高压氧联合帕罗西汀治疗抑郁症患者认知功能损害46例效果观察

目的：探讨抑郁症患者认知功能的损害特点及高压氧联合帕罗西汀治疗对抑郁症患者认知功能的疗效。方法：将92例抑郁症患者随机分为研究组和对照组各46例，两组均首先进行帕罗西汀抗抑郁治疗2周后，研究组给予高压氧治疗，对照组继续单一使用怕罗西汀抗抑郁治疗，共治疗12周。采用HAMD、MMSE、词汇流畅测验、联想学习、数字广度测验、相似、领悟及副反应量表，于治疗前、治疗后第2、4、8、12周末分别对两组进行评定。结果：研究组治疗第12周后MMSE、词汇流畅测验、联想学习测验、数字广度测验与对照组比较差异有显著性（P〈0．05）；两组HAMD在治疗第2、4、8、12周末分别与治疗前比较差异均有极显著性（P〈0．01）。结论：抑郁症患者认知功能损害与病情严重程度和患者特质有关，高压氧治疗可改善抑郁症特质性认知功能损害，提高患者的社会适应能力。     

脑蛋白水解物联合赛乐特治疗抑郁症患者认知功能损害92例效果观察

目的:探讨抑郁症患者认知功能的损害特点及脑蛋白水解物联合赛乐特治疗对抑郁症患者认知功能的疗效.方法: 将184例抑郁症患者随机分为研究组和对照组各92例,两组均首先进行赛乐特抗抑郁治疗2周后,研究组给予脑蛋白水解物治疗,对照组继续单一使用赛乐特抗抑郁治疗,共治疗12周.采用HAMD、MMSE、词汇流畅测验、联想学习、数字广度测验、相似、领悟及副反应量表,于治疗前、治疗后第2、4、8、12周末分别对两组进行评定.结果:研究组治疗第12周后MMSE、词汇流畅测验、联想学习测验、数字广度测验与对照组比较差异有显著性(P<0.05);两组HAMD在治疗第2、4、8、12周末分别与治疗前比较差异均有极显著性(P<0.01).结论: 抑郁症患者认知功能损害、病情严重程度与患者特质有关,脑蛋白水解物治疗可改善抑郁症特质性认知功能损害,提高患者的社会适应能力.     

脑蛋白水解物联合赛乐特治疗抑郁症患者认知功能损害92例效果观察

目的：探讨抑郁症患者认知功能的损害特点及脑蛋白水解物联合赛乐特治疗对抑郁症患者认知功能的疗效。方法：将184例抑郁症患者随机分为研究组和对照组各92例,两组均首先进行赛乐特抗抑郁治疗2周后,研究组给予脑蛋白水解物治疗,对照组继续单一使用赛乐特抗抑郁治疗,共治疗12周。采用HAMD、MMSE、词汇流畅测验、联想学习、数字广度测验、相似、领悟及副反应量表,于治疗前、治疗后第2、4、8、12周末分别对两组进行评定。结果：研究组治疗第12周后MMSE、词汇流畅测验、联想学习测验、数字广度测验与对照组比较差异有显著性（P〈0．05）;两组HAMD在治疗第2、4、8、12周末分别与治疗前比较差异均有极显著性（P〈0．01）。结论：抑郁症患者认知功能损害、病情严重程度与患者特质有关,脑蛋白水解物治疗可改善抑郁症特质性认知功能损害,提高患者的社会适应能力。     

中药抗抑郁汤配合帕罗西汀治疗抑郁症45例临床观察

目的探讨中药抗抑郁汤联合帕罗西汀治疗抑郁症的临床疗效及不良反应。方法将90例符合中国精神障碍分类与诊断标准第3版（CCMD-3）诊断标准的抑郁症患者随机分为研究组（中药抗抑郁汤合并帕罗西汀组）和对照组（单用帕罗西汀组）,每组各45例,共治疗8周。用汉密尔顿抑郁量袁（HAMD）评定疗效,用药物不良反应量袁（TESS）评定不良反应。结果治疗8周,研究组及对照组总有效率分别为95．6％和93．3％,两组比较差异无显著性。研究组起效快,与对照组比较,在治疗的第1周末即出现显著差异（P〈0．05）,至第4周末差异非常显著（P〈0．01）。治疗第1、2周末研究组副作用更少,较对照组比较差异有显著性（P〈0．05）;第4、8周末两组副作用比较差异无显著性（P〉0．05）。结论中药抗抑郁汤联合帕罗西汀治疗抑郁症,起效快,药物副作用减少,是值得推广的治疗方法。     

帕罗西汀联合逍遥散治疗抑郁症对照研究

目的探讨帕罗西汀联合逍遥散治疗抑郁症的临床疗效。方法将76例抑郁症患者随机分为两组各38例,两组均口服帕罗西汀治疗,研究组联合逍遥散治疗,观察8周。于治疗前及治疗第2周、4周、8周末用汉密尔顿抑郁量表（HAMD）评定临床疗效。结果观察组有效率为97．36％,对照组为81．57％,二者有显著性差异（P〈0．05）。两组治疗前HAMD无显著性差异,治疗8周末均较治疗前显著下降（P〈0．01）,但研究组较对照组下降明显（P〈0．05）。结论帕罗西汀联合逍遥散治疗抑郁症疗效显著。     

