低分子肝素抗凝治疗高血压脑出血后症状性深静脉血栓的疗效和安全性

目的分析低分子肝素抗凝治疗高血压脑出血后下肢深静脉血栓的疗效和安全性。方法选取2009-01—2014-07我院就诊的高血压脑出血后下肢深静脉血栓患者73例为研究对象,对照组31例,采用常规脱水、营养脑神经、保护胃黏膜等治疗,并配合相应的辅助康复训练,研究组42例,采用低分子肝素抗凝治疗,余治疗措施与对照组相同,治疗结束后,观察2组患者的临床疗效、患肢水肿消退时间及并发症情况。结果研究组有效率高于对照组(P0.05),研究组并发症发生率低于对照组,但差异无统计学意义(P0.05)。结论低分子肝素抗凝治疗高血压脑出血后下肢症状性深静脉血栓效果显著,起效时间短,且并发症发生率低,值得应用。     

髋关节置换后利伐沙班与低分子肝素预防下肢深静脉血栓的比较

背景：低分子肝素可显著降低髋关节置换后下肢深静脉血栓的发生率,但其因需皮下注射而存在局限性。 目的：比较全髋关节置换后应用利伐沙班与低分子肝素预防下肢深静脉血栓疗效和安全性的差异。 方法：58例全髋关节置换患者按随机数字表法分为2组,利伐沙班组28例,低分子肝素组(达肝素)30例。置换后行双下肢彩色多普勒检查评估DVT形成情况,并观察治疗期间出血情况。 结果与结论：利伐沙班组与达肝素组患者在预防下肢深静脉血栓疗效上差异无显著性意义(P > 0.05)。两组在治疗期间均无严重出血,置换后非严重出血差异也无显著性意义(P > 0.05)。提示利伐沙班在预防全髋置换后下肢深静脉血栓的疗效与安全性上与低分子肝素作用相当。     

空气波压力循环治疗仪预防脑卒中后下肢深静脉血栓形成的效果评价

目的评价空气波压力循环治疗仪预防脑卒中后下肢深静脉血栓形成的效果。方法 100例连续住院的脑卒中患者随机分为研究组和对照组。研究组采用空气波压力循环治疗仪预防血栓,对照组采用常规护理措施。应用彩超观察2组股静脉、腘静脉流速,记录2组下肢深静脉血栓发生例数,以及下肢疼痛、肿胀出现例数,比较其差异。结果 2组股静脉流速、腘静脉流速、血栓发生率比较差异有统计学意义(P0.05);下肢疼痛及肿胀发生率比较差异无统计学意义(P0.05)。结论行间歇空气波压力循环治疗能有效降低脑卒中患者下肢深静脉血栓的发生。     

前馈控制在预防颅脑损伤术后深静脉血栓形成中的应用

目的探讨前馈控制在预防颅脑损伤术后深静脉血栓中的应用。方法颅脑损伤术后患者84例,随机分为观察组与对照组各42例,对照组进行常规护理干预,观察组进行前馈控制护理干预,比较2组下肢静脉血流速度与深静脉血栓发生情况。结果观察组术后14d下肢静脉血流速度明显高于对照组,差异有统计学意义(P0.05);观察组深静脉血栓发生率为2.38%,下肢肿胀发生率为14.29%,均明显低于对照组,差异有统计学意义(P0.05)。结论通过前馈控制,能够有效改善颅脑损伤术后患者下肢血液循环,降低深静脉血栓发生率,有效预防颅脑损伤术后深静脉血栓的形成。     

