血管性头痛行高压氧联合西比灵治疗与护理体会

目的研究高压氧治疗血管性头痛的近期疗效与远期疗效.方法将132例患者随机分为对照组和高压氧治疗组,每组66例.对照组给予西比灵5～10mg口服,每晚1次,肠溶阿斯匹林25mg/次,3次/d,10d为1疗程.治疗组在药物治疗的基础上加用高压氧治疗.观察两组患者头痛、头晕、恶心、呕吐症状消失情况及半年内复发情况.结果高压氧治疗组头痛、头晕、恶心、呕吐症状消失较对照组快,总有效率比较有显著性差异(P＜0.01).结论高压氧联合西比灵治疗血管性头痛显效快、有效率高、远期疗效好.     

血管性头痛行高压氧联合西比灵治疗与护理体会

目的:研究高压氧治疗血管性头痛的近期疗效与远期疗效。方法:将132例患者随机分为对照组和高压氧治疗组,每组66例。对照组给予西比灵5~10mg口服,每晚1次,肠溶阿斯匹林25mg/次,3次/d,10d为1疗程。治疗组在药物治疗的基础上加用高压氧治疗。观察两组患者头痛、头晕、恶心、呕吐症状消失情况及半年内复发情况。结果:高压氧治疗组头痛、头晕、恶心、呕吐症状消失较对照组快,总有效率比较有显著性差异(P<0.01)。结论:高压氧联合西比灵治疗血管性头痛显效快、有效率高、远期疗效好。     

抗抑郁药与西比灵联合治疗血管性头痛疗效观察

目的：观察抗抑郁药与西比灵联合治疗血管性头痛的疗效。方法：随机将182例血管性头痛患者分为治疗组（抗抑郁药联合西比灵）91例与对照组（单纯西比灵）91例,对比观察疗效。结果：治疗组显效率为88%,对照组为58%。两组差异有显著性（P〈0.05）。说明治疗组疗效优于对照组。结论：抗抑郁药与西比灵联合治疗血管性头痛疗效确切。     

恩丹西酮联合针刺对化疗所致恶心与呕吐的疗效分析

目的：观察恩丹西酮联合针刺防治化疗所致恶心与呕吐的疗效。方法：80例血液系统恶性疾病化疗患者随机分为观察组和对照组。每天化疗前30分钟，观察组静注恩丹西酮8mg，配合针刺内关、足三里穴；对照组单纯静注恩丹西酮8mg。比较两组化疗24、96小时后的止恶心与止吐疗效及头痛、头晕、便秘和锥体外系症状等恩丹西酮毒副作用发生率。结果：观察组控制恶心与呕吐有效率均显著高于对照组（P＜0．01）；观察组恩丹西酮毒副作用发生率也明显低于对照组（P＜0．01）。结论：恩丹西酮配合针刺治疗，对化疗所致恶心与呕吐有防治具有协同作用。     

正天丸与西比灵联合治疗89例偏头痛的观察分析

目的：观察正天丸与西比灵联合治疗偏头痛的临床疗效。方法：治疗组44例，其中男16例、女28例，服用正天丸（深圳三九医药股份有限公司生产）6g，3次／日；西比灵（西安杨森制药公司生产）10mg，每晚睡前服1次；连续服药30天。对照组45例，其中男17例、女28例，平均年龄39岁。服用西比灵10mg，每晚睡前服1次，连用30天。服药1月后评定两组的疗效。结果：治疗前两组疼痛比较差异无显著性（P〉0．05）。治疗后两组患者疼痛程度均较治疗前显著减轻（P〈0．01），治疗后两组患者之间疼痛程度比较，治疗纽较对照组显著减轻（P〈0．01）。治疗一个月后治疗组与对照组头痛发作持续时间分别为5±10小时和14±15小时，治疗组头痛发作持续时间显著短于对照组（P〈0．01）。结论：正天丸与西比灵联合有协同作用，治疗偏头痛的临床疗效良好，值得临床推广。     

川芎清脑颗粒治疗脑梗死后头痛、头晕伴失眠的研究

目的 观察川芎清脑颗粒治疗脑梗死后头晕、头痛伴失眠的临床疗效.方法 320例脑梗死后头晕、头痛伴失眠患者,根据随机数字表法分为治疗组和对照组,每组160例.治疗组给予川芎清脑颗粒10 mg/次,3次/d,口服;对照组给予西比灵胶囊10 mg,1次/晚,睡前口服.连续给药4周.对两组患者治疗前、治疗2周后及治疗4周后的VAS疼痛评分进行比较,并对两组患者的头痛、头晕及失眠的整体临床疗效以及不良反应进行比较.结果 治疗2、4周后治疗组的VAS疼痛评分显著低于对照组,差异均有统计学意义（t值分别为5.199、18.00,P均＜0.05）;治疗1个月后,治疗组的治愈率和总有效率显著高于对照组差异均有统计学意义（31.9％与21.3％,86.9％与77.5％;x2值分别为4.630、4.803,P均＜0.05）.结论 川芎清脑颗粒能够有效改善脑梗死后头晕、头痛伴失眠的症状,是临床值得推广的治疗方案.     

