脑卒中患者生活质量的现状与影响因素分析

目的探讨脑卒中患者生活质量的现状及影响因素。方法采用自编的脑卒中患者生活质量自评量表,对住院和门诊的脑卒中患者52例进行问卷调查。结果患者的生活质量总分为(104.78±17.84)分,处于中等水平。个人平均月收入、同住人、居住状况和目前健康问题是影响生活质量的主要因素。结论对脑卒中患者及时进行语言和肢体功能锻炼,以最大限度地减少残障,恢复自理能力,有利于全面提高脑卒中患者的生活质量。     

左心室局部室壁异常与脑梗死复发的相关性分析

目的分析左心室局部室壁异常与脑梗死复发的相关性。方法选择2017年1—10月收治的脑梗死215例,入院后均予相应治疗,随访18个月,根据脑梗死有无复发,分为脑梗死复发组(复发组,n=50)与脑梗死未复发组(未复发组,n=165)。所有患者均于确诊脑梗死24 h内行超声心动图检查,并检测脑利钠肽(brain natriuretic peptide, BNP)、血压及血生化相关指标水平,分析影响脑梗死复发的相关因素。结果与未复发组比较,复发组收缩压、舒张压、甘油三酯、低密度脂蛋白胆固醇水平显著升高,BNP、左心室心肌重量指数水平上升,左心室后壁厚度、室间隔厚度及主动脉根部内径增大,每搏输出量、心输出量、左心室射血分数及二尖瓣口舒张早期血流峰值速度与二尖瓣口舒张晚期血流峰值速度的比值降低,且BNP水平上升、左心室后壁增厚、室间隔增厚的发生率升高,差异有统计学意义(P<0.05或P<0.01)。多因素logistic回归分析显示,BNP水平上升、左心室后壁增厚、室间隔增厚是脑梗死复发的独立危险因素(P<0.01)。受试者工作特征曲线分析显示,室间隔厚度预测脑梗死复发的曲线下面...     

"两点进针"头穴透刺电针治疗缺血性中风的疗效观察

Objective To probe methods and therapeutic effects of Head Acupuncture on ischemic stroke. Methods One hundred and twelve cases were randomly divided into observation group (head acupuncture group) and control group (body acupuncture group). After treatment of 28 days, changes of linguistic function and paralysis level of limbs before and after treatment were investigated. Results The total effective rate was 96.6% in the observation group and 90.7%, in the control group, with a significant difference between the two groups (P<0.05). Conclusion The electroacupuncture head point-through-point by penetrating two point therapy is one of effective methods for ischemic stroke.     

孟河费绳甫辨治中风学术思想浅探

费绳甫是孟河医派的代表医家之一,在继承其祖父费伯雄的学术思想之上多有发挥。通过对费绳甫现存医案的研究,发现其辨治中风具有以下特色:脏腑气血不调所致的内虚是中风的关键病机,风、痰(湿)、火(热)搏结,邪犯机窍经络是中风的主要病因;注重调理肝脾,佐以祛邪之法,善养胃阴,擅用川贝母配竹沥的特色药对,擅用动物类药。     

Acupuncture and massage combined with rehabilitation therapy for hemiplegia after stroke: A protocol for systematic review and meta-analysis

Background:The purpose of this study was to evaluate the effectiveness and safety of acupuncture and massage combined with rehabilitation in the treatment of hemiplegia after stroke.Methods:To collect relevant literature, we will research following databases: Medicine, PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wan-Fang Database, Chongqing VIP Chinese Science and Technology Periodicaols Database, and China Biomedical Database; the time is from its creation to May 2021, and the language is limited to Chinese and English. In addition, we will retrieve other literature resources, including the Chinese Clinical Trial Register and conference articles. Two reviewers will independently complete the literature screen and data extraction and quality assessment of the included studies will be independently completed by two other researchers. The primary outcomes included the Modified Ashworth scale and the simplified Fugl-Meyer Assessment scale. The Modified Barthel Index, the China Stroke Scale, and adverse reactions as secondary outcomes were assessed. RevMan V.5.4.1 software will be used for meta-analysis, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to assess the quality of evidence.Results:This systematic review will provide a high-quality synthesis to evaluate the efficacy and safety of acupuncture and massage combined with rehabilitation in the treatment of hemiplegia after stroke, providing a reference for the safe and effective treatment of hemiplegia after stroke.Conclusion:This study provides evidence that acupuncture and massage combined with rehabilitation therapy is effective.Ethics and dissemination:The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.Systematic review registration:INPLASY202210026.     

Cost-effectiveness of stent-retriever thrombectomy in large vessel occlusion strokes of the anterior circulation: Analysis from the French societal perspective

ObjectivesTo determine the cost-effectiveness of stent retriever thrombectomy (SRT) added to standard of care (SOC) in large vessel occlusion (LVO) strokes, adopting the French societal perspective given the lack of published studies with such perspective.MethodsWe developed an hybrid model (decision tree until one year post-stroke followed by a Markov model from one year onward). The time horizon was 20 years. We calculated transition probabilities across the modified Rankin Scale (mRS) based on a published meta-analysis. The main outcome measure was quality adjusted life-years (QALYs) gained. Resources and input costs were derived from a literature search. We calculated the incremental cost-effectiveness ratio (ICER) expressed as cost/QALY. We used 1-way deterministic and probabilistic sensitivity analysis (PSA) to evaluate the model uncertainty.ResultsIn the base-case, adding SRT to SOC resulted in increased effectiveness of 0.73 QALY while total costs were reduced by 3,874€ (ICER of −5,400€/QALY). In the scenario analysis adopting the French healthcare system perspective, the ICER was 4,901€/QALY. Parameters the most influential were the relative risks of SRT over SOC for 90-days mortality and for 90-days mRS 0–2, and the time horizon. PSA showed the 95% confidence interval of the ICER was −21,324 to 4,591€/QALY, with SRT having 85.5% chance to be dominant and 100% to be cost-effective at a threshold of 50,000€/QALY.ConclusionSRT was dominant from a French societal perspective, from 9 years post-stroke onwards. Cost-effectiveness of SRT added to SOC becomes undisputable with evidences from payer and societal viewpoints.