脑复素治疗脑血管病临床观察

脑复素治疗脑血管病200余例，疗效满意，未发现毒副作用，值得推广。我院自1995年5月以来，引进山西长治康宝制药厂生产的脑复素注射液，先后在内、儿、传、骨科试用共200余例，疗效满意，未发现有明显副、毒作用，现将资料完整的总结报告如下：     

恩经复治疗Ⅱ期压疮的疗效观察

患者可因疾病发生各种并发症,压疮是众多并发症中常见的一种。压疮又称压迫性溃疡,是身体局部长期受压、血液循环受到障碍、局部组织持续缺血及营养不良而引起皮肤及皮下组织发生坏死的结果^[1]。压疮分Ⅳ期,临床上以第Ⅱ期多见。治疗压疮的方法很多,但其效果均不甚理想。2006年1月至2007年5月,本院对40例Ⅱ期压疮在常规治疗护理的基础上加用恩经复湿敷,收到满意效果,现报告如下。     

刺五加注射液与脑复素联合治疗脑梗死疗效观察

目的:探讨刺五加注射液与脑复素联合治疗脑梗死的临床疗效。方法:治疗组采用刺五加注射液60mL、脑复素20mL分别加入生理盐水500mL、10％葡萄糖500mL中静脉滴注,每天1次,15d为1个疗程。对照组用丹参注射液40mL、胞二磷胆碱1.0分别加入生理盐水500mL、10％葡萄糖500mL中静脉滴注,每天1次,15d为1个疗程。结果:治疗第3周后,治疗组总有效率(91.6％)较对照组(63.3％)明显增高;2组治疗后神经功能缺损积分值比较有显著性差异,治疗组优于对照组(P<0.05)。结论:刺五加注射液与脑复素联合应用是治疗脑梗死较有效的方法。     

脑复素颈动脉注射治疗血管性痴呆的研究

为探讨血管性痴呆早期治疗方法,我院自1996年1月至1997年9月将60例患者随机分成两组。治疗组采用脑复素颈动脉注射,对照组采用脑复素静脉滴注,进行临床对比观察。结果两组在改善记忆、计算、语言、抽象思维方面无明显差异,但动脉注射组疗程短,费用少。现总结如下。 1 临床资料 1.1 一般资料及分组 脑复素颈动脉注射组30例,男20例,女10例;平均年龄60.7岁。病期最短12小时,最长26个月,平均病期4.5个月。多发性脑梗塞27例(包括7例多发性腔隙性脑梗塞并脑萎缩)。蛛网膜下腔出血并正常颅压脑积水3例。脑复素静     

脑复素注射液合灯盏花素注射液治疗老年人脑动脉硬化性眩晕36例

目的：观察脑复素注射液合灯盏花素注射液对老年人脑动脉硬化性眩晕的临床疗效。方法：临床采用单盲随机分为2组，治疗组36例用脑复素注射液合灯盏花素注射液治疗，对照组30例用低分子右旋糖酐治疗，疗程2周，疗程结束后进行临床评价分析。结果：治疗组显效率为55.6％，有效率为97.2％，对照组分别为30.0％、86.7％，经统计学处理，2组显效率比较具有显著性差异(P＜0.05)，治疗组疗效明显优于对照组，且都没有明显的不良反应。结论：脑复素注射液合灯盏花素注射液治疗老年人脑动脉硬化性眩晕安全有效，值得临床推广。     

神经生长因子与脑复素并功能训练对脑卒中患者功能恢复的作用

选择脑血管病患者100例随机分为两组，分别给予神经生长因子(恩即复)和脑复素治疗。两组给予相同的康复训练，经3个疗程的治疗后用Fugl-Meyer评价疗效。神经生长因子治疗组平均提高(37．0&;#177;7．8)分，脑复素组平均提高(32．0&;#177;7．6)分，经统计学处理，差异有显著性意义(t=3.242，P&;lt;0．05)，提示神经生长因子在促进受损伤神经断端的芽生效果显著。     

