近年来,随着人民生活水平的提高及人口老龄化的进展,脑血管疾病发病率呈直线上升趋势,对患者身心健康造成严重威胁.脑卒中是临床常见的脑部疾病,具有较高的发病率、致残率以及死亡率.一旦发病,随着病情的进展,患者可出现肌肉萎缩、四肢不协调等情况,最终导致偏瘫,丧失基本自理能力,不仅对患者个人、家庭、社会等会带来沉重的压力,也增加了临床医护人员治疗及康复的难度.临床上,通常对脑卒中患者采取针对性的内科治疗措施,如颅内降压、控制血压、脱水、维持电解质平衡、预防感染以及并发症等.虽然经常规治疗后,患者病情可得到有效缓解,但依旧存在较高的致残率.因此,需在常规治疗基础上实施早期康复治疗,保障最佳疗效.

伴随近几年社会人口发展趋势逐渐高龄化,使得骨质疏松情况愈发常见,不但影响患者正常行为,而且还对其生活质量带来影响[1].一旦老年者出现骨折,其代谢功能与生理特点能延缓恢复速度,所以如何加快患者患肢功能恢复是当前临床需要重点研究的问题.有研究指出,骨折康复疗法能最大程度促进患者患肢康复,为患者功能恢复提供支持[2].目前,临床常用的康复疗法主要包括物理疗法、运动疗法.本文以我院接收的60例老年下肢骨折患者为对象,探究联合应用物理疗法与运动疗法的效果.

目的 研究喹硫平与利培酮治疗老年痴呆精神行为症状的临床效果.方法 方便择取2018年1月—2019年8月该院130例老年痴呆精神行为症状患者作为研究对象,根据随机数字表的方法,将其划分成对照组与实验组,各65例.对照组运用利培酮进行治疗,实验组运用喹硫平进行治疗,在治疗前、治疗后第2、4、8周运用阿尔茨海默病病理行为评分表、药物副反应量表,比较两组的临床疗效与不良反应.结果 实验组与对照组治疗后阿尔茨海默病病理行为评分表均显著下降,差异有统计学意义(t=6.042,P=0.002).对照组显效57例,有效3例,无效5例,总有效率92.31％,实验组显效62例,有效2例,无效1例,总有效率98.46％,组间差异无统计学意义(x2=9.073,P=0.08).实验组治疗2周、治疗4周、治疗8周的TESS评分是(11.00±3.66)分、(9.96±3.10)分、(7.57±2.85)分,对照组分别为(16.29±4.46)分、(14.76±3.90)分、(11.70±3.20)分,实验组的评分显著低于对照组,差异有统计学意义(t=4.092、5.091、10.372,P<0.05).结论 当老年痴呆精神行为症状患者服用喹硫平后,会产生较少的不良反应,因此,该种治疗方法值得在临床中被广泛推广.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

目的:探讨不同神经肌肉电刺激强度对于缺血性脑卒中合并吞咽困难患者治疗的临床效果.方法:选择我院于2016年1月至2019年1月期间收治的诊断为缺血性脑卒中合并吞咽困难的患者138例,采用随机数字法将所有患者随机分为高强度组46例、低强度组46例、对照组46例,所有患者入院后均给予改善脑部微循环、降颅压、控制水肿、保护神经细胞等内科综合治疗,同时所有患者均积极进行吞咽功能的康复训练.高强度和低强度组的患者在此基础上采用神经肌肉电刺激的方式进行功能性训练,低强度组的患者的电流刺激强度设定为10 mA,高强度组的患者的电流刺激强度设定为20 mA.对比所有患者治疗前后的吞咽困难和营养状态评分,同时采用临床症状和洼田饮水试验对患者的治疗效果进行评价,此外记录治疗1个月后所有患者的鼻饲管的拔除率.结果:经过治疗后,所有患者的吞咽困难评分均显著降低而营养状态评分显著升高,治疗后高强度和低强度组的患者的吞咽困难评分显著高于对照组,而营养状态评分显著低于对照组,同时治疗后高强度组患者的吞咽困难评分也显著高于低强度组,营养状态评分显著低于低强度组,差异均具有统计学意义(P＜0.05).治疗后对照组患者治疗的总有效率显著低于高强度组和低强度组患者治疗的总有效率,同时高强度和低强度组患者的鼻饲管拔除率均显著高于对照组患者,差异均有统计学意义(P＜0.05).结论:通过功能性电刺激能够通过刺激肌肉收缩和神经通路的重建可显著缓解缺血性脑卒中合并吞咽功能障碍患者的临床症状,改善患者的吞咽功能和营养状态,提高鼻饲管拔除率,同时在患者可耐受的情况下,高的刺激强度能够进一步提高治疗效果.

