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1.
脑卒中病损评估量表中的运动功能部分的有效性研究   总被引:3,自引:0,他引:3  
目的:探讨脑卒中病损评估量表中的运动功能部分(SIASM)对脑卒中偏瘫患者进行运动功能评定的有效性和可行性。方法:应用SIASM对53例脑卒中偏瘫患者的运动功能进行评测,并与简式FuglMeyer运动功能评价法(FMA)及Barthel指数评定法(BI)进行相关分析比较。结果:SIASM总分与FMA总分显著相关(r=0.9545,P<0.001),SIASM上肢分与FMA上肢分显著相关(r=0.9776,P<0.001),SIASM下肢分与FMA下肢分显著相关(r=0.9329,P<0.001),SIASM总分、SIASM上肢分、SIASM下肢分与BI得分均显著相关(r1=0.7694,r2=0.6301,r3=0.7552,P<0.001)。结论:SIASM是有效的,并且简便、实用,能敏感地反映偏瘫患者运动功能的变化,值得在国内推广应用  相似文献   

2.
脑出血和脑梗塞的住院医疗康复效益分析   总被引:5,自引:1,他引:4  
目的:通过对脑卒中患者住院医疗康复效益的对比研究,探讨脑出血和脑梗塞的病理特征与功能恢复的关系及对预后的影响。方法:用功能独立检查对82例康复科住院的脑卒中患者进行测量,并计算康复效益,将脑出血和脑梗塞患者入院、出院值,住院期间获得值,以及康复效益进行配对分析。结果:脑出血患者入院功能独立检查运动分、认知分、总分均较脑梗塞患者低(P〈0.05),出院时各功能独立检查无显著性差异,脑出血患者住院期间  相似文献   

3.
多普勒超声心动图对急性心肌梗塞患者溶栓治疗的评价   总被引:3,自引:0,他引:3  
目的:探讨多普勒超声心动图对不同梗塞部位急性心肌梗塞(AMI)溶栓治疗再通评价的意义。方法:对160例首次AMI患者随机分成尿激酶溶栓治疗再通组和常规治疗对照组,采用彩色多普勒超声心动图测定左房内径(LAD)、室间隔和左室后壁运动最小幅度(IVSA和LVPWA)、左室射血分数(EF)、二尖瓣E点至室间隔距离(EPSS)和二尖瓣血流频谱A峰最大速度与E峰最大速度比(A/E)。结果:①溶栓治疗者再通率为58.82%(70/119)。②急性前壁心肌梗塞(AAMI)患者的LAD、EPSS和A/E在溶栓组明显低于对照组(P<0.01,P<0.01,P<0.01);溶栓再通组EF明显高于对照组(P<0.01)。③急性下壁心肌梗塞(AIMI)患者LVPWA溶栓再通组高于对照组(P<0.05);溶栓再通组A/E明显低于对照组(P<0.01)。④AAMI+AIMI患者EF在溶栓再通组明显高于对照组(P<0.01);EPSS低于对照组(P<0.05)。结论:溶栓治疗可限制梗塞面积,挽救濒死心肌,改善左室功能。在梗塞部位上,前壁优于下壁,AAMI+AIMI介于两者之间。  相似文献   

4.
脑瘫儿童功能独立检查的测量研究   总被引:2,自引:1,他引:1  
采用儿童功能独立检查法(WeeFIM)对30例脑瘫(cerebralpasly,CP)儿童进行测量,并与儿童适应行为量表(CABS)比较,探讨儿童功能独立检查在CP儿童残疾组类使用的有效性,统计结果显示30例CP儿童的WeeFIM总分和适应证商数(ADQ)基本呈正态分析,WeeFIM总分,分组及各维度与ADQ之间的总体相关系数为0.7951与CABS独立功能因子,CABS认知功能因子,CABS社会  相似文献   

5.
目的:观察早期康复疗法在急性心肌梗塞(AMI)治疗中的价值。方法:随机选取19例无泵衰的AMI患者为康复组,19例无泵衰的AMI为对照组。康复组行3周康复疗程,4周未作症状限制性运动负荷试验,测定平均运动耐受时间、安静及运动终点的心率×收缩压积值。心脏功能容量,作心脏B超测左室射血分数。结果:康复组平均运动耐受时间(16.2±6.23)与对照组(13.12±5.40)相比P<0.01;康复组平均心率×收缩压×10-2积值(安静9.94±1.78,运动终点15.21±3.96)与对照组(安静11.26±3.70;运动终点13.85±3.67)相比P<0.01;康复组心脏功能容量(METs)(5.72±1.44)。与对照组(4.03±1.35)相比P<0.01;康复组射血分数(56.31%±10.70%)与对照组(48.25%±9.62%)比P<0.01。结论:AMI的早期康复治疗,不但具有安全性,而且可以明显提高全身的运动能力,增加心血管储备能力,改善心功能  相似文献   

