义,P0.05;治疗前,两组美国国立卫生研究院卒中量表(NIHSS)评分、简易精神状态量表(MMSE)评分和Hcy水平相比较,差异均无统计学意义,P0.05;治疗后,观察组NIHSS评分和Hcy水平均明显低于对照组,MMSE评分高于对照组,差异均有统计学意义,P0.05。结论:丁苯酞氯化钠注射液联合依达拉奉注射液治疗急性进展性脑梗死,可有效改善患者脑部血液流变学状态,保护脑神经,改善预后。     

超声评分对膝骨性关节炎患者病变特点的评估价值

目的 探讨超声评分对膝骨性关节炎患者病情严重度的诊断价值。方法 回顾性收集我院收治的膝骨性关节炎患者52例,同期收集50例健康成人,分析超声评分与膝骨性关节炎患者病情严重度的相关性。结果 膝骨性关节炎患者超声评分显著高于健康成人(6.93±1.76 vs. 1.73±0.56,P=0.000)。膝骨性关节炎患者超声评分与髌上囊液体深度、髌下囊液体深度、关节腔液体深度、滑膜厚度显著正相关(r=0.265、0.216、0.310和0.255,P=0.004、0.035、0.000和0.012),与Lyshsolm显著负相关(r=-0.381,P=0.000)。与增生滑膜内血管阴性的患者相比,增生滑膜内血管阳性的患者超声评分显著增加(7.43±1.61 vs. 5.58±1.42, P=0.000)。结论 超声评分与膝骨性关节炎患者病情严重度相关。     

Use of the Role Checklist with the patient with multiple personality disorder

A paucity of occupational therapy evaluation tools exists for use with patients with multiple personality disorder. The Model of Human Occupation (Kielhofner & Burke, 1980), particularly the volition and habituation subsystems within this model, proved useful for the identification of the many facets of patients with multiple personality disorder on a short-term treatment unit. The Role Checklist (Oakley, Kielhofner, Barris, & Richler, 1986), a tool derived from the Model of Human Occupation, was adapted for use with this population and was found to be beneficial in the identification of common goals held by most of the personalities of each patient with multiple personality disorder. The use of the Role Checklist is illustrated with a case example.     

Living with a woman with fibromyalgia from the perspective of the husband

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome, which affects mostly middle-aged women. The syndrome is poorly understood and treatment is mainly palliative. The diagnosis is established from diagnostic criteria. Living with FM means living a life greatly influenced by the illness in various ways for people affected. Aim of the study. The aim of this study was to describe the experiences of living with a woman with FM from the husbands' perspective. METHODS: Five men married to women with FM were interviewed using a narrative approach. The interviews were analysed using qualitative thematic content analysis. FINDINGS: The analysis resulted in the following seven themes: increasing responsibility and work in the home; being an advocate for and supporting the wife; learning to see the woman's changing needs; changing relationship between spouses; changing relationship with friends and relatives; deepening relationship with the children and lacking information and knowledge about FM. The findings show that the women's illness had a great impact on husbands' lives, and that husbands lacked information about the woman's illness. CONCLUSION: This study shows that it is not only the women with FM who experience a changed life; the whole family life is influenced and limited by FM. The husband's role in the family changes, first and foremost concerning responsibility and workload within the family. This must be taken into consideration in care planning. This study also highlighted the need of information and knowledge about FM expressed by the participants, information that health care personnel have a great responsibility to give.     

Experience with the use of plasmapheresis in the combined treatment of children with the crush syndrome

Plasmapheresis (PP) was applied to the treatment of 5 children aged 6-14 years with the crush syndrome. The multimodality treatment using antibiotics, erythrocytic mass, rheologically active preparations, hemodialysis and blood rheologically active preparations, hemodialysis and hemoperfusion carried out for 6-7 days before PP did not bring about any appreciable improvement of the patients' status. The patients failed to get rid of anuria and manifested the signs of increasing intoxication. The treatment with PP consisted of 1 to 6 procedures, in the course of which 70 to 85 of the design volume of the circulating plasma was removed. The use of PP resulted in the disappearance of myoglobin from the patients' blood and urine, in the normalization of the coagulogram, a considerable decrease of the content of medium molecules, and in the appearance of the first urine towards the end of the procedure. Thus, the introduction of PP into multimodality treatment of the crush syndrome made it possible to eliminate anuria, disseminated intravascular coagulation, and to noticeably reduce intoxication and to clear the blood off myoglobin.