以精神症状为主要表现的肺癌误诊1例分析

现将以精神症状为主要表现的肺癌误诊1例分析如下。 1病历摘要 女，53岁。既往高血压病史1a，平素口服吲达帕胺2．5mg、1次／d及非洛地平5mg、2次／d。因恶心、呕吐2周，淡漠、不语1周入院。2周前，患者无明显诱因出现恶心、呕吐，为胃内容物，非喷射状，无咖啡样物，感头痛、头晕，食欲减退。     

纳络酮加还原型谷胱甘肽治疗重度酒精中毒疗效分析

目的：分析纳络酮加还原型谷胱甘肽治疗重度酒精中毒的临床疗效。方法；将40例重度酒精中毒患者随机分为两组，对照组采取常规治疗，治疗组在常规治疗的基础上加用纳络酮0．8mg立即静注1次，然后将纳络酮2．0～2．8mg 5％ GS 500ml静滴1次，还原型谷胱甘肽1．2g 5％ GNS 500ml静滴1次。结果：治疗组在恢复清醒时间、头痛头晕恶心呕吐缓解时间、烦躁控制时间、肝脏解毒方面均好于对照组。结论：纳络酮加还原型谷胱甘肽治疗重度酒精中毒有明显疗效。     

甲基强的松龙治疗毛细支气管炎24例临床观察

目的：观察甲基强的松龙治疗毛细支气管炎的疗效。方法：毛细支气管炎患儿48例随机分为2组，治疗组24例，对照组24例，治疗组在常规治疗基础上加用甲基强的松龙，首剂2mg／kg，以后按1mg／（kg·次），静脉点滴，8h1次，连用3d。对照组在常规治疗基础上加地塞米松0．3mg／kg次，2次／d，连用3d。结果：患儿在咳嗽、喘息、肺部哮呜音消失时间及住院日等方面，治疗组与对照组比较均有显著性差异（P〈O．01），且均未出现糖皮质激素的毒副作用。结论：甲基强的松龙治疗毛细支气管炎疗效好、显效快，可作为毛细支气管炎患儿，特别是重症患儿治疗的用药选择。     

正柴胡饮颗粒联合博抗治疗呼吸系统感染的临床观察

目的：探讨正柴胡饮颗粒联合博抗治疗呼吸系统感染的临床疗效。方法：68例呼吸系统感染患者随机分为两组：治疗组和对照组，每组34例。治疗组给予正柴胡饮颗粒3g，3次／d开水冲服，博抗0．5g加入0．9％氯化钠注射液500mL中静脉滴注，1次／d，7～10d为一疗程；对照组给予盐酸左氧氟沙星氯化钠注射液400mg分两次静脉滴注，1次／d，利巴韦林注射液0．5g加入0．9％氯化钠注射液500mL中静脉滴注，1次／d，7～10d为一疗程。结果：治疗组总有效率与对照组之间差异无统计学意义（P〉0．05）；治疗组的临床症状、体征消失时间较对照组短（P〈0．05，P〈0．01，P〈0．001）。结论：正柴胡饮颗粒联合博抗治疗呼吸系统感染其疗效与单用西药的对照组相近，但改善症状和体征的作用优于对照组。     

超声评分对膝骨性关节炎患者病变特点的评估价值

目的 探讨超声评分对膝骨性关节炎患者病情严重度的诊断价值。方法 回顾性收集我院收治的膝骨性关节炎患者52例,同期收集50例健康成人,分析超声评分与膝骨性关节炎患者病情严重度的相关性。结果 膝骨性关节炎患者超声评分显著高于健康成人(6.93±1.76 vs. 1.73±0.56,P=0.000)。膝骨性关节炎患者超声评分与髌上囊液体深度、髌下囊液体深度、关节腔液体深度、滑膜厚度显著正相关(r=0.265、0.216、0.310和0.255,P=0.004、0.035、0.000和0.012),与Lyshsolm显著负相关(r=-0.381,P=0.000)。与增生滑膜内血管阴性的患者相比,增生滑膜内血管阳性的患者超声评分显著增加(7.43±1.61 vs. 5.58±1.42, P=0.000)。结论 超声评分与膝骨性关节炎患者病情严重度相关。     