108例脑血管病的脑电地形图分析

分析１０８例脑血管病患者的ＢＥＡＭ，男７９例，女２９例，平均年龄５９．１４±８．８８岁．于发病１～７天内检查，部分病例在病后３０～４０天复查．全部病例经头ＣＴ扫描证实，其中脑出血６２例，脑梗塞４６例．其ＢＥＡＭ阳性率明显优于常规ＥＥＧ（经卡方检验表明ＢＥＡＭ阳性率明显高于ＥＥＧ，脑出血Ｐ＜０．０１、脑梗塞Ｐ＜０．０５）．对缺血性脑梗塞早期的发现，有时先于头颅ＣＴ扫描，弥补了头颅ＣＴ扫描不能显示大脑功能变化的不足，两者结合能提高临床早期诊断阳性率，也可为临床预后判断提供客观依据，有较大的临床应用价值．     

恩经复加复方丹参注射液治疗新生儿缺氧缺血性脑病的疗效观察

62例新生儿缺氧缺血性脏病患儿分为2组,治疗组35例予恩经复9μg肌肉注射,qd,配合复方丹参注射液6～8ml加入10%的葡萄糖注射液中静脉滴注治疗;对照组予胞二磷胆碱注射液治疗。新生儿神经行为评分采用鲍氏20NBNA项判定。结果随访半年,治疗组总有效率为91.4%,对照组总有效率为74.1%,差异显著。     

马来酸桂哌齐特在脑血管病康复治疗中疗效观察

马来酸桂哌齐特为新型Ca^2 通道阻滞剂，可以缓解脑血管阻力，增加脑血流量；提高红细胞变形能力，降低血液粘度，改善微循环；增加组织对血中葡萄糖的摄取，降低氧耗，对缺血脑组织起到保护作用，从而改善脑外周循环。同时马来酸桂哌齐特有扩张脑血管及增加椎动脉及颈内动脉的血流量，特别是在病变和局部缺血区域，增加血流量的作用更显著。     

颅脑MRA成像在脑血管疾病中的临床应用

目的:探讨颅脑MRA成像(magnetic resonance angiography,MRA)在脑血管疾病中的应用价值.材料与方法:对48例患者进行常规 MRI(Magnetic Resonance Image,MRI)及MRA检查.结果:44例中 6例正常,28例脑梗塞,4例动静脉畸形,2例海绵状血管瘤,4例颅内动脉瘤,全部病例MRA重建图像清晰显示颅内主要血管形态及常见血管疾病的异常改变.结论:MRA是一项快速、准确、有效、无创伤的检查手段,具有较高的临床应用价值..     

心脑血管疾病患者心率变异性与阿司匹林抵抗的研究

目的阿司匹林抵抗患者心率变异性指标的变化。方法服用阿司匹林（100 mg/d）至少7天以上的心脑血管患者作为入选标准。二磷酸腺苷（adenosine disphosphate,ADP）和花生四烯酸（arachidonic acid,AA）作诱导剂在Chrono-log 560 Ca上测定血小板聚集功能。记录受检者24小时动态心电图。结果阿司匹林抵抗发生率为12.5%（n=21）。阿司匹林抵抗组HRV时域参数和频域参数与阿司匹林敏感组比较均有统计学意义（P〈0.01）。阿司匹林抵抗组高血压患者的比率（42.9%）与阿司匹林敏感组（29.3%）比较有显著差别（P=0.01）。结论阿司匹林抵抗组HRV时域参数和频域参数与阿司匹林敏感组比较均有统计学意义,这提示我们HRV下降的患者服用阿司匹林时,要定期检测血小板聚集功能,一旦发生阿司匹林抵抗,应提示这类患者要及时调整抗血小板药物,加大阿司匹林的剂量或换用其他抗血小板药物。     

Effectiveness of Pulmonary Rehabilitation in Reducing Health Resources Use in Chronic Obstructive Pulmonary Disease

Rubí M, Renom F, Ramis F, Medinas M, Centeno MJ, Górriz M, Crespí E, Martín B, Soriano JB. Effectiveness of pulmonary rehabilitation in reducing health resources use in chronic obstructive pulmonary disease.