抑郁症患者认知功能障碍的比较研究

目的:探讨抑郁症患者认知功能损害特点。方法:对46例符合CCMD-3抑郁症诊断标准抑郁症患者和46名健康自愿者对照组进行威斯康星卡片测验(Wisconsincardsortingtest,WC-ST)、词汇流畅测验、联想学习、相似、领悟和数字广度测验,并对经过6周抗抑郁药治疗的46例抑郁症患者进行治疗前后比较。结果:抑郁症患者WCST的总测验次数82.19±21.55、持续错误数31.56±18.97、随机错误数25.53±11.31、词汇流畅测验41.68±5.96、联想学习19.78±6.21、相似9.68±3.15、领悟9.82±4.33和数字广度测验10.85±2.77,与正常人为53.66±5.87,16.89±12.54,9.48±15.53,56.27±13.34,28.56±5.60,13.91±2.75,13.91±2.75,14.73±2.38相比差异均有显著性意义(P<0.01),WCST的总测验次数、持续错误数、随机错误数与HAMD总分(r=0.35,0.33,0.31,P<0.05)及迟缓(r=0.45,0.41,0.41,P<0.01)、日夜变化(r=0.31,0.29,0.31,P<0.05)两因子分正相关。WCST与其他各项神经心理学测验无明显相关。46例抑郁症患者治疗后,WCST的上述各项指标与治疗前相比差异均有显著性意义(P<0.05)。治疗后WCST的总测验次数、持续错误数、随机错误数的减分率与HAMD的减分率正相关(P<0.05)。结论:抑郁症患者存在认知功能损害,其认知功能损害与病情严重程度和患者     

小剂量氨磺必利合用帕罗西汀治疗中重度抑郁症的疗效和安全性

目的:探讨小剂量氨磺必利合用帕罗西汀治疗中、重度抑郁症的疗效和安全性。方法:38例中、重度抑郁症患者随机分为对照组和研究组,各19例;对照组给予帕罗西汀治疗,研究组给予帕罗西汀及氨磺必利治疗,疗程均为8周。分别在治疗前和治疗1、2、4、8周末采用汉密尔顿抑郁量表(HAMD)评定疗效,采用副反应量表(TESS)评定不良反应,并测定患者各项生化指标,监测每日生命体征及体重。结果:2组疗效差异无统计学意义;治疗后各时间点,2组HAMD总分均较同组治疗前降低(P<0.05);治疗后第1、2周末,研究组HAMD评分低于对照组(P<0.05);2组均无严重不良反应。结论:加用小剂量氨磺必利可能有助于提高帕罗西汀治疗中重度抑郁症的起效速度,安全性好。     

氟西汀联合重复经颅磁刺激治疗对抑郁症患者疗效及认知功能的影响

目的：探讨氟西汀联合重复经颅磁刺激治疗对抑郁症患者疗效及认知功能的影响。方法将60例抑郁症患者随机分两组,每组30例。研究组口服氟西汀联合重复经颅磁刺激治疗,对照组口服氟西汀联合假经颅磁刺激治疗,观察6周。于治疗前后采用汉密顿抑郁量表评定临床疗效,威斯康星卡片分类测验评估认知功能,副反应量表评定不良反应。结果治疗第2周末研究组有效率显著高于对照组（P＜0．01）,治疗第4周、6周末两组比较差异无显著性（P＞0．05）。治疗后研究组威斯康星卡片分类测验的正确反应数及完成分类数均较治疗前显著升高（P＜0．01）,且研究组显著高于对照组（P＜0．05）;两组汉密顿抑郁量表评分较治疗前显著降低（P＜0．01）,治疗第2周、4周末研究组显著低于对照组（P＜0．05）。治疗过程中,两组均未出现严重不良反应。结论氟西汀联合重复经颅磁刺激治疗抑郁症疗效显著,起效快,安全性高,且能显著改善患者的认知功能,优于单用氟西汀治疗。     

中药对帕罗西汀治疗抑郁症的辅助作用

目的：探讨中药对帕罗西汀治疗抑郁症的辅助作用。方法：将46例抑郁症患者随机分为中药六郁汤合并帕罗西汀组与单用帕罗西汀组，于治疗后1、2、4、6周采用Hamilton抑郁量表(HAMD)、不良反应症状量表(Tess)评定疗效及副反应。结果：研究组抗抑郁作用优于对照组，且见效快，副反应轻。结论：中药合并帕罗西汀治疗抑郁症较单一用药好。     

认知行为治疗对首发抑郁症患者自尊水平的影响

目的探讨认知行为治疗对首发抑郁症患者的自尊水平的影响。方法将62例患者随机分成两组:研究组(31例)对照组(31例)。两组均采用帕罗西汀治疗,研究组合并认知行为治疗。分别于治疗前及治疗后8周末应用SES量表对患者自评1次,并对患者进行HAMD、HAMA量表评定1次。结果治疗前研究组及对照组SES、HAMD、HAMA评分差异无统计学意义(P0.05),治疗8周后,研究组SES评分显著高于对照组(P0.05),HAMD和HAMA评分显著低于对照组(P0.01)。结论认知行为治疗联合药物治疗能显著改善首发抑郁症患者的焦虑、抑郁情绪,能显著提高其自尊水平,增强自尊自信,有助于患者康复。     

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.