36例手足口病合并急性弛缓性麻痹患儿的肌电图分析

目的:探讨神经电生理检查在手足口病(HFMD)合并急性迟缓性麻痹(AFP)患儿的特点及应用价值.方法:对36例手足口病合并急性迟缓性麻痹患儿进行运动神经传导速度(MCV)、感觉神经传导速度(SCV)、F波及肌电图(EMG)检查,共检测176条运动神经、88条感觉神经、98条神经的F波及285块肌肉,并对结果进行分析.结果:运动神经传导异常率为52.8%,其中运动传导波幅下降占81%,未引出反应波者为15%,MCV减慢或潜伏期延长者为4%,感觉传导异常率为6%,F波异常率为10%,EMG出现自发电位者为28.4%,出现高大运动单位电位(MUP)者为48.1%,募集相减少63.9%.结论:HFMD合并AFP患儿有神经原性损害,以轴突损害电生理改变为主,多累及近端神经,以运动神经受累为主.神经电生理检查对HFMD合并AFP患儿的诊断治疗及判断预后有重要价值.     

肌电生物反馈治疗手足口病合并急性弛缓性麻痹患儿的疗效

目的研究肌电生物反馈治疗手足口病合并急性弛缓性麻痹患儿的疗效。方法将48例手足口病合并急性弛缓性麻痹患儿随机分为肌电生物反馈治疗组(常规康复治疗基础上联合肌电生物反馈治疗)及对照组(常规康复治疗),分别在康复治疗前、治疗1个月后采用表面肌电分析系统评估患侧肢体肌力。结果常规康复结合肌电生物反馈治疗对手足口病合并急性弛缓性麻痹患儿患侧三角肌、股四头肌的表面肌电信号相比仅给予常规康复治疗者有明显差异。结论肌电生物反馈结合常规康复治疗可提高手足口病合并急性弛缓性麻痹患儿患侧肌力,改善患侧肢体运动功能。     

手足口病患儿合并中枢神经系统损害临床分析

目的：探讨手足口病患儿合并中枢神经系统损害的临床特点及治疗方法。方法选取合并中枢神经系统损害的手足口病患儿137例,随机分为2组。回顾分析所有患者的临床特点、试验时间、检查结果,并进行统计。2组患儿均实施综合治疗,在此基础上,对照组给予胞二磷胆碱静滴,观察组给予神经节苷脂静滴。对2组患儿神经系统好转时间、发热缓解时间及痊愈时间进行统计。于治疗10 d时测定2组患儿神经元特异性烯醇化酶水平,评价2组患儿治疗效果。结果发热、皮疹、易惊是手足口病患儿合并中枢神经系统损害最为常见的临床表现;脑脊液细胞数升高是实验室检查中最常见的异常。观察组患者神经系统好转时间、发热缓解时间、痊愈时间及神经元特异性烯醇化酶水平均明显低于对照组。结论手足口病患儿合并中枢神经系统损害的临床表现缺乏特异性,治疗时应在综合治疗的基础上加用神经节苷脂静脉注射。     

小儿手足口病并发中枢神经系统损害45例脑电图分析

目的:探讨脑电图(EEG)检查对手足口病并发中枢神经系统损害的诊断、治疗及随访的价值.方法:回顾性分析45例手足口病并发中枢神经系统损害患儿的EEG改变及演变.结果:45例患儿中,男31例,女14例,5岁以下43例.病程4d内初检,42例患儿EEG异常,异常率为93%,EEG异常呈弥漫性改变.复查EEG显示,随着临床好...     

鼠神经生长因子穴位注射治疗手足口病合并急性弛缓性麻痹恢复期的临床研究

目的探讨鼠神经生长因子穴位注射治疗手足口病合并急性弛缓性麻痹恢复期的临床疗效。方法观察手足口病并发急性弛缓性麻痹恢复期患儿临床特点,早期给予鼠神经生长因子穴位注射治疗,配合针刺、按摩及功能训练。结果手足口病并发急性弛缓性麻痹恢复期患儿治疗组总有效率高于对照组,2组比较差异具有统计学意义(P0.05)。结论鼠神经生长因子穴位注射配合针刺及按摩能促进患儿受损的神经功能恢复。     

康复训练联合高压氧治疗手足口病所致弛缓性麻痹的疗效研究

目的探讨康复训练联合高压氧治疗手足口病所致弛缓性麻痹的疗效。方法将70例手足口病所致弛缓性麻痹患儿随机分为治疗组和对照组,每组各35例。对照组予隔离、抗感染、营养支持、护脑、鼠神经生长因子穴位注射等常规治疗,治疗组在对照组基础上加用康复训练及高压氧。通过徒手肌力评定、日常生活活动能力(ADL)评定和FMA运动功能评分评定疗效。结果治疗组肌力恢复程度好于对照组,BI指数评分、FMA评分均高于对照组,差异有统计学意义(P0.05)。结论康复训练联合高压氧治疗手足口病所致弛缓性麻痹可明显提高麻痹肢体的肌力,提高患儿BI指数评分及FMA评分,减轻致瘫致残比例,提高患儿日常生活能力,其总体效果优于常规治疗。     

