体针、水针配合康复锻炼治疗脑卒中后肩手综合征的疗效观察

目的 观察体针、水针配合康复训练对脑卒中后肩手综合征的治疗效果.方法 56例脑卒中后肩手综合征患者分为两组,对照组(23例)采用常规药物和康复训练,治疗组(33例)在对照组基础上加体针、水针治疗,治疗时间为1个月.两组在治疗前后采用目测类比评分法(VAS)、改良的Fugl-Meyer量表分别评定疼痛、水肿程度,上肢运动功能,评定临床疗效.结果 两组治疗后,偏瘫侧疼痛、水肿、Fugl-Meyer评分较治疗前均有显著改善.其中治疗组明显优于对照组,治疗组临床疗效总有效率亦明显优于对照组.结论 体针、水针配合康复训练对脑卒中后肩手综合征具有更好疗效.     

围刺法治疗脑卒中后肩-手综合征疗效观察

目的比较不同针刺法对急性脑卒中后肩-手综合征的影响。方法将90例患者分为围刺组49例和对照组41例,分别采用围刺法和常规针刺法。30次后进行临床疗效评定。结果围刺组的总有效率93.88%;对照组的总有效率73.17%(χ²=7.2863,P<0.01)。结论围刺组对急性脑卒中后肩-手综合征的疗效优于常规针刺法。     

高压氧配合康复训练对脑卒中肩手综合征的疗效观察

目的：观察高压氧配合康复训练对脑卒中后肩手综合征的治疗效果。方法：63例脑卒中后肩手综合征患者随机分为两组，对照组（31例）采用常规药物和康复训练，观察组（32例）在对照组基础上加高压氧治疗，治疗时间为4周。两组在治疗前后采用目测类比评分法（VAS）、改良的Fugl-Meyer量表、Barthel指数分别评定疼痛、水肿程度、关节活动范围、上肢运动功能和日常生活活动能力（ADL），评定临床疗效。结果：两组治疗后偏瘫侧肩痛、水肿、关节活动度、Fugl-Meyer评分及Barthel指数较治疗前均有显著改善（P〈0．01，P〈0．05），观察组明显优于对照组（P〈0．05），且观察组临床疗效总有效率亦明显优于对照组（治疗组96．87％，对照组74．19％，P〈0．05）。结论：高压氧配合康复训练对脑卒中后肩手综合征具有更好疗效。     

靳三针疗法结合康复训练治疗脑卒中后肩手综合征的疗效研究

目的:观察靳三针疗法结合康复训练对脑卒中后肩手综合征(SHS)患者治疗效果。方法:60例脑卒中后肩手综合征患者随机分为治疗组30例,对照组30例,治疗组给予靳三针疗法结合康复训练,对照组给予单纯康复训练,疗程28d。治疗前后采用上肢简化Fugl-Meyer评分(FMA)、视觉模拟量表(VAS)、功能综合评定量表(FCA)对患者的运动功能、疼痛及综合功能进行评定。结果:治疗后,两组患者的上肢运动功能、疼痛程度、综合功能与治疗前相比均有显著改善(P<0.01),且治疗组的改善程度明显优于对照组(P<0.01)。结论:靳三针疗法结合康复训练对脑卒中后肩手综合征患者有良好的疗效。     

艾灸联合耳穴贴压治疗脑卒中肩手综合征的疗效观察

目的:观察艾灸联合耳穴贴压治疗肩手综合征的临床疗效。方法:将65例脑卒中后肩手综合征患者按照随机数字表法分为实验组和对照组。对照组为32例,采用常规康复训练;实验组为33例,在常规康复训练的基础上加艾灸联合耳穴贴压,治疗4周。2组在治疗前后均采用目测类比评分法(VAS)、改良的Fugl-Meyer量表比较临床疗效。结果:治疗前2组偏瘫侧肩痛评分、Fugl-Meyer评分比较无统计学意义;治疗后实验组在减轻偏瘫侧疼痛和改善上肢运动功能效果优于对照组(P0.05)。结论:在常规康复训练的基础上艾灸联合耳穴贴压治疗脑卒中后肩手综合征疗效更好。     

针刺配合康复训练治疗脑卒中后肩手综合征的疗效观察

目的 观察针刺结合康复训练治疗脑血管病后肩手综合征的临床效果.方法 62例脑血管病后肩手综合征患者随机均分为两组,治疗组采用针刺配合康复训练治疗,对照组只采用康复训练治疗,总共治疗5周.治疗前后均进行疗效评定和日常生活能力修订的巴氏指数(MBI)评定.结果 治疗组总有效率(94.55%)明显高于对照组(74.19%),MBI评分也高于对照组,两组比较差异显著(P<0.01).结论 针刺结合康复训练治疗卒中后肩手综合征疗效优于单纯康复训练,值得临床推广应用.     

