甲状腺功能亢进症并发脑梗死的临床研究

目的　探讨甲状腺功能亢进症并发脑梗死的发病机制及二者之间的关系。方法　回顾性分析 10例甲状腺功能亢进症并发脑梗死患者的临床表现、诊断与治疗结果。结果　 10例患者经抗甲亢治疗 ,积极治疗脑梗死 ,全组无严重并发症 ,好转出院。结论　甲亢合并脑梗死可能是青年型脑梗死的一种病因 ,治疗甲亢是防治脑梗死的关键     

131I联合帕罗西汀对甲状腺功能亢进伴情绪障碍患者的效果

目的观察¹³¹I联合帕罗西汀治疗甲亢伴情绪障碍患者的临床效果及其对甲状腺功能的影响。方法选取我科2018年6月~2019年10月期间收治的109例甲状腺功能亢进伴情绪障碍患者作为研究对象,对照组54例给予¹³¹I治疗,观察组55例在对照组基础上加用帕罗西汀治疗,治疗两个月后对比两组患者的临床疗效、促甲状腺素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平和焦虑情况评分、抑郁情况评分、症状自评量表(SCL-90),以及两组用药后不良反应的发生情况。结果治疗后观察组总有效率为92.73%明显高于对照组的74.07%(P<0.05);治疗后两组患者体内TSH、FT4、FT3水平明显优于治疗前(P<0.05),治疗后观察组体内TSH、FT4、FT3水平明显优于对照组(P<0.05);治疗后两组患者SAS、SDS评分明显优于治疗前(P<0.05),治疗后观察组SAS、SDS评分明显优于对照组(P<0.05);两组患者不良反应发生率对比无统计学意义(P>0.05)。结论¹³¹I联合帕罗西汀能明显提高甲状腺功能亢进症伴情绪障碍患者的临床疗效,改善患者TSH、FT4、FT3水平,消除焦虑、抑郁情绪。     

甲状腺功能亢进症并发脑梗死的临床研究

目的 探讨甲状腺功能亢进症并发脑梗死的发病机制及二者之间的关系。方法 回顾性分析10例甲状腺功能亢进症并发脑梗死患者的临床表现、诊断与治疗结果。结果10例患者经抗甲亢治疗，积极治疗脑梗死，全组无严重并发症，好转出院。结论 甲亢合并脑梗死可能是青年型脑梗死的一种病因，治疗甲亢是防治脑梗死的关键。     

文拉法辛对产后抑郁患者负面情绪、睡眠及认知功能的影响

目的 探讨文拉法辛对产后抑郁患者负面情绪、睡眠及认知功能的影响及其可能的机制.方法 选取2017年6月～2019年6月期间我院收治的产后抑郁患者91例作为本次研究的主体对象,按随机数字表法将研究对象随机分为观察组和对照组.对照组患者(45例)给予阿米替林口服治疗,观察组患者(46例)给予文拉法辛口服治疗.观察对比两组患...     

医护一体化护理干预对保守治疗的急性胰腺炎患者住院时间和焦虑情绪的影响

目的 探讨医护一体化护理干预对住院保守治疗的急性胰腺炎患者住院时间、焦虑情绪的影响.方法 2019年05月～2020年05月,将本院接收的80例急性胰腺炎患者作为观察对象,根据双盲随机对照原则,予以分组探讨,其中一组名为常规组(常规护理),另一组名为研究组(医护一体化护理干预).每个小组分别40例.观察并对比两组胰腺炎...     

心理干预对初产妇负性情绪及睡眠质量的影响

目的探讨心理护理干预对初产妇产后焦虑情绪的影响。方法选取2008-06~2010-11待产的初产妇148例,随机分为干预组78例和对照组70例,干预组在常规护理的基础上进行特定的心理护理干预,及时引导产妇的负性情绪。对照组采用常规的护理和指导,对2组患者护理前后焦虑(SAS)和抑郁(SPS)评分进行比较分析。结果与对照组相比,心理护理干预后,干预组SAS、SDS的评分明显低于对照组,干预组睡眠时间明显长于对照组。结论心理护理干预能有效缓期初产妇的焦虑和抑郁情绪,有效增加睡眠时间,改善了睡眠质量,可以推广应用。     

帕罗西汀联合心理治疗对产后抑郁患者负面情绪及睡眠质量的影响

目的 探讨帕罗西汀联合心理治疗对产后抑郁患者负面情绪及睡眠质量的影响.方法 选取2017年1月～2019年6月我院收治的111例产后抑郁症患者作为主要研究对象.按随机数字表法将研究对象随机分为观察组和对照组,两组患者均接受心理治疗.在此基础上,对照组(55例)给予马普替林治疗,观察组(56例)给予帕罗西汀治疗,观察对比...     

