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1.
脑卒中后认知障碍及相关因素分析   总被引:11,自引:3,他引:8  
目的 探讨脑卒中后认知功能障碍与各种因素之间的关系。方法 对1997~2004年住院的脑卒中患者进行老年认知功能量表(SECF)、自评抑郁量表(SDS)、自评焦虑量表(SAS)和日常生活活动能力量表(ADL)检测,SECF≤90分为脑卒中后认知障碍,2个月后复查以上量表,分别以性别、年龄、受教育年限、病程、病因、偏瘫侧、SECF1、SECF3、ADL1、ADL3、SAS1、SAS3、SDS1和SDS314个变量中的1个变量为因变量,其他13个变量为自变量进行多元逐步回归分析。结果 脑卒中后认知障碍患者住院2个月后SECF、ADI。明显提高,SAS、SDS明显降低(P=0.000);年老患者中女性、脑梗死比例增高,ADL能力降低(P〈0.05);人院前病程长者,抑郁分高,ADL可提高的幅度小(P〈0.05);ADL高者焦虑情绪少(P=0.028)。结论 早期人院康复治疗有助于提高脑卒中患者的日常生活能力,降低抑郁情绪。  相似文献   

2.
510例脑卒中患者的抑郁、焦虑及其相关因素分析   总被引:10,自引:4,他引:6  
目的探讨脑卒中后抑郁、焦虑与各种因素之间的关系.方法对1997~2004年住院治疗的510例脑卒中患者在入院后7 d内进行老年认知功能量表(SECF)、自评抑郁量表(SDS)、自评焦虑量表(SAS)和日常生活能力量表(ADL)检测,两个月后复查.结果抑郁组患者病程长、左侧偏瘫比例高,入院时ADL评分低、SAS评分高,与非抑郁组有显著性差异,抑郁情绪与认知功能之间无明显关联;焦虑组患者入院时ADL评分低、SDS评分高,ADL评分提高幅度大,与非焦虑组有显著性差异;病程长者抑郁评分降低的幅度小;治疗后,抑郁组和焦虑组患者的抑郁及焦虑评分降低的幅度明显大于非抑郁组和非焦虑组.结论早期住院康复治疗有助于减轻抑郁;轻微焦虑情绪可以提高ADL能力;抑郁和焦虑密切相关.  相似文献   

3.
脑卒中抑郁及相关因素分析   总被引:50,自引:7,他引:43  
目的 了解脑卒中抑郁与焦虑情绪、认知功能的关系及预后情况。方法 对144例脑卒中患者进行抑郁自评量表(SDS)、焦虑自评量表(SAS)和老年认知功能量表(SECF)评定。SDS≥50分者为抑郁组,SDS<50分者为非抑郁组。结果 抑郁发生率是40.27%,有自杀意念者占总数的17.36%。抑郁组认知功能低于非抑郁组,焦虑情绪高于非抑郁组,有非常高度性差异(P<0.001)。2个月后复查,抑郁组抑郁、焦虑情绪显著降低(P<0.001),非抑郁组焦虑情绪亦明显降低(P<0.01)。两组认知功能改善不明显。结论 脑卒中后抑郁与患者焦虑情绪、认知功能密切相关。住院2个月后抑郁组患者抑郁、焦虑情绪均改善,非抑郁组患者焦虑情绪亦降低,但认知功能改善较慢,2个月内变化不大。  相似文献   

4.
脑卒中后抑郁治疗的初步探索   总被引:12,自引:2,他引:10  
目的探索脑卒中后抑郁治疗的最佳方案。方法对 1996— 2 0 0 1年间住院脑卒中患者在入院时进行自评抑郁量表(SDS)、自评焦虑量表 (SAS)、老年认知功能量表 (SECF)和日常生活能力量表 (ADL)的检测并进行心理治疗。自评抑郁量表SDS≥5 0分为脑卒中后抑郁 ,符合入组条件的有 115例 ,随机分为两组 :心理治疗加上百忧解药物联合治疗组 (甲组 ) 5 4人 ,单用心理治疗组 (乙组 ) 6 1人。 2个月后复查 1次。结果两组在年龄、性别、受教育年限、病程和偏瘫左右侧方面无显著性差异。住院 2个月后复查 ,两组抑郁、焦虑情绪明显降低 (P <0 0 0 1) ,日常生活能力明显提高 (P <0 0 0 1) ,认知功能改变不明显 (P >0 5 )。两组SDS、SAS、SECF、ADL两次测验降低或提高的分数无显著差异 (P >0 5 )。结论脑卒中后抑郁单用心理治疗与心理加上百忧解药物联合治疗疗效相似  相似文献   

5.
目的探讨认知行为干预对康复期精神分裂症患者焦虑、抑郁症状的影响。方法将100例康复期精神分裂症患者,随机分为对照组和实验组,每组50例。两组均给予精神科常规治疗及护理,实验组在此基础上联合认知行为干预,观察2个月。分别于干预前和干预后2个月对患者进行自尊量表(SES)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评定。结果干预前两组SES、SAS、SDS评分无显著性差异(P〉0.05),治疗2个月后,实验组SES评分显著高于对照组(P〈0.01),SAS和SDS评分显著低于对照组(P〈0.01)。结论认知行为干预能显著改善康复期精神分裂症患者的焦虑、抑郁情绪,增强自尊自信,有助于患者康复。  相似文献   

