截肢病人残端综合征的康复治疗

目的：总结多年临床经验，探讨残端综合征的康复治疗。方法：对近５年来，在我院门诊及住院的截肢病人７０例的名种康复治疗进行总结分析。结果：经过综合性的康复治疗，９７．１％的残端综合征病人的症状得到不同程度的改善。结论：正确的综合性康复治疗，能有效地改善残端综合征的各种症状。     

50例截肢者残端综合征的康复疗效分析

本文主要介绍50例截肢术后残端综合征的康复。通过综合性的康复治疗,残端综合征得到不同程度的改善、减轻,个别的达到临床治愈。同时讨论了今后医学和工程学怎样结合,怎样预防、减少截肢后残端综合征的发生及如何为配装假肢创造更好的条件。     

《中国康复医学杂志》1986年第1卷文题索引

(按汉语拼音字母顺序排列) B 痹证从痹证易外感谈正气的康复 (孙文雅)1(3):41 便秘治疗习惯性便秘验方 (马山)1(3):7 半导体激光穴位照射半导体激光穴位照射治疗周围性面神经瘫及其机理初探 (黄枫林等)1(4):10 C 残端综合征 50例截肢者残端综合征的康复疗效分析 (杨忠道等)1(2):30     

截肢术后残端综合征患者残肢功能的康复治疗

目的探讨截肢术后残端综合征的复杂表现和综合干预的有效性。方法通过理疗,同时结合体疗、手术、心理疏导及护理康复等多方位对解放军第五十九中心医院2000-08/2004-09截肢术后残端综患者21例进行治疗,并观察其疗效。结果其中21例临床症状明显缓解,治疗效果较为理想,最大限度的恢复了患者的生活及工作能力。结论对截肢术后残端综合征患者治疗是一个全面的、系统的、多方面的综合过程,针对不同患者特点采用不同的综合治疗,可取得满意的疗效。     

截肢术后残端综合征患者残肢功能的康复治疗

目的 探讨截肢术后残端综合征的复杂表现和综合干预的有效性。方法 通过理疗，同时结合体疗、手术、心理疏导及护理康复等多方位对解放军第五十九中心医院2000—08／2004—09截肢术后残端综患者21例进行治疗，并观察其疗效。结果 其中21例临床症状明显缓解，治疗效果较为理想，最大限度的恢复了患者的生活及工作能力。结论 对截肢术后残端综合征患者治疗是一个全面的、系统的、多方面的综合过程，针对不同患者特点采用不同的综合治疗，可取得满意的疗效。     

健康教育对脑外伤后综合征患者康复疗效的影响

目的 探讨健康教育对脑外伤后综合征患者康复疗效的影响.方法 将110例脑外伤后综合征患者随机分为对照组55例和治疗组55例.对照组病人给予常规临床护理,治疗组除给予常规临床护理外,进行了相应的健康教育.于初诊及治疗1个月后用症状自评量表(SCL-90)评定患者的躯体症状和心理状况.结果 治疗前两组病人的躯体症状和心理状况没有统计学差异(P＞0.05),不良心理状况主要表现为焦虑情绪和抑郁情绪;治疗后,对照组和治疗组病人的躯体症状和心理状况都有改善,但治疗组的改善程度与对照组的病人对比有显著性差异(P＜0.05).结论 健康教育有助于提高脑外伤后综合征病人的康复疗效.     