针刺配合刺血治疗卒中后肩手综合征疗效观察

目的:观察针刺配合刺血疗法对卒中后肩手综合征的疗效。方法:选择60例卒中后肩手综合征患者随机分为2组,对照组32例采用常规针刺和康复训练,观察组28例在对照组基础上加刺血治疗,治疗时间2组均为6周。结果:2组有效率分别为96.43%和71.88%,观察组较对照组疗效明显提高(P<0.05)。结论:针刺配合刺血对卒中后肩手综合征具有更好疗效。     

中药离子导入结合综合康复训练治疗脑卒中后肩手综合征的疗效分析

目的:探讨中药离子导入结合综合康复训练治疗脑卒中后肩手综合征的疗效。方法:脑卒中后肩手综合征的患者112例,随机分为对照组(采取综合康复训练治疗)和观察组(采取中药离子导入结合综合康复训练治疗)各56例,观察并记录2组临床疗效,运动功能恢复(FMA)评分和水肿分级以及治疗前后SF-36评分。结果:观察组治疗有效率明显高于对照组(P<0.05);治疗后观察组水肿分级低于对照组,FMA评分高于对照组(均P<0.05);治疗后观察组SF-36评分中的生理功能、生理职能、躯体疼痛评分均高于对照组(均P<0.05)。结论:中药离子导入结合综合康复训练对脑卒中后肩手综合征疗效好,可有效改善上肢功能,减轻手指、腕部水肿,减轻肩关节疼痛。     

偏振光星状神经节照射联合肩周封闭治疗肩-手综合征的临床观察

目的:探讨偏振光星状神经节照射联合肩周封闭疗法治疗脑卒中后肩-手综合征的临床疗效。方法:60例脑卒中后肩-手综合征患者随机分为2组,对照组采用康复训练疗法,观察组在康复训练疗法的基础上加用偏振光星状神经节照射联合肩周封闭治疗,于治疗2周后对患者临床疗效、肩关节疼痛程度、肩关节活动度进行评定,对评定结果进行对照分析。结果:治疗2周后,2组VAS评分均较治疗前明显下降(P0.05),且观察组更低于对照组(P0.05);2组肩关节活动度均明显大于治疗前(P0.05),且观察组更高于对照组(P0.05)。观察组总有效率明显优于对照组(93.3%、50.0%,P0.05)。结论:偏振光星状神经照射联合肩周封闭治疗脑卒中后肩-手综合征疗效显著,能明显降低肩-手综合征患者的肩痛评分,能明显改善肩-手综合征患者肩关节无痛外展的活动度。     

芒硝外敷治疗脑卒中后肩手综合征疗效观察

目的观察芒硝外敷对脑卒中后肩手综合征的治疗效果。方法 36例肩手综合征患者分为对照组和观察组。对照组采用药物治疗、康复训练、针灸、理疗等综合疗法。观察组在上述综合治疗的基础上增加芒硝外敷。治疗时间为1个月。两组在治疗前后采用目测类比评分法(VAS)、改良的Flug-Meyer法、改良的BI指数分别评定患侧上肢疼痛、水肿程度、关节活动范围、上肢运动功能及日常生活活动能力,评定临床疗效。结果两组治疗后偏瘫侧患手水肿、关节活动度、改良的Flug-Meyer法、改良的BI指数均有显著改善(P<0.05),观察组优于对照组。结论芒硝外敷对改善脑卒中后肩手综合征患手肿痛的疗效显著。     

Recurrence of tuberculosis after hip replacement 58 years after primary infection

The paper presents the case of a 73-year-old patient with a history of tuberculosis of the hip in childhood who received an Exeter total hip prosthesis. Tuberculosis recurred 58 years after primary infection and 9 years after THA. The authors analyzed the available literature, which described only a few case reports, because Mycobacterium tuberculosis infections of a joint implant after THA are extremely rare. They are frequently the result of local reactivation of the pathogen or, less commonly, an overlooked diagnosis of tuberculosis at the time of endoprosthesis implantation. Proper diagnostic work-up of infection is particularly difficult because synovial fluid cultures are usually negative. In addition, a coexisting Staphylococcus aureus infection may obscure the clinical presentation. In post-THA patients, complete anti-TB treatment is recommended. Particular caution should be observed in patients from regions with high TB morbidity or with a history of pulmonary and operated joint tuberculosis.     

