白癜风患者心理调查与结果分析

目的:对白癜风患者心理进行调查并作结果分析。方法:采用心理健康症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)以及汉密尔顿焦虑量表(HAMA),对40例暴露部位白癜风患者和30例非暴露部位白癜风患者进行问卷调查分析。结果:SCL-90测评结果显示:白癜风患者暴露组、白癜风患者非暴露组在人际关系、焦虑和抑郁项的得分明显高于对照组,差异有显著性(P<0.05)。HAMD、HAMA测评结果显示:白癜风患者暴露组、白癜风患者非暴露组的得分明显高于对照组,差异有显著性(P<0.05)。白癜风患者暴露组HAMA得分大于14分,存在焦虑症状。结论:白癜风患者可能存在焦虑、抑郁等心理障碍,本研究为白癜风患者的心理干预治疗提供了依据。     

通络安肠饮治疗情志不遂所致腹泻型肠易激综合症的疗效观察

目的:观察通络安肠饮对情志不遂所致腹泻型肠易激综合征(D-IBS)的疗效.方法:按罗马Ⅲ诊断标准[1]选择58例情志不遂所致腹泻型D-IBS的患者,给予通络安肠饮治疗,疗程共4周.治疗前后分别评定汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及D- IBS主症状.结果:58例患者完成研究,HAMD、HAMA和胃肠道主症状评分均明显减低,治疗前后差异有显著性(P＜0.01).抑郁、焦虑、精神状态和胃肠道主症状的改善在4周后治疗组总有效率为93.10％.结论:通络安肠饮能明显改善情志不遂、缓解肠道症状.     

美舒郁治疗慢性前列腺炎伴随的情绪障碍

1998年1月至2000年8月诊断慢性前列腺炎(CP)289例.经HAMD(汉密尔顿)量表评定,96例(33%)患者伴有不同程度的焦虑抑郁症(21-35分),其中18人(6%)有自杀念头,7人(2%)自杀未遂.对伴有焦虑抑郁症状的CP患者,给予骶管注药治疗或/和美舒郁药物治疗,总结如下.     

孕妇妊娠末期睡眠障碍与焦虑抑郁关系的研究

目的 探讨孕妇妊娠末期睡眠质量与焦虑、抑郁情绪的关系.方法 采用匹茨堡睡眠质量指数量表(PSQI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿押郁量表17项版本(HAMD-17),对96名妊娠末期孕妇(孕妇组)及100名正常非孕女性(对照组)的睡眠质量、焦虑和抑郁状态水平进行调查并对比.结果 孕妇组PSQI中睡眠质量、睡眠紊乱、日间功能评分和总分显著高于对照组(P＜0.05,P＜0.01),HAMA总分、躯体性焦虑评分及HAMD-17总分、焦虑/躯体化和睡眠障碍因子分亦显著高于对照组(P＜0.05,P＜0.01).孕妇睡眠质量维度评分、PSQI总分与HAMA总分及各因子分、HAMD-17总分呈显著正相关(均P＜0.05).结论 孕妇在妊娠末期存在明显的睡眠障碍和情绪问题,并且睡眠质量与焦虑和抑郁等情绪症状有正相关关系,应采取措施提高其睡眠质量,改善其心理状态.     

成批创伤性窒息患者心理危机及护理干预

目的改善成批创伤性窒息患者的心理危机。方法对17例创伤性窒息患者在病情平稳后4h进行评估和专业的心理危机识别、一般性心理干预、群体康复、放松训练等心理危机干预。干预前后采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)测评患者焦虑、抑郁状况。结果干预后患者HAMA、HAMD得分较干预前显著下降(均P<0.01)。结论对创伤性窒息患者及时进行心理危机干预,可以缓解患者负性情绪,使之早日回归家庭和社会。     

维、汉族心血管病住院患者抑郁焦虑状况调查分析

目的 了解新疆地区维、汉族心血管病患者抑郁、焦虑状况,使临床心理护理更具有针对性.方法 采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)对维、汉族心血管病住院患者各100例进行调查.结果 汉族患者SAS、SDS、HAMA、HAMD评分显著高于维族患者(均P＜0.01).结论 新疆地区汉族心血管病住院患者抑郁、焦虑状况显著高于维族患者,应根据民族差异实施针对性的心理护理.     