Objective To explore the correlation between the prognosis and the serum prealbumin (PA) of patients with acute cerebral hemorrhage .Methods This study was a retrospective study ,a total of 200 acute cerebral hemorrhage patients in Shanghai Smelter Hospitalas from January 2012 to June 2017 were recruited into cerebral hemorrhage group ,and 200 healthy persons as the control group .Compared the content of PA , the modified Rankin scale were used to evaluate the neurological function of patients with cerebral hemorrhage after the onset of three months ,divided into good prognosis group (0-2) and poor prognosis group (>2-6) . Logistic regression analysis the relevant indicators of many factors .Results The content of PA in cerebral hemorrhage group was significant higher than that of control group ,there was significant difference (t=7 .821 ,P<0 .05) .There were significant difference on low density lipoprotein ,fibrinogen ,uric acid ,PA and D-dimer in different prognosis groups(t=6 .321 ,4 .312 ,4 .525 ,4 .124 ,4 .672 and 3 .073 ,P<0 .05) .Age and PA after acute cerebral hemorrhage could be used as independent predictors of cerebral hemorrhage .Conclusion Acute cerebral hemorrhage with low PA has poor prognosis ,the index in the acute phase of the anomaly could predicte the prognosis of patients with cerebral hemorrhage .

偏瘫又被称之为半身不遂 ,是指同一侧的上下肢、面肌及舌肌下部发生的运动障碍 ,为畸形脑血管病的常见症状 ,也是主要后遗症之一[1 ] .脑出血患者病情稳定后早期开展积极的康复治疗对于改善患者预后及生活质量而言尤为重要.为探寻日常生活活动能力训练结合针灸疗法对脑出血后偏瘫的疗效 ,本次研究内容如下.

目的：探讨灯盏花素联合硫酸氢氯吡格雷对急性脑梗死患者治疗的临床效果。方法回顾性分析117例急性脑梗死患者，将患者按照治疗方案的不同分为对照组(n=60)和联合组(n=57)。对照组患者单纯使用硫酸氢氯吡格雷治疗，每次75 mg，每天1次，联合组则实施灯盏花素联合硫酸氢氯吡格雷治疗，硫酸氢氯吡格雷和对照组应用剂量一样，同时灯盏花素20 mL加入500 mL生理盐水或葡萄糖注射液中静脉滴注，每天2次，均治疗20 d，对比2组患者在不同治疗方案下治疗效果以及血液黏稠度情况。结果治疗后，对照组患者治疗总有效率70.00%（42/60），联合组治疗总有效率为94.74%（54/57），2组总有效率比较差异有统计学意义（P＜0.05）；同时2组患者治疗后的血液流变学数据均比治疗前有显著改善，差异有统计学意义（P＜0.05）。结论通过对急性脑梗死患者实施灯盏花素联合硫酸氢氯吡格雷治疗方案，比单纯的采用硫酸氢氯吡格雷治疗效果显著，同时也降低了脑梗死对患者神经功能的损伤。

Objective: To observe the clinical effects of comprehensive rehabilitation therapy with biofeedback with Mendelsohn approach based on induced dysphagia of pseudobulbar paralysis in patients with cerebral stroke.Methods:A retrospective analysis of the clinical data in our hospital pseudobulbar palsy after stroke patients with dysphagia caused 64 cases were randomly divided into two groups, the treatment group (31 cases) and control group(33 cases),31 patients subjected to biological treatment groups feedback with Mendelssohn-based integrated approach dysphagia rehabilitation therapy rehabilitation training,and with 33 cases in the control group of patients with biofeedback with comprehensive rehabilitation therapy on dysphagia conducted to compare the efficacy of rehabilitation. Respectively,before and after treatment with depression Kubota Toshio drinking twater test evaluation of swallowing function changes. Results:After treatment, the two groups were compared swallowing function before treatment significantly improved by Yi and test the difference was statistically significant (P<0.05),patients treated with swallowing function was significantly better than the control group, the Yi and test groups there was a significant difference (P<0.05).Conclusion:Through the implementation of comprehensive rehabilitation training with biofeedback with Mendelsohn means therapy patients with dysphagia after stroke,Can improve swallowing function is better than that of the control group patients.

<正>以胸痛为主要临床表现的胃食管反流病与冠心病引起的胸痛极为相似,临床易造成误诊。我院2009-12-2011-01收治以胸痛为主要临床表现的胃食管反流病28例,现分析报告如下。1临床资料1.1一般资料本组患者均符合胃食管反流病的诊断标准,其中男16例,女12例,年龄27～68(平均54.7)岁。临床