The influence of rewarming after therapeutic hypothermia on outcome after cardiac arrest

IntroductionTreatment with hypothermia has been shown to improve outcome after cardiac arrest (CA). Current consensus is to rewarm at 0.25–0.5 °C/h and avoid fever. The aim of this study was to investigate whether active rewarming, the rate of rewarming or development of fever after treatment with hypothermia after CA was correlated with poor outcome.MethodsThis retrospective cohort study included adult patients treated with hypothermia after CA and admitted to the intensive care unit between January 2006 and January 2009. The average rewarming rate from end of hypothermia treatment (passive rewarming) or start active rewarming until 36 °C was dichotomized in a high (≥0.5 °C/h) or normal rate (<0.5 °C/h). Fever was defined as > 38 °C within 72 h after admission. Poor outcome was defined as death, vegetative state, or severe disability after 6 months.ResultsFrom 128 included patients, 56% had a poor outcome. Actively rewarmed patients (38%) had a higher risk for poor outcome, OR 2.14 (1.01–4.57), p < 0.05. However, this effect disappeared after adjustment for the confounders age and initial rhythm, OR 1.51 (0.64–3.58). A poor outcome was found in 15/21 patients (71%) with a high rewarming rate, compared to 54/103 patients (52%) with a normal rewarming rate, OR 2.61 (0.88–7.73), p = 0.08. Fever was not associated with outcome, OR 0.64 (0.31–1.30), p = 0.22.ConclusionsThis study showed that patients who needed active rewarming after therapeutic hypothermia after CA did not have a higher risk for a poor outcome. In addition, neither speed of rewarming, nor development of fever had an effect on outcome.     

法洛四联症患儿体肺侧枝栓塞术并根治术的术后护理

法洛四联症是一种常见的发绀型先天性心脏病，在发绀型心脏病中居首位，存在肺动脉狭窄、室间隔缺损、主动脉骑跨、右心室肥厚4种畸形，根据病情可选择姑息术和根治术。重症患者体肺侧枝循环形成，术后渗血概率高，易并发低心排综合征、灌注肺等严重并发症。     

Psychotherapy of bereavement after homicide

The author presents guidelines for the assessment and initial treatment of bereavement after a homicide. Early interventions include nonverbal techniques applied in individual and group therapy. Because patients are over-whelmed and reactive, initial treatment strategy is supportive and focuses on reestablishing resiliency rather than on preexisting vulnerabilities (ambivalence, guilt, repression, denial). Adjustment to homicidal dying is lifelong, and therapist and patient should acknowledge that change may be limited.     

中耳乳突手术后治疗中耳内窥镜的应用

目的 探讨乳突根治术后耳内窥镜换药与常规换药相比是否具有优势.方法 2003年3月-2008年10月对89例共89只耳行开放式乳突根治术患者按随机数字表法随机分为试验组及对照组,试验组45例45只耳采用耳内窥镜换药,对照组44例44只耳常规换药;分别观察试验组和对照组的干耳人数及干耳的时间,计算干耳率及干耳的平均时间....     

Gastrointestinal blood loss after diflunisal and after aspirin: effect of ethanol.

Fecal blood loss was evaluated in normal subjects with 51Cr-labeled red cells. In a double-blind parallel study in 10 subjects, 250 mg diflunisal twice daily did not significantly increase blood loss in two consecutive treatment periods, while 750 mg acetylsalicylic acid (ASA) 4 times daily did so. In a double-blind crossover study in 2 subjects, diflunisal, 250 mg twice daily again did not significantly affect fecal blood loss during a 4-day treatment period, and there also was no significant effth diflunisal during two additional treatment days. ASA, 600 mg 4 times daily, induced an increase in blood loss and this effect was significantly enhanced by the addition of alcohol. The difference between treatments in the way they interact with alcohol was also statistically significant.