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不宁腿综合征11例分析 总被引:1,自引:1,他引:0
我科2004-01/2009-01收治不宁腿综合征(Restless legsSyndrome,RLS)11例,分析如下.
1 临床资料
1.1 一般资料 本组男2例,女9例,年龄42~77(平均59)岁,病程5d~3a.同时患有缺铁性贫血2例,震颤麻痹1例,慢性肾病1例. 相似文献
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目的探讨不宁腿综合征的临床表现、诊断、治疗及预后。方法对48例明确诊断的不宁腿综合征患者进行多导睡眠脑电图分析,采用左旋多巴类药物治疗,并进行随访1 a。结果 48例患者均有双下肢难以形容的感觉异常,治疗后症状减轻。结论本病是一种常见的神经系统感觉运动障碍性疾病,应用多巴胺能药物及其他对症药物,可以有效治疗。 相似文献
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目的:调查分析慢性肾功能不全血液透析患者不宁腿综合征症状对其睡眠质量影响。
方法:选择2003—07—24/2003—07—30在中山大学第一附属医院、广东省人民医院、中山大学孙逸仙纪念医院及中山大学第三附属医院进行血液透析的患者171例为观察对象。①睡眠质量评定采用匹茨堡睡眠质量指数量表。可划分为主观睡眠质量,睡眠潜伏期,睡眠持续性,习惯睡眠效率。睡眠紊乱,用睡眠药物和白天功能紊乱7个因子。各因子累计得分系总分。将总分以4分,8分为界限将睡眠分为好,中。差3个级别进行分析。②采用不宁腿综合征患者病情严重程度评定量表了解其严重程度。由10个项目构成,各项累计得分系总分。原量表将总分以10分,20分,30分为界限将严重程度分为轻微,中度,严重。非常严重进行分析。③采用自行设计的一般情况调查表,包括性别,年龄,职业,患病病程,每周透析次数。文化程度,家庭环境,家庭平均收入。身体健康情况,有无其他躯体疾病,有无服用药物,一级亲属睡眠问题等。运用统一问卷和统一指导语解释,让患者自己填写。个别不能填写的,患者回答后由调查人员填写。
结果:在171例血液透析患者中有43例符合诊断不宁腿综合征症状标准,发生率为25.2%,其中男28例,女15例。不宁腿综合征组的匹茨堡睡眠质量指数量表总分高于非不宁腿综合征组,差异有显著性[(10.07&;#177;4.49)。(7.03&;#177;3.94),t=3.881,P〈0.001]。不宁腿综台征组主观睡眠质量、睡眠潜伏期、用睡眠药物、总分、睡眠紊乱、日间功能障碍因子分均高于非不宁腿综合征组(P〈0.05),而两组睡眠持续性,习惯睡眠效率因子分差异无显著性。不宁腿综合征组睡眠质量较差。性别及不宁腿综合征各等级严重程度对肾脏透析不宁腿综合征睡眠质量无影响。不宁腿综合征严重程度总分与睡眠质量匹茨堡睡眠质量指数量表总分相关(相关系数为0.508,P=-0.001)。二者存在回归关系(b=0.508,t=3.585,P=0.001).
结论:慢性肾功能不全血液透析伴不宁腿综合征症状的患者睡眠质量明显较差。不宁腿综合征严重程度总分与睡眠质量严重程度相关。 相似文献
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不宁腿综合征 (restlesslegssyndrome,RLS) ,又称不安腿综合征、多动腿综合征。其病因与发病机理尚未完全清楚 ,一般认为与局部缺血、代谢障碍及精神、遗传等因素有关。大多并发于尿毒症、糖尿病、类风湿关节炎及各种贫血等 ,也常为尿毒症出现前的先兆。据国外研究[1] ,普通人群中下肢不宁综合征的发生率从百分之几到 15 % ,大多低于 10 % ;而在尿毒症患者中则达 2 0 %左右。据日本 3所医院对 4 5 1例肾透析患者调查 ,有 2 2 0例有下肢不宁综合征 ,占 4 9%。RLS的临床特征为腿部有异常感觉 ,如蚁行感、针刺感、痒… 相似文献
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1 病历简介 患儿女 ,3岁 ,因发热 3天入院。查体 :T 38℃ ,咽充血 ,扁桃体Ⅱ度肿大 ,峡部可见疱疹 ,心、肺、腹及神经系统未见异常。实验室检查 :WBC 12 .4× 10 9/L ,N 0 .72 ,L 0 .2 8,Hb 9g/L ,RBC 3.2× 10 12 /L ;尿常规、生化常规无异常。诊断 :①疱疹性咽峡炎 ;②轻度贫血。给予抗感染、退热、纠正盆血、对症等治疗。住院期间发现患儿于夜晚睡眠时 ,尤其在入睡 1小时后即开始哭闹 ,诉双腿发痒 ,并不停地搓动 ,需家长对其双腿进行按摩、揉搓 ,约 1~ 2小时后渐入睡 ,当时查体未见异常。追问病史 ,患儿自生后 8个月始即出现… 相似文献
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不宁腿综合征的护理新体会 总被引:1,自引:0,他引:1
徐敏 《中华现代护理学杂志》2004,1(4):297-298
不宁腿综合征(Rest less legs syndrome,RLS)是1685年由。Thams Wills首先提出的,并于1945年经由Ekbom正式命名。RLS是一种常见的中枢神经系统疾病,分为原发性和继发性,主要表现为静息时下肢不适感,不能长时间静坐,晚间睡眠时加重,活动下肢后可暂时缓解。Hening等人依据最新研究方法和诊断标准评估总人群发病率为2%~15%, 相似文献
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目的探讨多发性硬化(MS)患者合并不宁腿综合征(RLS)的临床特点,且进一步研究MS患者合并RLS的相关因素。方法选取确诊的70例MS患者,根据是否合并RLS分为伴RLS组和单纯MS组,比较两组患者的MS发病年龄、病程及神经功能损害严重程度(EDSS评分)等临床资料;分析RLS症状严重程度与EDSS的关系。结果70例MS患者中12例合并RLS,发生率为17.1%(12/70)。伴RLS组患者发病年龄为(47.6±10.0)岁,单纯MS组为(40.1±10.4)岁,两组比较差异有统计学意义(t=2.29,P=0.030);病程分别为(12.6±6.8)、(8.2±6.6)年,两组比较差异有统计学意义(t=2.10,P=0.039);EDSS评分分别为(4.5±2.5)、(2.5±2.0)分,两组比较差异有统计学意义(t=3.02,P=0.004)。RLS严重程度评分与EDSS评分无相关性(r=0.45,P=0.15)。结论RLS在MS患者中发病率较高,MS发病年龄越大,病程越长,神经功能损害越严重,发生RLS的可能性越大。 相似文献
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目的:观察左旋多巴联合应用普拉克索对原发性不宁腿综合征(RLS)患者的疗效。方法:中~重度原发性RLS患者30例,随机分为对照组和联合组各15例,2组均予普拉克索0.25~0.75 mg/d,联合组还予美多巴62.5~125 mg/d,治疗6周。利用RLS严重程度量表(IRLS)、临床总体印象改善量表(CGI-I)、患者总体印象量表(PGI)和Epworth嗜睡量表(ESS)评估患者治疗前后的RLS症状严重程度和嗜睡程度,同时记录不良反应。结果:2组治疗后IRLS评分均低于治疗前(P<0.05);联合组治疗后的IRLS评分低于对照组(P<0.05)。治疗后,联合组的CGI-I及PGI评估显效率高于普拉克索组(P<0.05)。2组治疗后ESS评分均低于治疗前(P<0.05),2组治疗后的ESS评分差异无统计学意义(P>0.05)。结论:左旋多巴联合应用普拉克索对原发性RLS的疗效优于单用普拉克索。 相似文献
