壮医经筋挑刺法治疗脑卒中偏瘫痉挛状态的效果

目的观察壮医经筋挑刺法对脑卒中后偏瘫肢体痉挛的疗效。方法 2014年1月至2015年12月,55例脑卒中后偏瘫痉挛患者随机分为治疗组(n=27)与对照组(n=28)。两组均接受常规康复治疗及中医针刺治疗,治疗组加用壮医经筋挑刺疗法。治疗前及治疗4周后,采用改良Ashworth量表(MAS)、Barthel指数(BI)、简化Fugl-Meyer评定量表(FMA)进行评定。随访3个月,记录不良事件发生。结果两组治疗后MAS、BI、FMA评分均明显改善(t3.32,P0.01),治疗组优于对照组(t2.286,P0.05)。随访期间未发现不良事件发生。结论配合壮医经筋挑刺法能更好缓解脑卒中后偏瘫患者的肌张力,改善其运动功能,提高生活自理能力。     

阶段化护理对脑卒中偏瘫患者治疗依从性和生活能力的影响

目的探讨阶段化护理对脑卒中偏瘫患者治疗依从性和生活能力的影响。方法将120例脑卒中偏瘫患者随机分入对照组与观察组,每组各60例。给予对照组患者常规康复护理措施,给予观察组患者分阶段三级康复治疗护理。采用Fugl Meyer（FMA）评定肢体运动功能,采用改良Barthel指数评估患者日常生活能力（ADL）,采用生活质量测评表评估患者生活质量。比较两组干预后治疗依从性、肢体运动功能、日常生活能力和生活质量。结果干预后观察组治疗依从性显著优于对照组（P〈0．05）;干预后6月观察组FMA评分和改良Barthel指数评分显著优于对照组（P〈0．05）;观察组生活质量各项评分及总分均显著低于对照组（P〈0．05）。结论对脑卒中偏瘫患者进行阶段化护理可显著提高患者治疗依从性,促进肢体功能恢复,改善日常生活能力和生活质量。     

循证护理在急性脑卒中偏瘫患者中的应用

目的:探讨循证护理在急性脑卒中偏瘫患者早期康复中的应用效果。方法:将110例急性脑卒中偏瘫患者随机分为观察组和对照组各55例,对照组给予常规护理,观察组给予循证护理。比较两组治疗前后的抑郁评分、FMA评分及Barthel指数。结果:治疗4周后,两组抑郁评分均降低,观察组抑郁评分明显低于对照组(P0.05),FMA评分及Barthel指数改善情况均优于对照组(P0.05)。结论:循证护理可明显降低急性脑卒中偏瘫患者的焦虑情绪,改善其肢体运动功能和日常生活活动能力。     

镜像疗法联合远程康复在脑卒中偏瘫患者上肢功能锻炼中的应用

目的:探讨镜像疗法(MT)联合远程康复在脑卒中偏瘫患者上肢功能锻炼中的应用方法及效果。方法:将71例脑卒中偏瘫出院患者随机分为对照组37例和观察组34例,对照组给予常规康复指导,观察组在此基础上给予MT联合远程康复,比较两组康复效果。结果:观察组出院后4、8周上肢简化Fugl-Meyer运动功能评定量表(FMA)、简易上肢功能评定量表(STEF)、改良Ashworth量表(MAS)和Barthel指数评分量表(BI)评分均优于出院前24 h(P0.05);对照组出院后4、8周STEF、MAS及BI评分均优于出院前24 h(P0.05),但上肢FMA评分较出院前24 h无明显变化(P0.05);观察组出院后4、8周上肢FMA、STEF及BI评分均优于对照组(P0.05),但两组MAS评分比较差异无统计学意义(P0.05)。结论:MT联合远程康复能有效改善脑卒中偏瘫患者上肢运动功能和自理能力,但手部痉挛改善无明显疗效。     

任务导向性训练在脑卒中偏瘫患者中的应用

目的:探讨任务导向性训练在脑卒中偏瘫患者中的应用效果。方法:将74例脑卒中偏瘫患者随机分为对照组和观察组各37例,均给予脑卒中常规康复干预,观察组加用任务导向性训练干预,治疗前和治疗8周后分别采用Fugl-Meyer评分标准(FMA)、Barthel指数法(BI)、老年人身体移动量表(EMS)比较2组的患侧肢体运动功能、日常生活能力和身体移动能力。结果:治疗后,观察组上肢FMA评分、下肢FMA评分、BI评分及EMS评分均明显升高,与对照组比较差异有统计学意义(P0.05)。结论:在常规康复治疗的基础上加用任务导向性训练,能显著改善脑卒中偏瘫患者的运动功能、日常生活能力及身体移动能力。     

早期康复护理对脑卒中偏瘫患者功能恢复的影响

目的探讨早期康复护理对脑卒中偏瘫患者功能恢复的影响。方法将90例脑卒中偏瘫住院患者随机分为实验组45例和对照组45例。实验组给予早期康复护理,对照组给予常规护理。分别于治疗前和治疗后第30d进行评定。肢体运动功能采用简化Fugl—Meyer运动功能评分量表（FMA）评定,日常生活能力采用国际通用量表Barthel指数（BI）评定。结果治疗后,两组FMA、BI与治疗前比较差异有统计学方法（P〈0．01或P〈0．05）,实验组FAM、BI较对照组改善更为明显（P〈0．01）。结论早期康复护理可明显提高患者的日常生活能力和肢体运动功能。     

