石蜡疗法治疗痉挛型脑瘫患儿368例护理体会

目的 总结石蜡疗法治疗痉挛型脑瘫患儿的疗效及护理经验.方法 选取我院儿童康复科2006-02—2016-06痉挛型脑瘫患儿368例,其中痉挛型双瘫212例,痉挛型偏瘫98例,痉挛型四肢瘫(包括三肢瘫)58例.应用综合的康复方法,如PT、OT、ST、针灸、推拿、穴注、引导式教育等方法,在此方法基础上加用石蜡疗法,并在蜡疗前、蜡疗中及蜡疗后给予良好的护理.结果 治疗3个月后,对368例痉挛型脑瘫患儿采用改良的Ashworth痉挛量表(MAS)对治疗前后肌张力进行评估,总有效率98.9%(360/368),显效率达87.5%(322/368).蜡疗后无出现1例烫伤及皮肤过敏现象.结论 蜡疗具有降低痉挛型脑瘫患儿肌张力、缓解肌腱挛缩的作用,是治疗痉挛型脑瘫的物理治疗方法之一,良好的护理至关重要,可避免烫伤及皮肤过敏等现象的发生,值得临床推广应用.     

232例脑性瘫痪患儿的视觉障碍分析

脑性瘫痪(脑瘫)是由于出生前、出生时及出生后一个月内各种原因脑损伤所导致的非进行性中枢性运动障碍、姿势异常,常伴随智力低下、语言障碍、癫(癎)及视听障碍,其中视觉障碍是脑瘫常见的伴随症状,对脑瘫患儿早期运动发育及认知能力有着严重不良影响.本文对232例伴随视觉障碍的脑瘫患儿进行相关因素分析,探讨视觉障碍与脑瘫型别、类型、高危因素的关系.     

小儿脑性瘫痪高危因素的调查与分析

目的探讨脑性瘫痪患儿的高危因素。方法采用回顾性调查分析4706例脑瘫患儿产前母体因素、产时及新生期危险因素。同时选择等量在我院儿童保健科进行儿童保健的正常同龄儿童作为对照。计数资料采用频数分布及百分构成比进行描述;危险因素的分析采用1：1匹配单因素条件Logistic回归分析,并进行1：1匹配多因素条件Logistic回归分析来控制混杂因素对结果的影响。结果60.4%有产前母体因素,24.5%为出生时异常因素,14.5%的患儿曾有新生儿期异常因素,0.3%有遗传因素,0.3%无明显原因。结论产前母体因素是造成脑瘫的主要原因,也是造成产时及某些新生儿期因素的重要原因,应加强孕期保健,重视孕期孕母相关的环境、营养、保持良好的心态,以降低脑瘫儿的发病率,提高患儿生存质量。     

脑蛋白水解物注射液结合康复训练治疗痉挛型脑瘫疗效分析

目的观察脑蛋白水解物注射液结合康复训练治疗痉挛型脑瘫的临床效果。方法选取我院2009-06—2014-08收治的痉挛型脑瘫患儿100例,随机分为观察组与对照组,对照组实施基础康复训练治疗,观察组在此基础上结合脑蛋白水解物注射液治疗,观察2组临床疗效。结果观察组显效率与总有效率均明显高于对照组;治疗后2组发育商(DQ)均明显提高,且观察组提高程度更为显著,差异均有统计学意义(P0.05)。结论脑蛋白水解物注射液结合康复训练治疗痉挛型脑瘫患儿,可显著提高临床疗效,促进患儿DQ发育,改善患儿智力、感知觉障碍及行为症状,具有进一步推广应用价值。     

动态脑电图在痉挛性脑瘫诊断中的价值

目的 通过41例痉挛型脑瘫临床与AEEG分析,探讨动态脑电图(AEEG)监测对其癫的发作类型的诊断的临床价值.方法 所有患儿均在就诊当日用MR95 10导AEEG检测仪进行8～24 h检测.结果 41例痉挛型脑瘫AEEG正常8例,异常33例.结论 AEEG检测对了解痉挛型脑瘫患儿的脑功能状态,诊断与鉴别诊断与其分型,治疗均有重要指导价值,并对预测是否发生癫有重要意义.     

