踝关节智能牵伸训练对偏瘫患者踝关节生物力学特性及其运动功能和日常生活活动能力的影响

目的:观察踝关节智能牵伸训练对脑卒中偏瘫患者踝关节生物力学特性、平衡、步行功能和日常生活活动能力的影响。方法:将脑卒中后偏瘫患者18例按随机数字表法分为试验组和对照组,每组患者9例。2组患者均接受常规临床药物和常规康复治疗,在此基础上,试验组每日增加20 min的踝关节智能牵伸训练,对照组则将常规康复治疗时间延长20 ...     

水枕在预防偏瘫患者压疮中的应用

目的：探讨水枕在偏瘫患者压疮预防中的效果。方法将2013年5～10月入科的偏瘫患者随机分为观察组和对照组各30例,对照组患者皮肤受压处使用普通软枕,观察组患者用水枕替代普通软枕,两组患者均使用气垫床,并定时协助翻身。观察两组患者受压处皮肤受损情况及受压后皮肤能否完全恢复。结果观察组患者仅有I期压疮2例,对照组患者发生I期压疮25例,Ⅱ期压疮2例。观察组患者皮肤受损程度明显低于对照组（ P＜0.01）。结论水枕在预防偏瘫压疮中起到了积极的作用,效果明显,是一种值得推广的好方法。     

醒脑开窍针法结合康复训练对脑卒中后偏瘫患者运动功能和日常生活活动能力的影响

【目的】观察醒脑开窍针法结合康复训练改善脑卒中后偏瘫患者运动功能和日常生活活动能力的疗效。【方法】将60例脑卒中后偏瘫患者随机分为治疗组和对照组各30例,所有患者均给予常规基础药物治疗,对照组同时给予常规康复训练,治疗组在常规康复训练基础上加用醒脑开窍针刺法治疗,治疗周期为4周,疗程结束后随访至12周。比较2组Fugl-Meyer运动功能评分（FMA）、 Barthel指数（MBI）及生存质量评分（SS-QOL）改善情况。【结果】治疗前,2组患者FMA、 MBI及SS-QOL评分的基线水平比较,差异均无统计学意义（P>0.05）;治疗4周后,2组患者的FMA、 MBI及SS-QOL评分均显著提高,差异均有统计学意义（P<0.05）,且治疗组效果优于对照组（P<0.05）;随访至12周时,2组患者的FMA、 MBI及SS-QOL评分也均较基线水平显著提高（P<0.05）。【结论】醒脑开窍针法结合康复训练是改善脑卒中后偏瘫患者运动功能和日常生活活动能力的重要手段,作用效果持续,其疗效优于单纯康复训练组。     

Non-traumatic lower limb older amputees: a database survey from a geriatric centre

Purpose: The purpose of this survey was to examine the characteristic of a geriatric population admitted for amputation of a lower limb and to explore some of the factors that may affect the course of their hospital stay. Method: The study took place in the geriatric division of a tertiary general hospital and included a close geriatric-orthopaedic liaison. Two-hundred and forty-one patients were included in the final analysis. Results: Many above knee amputations were performed, which correlated with advanced age. Rates of in hospital mortality and systemic complications were 16% and 19%, respectively. Thirty-three percent of the patients were discharged back home, and only 6% were supplied with an artificial limb. The general condition of most patients remained poor. Conclusion: We conclude that despite a team approach to the care of the geriatric amputee a poor functional result was obtained. By encouraging earlier referrals from the community it is postulated that a reduction in the costly provision of antibiotics would be beneficial and that perhaps lower levels of amputation could be performed thereby enhancing the possibilities for ambulation.     