低分子肝素预防脑出血后深静脉血栓有效性和安全性研究

目的 评估自发性脑出血（spontaneous intracerebral hemorrhage,sICH）患者早期皮下注射低分子肝素 （low molecular weight heparin,LMWH）预防深静脉血栓形成（deep vein thrombosis,DVT）的有效性。 方法 共104例急性sICH患者纳入研究,其中LMWH组51例,对照组53例。LMWH组在入院后第4天开始, 连续7 d皮下注射低分子肝素0.4 ml/d;对照组相对应给予下肢间断充气加压（intermittent pneumatic compression,IPC）措施。两组患者均于入院当天及LMWH治疗第7天检测溶血磷脂酸（lysophosphatidic acid,LPA）水平及抗凝血因子Ⅹa活性,并观察患者有无出血征象。 结果 治疗期间所有患者均未出现颅内血肿扩大及再出血事件,与对照组比较,治疗后LMWH组LPA 水平（11.74±5.30）ng/ml明显低于对照组（26.81±5.12）ng/ml,比较差异具有统计学意义（P＜0.05）。 治疗后LMWH组抗凝血因子Xa活性（25.96±7.97）ng/ml明显较对照组（8.06±1.32）ng/ml增高,比较 差异具有统计学意义（P＜0.05）。 结论 急性sICH住院患者为DVT的高发人群,sICH患者在急性期皮下注射低剂量LMWH预防DVT是有效 和安全的。     

脑出血患者下肢深静脉血栓形成的多因素回归分析

目的探讨脑出血患者下肢深静脉血栓形成的相关因素。方法收集2007年1月至2010年12月214例脑出血患者住院临床资料,通过单因素分析及多因素Logistic回归分析确定脑出血患者并发下肢深静脉血栓形成的独立危险因素。结果单因素分析发现格拉斯哥昏迷评分、出血部位、出血量及血浆同型半胱氨酸水平与脑出血患者下肢深静脉血栓形成相关(P<0.05),性别、年龄、高血压、糖尿病、高脂血症、吸烟、饮酒、D-二聚体、凝血酶原时间、活化部分凝血活酶时间及血小板计数与深静脉血栓形成无关(P>0.05)。多因素分析进一步证实出血部位、出血量及血浆同型半胱氨酸水平是影响脑出血患者下肢深静脉血栓形成的独立因素(P<0.05)。结论出血部位、出血量及血浆同型半胱氨酸水平是影响脑出血患者下肢深静脉血栓形成的独立危险因素,可以作为预防性抗凝治疗的参考指标。     

活血通络汤预防人工股骨头置换后下肢深静脉血栓形成

背景：人工股骨头置换已经成为老年股骨转子间粉碎性骨折常用的治疗手段。但是,置换后深静脉血栓形成发生率一直居高不下,尤其多见于下肢。因而如何有效防治下肢深静脉血栓形成,成为医学界的热点问题。 目的：观察活血通络汤对老年股骨转子间粉碎性骨折人工股骨头置换后下肢深静脉血栓形成的影响。 方法：选择老年股骨转子间粉碎性骨折行人工股骨头置换患者38例,随机分为两组,即活血通络汤组和低分子肝素组,人工股骨头置换后分别给予活血通络汤内服和低分子肝素皮下注射,观察比较两组患者切口引流量、血小板计数及凝血酶原时间的变化,下肢血管彩色多普勒检查深静脉血栓形成情况。 结果与结论：活血通络汤组患者切口引流量明显少于低分子肝素组(P < 0.05);活血通络汤和低分子肝素对血小板计数影响差异无显著性意义;活血通络汤和低分子肝素均能明显的延长凝血酶原时间和部分凝血活酶时间,但低分子肝素效果优于活血通络汤(P < 0.05);两组患者中各有2例轻度下肢深静脉血栓,两者在预防深静脉血栓形成方面效果相当。说明活血通络汤能够预防股骨转子间粉碎性骨折人工股骨头置换后深静脉血栓形成,其疗效同低分子肝素相当,且具有较好的安全性,值得临床推广应用。     

