神经肌肉电刺激疗法与吞咽康复功能训练对脑卒中患者吞咽障碍的治疗效果观察

目的：观察神经肌肉电刺激疗法联舍吞咽康复功能训练治疗脑卒中吞咽障碍的临床疗效。方法：使用随机数字表,将84例脑卒中吞咽障碍患者分为联合组和对照组,每组42例,对照组予以吞咽功能训练,联合组在对照组基础上,加用神经肌肉电刺激。结果：联合组治疗后的VFSS评分显著高于对照组,P〈0．05,差异均具有统计学意义。结论：吞咽康复功能训练联合神经肌肉电刺激治疗脑卒中患者吞咽障碍,能有效改善患者的吞咽功能,其改善效果比单行吞咽康复功能训练更好,值得推广。     

神经肌肉电刺激结合耳穴刺激及吞咽训练改善脑卒中吞咽障碍的研究

目的探讨神经肌肉电刺激结合耳穴刺激及吞咽训练治疗脑卒中吞咽障碍患者的效果。方法选择2018年1月至2020年6月我院收治的脑卒中吞咽障碍患者50例,随机分为两组各25例。对照组采用神经肌肉电刺激治疗,观察组在此基础上采用耳穴刺激与吞咽训练。对比两组的治疗效果及治疗前后的吞咽功能。结果观察组的治疗总有效率明显高于对照组(P<0.05)。治疗前,两组的SSA、VFSS评分比较无统计学差异(P>0.05);治疗后,观察组的SSA评分低于对照组,VFSS评分高于对照组(P<0.05)。结论对脑卒中吞咽障碍患者采用神经肌肉电刺激、耳穴刺激及吞咽训练治疗,效果确切,能够促进患者吞咽功能恢复。     

黄原胶类增稠剂对老年脑卒中后吞咽功能障碍的临床研究

目的研究黄原胶类增稠剂对老年脑卒中后吞咽功能障碍的临床疗效。方法前瞻性选择2018年1月～2020年1月山东第一医科大学第一附属医院收治的240例老年脑卒中患者,使用随机数表法分为观察组(120例)和对照组(120例)。对照组进行常规康复治疗(包括吞咽器官的康复训练和神经肌肉电刺激治疗)并在食物中添加凝固粉,观察组进行同样的常规康复治疗并在食物中添加黄原胶类增稠剂。观察并记录两组临床疗效、治疗前后吞咽造影(VFSS)评分、治疗前后营养指标水平、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分和治疗后不良反应发生情况。结果治疗后,观察组(86.67%)总有效率明显高于对照组(74.17%),差异有统计学意义(P 0.05);治疗后,两组吞咽期、咽喉期、误吸程度评分均显著高于治疗前,且观察组显著好于对照组,差异均有统计学意义(P 0.05);治疗后,两组体重、白蛋白水平、肱三头肌皮褶厚度均显著高于治疗前,且观察组显著高于对照组,差异均有统计学意义(P 0.05);治疗后1个月开始,两组NIHSS评分均呈现显著下降趋势,且观察组下降幅度显著高于对照组,差异均有统计学意义(P 0.05);治疗后,观察组误吸、刺激性呛咳、发音异常等不良反应率均少于对照组,差异有统计学意义(P 0.05)。结论黄原胶类增稠剂治疗老年脑卒中后吞咽功能障碍患者,能显著改善患者吞咽功能和营养状况,有利于患者神经功能恢复,临床效果好并且安全性高。     

神经肌肉电刺激仪联合吞咽功能训练对脑瘫患儿吞咽功能的影响

目的 探讨神经肌肉电刺激仪联合吞咽功能训练对脑瘫患儿吞咽功能的影响。方法 选取2019年3月至2021年3月在电子科技大学医学院附属绵阳医院(绵阳市中心医院)康复医学科就诊的100例脑瘫患儿为研究对象,采用随机数字表法将其分为对照组和观察组,每组50例。对照组采用吞咽功能训练,观察组在对照组基础上采用神经肌肉电刺激仪干预,均干预8周,比较两组吞咽功能障碍改善情况、生命质量[采用吞咽障碍特异性生命质量量表(SWAL-QOL)评估]及干预期间并发症发生情况。结果 观察组吞咽功能障碍改善情况优于对照组,差异有统计学意义(P<0.05)。干预前,两组SWAL-QOL评分比较,差异无统计学意义(P>0.05);干预后,两组SWAL-QOL评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组干预期间并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论 神经肌肉电刺激仪联合吞咽功能训练可显著改善脑瘫患儿吞咽功能,减少并发症发生,提高患儿生命质量。     