恩经复治疗手足口病合并急性弛缓性麻痹患儿临床分析

目的探讨恩经复治疗儿童手足口病合并急性弛缓性麻痹的临床疗效。方法收集79例手足口病合并急性弛缓性麻痹患儿的临床资料,其中恩经复治疗组49例,对照组30例,回顾性分析2组患者的临床特点,根据诊断学肌力级别为评定标准,记录患肢肌力恢复情况,分为显效、有效、无效。结果 79例手足口病合并急性弛缓性麻痹患儿中,26例合并单下肢瘫痪患儿下肢肌力恢复较好,可达Ⅲ～Ⅳ级,40例合并双侧肢体瘫痪及单上肢瘫痪患儿,肢体肌力分别较前增加Ⅰ～Ⅱ级,7例单侧肢体瘫痪患儿上肢肌力恢复至Ⅱ～Ⅲ级,下肢恢复至Ⅲ～Ⅳ级,6例四肢瘫痪者中,2例双侧上肢肌力恢复至Ⅰ级,双侧下肢肌力恢复至Ⅱ级,4例双上肢恢复至Ⅱ级,双侧下肢肌力恢复至Ⅲ～Ⅳ级。对于HFMD合并AFP患儿,在综合康复治疗的基础上尽早给予恩经复注射治疗肌力恢复明显。结论对于HFMD合并AFP患儿,早期给予恩经复治疗,能够促进受损的神经功能早日恢复,减少瘫痪的发生,降低患儿致残率。     

瞬目反射对周围性面瘫的诊断价值

目的 探讨瞬目反射(BR)对周围性面神经麻痹的诊断价值.方法 回顾性分析46例周围性面神经麻痹患者的常规神经电图(NCV)、肌电图(EMG)及瞬目反射(BR)检查结果.结果 在发病早期(1周以内)BR就表现出明显异常,异常率 100%,NCV、EMG异常率低.NCV、EMG在发病6～15d才表现明显异常.结论 BR对周围性面神经麻痹早期有重要诊断意义.     

27例产瘫的神经肌电图分析

目的探讨神经电图、肌电图在分娩性臂丛神经损伤(产瘫)的特点及应用价值。方法对27例产瘫患儿进行神经电图(NCV)及肌电图(EMG)检查,测定臂丛五大神经的运动神经传导及其主要支配肌肉的肌电表现,并定期进行复查。结果27例中,上干损伤9例(33.3%),上中干损伤11例(40.7%),全干损伤7例(26%),初次检查小于3月小婴儿神经电图及肌电图异常率均为100%,3~6月后复查,肌电图异常率高于神经电图。结论产瘫患儿以上干、上中干损伤占多数(74%),神经电图及肌电图在产瘫患儿不同时期的表现特点及应用价值不同。     

急性脑梗死合并肺部感染30例临床分析及防治

目的探讨急性脑梗死合并肺部感染的诱发机制,影响因素,以便有效的预防和治疗。方法分析2008-01~2008-12我科收治的急性脑梗死患者216例并发肺部感染30例,分析肺部感染的发生与患者年龄、病情程度、意识状态、延髓性麻痹、是否合并基础病以及预后的关系。结果高龄、病情重、昏迷者、存在延髓性麻痹及合并糖尿病、慢性肺病、心脏病及既往卒中史者肺部感染发生率明显增高。合并肺部感染者病死率明显高于无肺部感染者。结论控制肺部感染可有效提高急性脑梗死的救治成功率。     

Satisfaction with quality of life varies with temperament types of patients with schizophrenia

We sought to explore the relationships of three temperament factors with domain-specific subjective quality of life (QOL) of patients with schizophrenia. Ninety patients with schizophrenia were evaluated using the Quality of Life Enjoyment and Life Satisfaction Questionnaire, the Tridimensional Personality Questionnaire, the Positive and Negative Syndromes Scale, the Distress Scale for Adverse Symptoms, the Insight and Treatment Attitudes Questionnaire, the Insight Self-Report Scale, and standardized questionnaires for self-reported emotional distress and stress process-related variables. Predictors of domain-specific QOL were identified using multiple regression techniques. Temperament factors explain 6% to 16% of variability in QOL domain scores among patients with schizophrenia after controlling for the remaining variables (emotional distress, social support, self-esteem, avoidance coping, age, side effects, and depression). We found that higher levels of novelty seeking are associated with better general QOL, physical health, and more positive subjective feelings, whereas higher levels of reward dependence are related to better satisfaction from social relationships. Higher levels of harm avoidance are associated with poorer satisfaction with general activities, and medication. Thus, temperament factors, as assessed by the Tridimensional Personality Questionnaire, substantially influence satisfaction with life quality in schizophrenia. Novelty seeking, reward dependence, and harm avoidance are associated with different domains of QOL.     

