神经肌肉电刺激结合耳穴刺激及吞咽训练改善脑卒中吞咽障碍的研究

目的探讨神经肌肉电刺激结合耳穴刺激及吞咽训练治疗脑卒中吞咽障碍患者的效果。方法选择2018年1月至2020年6月我院收治的脑卒中吞咽障碍患者50例,随机分为两组各25例。对照组采用神经肌肉电刺激治疗,观察组在此基础上采用耳穴刺激与吞咽训练。对比两组的治疗效果及治疗前后的吞咽功能。结果观察组的治疗总有效率明显高于对照组(P<0.05)。治疗前,两组的SSA、VFSS评分比较无统计学差异(P>0.05);治疗后,观察组的SSA评分低于对照组,VFSS评分高于对照组(P<0.05)。结论对脑卒中吞咽障碍患者采用神经肌肉电刺激、耳穴刺激及吞咽训练治疗,效果确切,能够促进患者吞咽功能恢复。     

神经肌肉电刺激治疗脑卒中运动障碍的研究进展

神经肌肉电刺激疗法（NMES）作为刺激肌肉收缩和预防肌肉萎缩的主要物理疗法，因具有简单、便携、高效、安全的特点，被广泛用于脑卒中患者的康复治疗，尤其在脑卒中后运动功能障碍和吞咽功能障碍的治疗中，对脑卒中后运动功能障碍有较大改善作用。该研究主要介绍了神经肌肉电刺激的治疗作用及机制，并对其在脑卒中运动障碍治疗中的研究进展作一综述。     

酸冷刺激对脑卒中合并吞咽困难治疗效果的研究

目的探讨酸冷刺激与冷刺激对缺血性脑卒中合并吞咽困难患者的影响。方法选择缺血性脑卒中合并吞咽困难（洼田饮水试验≥3级）患者60例,30例为观察组,在实施针灸,中频电刺激治疗的同时实施酸、冷刺激治疗;另30例为对照组,在实施针灸、中频电刺激治疗的同时,实施冷刺激治疗。比较治疗前及治疗后lOd两组患者的吞咽困难治愈率、有效率、无效率。结果lOd后观察组和对照组吞咽困难治愈率、有效率、无效率比较,差异有统计学意义（P〈0．05）。结论酸冷刺激对缺血性脑卒中合并吞咽困难患者治疗意义优于冷刺激。     

双侧重复经颅磁刺激联合常规康复训练治疗脑卒中后吞咽障碍效果观察

目的 观察双侧重复经颅磁刺激(rTMS)在单侧脑卒中后吞咽障碍患者康复治疗中的效果.方法 前瞻性选取2018年8月～2019年11月于四川大学华西医院住院的单侧脑卒中后吞咽障碍患者90例,用随机数表法将患者分为双侧rTMS组、单侧rTMS组、假刺激组,每组各30例.各组均接受常规康复训练,rTMS频率为3 Hz,刺激强...     

银杏叶片合并百忧解治疗脑卒中后抑郁状态临床观察

脑卒中后抑郁为脑卒中后常见并发病,约占50%～60%.①早期发现抑郁或其他精神障碍,早期治疗,可以促进卒中的康复.对银杏叶提取物的研究发现,可以提高抗抑郁剂的疗效.临床我们采用银杏叶片合并百忧解治疗47例脑卒中后抑郁病人,取得很好效果,报告如下.……     

双侧电刺激对脑卒中后康复的影响

目的　探讨双侧电刺激治疗对脑卒中后神经功能康复的影响。方法　将 15 0例急性脑卒中偏瘫患者随机分为两组 ,均采用常规药物和功能锻炼进行治疗 ,康复组加用双侧电刺激治疗 ,对照组加用单侧电刺激治疗。疗程 1月。采用临床神经功能缺损程度评分 ,简式Fugl-meyer运动功能评分 (FMA) ,改良Barthel指数 (MBI)于初期、末期 ( 3个月 )对两组病人评定并进行t检验。结果　治疗后 ,康复组临床神经功能缺损程度评分明显减少 ,与对照组相比 ,P <0 .0 1;FMA、MBI明显提高 ,与对照组相比 ,P <0 .0 1。结论　双侧电刺激治疗可明显促进患肢运动功能康复 ,降低致残率 ,提高日常生活能力。     

神经和肌肉电刺激治疗对脑卒中患者吞咽功能恢复效果观察

目的:探究神经和肌肉电刺激治疗对脑卒中患者吞咽功能恢复的效果.方法:对我院2016年7月份至2017年3月份期间收治的120例脑卒中吞咽功能障碍患者的临床资料进行研究,将120名患者随机平均分为观察组和对照组,其中对照组给予常规的药物治疗,并定期对患者吞咽功能恢复情况进行检查,观察组在实施对照组治疗方案的基础上按照每天一次,每次二十分钟的频率给予患者神经和肌肉电刺激治疗,一个月后进行两组患者的吞咽能力比较.结果:一个月后对照组的吞咽评级明显比不上观察组,差异有统计学上的意义.结论:神经和肌肉电刺激治疗能够明显促进患者吞咽功能的恢复,临床效果要优于常规的治疗方案.     

