中药湿热敷配合Bobath技术治疗脑卒中后痉挛性偏瘫的观察

目的:分析探讨中药湿热敷配合Bobath技术对脑卒中后痉挛性偏瘫康复训练的效果。方法:采用中药湿热敷配合Bobath技术对脑卒中后痉挛性偏瘫患者进行康复训练(观察组)与仅采用Bobath技术进行康复训练(对照组)结果进行对比分析。结果:治疗组对脑卒中后痉挛性偏瘫患者进行康复训练的效果明显优于对照组(P<0.01)。结论:中药湿热敷配合Bobath技术对脑卒中后痉挛性偏瘫进行康复训练,能有效地改善患肢的痉挛、疼痛以及关节活动度。     

中药湿热敷配合康复训练对脑中风患者肩-手综合征的护理干预

目的:应用偏瘫上肢功能评分量表(manual function score,MFS)和偏瘫患者运动评定量表(the motor assessment scale,MAS)研究中药湿热敷配合康复训练对中风患者肩-手综合征的影响。方法:选择中风恢复期患者60例,随机分为观察组和对照组各30例,对照组行常规的治疗及护理,观察组在常规治疗及护理的基础上,加用活血化瘀、通经活络、祛风化湿中药湿热敷配合康复训练,治疗前后对2组患者分别进行MFS和MAS的评定。结果:观察组疗效明显优于对照组(P<0.01)。结论:中药湿热敷配合康复训练对中风患者肩-手综合征有较好的疗效。     

DMS联合Bobath疗法对脑卒中后上肢痉挛性偏瘫的 疗效分析

目的:探究电动肌肉震动仪(DMS)联合Bobath疗法对脑卒后上肢痉挛性偏瘫的疗效。方法:将50例脑卒中后上肢痉挛性偏瘫患者均分为实验组和对照组,2组均予常规治疗和DMS治疗,实验组加用Bobath疗法,均治疗8周,对比2组治疗总有效率、治疗前后患肢改良Ashworth量表(MAS)评级、Fugl-Meyer运动量表(FMA)评分,对比治疗前后1 d患肢的均方根值(RMS)。结果:实验组治疗总有效率为92.00%,高于对照组的64.00%(P0.05);治疗后,实验组的MAS评级低于对照组,患肢FMA评分高于对照组,且实验组优于对照组(P0.05);治疗前,2组RMS对比差异无统计学意义(P0.05),治疗后2组RMS均明显升高,且实验组高于对照组(P0.05)。结论:DMS联合Bobath疗法能显著改善脑卒中后上肢痉挛性偏瘫患者的患肢肌张力,提高患肢运动功能。     

中药湿热敷对脑卒中后RSD综合征的治疗作用观察

目的:观察中药湿热敷对脑卒中后反射性交感神经营养不良综合征(RSD)的疗效。方法:68例脑卒中后RSD患者随机分为2组各34例,对照组予以神经内科常规处理及针灸、推拿等综合治疗,观察组在此基础上加用中药湿热敷。应用偏瘫患者运动评定量表(MFS)和偏瘫上肢功能评分量表(MAS)对2组治疗前后疗效进行评价。10d为1个疗程,2个疗程予疗效评分。结果:与治疗前相比,治疗后2组MFS和MAS评分均较治疗前有明显改善(P<0.05);与对照组相比,观察组治疗后MFS和MAS评分均有统计学意义(P<0.05)。结论:中药湿热敷能明显改善脑卒中患者的RSD的临床症状,提高生活质量。     

个体音乐治疗联合常规康复训练对脑卒中后痉挛性偏瘫患者的影响

目的:观察个体音乐治疗联合常规康复训练对脑卒中后痉挛性偏瘫患者肢体痉挛程度及运动功能的影响。方法:将40例脑卒中后痉挛性偏瘫患者随机分为观察组(n=20)和对照组(n=20)。对照组接受常规康复训练,观察组接受常规康复训练联合个体音乐治疗。两组患者主动运动训练时长保持一致。分别于治疗前和治疗4周后比较两组患者偏瘫肢体肘、膝关节肌张力(MAS)评分和上、下肢运动功能(FMA)评分。结果:治疗前,两组患者肘、膝关节MAS评分和上、下肢FMA评分差异无显著性意义,组间具有可比性。治疗后,两组患者肘、膝关节MAS评分均较治疗前明显降低(P0.01),上、下肢FMA评分均明显提高(P0.01);组间比较,观察组肘、膝关节MAS评分和上、下肢FMA评分均优于对照组(P0.05)。结论:常规康复训练联合个体音乐治疗能更有效降低脑卒中后痉挛性偏瘫患者的肘、膝关节痉挛程度,提高偏瘫肢体运动功能。     

督脉中药湿热敷对中风病人肢体活动及自理能力的影响

[目的]探讨督脉中药湿热敷对中风病人肢体活动功能及自理能力的影响。[方法]将68例中风恢复期病人随机分为两组各34例,对照组给予常规治疗及护理,观察组在常规治疗及护理的基础上加用温经散寒、祛风除湿、活血化瘀中药湿敷督脉1个疗程,治疗前后采用卒中病人运动功能评估量表(MAS)和日常生活活动量表(Barthel指数)对两组病人分别进行评定。[结果]治疗后两组MAS评分和Barthel指数评分比较差异有统计学意义(P0.05)。[结论]督脉中药湿热敷有助于中风病人肢体活动功能和自理能力的恢复。     