6.
癫痫患者的生活质量以及与焦虑、抑郁情绪的相关性研究   总被引:10,自引:0,他引:10  
目的探讨癫痫患者的生活质量以及与焦虑、抑郁情绪的关系。方法应用生活质量综合评定问卷(GQOLI)、Zung焦虑自评量表(SAS)及Zung抑郁自评量表(SDS)对60例癫痫患者(癫痫组)及60名健康自愿者(对照组)进行评定,并对生活质量与焦虑、抑郁作相关分析。结果癫痫患者的生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均明显低于对照组(P〈0.01),而SAS及SDS评分则均明显高于对照组(P〈0.01);生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均与SAS及SDS评分呈显著性负相关。结论癫痫患者的生活质量较差,焦虑、抑郁情绪明显,其生活质量与焦虑、抑郁情绪密切相关。  相似文献   

7.
脑卒中病人的心理情绪评估   总被引:10,自引:4,他引:6  
区丽明 《中国临床康复》2002,6(9):1241-1243
脑卒中病人最常见的心理情绪变化是抑郁和焦虑,常用的评估量表包括症状自评量表(SCL-90)、Beck抑郁问卷(BDI)、自评抑郁量表(SDS)、抑郁状态问卷(DSI)、汉密顿抑郁量表(HRSD)、焦虑自评量表(SAS)、汉密顿焦虑量表(HAMA)等。各量 表的适用人群和侧重各有不同,使用时主要根据病人完成评估的能力和临床工作人员的需求选择适当的量表。及早发现和评定脑卒中病人的不良心理情绪,并给予及时、合理的心理辅导和药物治疗有利于卒中患的运动功能、认知功能和ADL的恢复。  相似文献   

8.
乳腺癌患者术后生活质量与焦虑、抑郁情绪的相关性分析   总被引:3,自引:1,他引:2  
目的探讨乳腺癌患者术后生活质量与焦虑、抑郁情绪的相关性,为临床护士开展心理护理提供依据。方法采用欧洲癌症研究与治疗组织研制的生活质量核心量表(QLQ-C30)、Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS)分别测评147例乳腺癌患者的生活质量及其焦虑和抑郁状况,并分析其相关性。结果乳腺癌患者术后QLQ-C30评分中的躯体功能、角色功能、情绪功能、认知功能、社会功能以及总体健康状况分别与SAS评分和SDS评分呈负相关。而症状维度与SAS评分和SDS评分呈正相关(均P〈0.05)。结论乳腺癌患者术后焦虑、抑郁情绪越严重,其生活质量越差。提示临床护士应对其进行相应的心理辅导,提高患者的生活质量。  相似文献   

9.
目的探讨脑卒中患者早期心理干预对负性情绪和睡眠障碍的影响。方法选取首次发病的脑卒中患者150例,随机分为对照组和观察组,各75例。对照组实施常规护理,观察组在对照组基础上实施心理障碍干预管理。评估2组患者焦虑、抑郁水平和睡眠障碍改善情况,并对比2组干预前后神经功能缺损程度(NDS)和日常生活能力量表(ADL)评分。结果管理后,2组焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数量表(PSQI)、NDS和ADL评分均显著低于管理前(P0.01),且观察组SAS、SDS、PSQI评分改善显著优于对照组(P0.01),干预后2组NDS和ADL评分比较,差异无统计学意义(P0.05)。结论早期实施心理障碍干预管理能够有效改善脑卒中患者焦虑和抑郁情绪,提高睡眠质量。  相似文献   

10.
目的探讨护校学生焦虑、抑郁情绪与个性的关系。方法采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和艾森克个性问卷(EPQ)对300名护校学生进行问卷调查。结果护校学生焦虑和抑郁检出率分别为16%和36%。焦虑、抑郁组在EPQ量表的N、P分显著高于对照组(t=-4.81~-5.90,P〈0.01)。SAS、SDS得分与EPQ量表的N分和P分呈正相关(γ=0.38~0.48,P〈0.05),与E分呈负相关(γ=-0.12~-0.18,P〈0.05)。多元逐步回归分析显示N、P和L分是影响焦虑和抑郁情绪的主要因素。结论护校学生焦虑、抑郁情绪与个性有关。  相似文献   

11.
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.  相似文献   

12.
Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.  相似文献   

13.
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.  相似文献   

14.
Ranganath C  Heller AS  Wilding EL 《NeuroImage》2007,35(4):1663-1673
Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.  相似文献   

15.
16.
This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.  相似文献   

17.
18.
目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4%(55/72)]明显高于成功组[31.7%(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3%(42/72)]高于成功组[38.1% (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9% (28/72)]高于成功组[23.8%(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大<6 cm、胎头位于坐骨棘上及宫口开大8~10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1%(44/72)]高于成功组[38.9%(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2%(52/72)]明显高于成功组[34.1 %(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.  相似文献   

19.
The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.  相似文献   

20.
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