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1.
A型肉毒毒素治疗局限性肌张力障碍和肌肉痉挛   总被引:37,自引:1,他引:36  
目的 探索A型肉毒素(BTX-A)在神经肌肉疾病中的治疗应用,证实和比较国产BTX-A(CBTX-A)与美国产BTX-A治疗局限性肌张力障碍和肌肉痉挛等的疗效和不良反应。方法 4年间用botox和CBTX-A分别注射治疗192和593例局限性肌张力障碍和肌肉痉挛等运动障碍性疾病,共计785例,注射1393次。随访3 ̄48个月,分析前瞻性,开放性临床研究的结果。结果botox或CBTX-A的疗效没有  相似文献
2.
冠心病患者心理状态的临床研究   总被引:28,自引:0,他引:28  
目的 探讨冠心病发生发展中的心理社会因素和心理症状。  方法 作者采用六种心理测验量表自评或他评的方法对住院冠心病 62例、非冠心病 3 2例进行了多因素对照调查。  结果发现冠心病患者病前个性以情绪不稳定多见 ,生活事件刺激量明显增多 ,A型行为是冠心病高危因素之一。病后以焦虑情绪为主的抑郁、强迫、敌对性、思维迟缓、睡眠障碍等心理症状与躯体症状并存 ,相互影响。  结论 心理社会因素和生物学因素对冠心病的防治同样重要。  相似文献
3.
Data from 616 patients suffering from idiopathic cervical dystonia were analyzed to determine the efficacy and safety of treatment with botulinum neurotoxin type A (BoNT/A). Since the specific purpose of this study was to determine the long-term effects of this treatment, the analysis focused specifically on the patients (n = 303) having received six or more injections. Statistical analysis of a standardized documentation showed sustained significant benefit as measured by a disease severity score independent of the type of cervical dystonia. Furthermore, pronounced individual differences were found in response to this treatment although initial clinical scores and doses of BoNT/A were similar. There was no indication of previously unknown adverse events, the only risk being the development of serum antibodies against the toxin. As in previous studies on short-term effects of BoNT/A treatment, the most frequent adverse event was dysphagia, which occurred on average 9.7 days after injection and lasted on average 3.5 weeks. While secondary nonresponse was seen in approx. 5% of patients, antibody tests revealed neutralizing serum antibodies in only 2%. On the basis of the present data, therapy of cervical dystonia with BoNT/A seems to be safe and yields good stable results even after 5 years of treatment. Received: 26 June 1997 Received in revised form: 17 July 1998 Accepted: 4 August 1998  相似文献
4.
After parotid surgery, gustatory sweating and flushing occur more frequently, the former reportedly in 15–100 % of cases, while no reliable data are available for the latter. Although botulinum toxin (BoNT) is effective in controlling sweating, little is known about its effect on flushing. In 17 patients suffering from Frey's syndrome after parotid surgery, we studied the gustatory flushing phenomenon as compared to gustatory sweating, analyzing their frequency, area, type of stimulus and response to BoNT administration. Cutaneous blood flow (CBF) was monitored by laser Doppler flowmetry (LDF) on affected and unaffected areas of the cheek in basal conditions and after meals, before and then 1 month after starting the BoNT injections. The Minor test was used to identify the sweating area. Flushing was observed in 7 of 17 patients after masticatory activity, spicy meals or citrus fruits. No clinical data correlated with any presence of flushing. Flushing regressed completely after BoNT administration and CBF reached similar values in the affected and unaffected sites. No adverse effects were observed. BoNT administration proved an effective and safe treatment for gustatory sweating and flushing in patients with Frey's syndrome. Received: 2 May 2001, Accepted: 27 March 2002  相似文献
5.
It is recognized that objective gait analysis is of great value in planning a multilevel botulinum toxin type A (BTX-A) treatment. After BTX-A treatment, objective outcome measures can provide new and interesting information for each individual child with cerebral palsy (CP). Moreover, by studying group results, we may evaluate our treatment hypotheses. The present prospective study attempts to document the effect of integrated multilevel BTX-A treatment on objective gait parameters and to define the optimal strategy for the combined treatment of BTX-A with casting in children with cerebral palsy. Objective three-dimensional gait analysis (3DGA) data were collected pre- and 2 months post-treatment, in two randomized patient groups: a first group of 17 children treated with lower leg casting prior to BTX-A injections, and a second group of 17 patients who received casting immediately after injections. The present study demonstrates that improved gait can be achieved after a multilevel BTX-A treatment, combined with casting, using a set of 90 gait parameters. The most pronounced improvement was seen at the ankle joint. The results in the knee, hip and pelvis imply that multilevel treatment of the child with CP should start at an early age, in order to prevent development of muscle contractures. Slightly more pronounced benefits, mainly in the proximal joints, were seen for the children who were casted after injections as compared to the children who were casted before injections.  相似文献
6.