Living with a woman with fibromyalgia from the perspective of the husband

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome, which affects mostly middle-aged women. The syndrome is poorly understood and treatment is mainly palliative. The diagnosis is established from diagnostic criteria. Living with FM means living a life greatly influenced by the illness in various ways for people affected. Aim of the study. The aim of this study was to describe the experiences of living with a woman with FM from the husbands' perspective. METHODS: Five men married to women with FM were interviewed using a narrative approach. The interviews were analysed using qualitative thematic content analysis. FINDINGS: The analysis resulted in the following seven themes: increasing responsibility and work in the home; being an advocate for and supporting the wife; learning to see the woman's changing needs; changing relationship between spouses; changing relationship with friends and relatives; deepening relationship with the children and lacking information and knowledge about FM. The findings show that the women's illness had a great impact on husbands' lives, and that husbands lacked information about the woman's illness. CONCLUSION: This study shows that it is not only the women with FM who experience a changed life; the whole family life is influenced and limited by FM. The husband's role in the family changes, first and foremost concerning responsibility and workload within the family. This must be taken into consideration in care planning. This study also highlighted the need of information and knowledge about FM expressed by the participants, information that health care personnel have a great responsibility to give.     

Use of the Role Checklist with the patient with multiple personality disorder

A paucity of occupational therapy evaluation tools exists for use with patients with multiple personality disorder. The Model of Human Occupation (Kielhofner & Burke, 1980), particularly the volition and habituation subsystems within this model, proved useful for the identification of the many facets of patients with multiple personality disorder on a short-term treatment unit. The Role Checklist (Oakley, Kielhofner, Barris, & Richler, 1986), a tool derived from the Model of Human Occupation, was adapted for use with this population and was found to be beneficial in the identification of common goals held by most of the personalities of each patient with multiple personality disorder. The use of the Role Checklist is illustrated with a case example.     

心血管疾病患者增长对专科护理发展的思考和建议

目前我国心血管疾病发病率持续增长,医疗技术水平亦不断提高,新技术、新业务广泛应用于临床,心血管疾病专科护理领域出现了疾病的复杂性提高、对护理服务的需求增加和护士护理教育、人力配备、专业化发展方面的问题。通过分析现阶段心血管疾病护理工作面临的机遇和挑战,提出合理配置护理人力资源、加强护十培训和探索心血管疾病专科护士培训方式等建议,以适应医学的快速发展,为患者提供安全优质的护理服务。     

Experience with the use of plasmapheresis in the combined treatment of children with the crush syndrome

Plasmapheresis (PP) was applied to the treatment of 5 children aged 6-14 years with the crush syndrome. The multimodality treatment using antibiotics, erythrocytic mass, rheologically active preparations, hemodialysis and blood rheologically active preparations, hemodialysis and hemoperfusion carried out for 6-7 days before PP did not bring about any appreciable improvement of the patients' status. The patients failed to get rid of anuria and manifested the signs of increasing intoxication. The treatment with PP consisted of 1 to 6 procedures, in the course of which 70 to 85 of the design volume of the circulating plasma was removed. The use of PP resulted in the disappearance of myoglobin from the patients' blood and urine, in the normalization of the coagulogram, a considerable decrease of the content of medium molecules, and in the appearance of the first urine towards the end of the procedure. Thus, the introduction of PP into multimodality treatment of the crush syndrome made it possible to eliminate anuria, disseminated intravascular coagulation, and to noticeably reduce intoxication and to clear the blood off myoglobin.     

Personality of the caregiver influences the use of strategies to deal with the behavior of persons with dementia

Personality of family caregiver is an important factor influencing the caregiver's burden, depression and distress. We now hypothesized that the personality is associated with specific strategies used by family caregivers to deal with the behavioral and psychological symptoms of demented relatives (BPSD). Participants were 98 consecutive persons with dementia and their family caregivers. Assessments included: Personality (NEO-FFI), Burden (ZBI), Depression (CES-D), Cognitive Function (MMSE), BPSD (NPI), Distress (NPI-D), and an open question to identify the strategies used by caregivers when faced with BPSD. Caregivers used different strategies to cope with their relatives' behavior: avoiding conflict; confronting; reassuring; orienting; responding coercively; distracting; colluding; medicating and restricting the movements. Extraversion was the only dimension of caregiver's personality that determined the use of caregiver strategies to deal with BPSD. Extroverted caregivers used the “confronting” strategy less often. Caregiver's personality should be taken into account when designing adapted intervention programs.