文拉法辛与帕罗西汀治疗躯体形式障碍对照研究

目的:观察帕罗西汀治疗躯体形式障碍的疗效.方法:42例躯体形式障碍患者分别用帕罗西汀或文拉法辛缓释片治疗4用,采用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评定疗效,用副反应量表(TESS)观察副作用.结果:文拉法辛组与帕罗西汀组疗效相当(p＞0.05),但在治疗第一周术时,文拉法辛组HAMD的分值有显著下降(p＜0.01).TESS各周无明显差异,两组不良反应较轻微.结论:文拉法辛与帕罗西汀治疗躯体形式障碍疗效相当,文拉法辛起效快,两者不良反应轻微.     

联合应用郁乐疏合剂治疗慢性前列腺炎的临床疗效评价

目的:探讨联合郁乐疏合剂治疗慢性前列腺炎的临床疗效。方法:将88例Ⅲ型慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)患者随机分为对照组和试验组,每组44例,对照组采用临床常规治疗,即口服抗生素、α受体阻滞剂、活血化瘀中成药及前列腺按摩;试验组44例,在接受临床常规治疗的同时口服郁乐疏合剂。治疗前后两组分别应用国际慢性前列腺炎症状评分(NIH-CPSI)测评症状严重程度,用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)测评患者焦虑、抑郁等情绪障碍状况,用国际勃起功能指数-5(IIEF-5)测评患者性功能状况,并对各项结果进行统计学分析。结果:治疗后两组患者前列腺炎症状均有明显改善,性功能障碍亦有改善,试验组改善程度明显优于对照组,其中对疼痛不适症状改善明显,试验组治疗后疼痛症状评分为(7.89±2.82)分,对照组为(10.41±2.55)分,两者比较有显著差异(P0.01)。对照组治疗前后HAMA、HAMD评分无显著性差异(P0.05);而试验组治疗前后HAMA、HAMD评分有显著性差异,试验组治疗前后HAMA评分分别为(24.30±5.07)分和(13.80±3.62)分(P0.01);试验组治疗前后HAMD评分分别为(23.81±5.01)分和(16.23±5.93)分(P0.01)。结论:郁乐疏合剂能缓解患者的焦虑、抑郁心理状态,改善慢性前列腺炎患者的症状,是治疗慢性前列腺炎的有效药物。     

路优泰与阿米替林治疗老年期抑郁症的对照研究

目的:比较路优泰(圣.约翰草提取物片)和盐酸阿米替林片对老年期抑郁症患者抗抑郁的疗效及安全性.方法:采用随机对照研究连续观察12周,路优泰组32例,剂量范围为300-900mg/d,盐酸阿米替林组31例,剂量范围为50-150mg/d,汉密尔顿抑郁量表(HAMD)和副反应评定量表(TESS)进行评定.结果老年期抑郁症患者经12周治疗,路优泰和阿米替林组HAMD分明显降低,与治疗前比较差异有显著性(P＜0.01).两组同比较,差异无显著性(P＞0.05).路优泰与阿米替林抗抑郁疗效相当,路优泰的副作用明显小于阿米替林.结论:对老年期抑郁症患者,路优泰抗抑郁疗效与盐酸阿米替林相当,副作用小,安全性高.     

贝克认知疗法在恶性骨肿瘤保肢术患者心理护理中的应用

目的探讨贝克认知疗法在骨科恶性肿瘤保肢术患者心理护理中的应用效果。方法将186例恶性骨肿瘤保肢术患者按随机数字表法分为观察组和对照组各93例。对照组给予骨科围术期常规心理护理,观察组在常规心理护理基础上进行贝克认知疗法,干预前后分别采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评价患者心理状况。结果干预后观察组HAMD和HAMA评分显著低于对照组(均P0.01)。结论贝克认知疗法能够降低恶性骨肿瘤保肢术患者围术期的焦虑和抑郁程度,有利于缓解患者不良情绪。     

女性直肠癌根治术中保留盆腔自主神经120例分析

目的探讨盆腔自主神经保留对改善女性直肠癌根治术后性功能和排尿功能的价值。方法回顾性分析120例女性中下段直肠癌病例盆腔自主神经保留组和非盆腔自主神经保留组的性功能障碍和排尿功能障碍的发生率。差异采用χ2检验。结果两组患者术后性欲下降、性高潮减退、阴道湿润度减退和性交时疼痛的发生率分别为12.5%、10.5%、8.33%、4.15%和54.1%、45.9%、41.7%、37.5%,差异有统计学意义(P<0.01);后盆腔清除术研究组和对照组术后性功能障碍的发生率分别为58.33%和66.67%,两组比较差异无统计学意义(P>0.05)。结论盆腔自主神经保留可明显改善女性直肠癌手术后性功能和排尿功能;但是后盆清除术时保留自主神经效果并不显著。     