目的观察单侧面肌痉挛(HFS)的A型肉毒毒素(BTXA)治疗效果;探讨治疗前后双刺激瞬目反射(BR)检测的意义.方法对134例患者进行BTXA局部肌肉注射,其中42例治疗前后行BR检测.结果134例患者中,症状完全缓解60例,占44.8%,明显改善74例,占55.2%.疗效持续时间(16.5±5.7)周.42例患者治疗前患侧BR检测,R1、R2、R'2潜伏期正常,R2间期缩短,R1、R2、R'2振幅增高.治疗后复查,其中R1消失者7例,R1、R2、R'2均消失者5例,余30例R1、R2、R'2潜伏期稍延长,但差异无显著意义;R1、R2、R'2波幅明显降低(P<0.05).结论BTXA治疗HFS疗效显著,是首选疗法;双刺激BR检测表明,患者脑干中间神经元兴奋性升高.  相似文献
7.
Treatment of gastroparesis: a multidisciplinary clinical review   总被引:9,自引:0,他引:9  
This clinical review on the treatment of patients with gastroparesis is a consensus document developed by the American Motility Society Task Force on Gastroparesis. It is a multidisciplinary effort with input from gastroenterologists and other specialists who are involved in the care of patients with gastroparesis. To provide practical guidelines for treatment, this document covers results of published research studies in the literature and areas developed by consensus agreement where clinical research trials remain lacking in the field of gastroparesis.  相似文献
8.
肌电图引导下A型肉毒毒素治疗痉挛性斜颈146例临床研究   总被引:8,自引:0,他引:8  
目的:探讨肌电图引导下A型肉毒毒素局部肌肉注射治疗原发性痉挛性斜颈的疗效。方法:对146例痉挛性斜颈患者在肌电图引导下进行A型肉毒毒素局部肌肉注射,观察其治疗效果以及不良反应。结果:146例痉挛性斜颈患者,治疗后Tsui量表评分明显下降;重复治疗者复发症状减轻,治疗剂量下降,疗效仍良好。所有患者均未见严重不良反应。结论:肌电图引导下A型肉毒毒素局部肌肉注射是一种治疗痉挛性斜颈有效和安全的手段。  相似文献
9.
Authors report the preliminary results of an open-label, prospective study to evaluate a functional benefit of botulinum toxin type A injections in diparetic cerebral palsy patients, using gross motor function measure (GMFM) score. In a group of 14 children (mean age 3.9 years, range 2-6) treated with Dysport 30 IU/kg, a statistically significant improvement (P < 0.05) was noticed in both simple measurements (Modified Ashworth Scale, Selective Motor Control, Passive Range of Movements, Physician Rating Scale and parental Clinical Global Impression) and complex functions (GMFM dimensions D and E) after 1 and 3 months. However, the simple measurement scores decreased (but not to the baseline) after 3 months; surprisingly, GMFM scores were still increasing (7.7% change after 3 months and 11.3% change after 6 months in nine patients). These results are in concordance with a few other data published to date. The study may support the concept of persistent functional gain in long-term treatment of spasticity caused by cerebral palsy with botulinum toxin type A.  相似文献
10.
Effective use of the upper limb can impact on educational outcomes, participation in activities of daily living and vocational options for many children with cerebral palsy (CP). This article presents the results of a systematic review of the literature on the management of upper limb dysfunction in children with CP. The range of management options includes therapies such as physiotherapy, occupational therapy, neurodevelopmental therapy and conductive education; peripheral splinting and casting; focal or generalized pharmacotherapy; and surgery to improve upper limb function or correct deformity. A literature search identified 60 papers, of which four were randomized controlled trials and 44 were prospective studies with objective outcome measures. Principal studies undertaken for each type of treatment and the efficacy of the different types of treatment were critically evaluated. In addition, the current level of evidence for each study was evaluated according to Sackett's (1989) model and ICIDH-2 classification. A close examination of two relatively new treatments for upper limb spasticity, constraint induced movement therapy and botulinum toxin type A (BTX-A) was conducted with reference to more extensive data on the efficacy of BTX-A in the lower limb.  相似文献
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