目的 观察与分析脑卒中中医康复单元中失语症患者的康复疗效.方法 选取2017年1月—2018年12月收治的50例脑卒中失语症患者为研究对象,经过简单随机法分为试验组25例,对照组25例.其中对照组患者予以基本的语言康复治疗、试验组则采用中医康复单元治疗.在治疗之前,将2组患者的文化程度、性别比例和WHOQOL-100评分进行统计学比较;治疗之后根据WHOQOL-100评分情况来统计2组患者治疗效果.结果 治疗之前试验组与对照组患者的性别比例、文化程度以及WHO-QOL-100差异均无统计学意义(P>0.05).试验组患者经过治疗之后,有2例患者无效,治疗有效率为92.0％;对照组患者经过治疗之后,有7例患者无效,有效率为72.0％.该结果具有统计学意义(P<0.05).结论 中医康复治疗单元对于脑卒中失语症患者的治疗具有较好的康复疗效.

Objective:To observe the effects of extracorporeal shock wave therapy (ESWT) on hypertonia in lower extremity after cerebral stroke.Methods:A total of 40 stroke patients during recovery stages treated in the Department of Rehabilitation of the First Affiliated Hospital of Zhengzhou University from October 2016 to October 2017 were selected. All patients had hypertonia, mainly distributed in quadriceps femoris muscle and triceps muscle of the calves. The muscle tension was mainly 2 to 3 grades. Patients were divided into conventional treatment group (control group), conventional treatment + ESWT treatment group (observation group) by random number table method, with 20 cases in each group. The control group was treated by routine rehabilitation therapy, once a day, 5 times a week for 4 weeks. In addition to the routine rehabilitation therapy, ESWT was also performed on quadriceps femoris muscle and triceps muscle of the calves of the patients in the observation group, twice a week for 4 weeks. Before treatment and 1, 2, 4 weeks after treatment, the extensor knee muscle group tension, ankle flexor metatarsal muscle group tension and lower extremity motor function were evaluated.Results:Before and after 1 week of treatment, there was no significant difference in the scores of muscle tension and motor assessment scale (MAS) between the two groups ( P>0.05); after 2 and 4 weeks of treament, the MAS scores of the observation group were 7.90 and 8.20, respectively, significantly lower than the 12.33 and 12.00 of the control group ( P<0.05). Before treatment and after 1 and 2 weeks of treatment, there was no significant difference in the scores of lower limb Fugl-Meyer assessment (FMA) between the two groups ( P>0.05). After 4 weeks of treatment, the FMA score of the observation group was significantly higher than that of the control group (16.00±1.41 vs.10.56±2.56), P<0.05. Conclusions:ESWT can alleviate hypertonia, improve motor function effectively and have significant improvements in treating muscle tone after cerebral stroke.

目的 观察体外冲击波疗法(extracorporeal shock wave therapy,ESWT)治疗老年脑卒中患者早期肩关节半脱位的疗效.方法 将40例符合入组标准的脑卒中早期肩关节半脱位患者随机分为试验组和对照组,每组20例,试验组为常规康复治疗+体外冲击波疗法,对照组为常规康复治疗.常规康复治疗每天1次,每周5天,持续4周;试验组除常规治疗外,还给予冈上肌、三角肌体外冲击波疗法治疗,每周2次,持续4周.治疗前、治疗2周和4周后分别拍摄患侧肩关节X片并进行指诊,测量肩峰与肱骨头之间的距离,进行统计分析.结果 治疗2周后,肩峰到肱骨头距离减小幅度比较,试验组明显高于对照组,有显著性差异(P=0.046);治疗4周后,两组肩峰到肱骨头距离减小幅度比较,无显著性差异(P=0.051).与治疗前相比,治疗2周、4周后试验组和对照组肩峰到肱骨头距离均明显减小,差异有统计学意义(P<0.05),但治疗4周后与2周后比较差异无统计学意义(P>0.05).结论 早期体外冲击波疗法治疗能改善脑卒中早期肩关节半脱位的症状.

目的:探究早期运动康复对下肢骨折患者骨密度水平、关节活动度及并发症的影响.方法:选取2016年4月～2017年3月收治的下肢骨折患者84例,采用随机数字表法分为观察组和对照组各42例.对照组给予常规护理,观察组在常规护理基础上采用早期运动康复指导.比较两组骨密度水平、关节活动度及并发症.结果:干预后观察组髋关节骨密度水平(0.78:± 0.19) g/cm3高于对照组的(0.49±0.12)g/m3,腰椎2～4骨密度水平(0.61±0.15) g/cm3高于对照组的(0.34±0.08)g/cm3,差异有统计学意义(P＜0.05);干预后观察组膝关节活动度评分(82.41±8.25)分高于对照组的(76.28±7.35)分,髋关节活动度评分(73.41±8.15)分高于对照组的(65.28±7.25)分,差异有统计学意义(P＜0.05);观察组并发症发生率14.29％低于对照组的33.33％,差异有统计学意义(P＜0.05).结论:早期运动康复可显著提高下肢骨折患者骨密度水平及关节活动度,减少并发症的发生,有利于患者生活质量的改善.

Objective To investigate the relationship between total atrial conduction time(TATC) and recurrence of paroxysmal atrial fibrillation after radiofrequency catheter ablation (RFCA).Methods 116 patients with paroxysmal atrial fibrillation who underwent RFCA from 2012 to 2014 were enrolled in this study,when patients were in sinus rhythm before RFCA,TACT was estimated by measuring the time delay between the onset of the P-wave in lead Ⅱ of the surface electrocardiogram and the peak A-wave on the tissue Doppler tracing of the left atrial lateral wall (PA-TDI duration),3 cardiac cycles were measured and their mean values were determined.Clinical success was assessed after 3-month blanking period and all patients were follow-up for 6 months.According to the results of the follow-up,the patients were divided into recurrent group and unrecurrentgroup.Results In the end of follow-up period,29 patients(25％) suffered from recurrent AF.Univariate analysis showed that the mean TACT of the recurrent group of patients was longer than that of the unrecurrent group of patients[(144 ± 23) ms vs (124 ± 20) ms,P ≥ 0.001].Multivariable analysis revealed that TACT was an independent risk factor responsible for the recurrence of AF(OR=1.045,95 ％CI 1.021-1.073,P≥0.001).Conclusion TACT can be used to predict the recurrence of paroxysmal atrial fibrillation after RFCA.

目的：探讨左房容积指数（LAVI）联合血尿酸（UA）水平在射血分数保留的心力衰竭（HFPEF）中的诊断价值。方法选择2012年9月至2013年9月90例患者分为观察组（HFPEF）和对照组（非HFPEF），每组各45例。分别比较两组人群UA水平、超声心动图指标及临床资料，并对LAVI、UA与超声心动图舒张功能指标之间进行Pearson相关分析，并采用ROC曲线对比LAVI、UA及LAVI联合UA在HFPEF中的诊断价值。结果 HFPEF组UA及LAVI平均值为（459.7±99.2）μmol/L及（38.8±9.5）ml/m2，非HFPEF组为（337.3±83.7）μmol/L及（26.4±7.1）ml/m2，两组差异有统计学意义（P<0.05）。相关性分析提示UA及LAVI呈正相关，相关系数为0.602。LAVI联合UA诊断HFPEF中的ROC曲线下面积（AUC）较LAVI及UA增大（0.884vs0.856，P<0.05；0.884vs0.820，P<0.05），LAVI诊断HFPEF中的AUC较UA增大（0.856vs0.820，P<0.05）。结论 LAVI联合UA对HFPEF具有较高的诊断价值。

Objective To assess the prognostic impact of admission heart rate in patients with precordial ST-elevation myocardial infarction undergoing acute percutaneous coronary intervention.Methods Restrospective analysis of prospectively collected data on 208 PCI-treated STEMI patients between March 2010 and February 2012.208 patients were divided according to the admission heart rate into either low rate group(≤70bpm, n=64)or high rate group(>70bpm,n=144).The time from illness to operation,coronary disease,left ventricular ejection fraction of admission into hospital and long-term progrosis were compared between the two groups.Results Patients with heart rate>70bpm had a longer time from illness to operation,higher cardiac function and lower ejection fraction.The results of coronary angiography showed that both two groups patients were present with left anterior descending artery lesions,and there were significant differences between high rate group and low rate group with regard to the incidence rates(41.7%VS31.3%).During a follow-up period of two years,cardiac events(heart failure,reinfarction,sudden death) was recorded in 44 patients,34(23.6%)in the high heart rate group compared to 10 patients in the high heart group.Conclusion As long as heart rate increased,the time from illness to operation was longer,coronary disease was more severe ,cardiac fraction gradually decreased and long-term prognosis was worse.