Scarf osteotomy without internal fixation for correction of hallux valgus: A clinical and radiographic review of 148 cases

Background

Hallux valgus is a common condition with in excess of 120 procedures described in the literature for its correction. Traditionally, distal metatarsal osteotomies have been employed in the treatment of mild deformities, with proximal osteotomies being reserved for more severe presentations. The Scarf osteotomy without internal fixation allows large translations which can successfully correct severe hallux valgus deformities, without limitations related to screw placement.

Psychiatric disorders in patients admitted to emergency department wards

Even though psychiatric problems are commonly observed in patients attending emergency departments (ED), to our knowledge, there are no studies about the prevalence of mental disorders in patients admitted to ED wards. In the present study we evaluated the psychiatric disorder morbidity in patients admitted to ED wards for physical problems. General Health Questionnaire‐30 (GHQ‐30) was submitted to 556 patients admitted to the ED ward. All GHQ‐30 positive (score > 4) and one third (randomly selected) of the GHQ‐30 negative (score < 5) patients underwent the Mini International Neuropsychiatric Interview (MINI‐IV), a structured interview to diagnose mental disorders according to DSM‐IV criteria. Patients with positive and negative scores to GHQ‐30 were 293 (52.7 per cent) and 263 (47.3 per cent) respectively. A total of 351 patients underwent the MINI‐IV. In the total sample the extrapolated prevalence was 44.4 per cent for all mental disorders, 21.7 per cent for Anxiety Disorders, 10.2 per cent for Depressive Disorders, 9.7 per cent for Adjustment Disorders and 3.2 per cent for Alcohol Dependence. In only 53 patients (9.8 per cent) the diagnoses at discharge was a mental disorder and in 32 patients (5.7 per cent) a psychiatric consultation was requested. In conclusion, a high rate of Anxiety and Depressive Disorders was found in patients admitted to the ED ward, but in most of these patients the mental disorders were not recognized by the emergency physicians. Copyright © 2001 John Wiley & Sons, Ltd.     

保存植物神经的直肠癌根治术对排尿和性功能的影响

目的 探讨中下段直肠癌患者行保存植物神经的肿瘤根治术对排尿和性机能的影响。方法 根据不同病情实施不同保存植物性神经的直肠癌根治术１８８例：Ｄｕｋｅｓ Ａ期９８例,完全保存神经;Ｂ期７８例,保存一侧或两侧神经;Ｃ期１２例,只保存Ｓ３、４神经。结果 术后自行排尿时间平均为：Ａ期８．５ｄ,Ｂ期９．０ｄ,Ｃ期１６．８ｄ。保存勃起和射精机能者：Ｄｕｋｅｓ Ａ期分别是９６．９％和１００％;Ｂ期是４７．４％和５０％;Ｃ期均为０。术后肿瘤局部复发者占１２．８％（２４／１８８）,其中Ｄｕｋｅｓ Ａ、Ｂ、Ｃ期分别为４．１％、２０．５％和３３．３％。５年生存率Ｄｕｋｅｓ Ａ、Ｂ、Ｃ期分别是７７．６％、５２．６％、３３．３％。结论 保存植物神经的直肠癌根治术,在不增加局部复发率和减少５年生存率的同时,可明显提高患者的生存质量。     

The long-term prognosis of whiplash-associated disorders (WAD)

Somatic and mental symptoms in 22 patients (16 women and 6 men) 22–73 months after a whiplash injury are described. The results of the present study are compared with the corresponding results of a previous study on the same patients. According to the Quebec Classification System, the whiplash injuries of 15 patients were classified as grade 2 and those of 7 patients as grade 3. Pain intensity was evaluated by means of a visual analogue scale and muscular tenderness was assessed by pressure algometry. Algometry was also used to measure the pain tolerance level. The Mood Adjective Check List was used as a measure of mental well-being. During the 2 years that had passed since the previous study, the patients had improved regarding pain intensity, pain tolerance level and mental well-being. The results show that patients with prolonged disability after a whiplash injury can improve even after a long time. Received: 29 June 1998 Revised: 23 March 1999 Accepted: 11 May 1999     