低频经颅电刺激联合镜像视觉反馈疗法对脑卒中后偏瘫患者下肢功能的影响

目的低频经颅电刺激联合镜像视觉反馈疗法对脑卒中后偏瘫患者下肢功能的影响。方法选择2018年2月—2020年11月医院治疗的脑卒中后偏瘫患者80例为研究对象,按照组间均衡可比的原则根据治疗方法不同分为对照组与观察组,各40例。对照组接受常规康复训练加镜像视觉反馈疗法,观察组在对照组基础上加低频经颅电刺激。比较两组治疗效果、下肢功能、平衡功能、生活能力及生活质量。结果观察组治疗总有效率为95.00%,明显高于对照组75.00%(P0.05);观察组治疗后FMA-L、BBS评分较对照组高(P0.05);观察组治疗后MBI、SS-QOL评分均较对照组高(P0.05)。结论低频经颅电刺激联合镜像视觉反馈疗法对脑卒中后偏瘫患者不仅能有效提升治疗效果,还能促进患者下肢功能及身体平衡性恢复,改善其日常生活能力及生活质量。     

脑卒中并发精神障碍的护理

目的:探讨脑卒中后精神障碍的护理对策.方法:对1380例脑卒中患者符合中国精神障碍分类与诊断标准的104例进行分类,并进行相应护理.结果:104例患者在出院时精神障碍症状均消失或好转.结论:脑卒中后精神障碍可直接影响患者功能恢复及生活质量.在药物治疗和心理治疗同时,加强护理,严防自杀,可减轻或消除焦虑、抑郁、躁动、神经衰弱症状,提高生存质量.     

头皮针联合经颅直流电刺激治疗脑卒中后认知功能障碍的疗效观察

目的 探讨头皮针联合经颅直流电刺激治疗脑卒中后认知功能障碍的疗效。方法 选取2019年9月-2021年9月医院收治的脑卒中后认知功能障碍(post-stroke cognitive impairment,PSCI)患者46例为研究对象,按照性别、年龄、脑卒中类型、文化程度组间均衡匹配的原则分为观察组和对照组,每组23例。对照组给予常规治疗及头皮针治疗,观察组在对照组基础上联合进行经颅直流电刺激(tDCS)治疗,比较两组患者的认知功能及治疗效果。结果 治疗前,两组患者视空间与执行功能、记忆、命名、语言、抽象、注意、延迟回忆、定向比较,差异无统计学意义(P>0.05);治疗后,两组患者视空间与执行功能、记忆、命名、语言、抽象、注意、延迟回忆、定向得分都有提高,但观察组得分高于对照组,差异有统计学意义(P<0.05)。观察组治疗有效率高于对照组,差异有统计学意义(P<0.05)。结论 脑卒中后认知功能障碍患者行头皮针联合经颅直流电刺激治疗,可有效改善患者认知功能,促进患者康复。     

护理干预对脑卒中患者早期康复影响的研究

目的:探讨护理措施对脑卒中患者康复的方法及疗效。方法:笔者所在医院治疗的100例患者随机分为两组,50例对照组,50例观察组,观察组患者给予康复训练。结果:经治疗和护理后,对照组中下肢运动功能和生活活动能力明显低于观察组,差异有显著性(P<0.05)。结论:早期康复治疗,可减轻和缩短脑卒中后患者的病情和病程,提高患者的生存质量,促进疾病的康复。     