经皮神经肌肉电刺激联合康复训练治疗脑卒中吞咽困难患者的临床效果评价

目的 探讨对脑卒中后吞咽困难患者进行康复训练联合经皮神经肌肉电刺激的临床效果。方法 选取2022年5月—2023年4月盘锦市中心医院收治的脑卒中吞咽困难患者120例,随机分为对照组61例和观察组59例。对照组接受药物治疗,进食训练、口腔肌肉锻炼等综合康复训练;观察组在对照组治疗方案基础上采取经皮神经肌肉电刺激。观察并比较两组的治疗效果、吸入性肺炎发生情况,以及治疗前后吞咽功能。结果 观察组治疗总有效率91.52%,高于对照组的75.41%,差异有统计学意义(P<0.05)。观察组吸入性肺炎发生率10.17%,低于对照组的24.59%,差异有统计学意义(P<0.05)。治疗后两组吞咽功能均较治疗前得到改善,且治疗后观察组吞咽功能优于对照组,差异有统计学意义(P<0.05)。结论 经皮神经肌肉电刺激联合康复训练治疗脑卒中后吞咽困难,能够进一步改善患者的吞咽困难症状,降低吸入性肺炎发生率,值得推广使用。     

低频电刺激吞咽障碍训练仪治疗卒中后吞咽功能障碍患者的疗效

目的探讨低频电刺激吞咽障碍训练仪治疗卒中后吞咽功能障碍患者的疗效。方法选取2019年10月至2020年10月天津市宝坻区人民医院神经内科接收的98例卒中后吞咽功能障碍患者作为研究对象,按照随机数字表法分为试验组与对照组,每组49例。两组均采用基础治疗,试验组在此基础上采用低频电刺激吞咽障碍训练仪治疗,比较两组的吞咽功能恢复情况及生命质量。结果治疗4周后,试验组临床治疗有效率高于对照组,差异有统计学意义(P<0.05);两组吞咽障碍特异性生命质量量表(SWAL-QOL)评分均高于治疗前,且试验组高于对照组,差异有统计学意义(P<0.05)。结论采用低频电刺激吞咽障碍训练仪治疗卒中后吞咽功能障碍患者,可减轻吞咽功能障碍症状,提升生命质量。     

低频电刺激治疗仪治疗脑卒中后吞咽功能障碍的临床观察

目的：探讨低频电刺激治疗仪治疗脑卒中后吞咽功能障碍的临床效果和临床价值。方法：在2020年1月～2021年1月选择本院收治的脑卒中后吞咽功能障碍患者作为本次研究对象,患者共94例,对患者分组采用的方法为随机数字表法,各47例,对照组不采用低频电刺激治疗仪治疗,仅进行常规吞咽指导,观察组采用低频电刺激治疗仪进行治疗,对比两组患者干预前后SSA评分变化情况以及生活质量评分情况,明确低频电刺激治疗仪治疗脑卒中后吞咽功能障碍的临床价值。结果：经过不同治疗干预,观察组在治疗后NIHSS评分降低更加明显,并且SSA评分也呈明显降低情况,观察组均显著低于对照组,P<0.05;干预后将两组生活质量评分进行比较,结果发现,在各项指标方面（角色功能、躯体功能、情绪功能、社会功能和认知功能）评分,观察组均显著高于对照组,P<0.05,有统计学意义。结论：对脑卒中后吞咽功能障碍患者采用低频电刺激治疗仪治疗,治疗效果理想,有助于缓解患者神经功能受损情况,同时对于改善其吞咽功能和生活质量具有积极作用,具有较高的临床应用价值。     

VitalStim电刺激对卒中后吞咽障碍的疗效观察

目的观察VitalStim电刺激治疗仪对脑卒中后吞咽障碍的治疗效果。方法选取天津市环湖医院康复科2015年8月-2017年4月入院的120例脑卒中后吞咽障碍的住院患者,随机分为治疗组和对照组,每组60例。对照组给予脑卒中常规治疗及单纯的康复吞咽训练,治疗组在对照组的基础上给予增加60 min的电刺激治疗。治疗前后,采用洼田饮水试验疗效评价标准对两组患者进行效果评估。结果两组洼田饮水试验评分,治疗前,差异无统计学意义(P0.05);治疗后,治疗组与对照组比较差异有统计学意义(P0.01)。按吞咽功能判定的疗效评价,治疗后,治疗组总有效率为96.67%,高于对照组的50.00%,差异有统计学意义(P0.05)。结论 VitaI Stim电刺激配合吞咽训练对改善脑卒中后吞咽功能障碍的治疗效果优于单纯给予吞咽训练。     

神经和肌肉电刺激治疗对脑卒中患者吞咽功能恢复效果观察

目的:探究神经和肌肉电刺激治疗对脑卒中患者吞咽功能恢复的效果.方法:对我院2016年7月份至2017年3月份期间收治的120例脑卒中吞咽功能障碍患者的临床资料进行研究,将120名患者随机平均分为观察组和对照组,其中对照组给予常规的药物治疗,并定期对患者吞咽功能恢复情况进行检查,观察组在实施对照组治疗方案的基础上按照每天一次,每次二十分钟的频率给予患者神经和肌肉电刺激治疗,一个月后进行两组患者的吞咽能力比较.结果:一个月后对照组的吞咽评级明显比不上观察组,差异有统计学上的意义.结论:神经和肌肉电刺激治疗能够明显促进患者吞咽功能的恢复,临床效果要优于常规的治疗方案.     

