脑卒中后抑郁早期治疗对神经功能康复的影响

目的:探讨脑卒中后抑郁早期治疗对神经功能康复的影响。方法:根据综合医院焦虑/抑郁(HAD)情绪测定量表得分(HAD得分≥8)选出脑卒中伴抑郁患者60例,随机分为治疗组(30例)和非治疗组(30例),每天均接受神经内科常规药物治疗及物理治疗40min,治疗组同时给予心理干预和药物治疗,于治疗前、后分别评定患者运动功能和日常生活活动能力,比较两组神经功能康复情况。结果:非治疗组治愈4例(13.3%),好转10例(33.3%),未愈16例(53.3%);治疗组治愈9例(30.0%),好转14例(46.7%),未愈7例(23.3%),非治疗组神经功能康复情况明显差于非治疗组,两组比较差异有显著意义(P<0.01)。结论:早期抗抑郁治疗影响脑卒中患者神经功能的康复,应引起临床医生足够重视。

快速康复外科护理在减轻胆肠吻合术吻合术病人术前焦虑及加速术后康复中的应用分析

深入研究与探讨快速康复外科护理在减轻胆肠吻合术病人术前焦虑以及加速术后康复中的实际应用。方法:以2019年1月至2020年1月这一阶段,我院对100例胆肠吻合术病人开始研究和观察。实施普通围术期护理手段的50例胆肠吻合术病人为对照组,实施快速康复外科护理手段的50例胆肠吻合术病人为实验组,展开此次观察探讨。通过对比和观察两组胆肠吻合术病人的术前临床相关指标、SDS分和SAS评分、术中后临床相关指标、生活质量以及并发症发生率结果;结果:实施普通围术期护理手段的对照组胆肠吻合术病人并发症发生率达90.0℅。实施快速康复外科护理手段的实验组胆肠吻合术病人并发症发生率达10.0℅,并且生活质量比对照组病人高,术前和术后相关指标、SAS和SDS评分比对照组病人低。结论:实施快速康复外科护理手段针对胆肠吻合术病人降低术前和术中临床相关指标、SDS分和SAS评分、并发症发生率,提高生活质量都有积极作用。应逐渐扩大肝胆疾病的医治领域,不断完善快速康复外科护理护理手段,对提高胆肠吻合术病人生活质量以及康复率,降低术前和术中临床相关指标、SDS分和SAS评分、并发症发生率具有重要作用,值得普及和应用。

药物干预脑卒中后焦虑的近期疗效

目的:探讨阿普唑仑、氟西汀对脑卒中后焦虑患者焦虑症状、神经功能和日常生活能力的影响。方法:将濮阳市人民医院神经内科脑卒中后焦虑患者60例按入组标准,随机分为阿普唑仑+氟西汀组(治疗组,n=30)和阿普唑仑组(对照组,n=30),除给予脑卒中后常规的药物治疗和康复训练外,治疗组给予氟西汀20mg/d+阿普唑仑0.2mg/次,3次/d),对照组给予阿普唑仑0.2mg/次,3次/d,两组均治疗60d。分别在治疗前、治疗后30和60d,用汉密顿焦虑量表、改良爱丁堡-斯堪的纳维亚卒中量表及Barthel指数评价患者的情绪和神经功能。结果:治疗30和60d后,实验组脑卒中后焦虑程度明显减轻(17.33±7.17和7.43±3.63),Barthel指数明显提高(53.83±9.35和70.33±10.74),与对照组比较,差异有显著性意义(t=2.15,2.92,-2.37,-2.48;P<0.05)。治疗后30d实验组神经功能缺陷减轻程度(13.00±2.03)明显优于对照组(14.40±2.88),差异有显著性意义(t=2.17,P<0.05);治疗后60d两组神经功能缺陷减轻差异无显著性意义(t=1.85,P>0.05)。结论:氟西汀联合阿普唑仑能够更好地减轻焦虑,促进脑卒中后焦虑患者的神经功能的恢复。

Retrospective analysis of exercise capacity in patients with coronary artery disease after percutaneous coronary intervention or coronary artery bypass graft

Objectives:To describe the current state of exercise capacity as well as to identify its predictors in patients with coronary artery disease (CAD) following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in the mainland of China.Methods:A retrospective study design was employed.We evaluated 230 CAD patients following PCI or CABG in a cardiac rehabilitation center from January 2019 to October 2019.The patients were referred to undergo incremental cardiopulmonary exercise testing with a cycle ergometer.The Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale were used to evaluate patients' mental health.Statistical analysis was performed using the chi-square test,Fisher's exact test,t-test,Mann-Whitney U test,and binary logistic regression.Results:Among the 230 patients,223 patients demonstrated reduced exercise capacity.Resutlts of the logistic regression analysis showed that anxiety (OR =1.13,95% CI 1.01-1.32,P =0.029) was an independent risk factor for reduced exercise capacity in patients following the PCI or CABG.Conclusions:Exercise capacity of Chinese CAD patients after PCI or CABG was relatively poor.Alleviating symptoms of anxiety and making exercise prescriptions according to the results of the cardiopulmonary exercise test should be considered during the intervention to improve CAD patients' exercise capacity.

Effect of acupuncture on improving the quality of life in children with cerebral palsy and their parents

Objective： To observe the spleen-strengthening and mind-regulating acupuncture method on the quality of life of children with cerebral palsy （CP） and their parents. Methods： A total of 76 CP children were randomly allocated into a treatment group （n=38） and a control group （n=38） according to their vJsJt sequence. The CP chJJdren and theJr parents Jn both groups receJved the same psychologJcaJ counselling. The CP children in the treatment group were intervened with spleen-strengthening and mind-regulating acupuncture method, versus routine acupuncture method in the control group. The parents of CP children in the treatment group were intervened with three mind-regulating points, versus placebo in the control group. The developmental quotients were evaluated using the Gesell scale before and after treatment. The anxieties of parents were assessed using the self-rating anxiety scale （SAS） before and after treatment. The efficacies were evaluated using the comprehensive functional assessment of CP children. Results： After 6 months of treatment, the Gesell scores of CP children and SAS scores of the parents were significantly improved in both groups, and there were intra-group and inter-group statistical differences （both P〈0.05）. In addition, the scores of comprehensive functional assessment of CP children in the treatment group were significantly higher than those in the control group （P〈0.05）. Conclusion： The spleen-strengthening and mind-regulating acupuncture method can effectively improve the comprehensive ability of CP children, alleviate the anxiety in parents of CP children, improve the quality of life of CP children and their parents, and play an active role in rehabilitative care of CP children.