良肢位摆放标识护理在脑卒中偏瘫病人中的应用

[目的]观察良肢位摆放标识护理在脑卒中偏瘫病人中的应用效果。[方法]选择良肢位摆放标识护理实施前(2016年1月—2016年6月)收治的43例脑卒中首次发病致偏瘫病人为对照组,选择良肢位摆放标识护理实施后(2016年7月—2016年12月)43例脑卒中首次发病致偏瘫病人为观察组,对照组病人接受常规良肢位摆放护理,观察组在常规良肢位摆放护理基础上加用良肢位摆放标识护理干预。比较两组干预后良肢位摆放依从率、正确率、关注度评分、并发症发生情况。[结果]观察组病人干预后良肢位摆放依从率、正确率和关注度评分均高于对照组,并发症发生率低于对照组(P0.05)。[结论]对脑卒中后偏瘫病人采用良肢位摆放标识护理可提高病人的良肢位摆放依从率、正确率与关注度,降低并发症发生率。     

良肢位摆放配合中医护理技术对中风病早期康复效果的研究

摘要 目的 探讨良肢位摆放配合中医护理技术在中风病早期康复中的作用。 方法 观察组是在生命体征平稳48h后应用良肢位摆放配合中医护理技术进行康复治疗,对照组患者采用良肢位摆放进行常规康复护理,对照观察两组间疗效差异。 结果 观察组患者偏瘫肢体运动功能及肌力的改善、生活自理能力改善程度,对护理工作满意度优于对照组,与对照组比较差异有显著性(P<0．05) 具有统计学意义。结论 良肢位摆放配合中医护理技术对中风早期患者可明显降低中风并发症和后遗症的发生,降低致残率;促进肢体功能与日常生活能力的康复,值得临床推广应用。     

中医推拿颤法对脑卒中痉挛的影响

目的观察中医推拿颤法对脑卒中偏瘫患者痉挛的影响。方法脑卒中痉挛性偏瘫患者44 例,随机分对照组(n=22)和观察组(n=22),对照组采用现代康复技术加常规推拿,观察组采用现代康复技术加中医推拿颤法。治疗前及治疗4 周后,采用改良Ashworth 评定量表(MAS)、简化Fugl-Meyer 评定量表(FMA)、Barthel 指数(BI)进行评定。结果治疗后,两组MAS 评分无显著性差异(P>0.05),FMA及BI 评分较治疗前均有提高(P<0.05),观察组治疗前后差值高于对照组(P<0.05)。结论中医推拿颤法能促进脑卒中痉挛性偏瘫患者运动功能和日常生活活动能力的恢复。     

良肢位摆放标示牌的设计及在脑卒中偏瘫患者中的应用效果

目的探讨良肢位摆放标示牌的设计及在脑卒中偏瘫患者中的应用效果。方法选取2017年6月—12月良肢位摆放标示牌使用前住院的46例急性脑卒中偏瘫患者为对照组,选取2018年1月—6月良肢位摆放标示牌使用后住院的48例急性脑卒中偏瘫患者作为观察组。对照组患者入院当日接受良肢位摆放的口头宣教、良肢位摆放视频播放、实际良肢位摆放的演示及良肢位摆放行为的督导与观察等常规护理方式;观察组则在此基础上增加良肢位摆放标示牌的使用讲解及临床应用。评价并比较两组偏瘫患者良肢位摆放的依从率、正确率及偏瘫后肢体并发症发生率。结果观察组偏瘫患者的良肢位摆放依从率与正确率显著高于对照组,偏瘫后肢体并发症发生率明显低于对照组,差异均有统计学意义(P 0.05)。结论良肢位摆放标示牌的设计及在脑卒中偏瘫患者中的应用,可显著提高脑卒中偏瘫患者的良肢位摆放依从率与正确率,降低偏瘫后肢体并发症发生率。     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.     

自动化酸碱平衡图在急诊社区获得性肺炎诊治中的应用

目的 探讨自动化酸碱平衡图在急诊科社区获得性肺炎(CAP)患者诊断中的价值.方法 根据病史、肺功能测定结果、慢性阻塞性肺疾病(COPD)诊断标准,将111例CAP患者分为单纯CAP组(56例)和COPD合并CAP组[即慢性阻塞性肺疾病急性加重(AECOPD)组,55例].询问患者病史后即刻抽取动脉血测血气并进行自动化酸碱平衡图分析.结果 血气分析结果显示,AECOPD组动脉血二氧化碳分压(PaCO2,kPa)、HCO3- (mmol/L)、剩余碱(BE,mmol/L)均显著高于CAP组(PaCO2:7.714±2.414比5.896±1.308,HCO3-:30.767±7.185比25.014±3.043,BE:4.345±5.371比-0.354±3.180,均P＜0.01).自动化酸碱平衡图分析结果显示,AECOPD组患者酸碱平衡紊乱高达89.1％,CAP组为66.1％.将AECOPD组和CAP组患者中正常(10.9％、33.9％)、急性呼吸性酸中毒(急性呼酸,12.7％、14.3％)、慢性呼吸性酸中毒(慢性呼酸,49.1％、10.7％)、呼吸性碱中毒(呼碱,7.3％、14.3％)、代谢性酸中毒(代酸,12.7％、17.9％)、代谢性碱中毒(代碱,12.7％、8.9％)综合进行x2分析,差异有统计学意义(x2=24.421,P=0.001),而将正常、急性呼酸、呼碱、代酸及代碱进行x2分析,差异无统计学意义(x2=5.280,P=0.260),提示AECOPD患者慢性呼酸的发生率较单纯CAP患者显著增加.结论 自动化酸碱平衡图能帮助急诊科医师快速识别CAP患者是否存在多重酸碱平衡紊乱,并可快速识别急、慢性呼吸系统疾病.