吞咽功能训练结合神经肌肉电刺激对神经源性吞咽功能障碍疗效的影响

目的：对神经源性吞咽功能障碍患者进行神经肌肉电刺激治疗,结合吞咽功能训练的治疗效果观察. 方法：选取80例我院2010.7-2013.7收治的神经源性吞咽功能障碍患者,随机分为两组,38例患者单独进行吞咽功能训练作为对照组,42例患者进行吞咽功能训练结合神经肌肉电刺激治疗作为观察组.观察两组患者吞咽障碍评分、总有效率及不良反应等情况.结果：观察组患者治疗后的吞咽障碍评分、总有效率及不良反应发生率分别为（1.6±0.8）分、92.86%、4.76%;对照组患者治疗后的吞咽障碍评分、总有效率及不良反应发生率分别为（2.6±1.2）分、68.42%、15.79%.两组对比差异显著,P〈0.05.结论：对于神经源性吞咽功能障碍的患者,使用吞咽功能训练结合神经肌肉电刺激的治疗方法,疗效显著,总有效率高,不良反应少,值得临床应用及推广.     

有性才会有健康

性是基本的人权。根据我国著名的性学家史成礼教授的研究,性有“三大功能”:生育功能、享乐功能和健康功能。     

Communicating with people with dementia

It can be very difficult to communicate with people with dementia. Each case requires its own unique handling. Not every scenario is covered, as many times your own judgment is what will work, best according to the circumstances. These can change from dawn to evening and from day to day. Never assume things will be the way they were the last time you communicated. Be on your guard. Be adaptable. The article will help get you started to think of your own ways to communicate.     

经方汗证治验

临床上汗证病情复杂,分自汗、盗汗、黄汗和但头汗出,治疗汗证方药诸多,有益气固表、养阴清热和清热除湿等方法,疗效不一。受恩师刘健主任教导和《伤寒论》《金匮要略》病脉证并治启发,以脉证并治、方证对应思想,浅谈桂枝加附子汤、黄芪芍药苦酒汤、柴胡桂枝干姜汤和三物黄芩汤治疗汗证的经验,为经方治疗汗证提供新思路。     

Working with patients with physical disabilities

Medical practices need to make a number of adaptations to ensure that their facilities and staff are accessible to patients and other office visitors with physical disabilities. This article describes 10 specific strategies for preparing your medical practice for patients with disabilities, both inside and outside your office. It describes minimum standards for office doorways, sidewalk inclines, ramps, reception areas, and other adaptations medical offices need to make. The article also describes specific do and don't advice for communicating with patients with physical disabilities. It suggests strategies for preparing written materials for disabled patients, for communicating verbally, and for providing healthcare education. Finally, it suggests an appropriate role for medical practice staff in the delivery of healthcare services to patients with physical disabilities.     

Coping with Children with ADHD: Coping Styles of Mothers with Children with ADHD or Challenging Behaviours

Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) can experience significant levels of stress in their parenting roles, however, little is known about the specific coping strategies used by these parents. This pilot study Investigated the coping strategies used by mothers of children with ADHD. A 34 item questionnaire was developed to identify maternal coping strategies. A cohort of 38 mothers of children with ADHD and a control group of 30 mothers of children without ADHD or any other disability/illness completed the questionnaire. Factor analysis of responses produced three factors: Aggressive/Confrontive Coping, Rational Coping, and Indirect Coping. These factors are similar to coping dimensions proposed by Folkman and Lazarus. Comparisons between the two groups of mothers revealed that mothers of children with ADHD used significantly more Indirect Coping.     

Problems with measuring satisfaction with social care

The measurement of customer satisfaction has become widespread in both healthcare and social care services, and is informative for performance monitoring and service development. Satisfaction with social care services is routinely measured with a single question on overall satisfaction with care, comprising part of the Adult Social Care Survey. The measurement of satisfaction has been problematised, and existing satisfaction measures are known to be under‐theorised. In this article, the process of making an evaluation of satisfaction with social care services is first informed by a literature review of the theoretical background, and second examined through qualitative interviews conducted in 2012–2013 with 82 service users and family carers in Hampshire, Portsmouth and Southampton. Participants in this study were from white British and South Asian backgrounds, and the influence of ethnicity in the process of satisfaction evaluation is discussed. The findings show that the majority of participants selected a positive satisfaction rating even though both positive and negative experiences with services were described in their narratives. It is recommended that surveys provide opportunity for service users and family carers to elaborate on their satisfaction ratings. This addition will provide more scope for services to review their strengths and weaknesses.     

Ending clinical relationships with people with schizophrenia

The potential for the social worker-client relationship to contribute to therapeutic outcomes is not always apparent with clients who have schizophrenia. Their cognitive impairments often make it difficult for these clients to regulate interpersonal boundaries and for social workers to connect with them. Clinical practice is enhanced, however, by recognizing that severely impaired clients have the capacity and desire for relationships with service providers and others. The manner in which the clinical relationship ends is important for maintaining clinical gains and determining whether the client will risk investing in future relationships. The purpose of this article has been to sensitize social workers to the delicate nature of managing the endings of those relationships.