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目的:通过横断面调查帕金森病(PD)合并不宁腿综合征(RLS)的发病率及临床特征。方法:采用病例对照研究,连续选取自2015年10月至2016年1月我院及天坛医院帕金森专病门诊PD患者,分析RLS组、非RLS(NRLS)组的临床相关性,并根据RLS严重程度评分,分为轻、中、重度。同时收集患者发病年龄、病程、有无毒物接触史、UPDRS-Ⅲ评分、改良H-Y分级、贝克焦虑量表(BAI)等临床资料。结果:共收集294例PD患者,合并RLS共87例(29.6%),其中轻度32例、中度36例、重度19例,既往RLS诊治率仅19.5%。RLS组与NRLS组比较,在病程、改良H-Y分级、UPDRS-Ⅲ、BAI等方面差异有统计学意义(P0.05),在发病年龄、文化程度、是否有毒物接触史、PD家族史等方面差异无统计学意义(P0.05)。结论:PD合并RLS存在发病率高、漏诊率高的特点。运动症状较重、病程较长的患者,易合并RLS。 相似文献
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Background
Restless legs syndrome (RLS) is a common chronic neurologic disorder. Symptoms are most prevalent during the evening and at night, although daytime symptoms may emerge as the disease progresses. Dopamine agonists are currently considered first-line therapy for moderate to severe idiopathic RLS. Most dopamine agonists have short half-lives and are administered in the evening, shortly before the onset of RLS symptoms. Rotigotine is a non-ergot dopamine receptor agonist that has been specifically developed as a transdermal patch to provide continuous drug delivery over a 24-hour period.Objective
This review details the development of rotigotine, from the preclinical studies that established its pharmacokinetic profile to large-scale clinical trials in patients with RLS. Placebo-controlled trials that demonstrated the efficacy and tolerability of rotigotine are discussed, in addition to open-label studies that investigated long-term therapy.Methods
Studies were identified by a PubMed search using the key word rotigotine in conjunction with restless legs syndrome and by reviewing reference lists of retrieved publications. All clinical trials of rotigotine in RLS published before September 2013 were included.Results
Preclinical studies have established activity of rotigotine as a dopamine receptor agonist, and pharmacokinetic data have shown that transdermal delivery maintains stable plasma levels over 24 hours. Rotigotine has demonstrated efficacy in improving moderate to severe RLS symptoms in randomized, placebo-controlled trials, based on scores on the International RLS Study Group rating scale, the RLS-6 scale, and the Clinical Global Impression–Severity subscale. Results of an open-label extension study suggest that efficacy may be maintained for up to 5 years. A polysomnographic study demonstrated an improvement in periodic limb movement index with rotigotine, and subjective assessments have suggested beneficial effects in terms of amelioration of sleep disturbances. Premature discontinuations from rotigotine treatment have ranged from 8% to 38% in studies of 6 weeks to 12 months in duration; 57% of patients discontinued prematurely during a 5-year study. In each trial, adverse events were typical of dopaminergic stimulation and use of a transdermal patch. The most common adverse events were application-site reactions, with a reported prevalence ranging from 17% (1-month sleep laboratory trial) to 58% (5-year open-label extension study). Clinically significant augmentation was recorded in 39 of 295 patients (13%) receiving rotigotine during the 5-year study, of whom 15 (5%) were receiving a dose within the US Food and Drug Administration–approved range of 1 to 3 mg/24 h.Conclusions
Findings from clinical studies have suggested that rotigotine is efficacious in improving RLS symptoms and is generally well-tolerated. The risk of developing clinically significant augmentation appears to be low. As such, rotigotine represents an important addition for RLS treatment. 相似文献18.