PDCA护理模式对高血压性基底节区出血术后病人深静脉血栓形成的影响

目的 探讨PDCA护理模式对高血压性基底节区出血术后病人深静脉血栓形成的影响。方法 回顾性分析2019年1月至2020年4月手术治疗的高血压性基底节区出血96例，根据护理方法分为对照组（42例）和观察组（54例）。对照组给予常规护理，观察组实施PDCA护理模式。干预前、干预7 d采用彩色多普勒仪检测股静脉血流峰速度和平均速度；记录护理14 d内深静脉血栓形成和再出血发生率。结果 干预7 d，观察组股静脉血流峰速度和平均速度均明显高于对照组（P<0.05）。对照组出现深静脉静脉血栓形成7例（16.67%，7/42），再出血5例（11.90%，5/42）；观察组出现深静脉静脉血栓形成2例（3.57%，2/56），再出血1例（1.79%，1/56）。观察组深静脉静脉血栓形和再出血发生率均明显低于对照组（P<0.05）。结论 PDCA护理模式应用于高血压性脑出血术后病人，可显著改善血流动力学，降低静脉血栓发生率和再出血发生率。     

低分子肝素钙注射液预防高血压脑出血术后患者下肢深静脉血栓形成的疗效和安全性探讨

高血压脑出血术后卧床患者如何有效预防下肢深静脉血栓形成,从而预防肺栓塞的发生一直是困扰临床医生的难题.我们试用低分子肝素钙注射液预防高血压脑出血术后卧床患者下肢深静脉血栓形成,并对其疗效和安全性进行研究,现将结果报道如下.     

集束化护理预防脑出血患者术后下肢深静脉血栓形成的效果

目的 探讨集束化护理预防脑出血患者术后下肢深静脉血栓形成的效果。方法 回顾性纳入郑州大学第二附属医院2020-01—2021-12收治的行外科手术治疗的脑出血患者126例。根据术后护理方法不同,分为集束化护理组和常规护理组。术后3周监测2组患者股静脉血流速度及凝血功能各项指标,比较2组患者术后下肢深静脉血栓的发生率、术后并发症发生率及患者满意度。结果 术后护理3周,集束化护理组患者的股静脉血流平均速度和峰值速度均显著高于常规护理组,差异有统计学意义(P<0.05);2组患者的凝血功能指标(PT、TT、APTT、FBG)比较,差异无统计学意义(P>0.05);集束化护理组患者术后下肢深静脉血栓发生率及术后并发症发生率均显著低于常规护理组(3.17%vs 17.46%,P<0.05;34.92%vs 14.29%,χ²=7.231,P=0.007)。集束化护理组患者的术后护理满意度显著高于常规护理组(96.83%vs 79.37%,χ²=9.157,P=0.002)。结论 集束化护理虽然对脑出血患者外科手术后的凝血功能指标基本无...     

Audiovisual integration in low vision individuals

Behavioral and neurophysiological studies have shown an enhancement of visual perception in crossmodal audiovisual stimulation conditions, both for sensitivity and reaction times, when the stimulation in the two sensory modalities occurs in condition of space and time congruency. The purpose of the present work is to verify whether congruent visual and acoustic stimulations can improve the detection of visual stimuli in people affected by low vision. Participants were asked to detect the presence of a visual stimulus (yes/no task) either presented in isolation (i.e., unimodal visual stimulation) or simultaneously with auditory stimuli, which could be placed in the same spatial position (i.e., crossmodal congruent conditions) or in different spatial positions (i.e., crossmodal incongruent conditions). The results show for the first time audiovisual integration effects in low vision individuals. In particular, it has been observed a significant visual detection benefit in the crossmodal congruent as compared to the unimodal visual condition. This effect is selective for visual stimulation that occurs in the portion of visual field that is impaired, and disappears in the region of space in which vision is spared. Surprisingly, there is a marginal crossmodal benefit when the sound is presented at 16 degrees far from the visual stimulus. The observed crossmodal effect seems to be determined by the contribution of both senses to a model of optimal combination, in which the most reliable provides the highest contribution. These results, indicating a significant beneficial effect of synchronous and spatially congruent sounds in a visual detection task, seem very promising for the development of a rehabilitation approach of low vision diseases based on the principles of multisensory integration.     