Objective

To determine the effectiveness of a multidisciplinary, outpatient pulmonary rehabilitation (PR) program in patients with severe and very severe chronic obstructive pulmonary disease (COPD). PR is recommended in advanced COPD, but there is limited evidence on the effectiveness of PR in reducing health care resources when applied in outpatients.

Design

Before and after intervention, a prospective research trial of patients enrolled in a PR program.

Setting

Outpatient respiratory department in a specialized hospital.

Participants

We considered prospectively 82 consecutive patients with advanced COPD and finally studied 72 patients who completed the PR intensive phase.

Intervention

PR program.

Main Outcome Measures

The effectiveness of this PR program was assessed by comparing health resources use from the year before and the year after PR. Clinical variables including dyspnea; the body mass index, obstruction, dyspnea, exercise capacity (BODE) index; and the Chronic Respiratory Questionnaire and health resources use including the number of exacerbations, the number of hospitalizations, and days of hospitalization.

Results

Patients had a forced expiratory volume in the first second percentage predicted (mean ± SD) of 33.0±9.8 and a BODE index of 5.0±2.0. Significant improvements after PR were found in dyspnea, exercise capacity, and quality of life and on the BODE index (P<.05). Compared with the 12 months before PR, there were also significant reductions during the year after PR on exacerbations (3.4±3.5 vs 1.9±2.0, P=.002), hospitalizations (2.4±2.0 vs 0.9±1.2, P<.001), and days of hospitalization (36.1±32.7 vs 16.1±31.3, P<.001) (ie, a reduction of 44%, 63%, and 55%, respectively; all P<.05).

Conclusions

We conclude that a multidisciplinary, outpatient PR program substantially reduces health resources use in patients with severe and very severe COPD.     

康复治疗在帕金森病治疗中的作用及进展

帕金森病治疗是神经科学研究的一大难题,康复治疗能起到一定的作用,最近有新的康复治疗的方法出现,本文对其进行综述.     

Cardiac Rehabilitation in the Elderly: Improving Effectiveness

Heart disease is a major cause of mortality and morbidity among adults who are older than 65 years of age. One-third of cardiac operations on adults in the United States are performed on patients who are more than 65 years old, and almost half of the hospitalized candidates for an outpatient cardiac rehabilitation program are in the older patient population. Structured educational programs that include exercise and modification of risk factors have been shown to reduce the risk of subsequent coronary events; however, studies show that older adults enroll in these programs at a significantly lower rate than do patients in other age groups. Nurses and other healthcare professionals must eliminate barriers to participation and adapt their programs to meet the needs of older adults with cardiac disease to reduce morbidity, enhance functioning, and improve quality of life. In this article, the authors describe current knowledge about the efficacy and use of cardiac education and rehabilitation in elderly patients and suggest implications for future practice and research.     

脑血管病的康复预防

目的：探讨康复预防在脑血管病康复中的重要性。方法：采用各种预防措施;进行早期诊断和治疗,以及早期康复干预;采用综合的康复方法,改造和利用现有的环境资源。结果：减少脑血管病的发病率;降低脑血管病的致残率;消除或减轻脑血管病患者的残障。结论：积极地进行康复预防,有助于降低脑血管病的发病率,改善脑血管病患者的功能,提高其生活质量。     

体外反搏与药物治疗缺血性脑血管病的疗效对照观察

缺血性脑血管病患者204例,随机分为2组,体外反搏组149例;药物对照组55例。治疗后进行疗效比较,结果体外反搏组总有效率为94.63％,药物对照组总有效率为81.8％,2组疗效有显著差异,P<0.01。     

Effectiveness of Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease With Different Degrees of Static Lung Hyperinflation

Objective

To evaluate the effect of pulmonary rehabilitation (PR) on exercise performance and quality of life in patients with chronic obstructive pulmonary disease (COPD) with different degrees of static lung hyperinflation (LH).