Developing a novel peer support intervention to promote resilience after stroke

Stroke can lead to physical, mental and social long‐term consequences, with the incidence of stroke increasing with age. However, there is a lack of evidence of how to improve long‐term outcomes for people with stroke. Resilience, the ability to ‘bounce back’, flourish or thrive in the face of adversity improves mental health and quality of life in older adults. However, the role of resilience in adjustment after stroke has been little investigated. The purpose of this study is to report on the development and preliminary evaluation of a novel intervention to promote resilience after stroke. We applied the first two phases of the revised UK Medical Research Council (UKMRC) framework for the development and evaluation of complex interventions: intervention development (phase 1) and feasibility testing (phase 2). Methods involved reviewing existing evidence and theory, interviews with 22 older stroke survivors and 5 carers, and focus groups and interviews with 38 professionals to investigate their understandings of resilience and its role in adjustment after stroke. We used stakeholder consultation to co‐design the intervention and returned to the literature to develop its theoretical foundations. We developed a 6‐week group‐based peer support intervention to promote resilience after stroke. Theoretical mechanisms of peer support targeted were social learning, meaning‐making, helping others and social comparison. Preliminary evaluation with 11 older stroke survivors in a local community setting found that it was feasible to deliver the intervention, and acceptable to stroke survivors, peer facilitators, and professionals in stroke care and research. This study demonstrates the application of the revised UKMRC framework to systematically develop an empirically and theoretically robust intervention to promote resilience after stroke. A future randomised feasibility study is needed to determine whether a full trial is feasible with a larger sample and wider age range of people with stroke.     

Life after Stroke: Coping mechanisms among African Caribbean Women

In the UK, stroke is the third most common cause of death for women and the incidence in African Caribbean women is higher than that in the general population. Stroke burden has major consequences for the physical, mental and social health of African Caribbean women. In order to adjust to life after stroke, individuals affected employ a range of strategies which may include personal, religious (church) or spiritual support (i.e. prayer), individual motivation or resignation to life with a disability. This study explored these areas through the coping mechanisms that African Caribbean women utilised post stroke in the context of stroke recovery and lifestyle modification efforts needed to promote healthy living post stroke. A qualitative approach using interpretative phenomenological analysis was adopted. Seven women were recruited into the study. Semi‐structured, in‐depth interviews were audio recorded and were transcribed verbatim. Data were analysed using a four‐stage framework: familiarisation, sense making, developing themes, and data refinement and analysis. Three main themes on coping emerged: the need to follow medical rules to manage stroke, strength and determination, and the use of religion and faith to cope with life after stroke. These findings illustrate both a tension between religious beliefs and the medical approach to stroke and highlight the potential benefits that religion and the church can play in stroke recovery. Implications for practice include acknowledgement and inclusion of religion‐ and church‐based health promotion in post‐stroke recovery.     

综合干预对脑卒中后社区康复患者康复效果的影响

目的 分析综合干预对提高脑卒中后社区康复患者日常生活能力和生活满意度的作用.方法 2012年7月到2013年7月间,随机抽取社区脑卒中后康复患者122例进行研究,将所有患者随机分入观察组和对照组,每组均有61例患者.对观察组患者进行为期一年的综合干预,包括心理干预、生活方式指导、康复训练指导.对照组患者接受常规宣教.干预结束后,统计分析对比两组患者在日常生活能力和生活满意度方面的差异.结果 治疗前,两组患者生活自理能力评分的差异无统计学意义（P＞0.05）,治疗后观察组评分较高,组间差异具有统计学意义（P＜0.05）;干预一年后,观察组患者对生活非常满意和满意的例数多于对照组,经检验,满意率的差异具有统计学意义（P＜0.05）.结论 综合干预可以纠正患者消极情绪,调动患者及其家属配合治疗的积极性和主动性,促进患者的康复,提高患者的日常生活自理能力及对生活的满意度.     

整体护理对脑卒中后吞咽障碍康复的价值

脑卒中后吞咽障碍是脑卒中常见的严重症状之一。目前表明,脑卒中后吞咽障碍发病原因主要为皮质下行纤维、吞咽皮质中枢、延髓吞咽中枢及锥体外系损伤。临床常表现为发音困难、饮食后呛咳噎食、构音障碍、营养不良、吸入性肺炎,增加住院时间、加重经济负担,并严重威胁患者生命健康及生活质量。因此对脑卒中后吞咽障碍的康复护理要求需提出更高的目标。相关研究发现,整体护理对脑卒中后吞咽障碍的康复有重要的临床价值。本文结合近些年来关于对脑卒中后吞咽障碍的整体护理的相关文献,通过对脑卒中后吞咽障碍鉴别方法、时效性护理、基础训练、进食、预防和心理护理的阐述,为今后对吞咽障碍的研究提供参考价值。     

Life satisfaction and functional disabilities in long-term survivors after first stroke