Yuan-yuan Song Ru-jun Hu Yong-shu Diao Lin Chen Xiao-lian Jiang 《Journal of pain and symptom management》2018,55(4):1184-1195
Context
Hemodialysis (HD) patients experience a heavy symptom burden that leads to a decreased quality of life. Pharmacological treatment is effective but costly and has adverse effects. Exercise is a promising approach for symptom management, but the effect of exercise on restless legs syndrome (RLS), depression, sleep quality, and fatigue in HD patients is still uncertain.Objectives
This meta-analysis was conducted to identify whether exercise training is beneficial in the treatment of the symptoms of RLS, depression, poor sleep quality, and fatigue in patients receiving HD.Methods
A systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Central Register of Controlled Trials, and Web of Science was conducted to identify randomized controlled trials (RCTs) comparing exercise training with routine care on RLS, depression, sleep quality, and fatigue among HD patients. Quality assessment was conducted using the Cochrane risk of bias tool, and RevMan 5.3 was used to analyze the data.Results
Fifteen RCTs that met our inclusion criteria were included. The pooled effect size showed that exercise training was effective on RLS (P < 0.001), depression (P < 0.001), and fatigue (P < 0.001). However, effect size combinations for sleep quality were not performed owing to the sensitivity analysis results.Conclusion
Exercise training may help HD patients to reduce the severity of RLS, depression, and fatigue. More high-quality RCTs with larger samples and comparative RCTs focused on different exercise regimens are needed. 相似文献19.
不安腿综合征伴睡眠障碍是一种严重影响患者生命质量且难以根除的中枢神经系统疾病.本文将穴位埋线与常规针刺联合治疗不安腿综合征的疗效进行观察研究,以说明穴位埋线在症状改善及远期疗效上的作用和优势.结果表明,经过2个疗程的治疗后,穴位埋线在腰膝酸软、睡眠障碍及焦虑抑郁方面较普通针刺的改善程度方面更优,且疗效维持时间更久.穴位... 相似文献
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目的系统评价加巴喷丁治疗不宁腿综合征的临床疗效和安全性。方法计算机检索PubMed、EBMbase、CENTRAL及CBM等数据库,全面收集加巴喷丁治疗不宁腿综合征的随机对照试验(RCT)。按Cochrane系统评价方法对纳入研究进行资料提取和质量评价后,采用RevMan5.1软件进行Meta分析。结果共纳入7个RCT,1 163例患者,包括4个安慰剂平行对照试验和3个安慰剂交叉试验。Meta分析结果显示:①不宁腿综合征改变量(IRLSSG评分),加巴喷丁组明显优于安慰剂组[MD=–3.24,95%CI(–4.40,–2.09),P<0.000 01];②反应率(用研究者评价的CGI-I评分),加巴喷丁组(77%)较安慰剂组(50%)有更高的反应率[RR=1.81,95%CI(1.54,2.11),P<0.000 01];③睡眠质量:加巴喷丁组较安慰剂组能更好地减少睡眠紊乱[MD=–11.31,95%CI(–14.46,–8.16)]、保证睡眠质量[MD=0.27,95%CI(0.10,0.44)]和减轻日间嗜睡[MD=–3.96,95%CI(–6.42,–1.50)];④不宁腿综合征疼痛评分,加巴喷丁组较安慰剂组更好地减轻疼痛[MD=–0.97,95%CI(–1.47,–0.47)]。不良反应主要有嗜睡(3.1%~26.5%)、头晕(2.1%~19.5%),且加巴喷丁组发生率更高(嗜睡:P<0.000 01;头晕:P<0.000 1)。结论加巴喷丁能有效改善不宁腿综合征患者的病情,提升睡眠质量,减轻疼痛,耐受性良好。 相似文献