巴氯酚联合综合康复训练治疗缺血性脑卒中伴偏瘫对肢体运动及神经功能的影响

目的探讨巴氯酚联合综合康复训练治疗缺血性脑卒中伴偏瘫对肢体运动及神经功能影响。方法选择我院收治的68例脑卒中伴偏瘫患者为研究对象,随机数字表法分为2组。对照组予以综合康复训练,观察组在对照组基础上联合巴氯酚治疗,比较2组Fugl-Meyer评分、鲍氏NBNA评分、治疗总有效率、不良反应发生率。结果 2组治疗前Fugl-Meyer评分、NBNA评分的比较均无统计学意义,治疗后2组两项评分均改善,与治疗前比较差异有统计学意义(P0.05);观察组治疗后Fugl-Meyer评分明显高于对照组,NBNA评分明显低于对照组,差异有统计学意义(P0.05)。观察组治疗总有效率为85.3%(29/34),高于对照组的61.8%(21/34),差异有统计学意义(P0.05)。2组不良反应比较差异无统计学意义(P0.05)。结论巴氯酚联合综合康复训练治疗缺血性脑卒中伴偏瘫利于改善患者肢体运动及神经功能,预后更佳,安全性高,具有较高临床应用价值。     

早期康复训练用于缺血性脑卒中偏瘫患者的效果评价

目的探讨早期康复训练用于缺血性脑卒中偏瘫患者的效果。方法选取2013-01—2015-01我院收治的108例缺血性脑卒中偏瘫患者为研究对象,采用随机数表法将其分为观察组和对照组各54例。对照组给予神经内科常规护理方法,观察组给予早期康复训练。对比2组住院时间、住院1周和出院时的Barthel指数、住院1周和出院时Fugl-Meyer运动功能评分和并发症发生率。结果入院1周时2组Barthel指数、Fugl-Meyer运动功能评分差异无统计学意义(P0.05)。出院时观察组的Barthel指数、Fugl-Meyer运动功能评分均高于对照组,差异有统计学意义(P0.05)。观察组的住院时间低于对照组,差异有统计学意义(P0.05)。观察组的并发症发生率为11.10%,对照组为38.88%,差异有统计学意义(P0.05)。结论缺血性脑卒中偏瘫患者采用早期康复训练能提高患者的生活活动能力和运动能力,缩短住院时间。     

互动式头针治疗脑卒中恢复期患者步态的康复疗效评价

目的 :观察互动式头针对脑卒中恢复期患者偏瘫步态及移动能力的治疗作用。方法 :将连续纳入研究的90例符合病例选择标准的脑卒中恢复期伴偏瘫步态的患者随机分入互动式头针组(30例,头针治疗同时进行康复训练)、传统头针组(30例,头针治疗后进行康复训练)和对照组(30例,仅康复训练),连续治疗3个月。采用5 m折返行走试验评估治疗后的步态质量改善情况,采用改良Barthel指数评估移动能力改善对整体康复疗效的影响。结果 :治疗后,3组患者的5 m折返行走时间和改良Barthel指数均较治疗前显著改善(P值均0.01)。互动式头针组治疗前后5 m折返行走时间的差值显著大于传统头针组(P0.05)和对照组(P0.01);治疗前后改良Barthel指数的差值显著大于对照组(P0.05),亦高于传统头针组,但差异无统计学意义(P0.05)。结论 :互动式头针治疗有助于脑卒中恢复期患者偏瘫步态的改善,从而提高其移动能力。     

临床康复路径对脑卒中患者日常生活及运动能力的影响

目的分析临床康复路径对脑卒中患者日常生活及运动能力的影响。方法选取100例脑卒中伴偏瘫患者为研究对象,随机分为观察组和对照组各50例。对照组给予常规康复治疗,观察组应用临床路径进行康复治疗。对2组治疗前后的Barthel指数评分、Fugl-Meyer评分及疗效进行比较。结果观察组治疗后Barthel指数评分、Fugl-Meyer评分均显著高于对照组,差异有统计学意义(t=9.323、15.317,P0.05),观察组疗效分布和临床有效率均优于对照组,差异有统计学意义(U=4.132,χ~2=5.263,P0.05)。结论在脑卒中的康复治疗中应用临床路径,能够提高治疗效果,改善患者的日常生活能力和运动能力,具有一定的应用前景。     

早期康复训练联合行为疗法对老年脑卒中偏瘫患者康复效果的影响

目的探讨行为疗法联合早期康复训练对老年脑卒中偏瘫患者的康复效果。方法选取2013—2014年我院收治的老年脑卒中偏瘫患者88例,随机平均分为2组,对照组选择早期康复训练,观察组联合行为学疗法。结果治疗后2组FAC步态能力评分、FMA下肢运动与平衡功能评分、步行指标、Barthel日常生活能力评分及偏侧空间忽略指标均明显改善(P0.05),观察组各项指标改善均优于对照组(P0.05)。结论早期康复训练联合行为学疗法能够有效治疗老年脑卒中偏瘫,改善步态及下肢功能情况,还能够有效改善偏侧空间忽略情况,具有较高的临床推广价值。     