中国佳木斯地区小儿脑性瘫痪环境危险因素的调查

摘要 背景：国外对脑性瘫痪是否存在环境危险因素的研究很少,国内的研究尚未涉及该领域,目前对脑性瘫痪人群环境危险因素进行系统的分析尚未见报道。 目的：通过人群流行病学调查,探讨与小儿脑性瘫痪有关的环境危险因素,为本病的防治及进一步病因学研究提供理论依据。 设计、时间及地点：回顾性病例对照研究,于2007年9月至2010年5月在黑龙江省小儿脑性瘫痪防治疗育中心完成。 方法：选取中国佳木斯地区202例脑瘫儿童构成病例组,随机选取404例对照儿童,按年龄相差不超过3个月,性别、民族相同进行1:2配对。对所有儿童进行调查,重点是孕期环境因素。调查数据应用SAS9.13 for windows软件,进行单因素、多因素条件Logistic回归分析。 主要观察指标：新生儿出生季节、孕期使用移动电话、孕期使用电子产品、孕期居室周围环境情况、孕期使用大理石厨台做饭、孕期产前仪器设备检查情况、孕期摄取食物情况等。 结果：将调查因素进行多因素分析显示,与脑瘫有关的环境危险因素中,居室周围环境有污染危险性最大（OR＝2.432, 95%CI=1.172~5.047,P=0.017),其次为孕期使用高辐射移动电话、每天观看电视时间超过5小时、孕期使用大理石厨台做饭。 结论：小儿脑性瘫痪存在环境危险因素。加强孕期和围产期保健的同时,关注环境因素的影响,是减少脑瘫发生的重要措施。 关键词: 脑性瘫痪;环境危险因素;Logistic Regression分析     

新生儿缺氧缺血性脑病的早期综合干预分析

新生儿缺氧缺血性脑病属于新生儿发生窒息后的严重并发症,发病情况严重,致死率高,少部分存活下来的儿童(特别是中、重度HIE)常伴有脑功能障碍[1],小儿脑瘫、精神发育延迟、癫疒间等不良症状。本文选取64例足月新生儿缺氧缺血性脑病患儿,实施早期干预康复治疗,定时随访。现报告如下。1资料与方法1.1一般资料选取我院2008-06—2011-06收治的64例     

痉挛型脑性瘫痪患儿肌酸激酶、乳酸脱氢酶和α-羟丁酸检测水平及意义

本文对221例痉挛型脑瘫和患儿血清肌酸激酶(CK)、乳酸脱氢酶(LDH)和α-羟丁酸脱氢酶(α-HBD)检测水平进行对照分析,发现痉挛型脑瘫患儿可能存在肌酶代谢紊乱,以及可能是出现痉挛型运动性肌无力的主要原因,应在进行综合康复的基础上给予改善肌肉代谢及能量的药物治疗,以改善痉挛型运动性肌无力,提高脑瘫患儿运动功能.     

父母生育年龄及母孕期因素与孤独症的关系

目的探讨父母生育年龄及母孕期因素对孤独症发病的影响。方法对符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的124例孤独症患儿(孤独症组)及健康对照组的父母生育年龄、家族史、母孕期情况进行统计分析。结果母亲生育年龄29岁孤独症组占比例较对照组高,差异有统计学意义(χ2=10.716,P=0.001),父亲年龄29岁孤独症组和对照组有显著差异(χ2=15.514,P=0.000),孤独症组母亲孕期使用电脑史所占比例较大,两组差异有统计学意义(χ2=7.893,P=0.005);多因素Logistic回归,结果显示母亲生育年龄、孕期经常使用电脑与孤独症发病相关,可能是孤独症危险因素。结论母亲高生育年龄(29岁)、孕期经常使用电脑与孤独症的发病相关。     

小儿高热惊厥120例临床分析

目的：探讨小儿高热惊厥发生的相关因素,分析最理想的治疗方案。方法选择我院2009-06-2013-06收治的120例高热惊厥患儿,其中简单型56例,复杂型64例。分析患儿发病情况、体温、惊厥类型及脑电图等相关情况。结果简单型患儿体温达38·5～39·5℃时导致惊厥现象,持续时间短,脑电图在体温恢复后2周表现正常;复杂型发生惊厥时体温＜38·5℃,伴随持续抽搐,且复发性高,24 h 内均有发作,而脑电图在体温恢复后2周仍有异常。结论早期预防及第一时间正确处理小儿高热惊厥的症状至关重要。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of Legislation of 1933 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -