左乙拉西坦对部分性癫痫患者认知功能及情绪影响的研究

目的 探讨左乙拉西坦对部分性癫痫患者认知功能及情绪的影响.方法 将62例部分性癫痫患者按随机数字表法分为卡马西平组（30例）和左乙拉西坦组（32例）,卡马西平组给予卡马西平治疗,左乙拉西坦组给予左乙拉西坦治疗,两组于治疗前及治疗第4,8,12,16周采用蒙特利尔认知评估量表（MoCA）、焦虑自评量表（SAS）和抑郁自评量表（SDS）进行评估.结果 两组治疗前和治疗第4周MoCA评分比较差异无统计学意义（P＞0.05）;左乙拉西坦组治疗第8,12,16周MoCA评分优于卡马西平组[（22.6±2.1）分比（20.8±2.6）分、（23.5±2.7）分比（21.3±2.8）分、（24.6±4.7）分比（21.2±3.0）分],差异有统计学意义（P＜0.05）.两组治疗前后SAS评分、SDS评分比较差异无统计学意义（P＞0.05）.结论 在部分性癫痫患者的药物治疗过程中,左乙拉西坦对患者认知功能的改善优于卡马西平,但对情绪的改善不明显.     

奥卡西平联合左乙拉西坦治疗卒中后癫痫的效果研究

目的 探讨奥卡西平联合左乙拉西坦治疗卒中后癫痫的长程脑电图特征。方法 收集2019年1月—2020年1月于齐齐哈尔医学院附属第二医院神经内科诊疗的卒中2周后且至少有2次间隔≥24 h的癫痫发作的患者60例。按照随机数字表法分为对照组（n=31）和联合组（n=29）。其中对照组给予奥卡西平治疗,联合组给予奥卡西平联合左乙拉西坦治疗,治疗后分析联合用药对卒中后癫痫脑电图、癫痫的影响。结果 治疗8个月后,两组患者的癫痫年发作次数和持续时间比较,联合组患者的癫痫年发作次数更短（P <0.05）。相较于对照组,联合组患者的癫痫发作持续时间显著缩短（P <0.05）;两组痫样放电均显著降低,并且联合组显著低于对照组（P <0.05）;两组累及导联数明显减少,联合组评分更高（P <0.05）。治疗总有效率比较,联合组（93.10%）高于对照组（67.74%）(P <0.05)。认知功能评分与治疗前比较,两组患者治疗后均显著提升,以联合组评分为著;联合组不良反应发生率（13.79%）高于对照组（9.68%）,差异无统计学意义（P> 0.05）。结论 奥卡西平联合左乙...     

卡马西平联合叶酸治疗妊娠期癫痫的效果及对母婴结局的影响

目的探究卡马西平联合叶酸治疗妊娠期癫痫效果及对母婴结局的影响。方法将2013年10月-2016年6月该院收治的82例妊娠期癫痫患者根据入院时间分为观察组和对照组,每组各41例。对照组服用卡马西平,观察组服用卡马西平加叶酸,观察并记录两组患者妊娠期癫痫发作程度、发作次数、胎儿妊娠结局及并发症发生情况。结果观察组孕妇妊娠期癫痫发作6例,发作率为14.63%;对照组孕妇妊娠期癫痫发作17例,发作率为41.47%,两组比较差异有统计学意义(P0.05)。观察组孕妇出现妊娠高血压综合征、癫痫发作以及抑郁症等并发症概率显著低于对照组(P0.05);两组孕妇流产、早产以及前置胎盘例数比较差异无统计学意义(P0.05)。观察组新生儿畸形率为7.32%,对照组为29.27%,两组比较差异有统计学意义(P0.05);两组出现死胎、胎儿宫内窘迫和低出生体重儿的概率比较差异无统计学意义(P0.05)。结论卡马西平联合叶酸治疗妊娠期癫痫效果较好,癫痫发作情况得到有效控制,孕妇妊娠高血压综合征、围生期癫痫发作以及新生儿畸形、低出生体重儿等不良事件发生概率显著降低。     

心理干预对药物治疗癫痫患者的增效作用

目的观察心理干预对卡马西平治疗癫痫患者的临床增效作用。方法随机选取72例癫痫患者按就诊顺序分为两组,各36例,观察组采用心理干预合并卡马西平治疗,对照组单纯采用卡马西平治疗,6个月后对临床疗效及生活质量进行评定。采用SPSS13.0进行统计分析。结果观察组控制5例、显效9例、有效16例、无效3例、加重1例,有效率88.24%,对照组分别为2例、6例、15例、8例、2例,69.70%,两组比较差异有显著性意义(P<0.05)。两组患者的生活质量评分与治疗前比较差异均有显著性意义(P<0.01),组间比较差异有显著性意义(P<0.01)。结论心理干预对卡马西平治疗癫痫患者具有临床增效及提高生活质量的作用。     

丁螺环酮联合舍曲林治疗对伴有焦虑症状的抑郁症患者情绪变化及认知功能的影响

目的探讨丁螺环酮联合舍曲林治疗对伴有焦虑症状的抑郁症患者情绪变化及认知功能的影响。方法80例伴有焦虑症状的抑郁症患者随机分为两组,对照组采用舍曲林治疗,观察组采用丁螺环酮联合舍曲林治疗,比较两组的情绪、认知功能及不良反应。结果治疗后,两组的HAMD、HAMA评分均较治疗前降低,MoCA评分均较治疗前升高(P<0.05);且与对照组相比,观察组的HAMD、HAMA评分均更低,MoCA评分更高(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论丁螺环酮联合舍曲林治疗可有效改善伴有焦虑症状抑郁症患者的负性情绪,提高患者的认知功能,且安全性较高。     

卡马西平联合丙戊酸钠对早期癫痫治疗效果观察

目的:观察卡马西平联合丙戊酸钠对早期癫痫治疗效果。方法:选取100例我院收治的早期癫痫患者,随机均分为单一组和和联合组,给予单一组患者单一药物卡马西平治疗,给予联合组患者卡马西平联合丙戊酸钠治疗,观察比较两组患者临床疗效及不良反应发生情况。结果:联合组患者治疗有效率高于常规组患者(P0.05),两组患者不良反应发生率比较差异不明显(P0.05)结论:卡马西平联合丙戊酸钠对早期癫痫治疗效果显著,能有效改善患者临床症状,具备较高的安全性。     

认知行为疗法联合利培酮片治疗精神分裂症患者的效果分析

目的 分析认知行为疗法联合利培酮片治疗精神分裂症患者的效果。方法 选择云浮市罗定第三人民医院76例精神分裂症患者,随机分为研究组和对照组,每组各38例。对照组给予利培酮片治疗,研究组在对照组基础上联合认知行为疗法干预。比较两组治疗前后PANSS评分、MoCA评分、SCL-90评分。结果 治疗前,两组PANSS评分、MoCA评分、SCL-90评分各项目分及总分均无显著差异(P>0.05)。治疗后,研究组PANSS评分中的阴性症状评分及总分显著低于对照组(P<0.05),MoCA评分中的延迟记忆、注意力、定向力及总分显著低于对照组(P<0.05),SCL-90评分中的各项目因子分及总分显著低于对照组(P<0.05)。结论 认知行为疗法联合利培酮片治疗精神分裂症患者可以改善阴性症状和部分认知能力,提高心理健康水平。     

丙戊酸钠联合拉莫三嗪治疗老年癫痫的临床疗效及安全性观察

目的探讨丙戊酸钠联合拉莫三嗪治疗老年癫痫的临床疗效及安全性。方法回顾性分析我院2017年6月至2019年3月收治的98例老年癫痫患者的临床资料,根据治疗方法分为两组。对照组58例使用丙戊酸钠治疗,观察组40例在对照组基础上给予拉莫三嗪治疗,比较两组的临床疗效和不良反应。结果治疗后,观察组的治疗总有效率为77.5%,显著高于对照组的51.7%(P<0.01)。治疗后,观察组的长期记忆、短期记忆和瞬时记忆评分均显著高于对照组(P<0.01)。两组的不良反应发生率无统计学差异(P>0.05)。结论丙戊酸钠联合拉莫三嗪能够有效降低癫痫发作次数,改善患者认知功能且不增加不良反应。     

成人癫痫应用丙戊酸钠及卡马西平的临床疗效探析

目的 探析成人癫痫应用丙戊酸钠及卡马西平的临床疗效。方法 研究对象均从吉林省第四人民医院就诊患者中选取符合癫痫诊断标准。挑选时间为2019年7月-2020年6月。挑选原则遵循纳入和排除标准,最终入选110例。随机分组,一组为对照组,一组为观察组。对照组应用卡马西平治疗,观察组应用丙戊酸钠+卡马西平治疗,对比两组治疗效果有效率和不良反应发生率。结果 观察组和对照组组间治疗效果有效率、治疗后组间操作智力评分、语言智力评分、总智力评分均为观察组更优,对比结果差异有统计学意义(P<0.05)。观察组和对照组组间不良反应发生率的对比结果为(P>0.05)。结论 成人癫痫应用丙戊酸钠及卡马西平的临床有效率更高,可提升患者的智力情况,而且不会带来较多的不良反应。     

吡拉西坦联合颅内血肿微创清除术治疗脑出血的效果观察

目的 探讨吡拉西坦联合颅内血肿微创清除术治疗脑出血的临床效果。方法 纳入44例行颅内血肿微创清除术治疗的脑出血患者为对照组,44例行吡拉西坦联合颅内血肿微创清除术治疗的脑出血患者为观察组,比较两组的神经功能和认知功能。结果 治疗后,两组的NIHSS评分均显著低于治疗前,MoCA评分均显著高于治疗前（P <0.05）;观察组的NIHSS评分显著低于对照组,MoCA评分显著高于对照组（P <0.05）。结论 吡拉西坦联合颅内血肿微创清除术治疗脑出血效果显著,可有效促进患者神经功能和认知功能恢复。     

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.