氟马西尼和纳洛酮对东莨菪碱致大鼠认知功能障碍的影响

目的 探讨氟马西尼和纳洛酮对东莨菪碱致大鼠认知功能障碍的影响.方法 健康清洁级雄性SD大鼠40只,随机分为4组(n=10):正常对照组(C组)腹腔注射等容量生理盐水;东莨菪碱组(S组)腹腔注射东莨菪碱0.8 mg/kg;东莨菪碱+氟马西尼组(SF组)腹腔注射东莨菪碱0.8 mg/kg和氟马西尼0.5 mg/kg;东莨菪碱+纳洛酮组(SN组)腹腔注射东莨菪碱0.8 mg/kg和纳洛酮2 mg/kg.1次/d,连续3 d.于第3天末次给药后30 min采用Y型迷宫进行学习记忆能力测试,记录达标训练次数和达标时间.处死后取脑,冰浴下分离海马,应用免疫组化法计数胆碱乙酰基转移酶(ChAT)免疫阳性神经元,采用RT-PCR法测定毒蕈碱受体M1亚型(mAChRM1)mRNA的表达.结果 与C组比较,S组、SF组和SN组达标时间延长,训练次数增加,ChAT阳性神经元计数减少,mAChRM1 mRNA表达下调(P<0.05).与S组比较,SF组和SN组达标时间缩短,训练次数减少,ChAT阳性神经元计数增多,mAChRM1 mRNA表达上调(P<0.05).结论 氟马西尼和纳洛酮可减轻东莨菪碱致大鼠认知功能障碍,其机制可能与改善大鼠中枢胆碱能神经系统功能有关.     

氟马西尼和纳洛酮对东莨菪碱致大鼠认知功能障碍的影响

目的 探讨氟马西尼和纳洛酮对东莨菪碱致大鼠认知功能障碍的影响.方法 健康清洁级雄性SD大鼠40只,随机分为4组(n=10):正常对照组(C组)腹腔注射等容量生理盐水;东莨菪碱组(S组)腹腔注射东莨菪碱0.8 mg/kg;东莨菪碱+氟马西尼组(SF组)腹腔注射东莨菪碱0.8 mg/kg和氟马西尼0.5 mg/kg;东莨菪碱+纳洛酮组(SN组)腹腔注射东莨菪碱0.8 mg/kg和纳洛酮2 mg/kg.1次/d,连续3 d.于第3天末次给药后30 min采用Y型迷宫进行学习记忆能力测试,记录达标训练次数和达标时间.处死后取脑,冰浴下分离海马,应用免疫组化法计数胆碱乙酰基转移酶(ChAT)免疫阳性神经元,采用RT-PCR法测定毒蕈碱受体M1亚型(mAChRM1)mRNA的表达.结果 与C组比较,S组、SF组和SN组达标时间延长,训练次数增加,ChAT阳性神经元计数减少,mAChRM1 mRNA表达下调(P<0.05).与S组比较,SF组和SN组达标时间缩短,训练次数减少,ChAT阳性神经元计数增多,mAChRM1 mRNA表达上调(P<0.05).结论 氟马西尼和纳洛酮可减轻东莨菪碱致大鼠认知功能障碍,其机制可能与改善大鼠中枢胆碱能神经系统功能有关.     

Insomnia severity,combat exposure and mental health outcomes

Few studies have examined insomnia severity as a moderator of the impact of combat experiences on posttraumatic stress disorder (PTSD) and alcohol problems, such that combat exposure is expected to have more negative consequences for soldiers who report insomnia. In this study, a sample of 522 military personnel completed measures of PTSD and alcohol problems prior to a 12‐month deployment to Iraq, and then completed measures assessing insomnia severity, combat exposure, PTSD, alcohol problems and overall distress 3 months post‐deployment. Results of a moderated multiple regression indicated that insomnia severity interacted with combat exposure to predict PTSD and alcohol problems after controlling for pre‐deployment baseline measures of these outcomes, such that the relationship between combat exposure and the mental health symptoms was stronger when insomnia severity was greater. Results are discussed from the perspective of the role of insomnia in the development of PTSD and alcohol problems, as well as from an occupational health perspective where insomnia may deprive individuals of the resources they need to recover from the effects of severe occupational stressors found in high risk occupations. Published in 2010 by John Wiley & Sons, Ltd.