6.
脑瘫儿童功能独立与适应行为的相关性研究   总被引:3,自引:1,他引:2  
本研究采用儿童功能独立评测法(WeeFIM)和中国版儿童适应行为量表(CABS)对脑瘫儿童进行评估,探讨脑瘫儿童功能独立与适应行为之间的相关性。初期测评选18名脑瘫儿童。统计结果显示WeeFIM运动类各项与适应行为中的运动独立因子呈正相关,r=0.5725~0.7146;认知类各项与适应行为三因子呈正相关,r=0.5310~0.7873。WeeFIM总分与适应行为的发育商数呈正相关,r=0.7053。初步研究表明脑瘫儿童功能独立测量与适应行为测量有较高的相关性,各项与适应行为三因子均有不同程度的相关,能反映脑瘫儿童的功能状态,由于WeeFIM以等级量化的形式表示,较简单和易于掌握,为今后脑瘫康复功能评估提供了一种实用的方法。  相似文献   

7.
促进技术对中风运动功能的疗效观察   总被引:10,自引:1,他引:9  
采用促进技术治疗36例中风偏瘫患者。评测方法为Fugl-Meyer运动积分法、ADLBarthel指数、简易智力量表。结果表明:治疗后患者的运动功能恢复率比治疗前显著提高(P<0.01);多元逐步回归提示智力对治疗前后运动功能恢复率无显著影响(P>0.05);运动功能恢复率对独立生活能力有影响(P<0.01),尤以对平衡和肢体运动功能的影响最大。  相似文献   

8.
目的探讨早期康复护理干预对急性脑卒中偏瘫患者的运动功能、平衡功能、日常生活活动能力(ADL)的影响。方法脑卒中偏瘫患者60例,对其中30例患者实施早期康复计划(康复组),另外30例患者给予神经内科一般治疗(对照组)。结果两组治疗前,治疗后一个月分别给予 Fugl-Meyer评测法和FIM评测法,对患者肢体的残损程度和活动功能进行评定,经过统计学检验得出:治疗前评测,两组无明显差异(P>0.05)。治疗后1个月评测,康复组明显优于对照组(P<0.01)。结论早期给予康复护理干预可以明显改善急性脑卒中偏瘫患者的肢体运动和平衡功能及ADL。  相似文献   

9.
目的: 评价溶栓治疗对急性心肌梗塞(AMI)患者左心功能的影响。方法:经静脉溶栓治疗的96 例患者AMI后1 个月进行锝99 心肌扫描,计算各项心功能指标。结果:59 例再通者的EF% 、PER和PFR均明显优于37 例未通者(P均< 0.01)。左室扩张者的各类指标与LVEDd 呈负相关(r= - 0.41~- 0.80, P< 0.01)。结论: AMI的溶栓治疗能明显地改善心功能  相似文献   

10.
目的:探讨颅脑损伤患者血清和脑脊液(CSF)中髓鞘碱性蛋白(MBP)含量变化及其与脑损伤的关系。方法:应用514MC酶标仪,采用酶联免疫吸附法分别测定弥漫性轴索损伤(DAI)、颅内血肿(ICH)和硬膜外血肿(EDH)共60例颅脑损伤患者(病例组)的血清和CSF中MBP含量,并与同期腰椎麻醉手术的20例非脑损伤患者(对照组)作对比。结果:病例组患者血清和CSF中MBP含量均高于对照组;DAI组CSF中MBP含量与ICH组间无显著性差异(P>0.05),但2组间血清MBP含量差异显著(P<0.01);EDH组CSF和血清MBP含量均低于DAI组和ICH组(P均<0.01),但稍高于对照组(P<0.01,P>0.05)。结论:重型颅脑损伤患者血清和CSF中MBP含量增高,其上升水平与脑损伤类型及损伤程度有关。  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.
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   

14.
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   

15.
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   

16.
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   

17.
18.
目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高<20%视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P<0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P<0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P<0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.  相似文献   

19.
20.
Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.  相似文献   

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