Despite good recovery from a stroke, the quality of life (QOL) of most stroke patients living in the community is not always restored in their acute or recovery phase. Our aim of this study was to evaluate the relation between basic/social functional disabilities and life satisfaction (one of the indicators of QOL) in long-term survivors after a first stroke. Sixty three consecutive outpatients who had received comprehensive inpatient rehabilitation after their first stroke participated in this cross-sectional study. The profile, basic activities of daily living, life style and life satisfaction of these outpatients were evaluated based on their interview. More than half of the subjects had a decrease in life satisfaction. There was mostly weak positive correlation between functional/social disabilities and the life satisfaction, and both age and sex were not predictors of their QOL. Therefore, functional disabilities had a weak impact on QOL in the long-term survivors after the first stroke.     

缺血性脑卒中免疫炎症反应机制的研究进展

缺血性脑卒中(ischemic stroke,IS)是世界范围内引起人类死亡、残疾的重大疾病.卒中早期,由死亡和受损神经元释放的多种损伤相关模式分子诱导神经胶质活化、外周免疫应答以及炎性介质分泌增加,从而加速血脑屏障破坏、加剧脑水肿和微循环障碍,造成继发性脑损伤.急性期后,免疫细胞逐渐通过表型改变促进神经元修复,再加上...     

三级单位卒中单元模式对脑卒中疾病经济负担的影响

目的:探讨三级单位卒中单元在降低医疗费用、实现医疗资源合理配置方面的作用效果。方法:建立三级单位卒中单元,包括急性卒中病房、康复中心和家庭护理单位。通过完备的专人随诊体系,对卒中病人提供卒中管理,随诊1年。于急性期、康复期、3个月末、6个月末和12个月末共进行5次评价,统计各阶段的医疗费用。结果:三级单位卒中单元内患者,脑出血及脑梗塞急性期例均住院费用分别为7547元和6078元,仅为全国同类省级医院平均住院费用的57.30%及59.30%;平均住院日分别为14日和11日,均较全国同类省级医院为短。脑卒中患者发病1年内例均疾病负担为15074元,其中,入院急性期费用占45.57%,康复期占21.86%,出院康复期及间接费用占32.57%。结论:三级单位卒中单元是治疗脑卒中的一种有效方法,能明显减少住院时间和医疗费用,将有限的医疗资源合理分配到疾病全程,有助于调整医疗费用的结构,实现医疗资源的合理配置。     

针灸治疗中风后遗症的临床效果应用

目的：研究针灸在中风后遗症疾病中的应用价值。方法：选取我院在2013年1月至2014年3月间收治的72例中风后遗症患者的临床资料，随机将患者分为两组，每组各36例病例，观察组采用针灸治疗，对照组采用维脑路通治疗，比较两组患者的治疗效果。结果：观察组中有29例患者治愈，5例患者治疗有效，总有效率为。对照组中有22例患者治疗治愈，6例患者治疗有效，总有效率为。观察组治疗效果明显优于对照组，对比差异显著，具有统计学意义（P〈0．05）。结论：针灸在中风后遗五疾病的治疗中有着较高的应用价值，可有效促进患者疾病的好转，提高其生活质量，值得临床推广应用。     

The role of vinpocetine in the treatment of cerebrovascular diseases based in human studies

INTRODUCTION: It shows the importance of cerebrovascular diseases that they are the third main cause of death exceeded only by coronary artery diseases and cancer. Cerebral ischemia leads to irreversible brain damage, thereby it is important to rescue the hypoperfused areas. Patients without stroke but with chronic cerebral hypoperfusion can also benefit from the increasing of the cerebral blood flow. METHODS: The aim of this review was to summarize the indications and the potential effects of vinpocetine in acute and chronic cerebrovascular diseases based on clinical studies. RESULTS: There is no evidence that vinpocetine treatment is applicable in acute ischemic stroke, only few study with low patient number showed a slight but significant improvement in the patients conditions. In chronic cerebrovascular patients after single dose and long-term vinpocetine therapy, PET, TCD, SPECT and NIRS examinations showed increasing perfusion and elevated glucose and O 2 consumption of the examined areas, furthermore significant improvement of the rheologic factors was detected. A meta-analysis of international clinical studies showed a significant improvement in cognitive achievement in chronic stroke patients after oral therapy. CONCLUSION: The cited studies showed the potential multi-pharmacological effects of vinpocetine and its beneficial hemorheological potential. The drug also improves the blood flow and the metabolism of the affected brain areas. There is increasing evidence that vinpocetine improves the quality of life in chronic cerebrovascular patients.