不同年龄组儿童急性偏瘫伴随症状与病因的关系

目的 探讨儿童不同年龄组急性偏瘫伴随症状和病因的关系。方法 对2007-2009年本院收治的31例急性偏瘫患儿的临床资料进行回顾性分析。结果 31例患儿中，＜1岁5例，＞1～3岁12例，＞3～6岁儿童4例，＞6岁年长儿10例。主要伴随症状：惊厥21例、发热12例、意识障碍10例。急性偏瘫的主要病因：①脑血管病10例：其中脑血管畸形4例（幼儿3例、学龄儿1例）、外伤性脑梗死2例（学龄前）、合并先天性代谢缺陷病（同型半胱氨酸血症）2例；②中枢神经系统感染9例（<1岁4例）；③先天代谢性缺陷病5例（均为年长儿）；④偏侧惊厥偏瘫综合征/偏侧惊厥偏瘫癫痫综合征（hemiconvulsion-hemiplegia/hemiconvulsion-hemiplegia-epilepsy syndrome，HH/HHE）4例；交替性偏瘫2例；⑤其他：维生素K1缺乏性颅内出血、急性播散性脑脊髓炎和脑干肿瘤各1例。结论 ①小儿急性偏瘫病因繁多，各年龄段均有发病，其中1～3岁所占比例最大；②偏瘫主要伴随症状有惊厥、发热、意识障碍；伴随症状不同其病因各异；③婴幼儿主要病因是中枢神经系统感染，幼儿和学龄前期儿童中外伤性脑梗死和脑血管畸形并不少见；先天性代谢缺陷病是年长儿偏瘫的病因之一。     

针刺配合康复训练对脑卒中后运动功能恢复的影响

目的 观察"醒脑开窍"针刺法配合康复训练对脑卒中后运动功能及日常生活能力(ADL)改善的影响.方法 90例脑卒中后偏瘫患者随机分为治疗组、对照组Ⅰ、对照组Ⅱ,每组各30例,对照组I采用"醒脑开窍"针刺法,对照组Ⅱ采用康复训练疗法,治疗组为两种方法联合使用,比较三组临床治疗效果.结果 治疗组总有效率90.0%,对照组Ⅰ总有效率66.7%,对照组Ⅱ总有效率63.3%,治疗组与对照组Ⅰ、Ⅱ比较差异有统计学意义(P<0.01);治疗组运动功能及日常生活能力的改善情况与对照组Ⅰ、Ⅱ比较,差异有统计学意义(P<0.01).结论 "醒脑开窍"针刺法配合康复训练对脑卒中后偏瘫的运动功能改善及日常能力的改善疗效显著.     

Treatment of 30 Cases of Apoplectic Language Disorders by Electroacupuncture

Objective: To discuss the therapeutic method of apoplectic patients with language disorders.Methods: Sixty cases of apoplexy were classified into electroacupuncture group of 30 cases and acupuncture group of 30 cases. In electroacupuncture group, acupoints Lianquan (CV 23), Tongli (HT 5) and lower 2/5 part of motor area and sensory area were selected. In acupunc -ture group, acupoints Lianquan (CV 23) and Tongli (HT 5) were selected. Results and conclusions: After 2 courses of treatment, the total effective rate in electroacu -puncture group was 93.3% and that in acupuncture group was 76.6%. There was a significant difference in the therapeutic effect between the two groups (P＜0.05).     

COMPARATIVE ANALYSIS ON THERAPEUTIC EFFECTS OF APOPLEXY TREATED BY XINGNAO KAIQIAO ACUPUNCTURE METHOD AND WESTERN MEDICINE

The therapeutic effects of Xingnao Kaiqiao (醒脑开窍) acupuncture method and West-ern medicine treating apoplexy were compared in this paper. The results show that the total effectiverate is over 90. 00% in acupuncture group for treating motor dysfunction of limbs and main clinicalsymptotns, especially for treating paralysis of extremities, the total effective rate is up to 97. 72%,which is obviously better than that of Western medicine; moreover, the acupuncture has a special ef-fectiveness for restoring the function of cerebral tissue, and treating aphasia and central facial palsy.The characteristics of Xingnao Kaiqiao acupuncture method were described too.     

Conditioning and recovery of functions lost by brain damage

The muscle spindle is a receptor apparatus in striated muscle that is necessary for voluntary muscle movement. Paralysis victims lose the feedback of this receptor and cannot initiate motor responses. Four hemiplegic patients were trained to use auditory feedback from electromyographic recordings to initiate activity in paretic limbs. With the addition of visual feedback and the use of the auditory signal as a reinforcing stimulus, the patients' muscle activity was then shaped to approximate normal movement.