烟雾病合并甲状腺功能亢进症10例临床分析

目的探讨烟雾病合并甲状腺功能亢进症(甲亢)的临床特点及其可能的发病机制。方法回顾性分析10例烟雾病合并甲亢患者的临床资料。结果本组10例患者中,男1例,女9例。所有患者均表现为缺血性脑血管病。其中DSA确诊烟雾病1例,CTA确诊4例,MRA确诊5例;双侧颈内动脉系统受累9例,单侧受累1例。结论对于烟雾病患者,尤其是女性,应常规行甲状腺功能筛查;而甲亢患者也应行脑血管病变筛查,以尽早发现脑血管病变,早期预防,避免卒中。     

强化护理联合循证护理干预对髋关节置换术后患者的负性情绪、睡眠质量及肢体功能的影响

目的 评价髋关节置换手术患者接受强化护理结合循证护理对其负性心理、睡眠质量与肢体功能评分影响.方法 通过随机抽样法选取2018年4月～2019年6月本院收治80例接受髋关节置换手术患者,依据患者入院先后顺序依次分为参照组(n=40)与研究组(n=40).参照组患者予以常规手术护理,研究组患者予以强化护理结合循证护理.比...     

脑电生物反馈联合艾司唑仑对突发性耳鸣合并睡眠障碍患者的疗效观察

目的 分析突发性耳鸣合并睡眠障碍患者应用脑电生物反馈放松联合艾司唑仑治疗后效果,及对睡眠质量与不良情绪的影响。方法 选取我院2019年06月～2021年06月期间收治的突发性耳鸣合并睡眠障碍患者168例,依据随机数字表法进行分组,药物组患者84例给予艾司唑仑口服治疗,联合组患者84例增加脑电生物反馈放松治疗,对比两组患者心理状态、睡眠质量、脑电Alpha波频率及临床疗效。结果 治疗前,联合组及药物组患者汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分、匹兹堡睡眠质量指数（PSQI）评分、脑电阿尔法（Alpha）波频率无统计学意义（P>0.05）;治疗4周后,两组HAMA评分、HAMD评分、PSQI评分、Alpha波频率均较治疗前降低,联合组HAMA评分、HAMD评分、PSQI评分及Alpha波频率均低于药物组,临床疗效高于药物组（P<0.05）。结论 脑电生物反馈放松联合艾司唑仑能够有效消除突发性耳鸣合并睡眠障碍患者不良心理状态,调节脑电波,提升患者睡眠质量,促进疾病转归。     

Health-related quality of life in primary care patients with recognized and unrecognized mood and anxiety disorders

OBJECTIVE: Primary care providers have been criticized for underrecognizing and undertreating mental health disorders. This criticism assumes patients with recognized disorders and those with unrecognized disorders suffer the same burden of illness. This study describes differences in health-related quality of life (HRQOL) in patients with recognized and unrecognized mood and anxiety disorders in a primary care setting. METHODS: A probability sample of 500 adult ambulatory patients from a university-based, family practice clinic, completed the PRIME-MD mood and anxiety disorder modules and the SF-36 Health Survey. Computerized patient records were reviewed retrospectively to determine recognition of mood and anxiety disorders. The Mental Health (MCS) and Physical Health (PCS) Component Summary scales of the SF-36 served as the primary outcome measures. RESULTS: Sub-threshold mood and anxiety disorders were less likely to be recognized by physicians than disorders meeting DSM-III-R criteria. Recognized mood disorders were associated with a significant decrement in MCS scores (poorer HRQOL) compared with unrecognized disorders. In contrast, recognized mood disorders demonstrated slightly higher PCS scores. Recognized and unrecognized mood disorders differed significant ly in physical functioning, vitality, social functioning, role functioning related to emotional state, and mental health. Recognition of anxiety disorders was not related to HRQOL. Conclusions: Patients with mental health disorders that have been recognized by their health providers appear to suffer from poorer HRQOL than patients whose disorders have not been recognized. This relationship, though, is only apparent for mood disorders. Poorer physical functioning may mask less severe emotional symptoms in mood disorders; profound emotional symptoms make recognition easier.     