康复训练结合针刺疗法治疗脑梗死偏瘫48例疗效分析

目的 观察康复训练结合针刺疗法治疗脑梗死的临床疗效.方法 将96例脑梗死患者随机分为观察组和对照组各48例,对照组采用康复训练治疗,观察组在康复训练治疗基础上结合针刺疗法.于治疗前和治疗1个月后,对患者运动功能采用简氏Fugl-Meyer运动功能评分法评定,对日常生活活动能力采用Barthel指数评定.结果 观察组患者运动功能、日常生活能力均优于对照组,2组比较差异有统计学意义(P＜0.01).结论 康复训练结合针刺疗法治疗脑梗死偏瘫疗效显著,能有效提高患者生活质量.     

镜像疗法联合康复训练对缺血性脑卒中偏瘫患者上肢功能的影响

目的探讨镜像疗法联合康复训练对缺血性脑卒中偏瘫患者上肢功能的影响。方法选取60例缺血性脑卒中上肢功能障碍的偏瘫患者,随机分为对照组29例行常规综合康复治疗,实验组31例为镜像疗法联合常规康复训练。采用Fugl-Meyer运动功能评价量表(Fugl-Meyer assessment,FMA)、Wolf运动功能评价量表(Wolf motor function test,WMFT)和改良Barthel指数(modified Barthel indext,MBI)评分对上肢和手的运动功能及日常生活能力进行评价。结果与对照组同期相比,治疗1个月和治疗2个月实验组FMA评分较对照组提高(P0.05),治疗2个月实验组WMFT评分较对照组提高(P0.05)。与治疗前相比,治疗1个月和2个月时实验组上肢MBI评分提高(P0.05);与同期对照组比较,治疗2个月时实验组MBI评分显著提高(P0.05)。结论镜像疗法联合康复训练有助于缺血性脑卒中偏瘫患者上肢运动功能的恢复,改善患者的日常生活能力,可作为缺血性脑卒中后上肢功能康复的一种治疗手段。     

早期康复结合低频电刺激对脑卒中患者运动功能的疗效观察

目的探讨早期康复结合低频电刺激疗法在改善脑卒中患者运动功能的临床疗效。方法 70例脑卒中患者随机分为观察组与对照组,对照组予早期康复训练,观察组加用低频电刺激治疗,比较临床神经功能缺损程度、运动及日常生活活动能力改善情况。结果经康复治疗后2组患者临床神经功能缺损评分、Fugl-Meyer评分及Barthel指数均有不同程度的改善,差异有统计学意义(P<0.05),而观察组治疗后上述指标均明显优于对照组,差异有统计学意义(P<0.05)。结论早期康复训练结合低频电刺激对脑卒中患者肢体运动功能恢复有良好的效果,可提高患者的肢体功能和日常生活运动能力。     

精神疗法联合运动疗法在脑卒中偏瘫患者恢复期的运用

目的研究精神疗法联合运动疗法在脑卒中偏瘫患者恢复期的运用效果。方法选择2015年10月至2016年月2月期间收治入院的脑卒中偏瘫患者患者82例,按照入院ID号随机平均分为对照组与观察组,对照组采用常规康复训练,观察组在对照组基础上采用精神疗法联合运动疗法。比较患者康复训练后步行功能、平衡功能、下肢运动功能改善情况。结果两组患者治疗前的步行功能、平衡功能、下肢运动功能和生活质量的评估组间比较,差异不明显(P0.05)。治疗后两组患者的步行功能、平衡功能、下肢运动功能较级生活质量评估治疗前均有改善(P0.05);而且观察组患者的上述功能指标评分均显著优于对照组患者,存在统计学差异(P0.05。结论在脑卒中偏瘫患者恢复期运用精神疗法联合运动疗法进行康复训练可更显著改善患者预后情况,提高患者生活质量,可在临床治疗中推广应用。     

中西医结合康复方案对脑卒中偏瘫患者生活质量的影响

目的分析中西医结合康复方案对脑卒中偏瘫患者生活质量的影响。方法选取鹿邑县人民医院2013-06—2015-10收治的244例脑卒中偏瘫患者,随机分为2组各122例,对照组采用常规治疗,观察组采用常规治疗和中西医结合康复,比较2组生活质量。结果 2组治疗前Fugl-Meyer评分和Barthel指数比较差异无统计学意义(P0.05);治疗后观察组Fugl-Meyer评分和Barthel指数明显高于对照组(P0.05)。结论中西医结合康复方案对脑卒中患者的临床效果明显,有助于改善患者肢体运动功能和日常生活能力,减少致残,提高预后生活质量。     

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。