中医护理适宜技术对脑卒中痉挛性偏瘫患者下肢功能的影响

【摘要】目的 观察中医护理技术对改善脑卒中后下肢偏瘫痉挛状态、患者日常生活能力的情况及患者的肢体运动功能情况,给予卒中后遗症的偏瘫痉挛状态一种有效、的护理方法。 方法 本研究采用随机对照试验,将合符纳入标准的86例脑卒中后痉挛性偏瘫患者按照随机分配原则,分为43例中医护理技术组（治疗组）和43例常规护理组（对照组）。治疗组给予常规治疗包括控制血压、控制血糖,在此基础上给予中医护理技术（走罐、中药离子导入、砭石疗法和疏经通络操）,对照组给予常规治疗以及常规护理。分别在治疗前、治疗后1个月及治疗后2个月（结束疗程）,这三个时间段对两组患者的临床痉挛指数CSI、日常生活能力情况Ashworth量表(MAS)以及肢体的运动功能简化Fugl-Meyer量表（FMA）进行评定。结果 两组患者基线资料包括性别、年龄、疾病进程等以及治疗前患者的肢体运动功能、肢体痉挛状态、日常生活能力比较均无统计学意义（P>0.05）。疗程结束后对分别评定治疗组和对照组患者的上肢偏瘫痉挛状态、日常生活能力的情况,以及患者的肢体运动功能情况,两组患者的治疗前后和组间比较差异均有统计学意义（P＜0.05）,说明两组治疗方法均有效,而且治疗组效果优于对照组。结论 中医护理技术能有效缓解患者脑卒中后偏瘫痉挛状态,比单一的治疗或护理手段更优,并具有良好的安全性,适于推广。     

子午流注中医定向透药配合电针治疗缺血性脑卒中偏瘫肢体康复护理观察

目的:观察探讨子午流注中医定向透药配合电针治疗缺血性脑卒中偏瘫肢体的临床应用效果。方法:选取本院康复科缺血性脑卒中(中医证型为风痰阻络型)患者80例,随机分为对照组和观察组,每组40例。对照组给予化痰通络配合针灸康复治疗、功能训练和护理指导;观察组在常规训练基础上实施子午流注中医定向透药配合电针治疗干预措施。对比两组患者治疗前和出院前的偏瘫肢体运动功能评估(FMA)、日常生活活动能力(ADL)改良Barthel指数评估结果。结果:治疗前,两组患者运动功能、日常生活活动能力评估指标比较无明显差异(P>0.05);出院前,两组患者运动功能、日常生活活动能力评估指标均明显优于治疗前,但观察组各项指标又明显优于对照组,差异有统计学意义(P<0.05)。结论:子午流注中医定向透药配合电针治疗能有效促进脑卒中肢体偏瘫患者肢体运动功能和肌张力的恢复,有助于提高日常生活活动能力,提高总体生活质量。     

联合中医按摩及神经促通技术治疗脑卒中后偏瘫肢体痉挛的疗效观察

目的观察联合中医按摩及神经促通技术治疗脑卒中后偏瘫肢体痉挛的临床疗效。 方法将42例脑卒中后肢体痉挛患者随机分为治疗组及对照组。对照组患者应用神经肌肉促通技术进行治疗，治疗组患者则同时联用神经促通技术及中医按摩疗法，2组患者均给予常规剂量巴氯芬药物口服。分别采用Ashworth分级法(ASS)、Fugl-Meyer评定法(FMA)和改良Barthel指数评分法(MBI)对2组患者治疗前后肌张力、肢体运动功能及生活自理能力进行评定。 结果治疗后2组患者偏瘫侧肢体肌张力均较治疗前明显降低(P<0.01)，肢体运动功能和生活自理能力均较治疗前明显提高(P<0.01)，并且治疗组患者疗效明显优于对照组(P<0.05)。 结论中医按摩及神经促通技术联合治疗对脑卒中后偏瘫肢体痉挛具有显著疗效，值得临床推广、应用。     

早期康复护理对脑卒中偏瘫病人日常生活活动能力的影响

[目的]观察早期康复护理对脑卒中偏瘫病人日常生活活动能力的影响。[方法]将116例急性脑卒中偏瘫病人随机分为观察组与对照组,每组58例,两组病人均给予神经内科常规治疗与护理,观察组在神经内科常规治疗与护理的基础上,进行早期康复护理。采用Barthel指数法(BI)评定日常生活活动能力(P<0.05),观察并发症发生情况。[结果]观察组病人治疗后BI评分明显提高(P<0.05),且高于对照组治疗后BI评分;观察组病人并发症少于对照组(P<0.05)。[结论]早期康复护理可改善急性脑卒中偏瘫病人肢体运动功能,提高病人日常生活活动能力。     

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。     

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.     

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.     

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.