Social timing influences sleep quality in patients with sleep disorders

ObjectivesWe aimed to compare three variants of the Pittsburgh Sleep Quality Index (PSQI usual, work- and work-free days: PSQI_u, PSQI_w, PSQI_f) and to assess whether chronotype (MSF_sc)/social jetlag (SJL) are associated with sleep quality in patients with sleep disorders (SD).MethodsIn sum, 431 SD patients and 338 subjects from the general population (GP) were included. Participants filled in three variants of the PSQI and the Munich ChronoType Questionnaire (MCTQ). We used Generalized Estimating Equations (GEE) to investigate effects of group (GP, SD), PSQI (usual, work or free) and their interaction (group1PSQI) on scores. To investigate associations between MSF_sc/SJL and the difference between PSQI_w and PSQI_f (PSQI_diff) in patients with SD we used linear regressions (N = 352). We used Sobel to test whether there was a mediation effect of SJL on the association between MSF_sc and PSQI_diff.ResultsPSQI scores differed between groups (p < 0.001). Post-hoc analysis revealed a significant difference between PSQI_u vs. PSQI_f and PSQI_w vs. PSQI_f with PSQI_f presenting lower scores, while PSQI_u vs. PSQI_w did not differ in any group. In line with previous findings, SJL was associated to PSQI_diff in SD patients.ConclusionsPSQI_u mainly represents sleep quality on workdays also in SD patients. Being a late chronotype seems to be associated with higher differences in sleep quality on work-vs. free days mostly when it coincides with societal time constraints. Since sleep quality is poorer on workdays even in SD patients, we suggest that treatment strategies should address social aspects affecting sleep, including ways of minimizing SJL.     

Beliefs about sleep in disorders characterized by sleep and mood disturbance

OBJECTIVES: Maladaptive sleep beliefs play an important role in primary insomnia, but their role in other disorders with concomitant sleep disruption has rarely been explored. Thus, this study investigated the link between insomnia and sleep beliefs in five groups (N=422): primary insomnia (PI), good sleepers (GS), fibromyalgia (FM), major depressive disorder (MDD), and Community Sleep Clinic patients with comorbid insomnia and mood disturbance (CSC). METHOD: Groups were compared on the Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16) scale. RESULTS: Unlike the GS group, the MDD, FM, and CSC groups had elevated DBAS-16 scores that were similar to, or more pathological than, those of primary insomnia sufferers. Only some of the differences were removed after controlling for depression. CONCLUSION: Like primary insomnia patients, other sleep-disturbed patient groups have problematic sleep beliefs. Depression was not sufficient to account for all elevations in beliefs. The presence of maladaptive sleep beliefs in these patients suggests that belief-targeted treatment might be helpful in alleviating sleep complaints.     

Effect of sleep apnea on cognition and mood

Obstructive sleep apnea syndrome (OSAS) is a common disorder in adults and children, which is characterized by repetitive transient reversible upper airway obstructions during sleep. Due to disrupted sleep architecture and intermittent hypoxemia, OSAS leads to impaired daytime functioning in various neuropsychological and affective domains. The most common abnormalities are executive dysfunction, impaired vigilance, depression, and possibly anxiety and, in children, hyperactivity. Optimal treatment of OSAS with continuous positive airway pressure may reverse the cognitive and affective dysfunction, however, in some patients a residual impairment persists. This persistent deficit, despite effective treatment, raises the possibility of a remaining subtle structural brain damage; such damage has been demonstrated through the use of sensitive functional and other neuroimaging techniques. Prefrontal cortical damage may underlie the cognitive dysfunction in OSAS. Early recognition and treatment may prevent this untoward effect of OSAS.     

西酞普兰联合普瑞巴林对椎体压缩性骨折患者睡眠、情绪和疼痛的影响

目的 探讨西酞普兰联合普瑞巴林对接受椎体成形术治疗的椎体压缩性骨折患者的治疗效果.方法 选取我院97例拟行椎体成形术治疗的椎体压缩性骨折患者,采用随机数字表法进行分组,对照组48例采用普瑞巴林治疗,观察组49例增加西酞普兰联合治疗,两组患者均于术前1d进行治疗,术后持续治疗13d,总疗程14d,对比两组患者术后12h、...