Aspects of inattention in low birth weight children

The objective of this study was to explore the nature of impaired attention in low birth weight children. A population-based sample (n = 129) of 11-year-old low birth weight children was compared with a randomized group of normal birth weight children (n = 128). Continuous Performance Test, a Cue-Target Task, and a Stroop Color-Word test were used to assess the following dimensions of attentional function: inattention, impulsivity, vigilance, selected attention, and alternating attention. The attention subscale from the Child Behavior Check List questionnaire was included to assess maternal report of inattention. Low birth weight children had generally slower reaction time than normal birth weight children and manifested impaired vigilance, but this could be attributed to group differences in confounding parental factors. Impairment was not a function of birth weight within the low birth weight group, but low birth weight boys manifested impaired vigilance compared with normal birth weight boys. Every fourth low birth weight child was reported with inattention, but small differences were found between the inattentive and attentive low birth weight children. No specific attentional dysfunction was observed in the low birth weight study group. The nature of reported impaired attention among low birth weight children is still uncertain.     

Unusual patterns of recurrence in low grade gliomas

Some of the more unusual patterns of recurrence in previously treated low grade gliomas are demonstrated. As treatment choices develop and life expectancy is prolonged, patterns of tumour recurrence are likely to change within such a heterogeneous group of tumours, including metastatic spread via cerebrospinal fluid pathways.     

Ophthalmic findings in infants of very low birthweight

The ophthalmic findings in 127 very low-birthweight infants seen at a mean corrected age of 7.6 months (range one to 15 months) are presented and related to their neonatal findings on cerebral ultrasound scanning and eye examinations for retinopathy of prematurity. 19 infants (15 per cent) had significant ophthalmic abnormalities, including reduced visual acuity (11), squints (13), disorders of supranuclear eye-movement (three) and retinal abnormalities (eight). A strong association was found between cystic periventricular leukomalacia and ophthalmic morbidity.     

Review of psychological factors in low sexual desire

During the last decade an increasing number of papers have been published on low sexual desire (LSD). The purpose of this paper is to highlight some important issues related to LSD and critically examine what has been reported in the literature. Problems related to assessment and treatment are presented. The author suggests that research is needed on the characteristics of the subjects suffering from LSD to have a better understanding of this complex sexual problem and to develop effective methods of assessment and treatment.     

Fosphenytoin in infants of extremely low birth weight

Fosphenytoin, a phosphorylated prodrug of phenytoin, is useful for acute seizures, is given by parenteral administration, and has few cardiac and local irritation adverse effects. There is limited experience in the administration of this new agent to newborns, and concern has been raised regarding the conversion of the prodrug to phenytoin. In two low--birth-weight infants, it was observed that fosphenytoin was converted adequately with varying effects on seizure control.     

Chronic low back pain and the failed low back syndrome

Disorders associated with back pain usually have two components. One pertains to the spinal disorder and the other to symptoms and signs that result from compromise of individual nerve roots, the cauda equina, or, in some cases, the conus medullaris. In this article, those spinal structures capable of giving rise to pain, its approximate distribution, the nature of the discomfort and disturbance of spinal and neural function consequent upon disease of the vertebral column, and the evaluation and management of the individual patient will be considered.     

Leadership in low intensity Intermediate Treatment groups

One of the significant developments in social work over the last 10 years has been the growth of work in small groups with adolescents, under the aegis of intermediate treatment. A typical model has been a group of eight members, with two adult leaders meeting once a week for approximately six months. Although recently overshadowed by the demand for, and subsequent development of, more intensive provision as an alternative to detention centre and care orders, much of this low-intensity work still continues. This paper explores the problems posed in leading such groups and how some of them have arisen from the historical development of the approach and the effect of fundamental attitudes in social work. It offers a three stage developmental model for exploring leadership styles in such groups.