Compliance with health regimens of adolescents with epilepsy

The purpose of this paper was to describe the compliance of adolescents with epilepsy and some factors connected to it. Altogether 300 individuals with epilepsy aged 13-17 years were randomly selected from the Finnish Social Insurance Institution's register. Every fifth person on the list was included in the sample. Seventy-seven per cent (n= 232) of the selected adolescents with epilepsy returned a questionnaire sent to them relating to compliance. The data were analysed using the SPSS software. Twenty-two per cent of the adolescents with epilepsy felt that they complied fully with their suggested health regimens, while 44% placed themselves in the category of "satisfactory compliance", and the remaining 34% reported poor compliance. Compliance with their recommended life-style was poorest, while the highest degree of compliance was recorded for medication. Background variables, such as the duration of the disease, exercise, smoking, alcohol-intake and the number of seizures, were statistically significantly related to compliance (P< 0.001). Good motivation, a strong sense of normality, experience of results, subjective outcome, energy and will-power, support from parents, physicians and nurses, and a positive attitude towards to the disease and its treatment, no threat to social and emotional well-being and no fears of complications and no fear of seizures explained good compliance (P< 0.001).     

Treatment of patients with tardive dystonia with olanzapine

Tardive dystonia represents a complication of long-term use of neuroleptics and its treatment is often unsatisfactory. Atypical neuroleptics appear to improve tardive dystonia, and cases of tardive dystonia successfully managed with clozapine have been reported. The aim of this open-label video-blinded study was to evaluate the antidystonic efficacy of olanzapine, a new atypical neuroleptic with a low risk of agranulocytosis, in a group of four patients (one man and three women) with tardive cervical dystonia. They developed severe dystonia after several years of neuroleptic treatment. Extensive laboratory evaluations, as well as neurophysiologic and neuroradiologic investigations, were negative. Olanzapine was started at a dose of 5 mg/d and increased up to 7.5 mg/d. All patients were evaluated at baseline and after 2, 4, 8, and 12 weeks of treatment, using the Toronto Western Spasmodic Torticollis Rating Scale, and videotaped. At the end of the trial, the videotapes were reviewed and scored by a blind observer. A self-rating visual analog scale completed the disability evaluation.A moderate to marked improvement in dystonia was observed in all patients, and significant differences were observed in Toronto Western Spasmodic Torticollis Rating Scale scores and videotape ratings after 8 and 12 weeks of treatment compared with the basal values (p < 0.05). The average percentage of improvement in Toronto Western Spasmodic Torticollis Rating Scale score and visual analog scale was 26.4% and 42.6%, respectively. No serious side effects were reported at the maximum dosage reached (7.5 mg/d). This study warrants a larger controlled study to conclusively demonstrate the efficacy of olanzapine in tardive dystonia.     

血管内栓塞治疗未破裂脑动静脉畸形并发癫痫患者的预后分析

目的分析血管内栓塞治疗未破裂脑动静脉畸形(CAVM)并发癫痫患者的预后情况。方法选择2013年3月至2017年6月收治的符合诊断标准的CAVM并发癫痫发作患者49例为研究对象,分析血管内栓塞治疗后患者的临床症状、生活质量(QOLIE-31)改善情况。结果患者经血管内栓塞治疗后,QOLIE-31各项指标(除了药物影响)评分均明显提高,高于治疗前(P0.05);Spetzler-Martin分级与Engel分级的I~II级例数多于治疗前(P0.05),同时Spetzler-Martin分级I~II级生活质量评分(76.04±18.33)分明显高于III~V级的(65.65±16.76)分(P0.05);Engel分级I~II级的生活质量评分(75.25±17.78)分明显高于III~V级的(66.23±13.22)分(P0.05);血管内栓塞比例80%的生活质量总评分(78.37±18.87)分明显高于栓塞比例80%的(64.16±16.92)分(P0.05);术后患者的头疼症状中重度例数明显低于治疗前(P0.01);患者的NIHSS评分和MRS评分均明显低于治疗前,头疼症状的生活质量评分高于治疗前(均P0.05)。结论血管内栓塞能明显改善未破裂脑动静脉畸形并发癫痫患者的头疼症状、癫痫发作情况、神经功能缺损,提高血管内栓塞比例能够提高患者生活质量。