偏瘫后肩手综合征的综合康复

目的：观察综合性康复方案对偏瘫后肩手综合征的治疗效果。方法：采用低频电刺激、针灸和现代康复医疗技术相结合的综合性康复方法对６９例偏瘫后合并肩手综合征患者进行了治疗观察，并对上肢疼痛、水肿、掌指关节活动度、皮色进行康复评定。结果：治疗后患者肩手症状明显改善或部分消除，上肢综合功能评定积分明显高于治疗前（Ｐ＜０．０１），恢复至辅助手以上者达５７．３％。结论：观察结果表明，本组采用的综合性康复措施对偏瘫后肩手综合征有较好治疗效果。     

胃癌病人康复治疗

胃癌是常见的恶性肿瘤之一，疾病本身、病后的各种治疗均严重影响患者的生存质量。因此康复治疗是十分重要的。现将康复指征和康复疗法有关情况予以介绍。１康复指征１．１胃癌术后倾倒综合征在胃切除术后，失去幽门或其正常功能，大量高渗性食糜容易倾倒入肠腔，使肠腔膨胀，经过神经反射机理，肠粘膜立即渗出大量液体，以稀释为等渗性食糜便于消化，于是引起急剧的血浆容量下降而出现心悸、眩晕等症状，这些症状一般在食后２０～３０ｍｉｎ出现。１．２胃癌术后体重减轻由于胃癌术后残胃容量减小，稍进食即有饱感；或病人因餐后综合征而惧…     

脑卒中患者肩手综合征的早期综合康复护理

目的 观察早期康复护理干预对肩手综合征Ⅰ期患者的临床疗效.方法 选择肩手综合征患者60例.采用综合性康复护理方案进行治疗及护理.包括体位疗法、冰水浸泡法、向心性缠绕法、被动、主动运动、心理干预等.疗程:30 d,每日1次.结果 康复训练30 d后,观察组的效果明显高于对照组(P＜0.05).结论 康复护理能明显改善脑卒后肩手综合征患者上肢的运动功能,提高病人的生活质量.     

38例胫腓骨骨折并发骨筋膜室综合征病人的早期观察及护理

[目的]总结胫腓骨骨折并发骨筋膜室综合征病人的早期观察及护理。[方法]对38例胫腓骨骨折合并骨筋膜室综合征病人的肢体肿胀、疼痛及肢端循环等情况进行早期观察,及时采取有效的护理措施。[结果]37例病人病情得到控制,恢复健康,1例病人截肢。[结论]加强对病人早期的观察与护理,及时发现骨筋膜室综合征的先兆症状,是提高治愈率和改善预后的保证。     

综合康复治疗对急性期中重度脑血管病患者预后的影响

目的:探讨综合康复治疗对急性期中、重度脑血管病患者预后的影响。方法:急性中、重度脑血管病患者397例,按照开始康复治疗的时间和治疗疗程分为A组(发病14d内开始康复治疗,疗程>14d)、B组(发病14d后开始康复治疗,疗程>14d)、C组(发病14d内开始康复治疗,疗程<14d)、D组(发病14d后开始康复治疗,疗程14d)、E组(无康复治疗),记录患者出入院时Barthel指数(BI)、改良Rankin量表评分(MRS)、美国国立卫生研究所脑卒中评分(NI HSS)及其改善值,记录出院时住院总费用和药费。发病后3、6、12、18个月随访记录BI及MRS评分。结果:5组患者经过康复治疗出院时NI HSS明显改善(P<0.005),其中A组患者瘫痪肢体神经功能恢复程度优于E组(P<0.05),出院后12个月神经功能可达到比较满意的恢复。短疗程组与无康复治疗组的疗效无明显差别。各组的医疗费用并无明显差异。结论:中、重度脑血管病患者应尽早开始康复治疗,且疗程要尽量>2周;综合康复治疗不增加住院总费用。     

Does botulinum toxin A make prosthesis use easier for amputees?

Four post-amputation patients (1 with phantom pain, 3 with stump pain) were each treated with 100 IU botulinum toxin A, divided between several trigger points in the distal stump musculature. In 1 female patient (along with a pronounced reduction in phantom pain) hyperhidrosis of the stump ceased completely, probably after diffusion of the drug into the dermal sweat glands, leading to longer and safer use of the prosthesis. Intentional intradermal injection for this issue therefore could be valuable. Another patient was able to use her prosthesis for the whole day again after botulinum toxin A treatment for substantial stump pain, compared with only 4 hours a day before treatment. In 2 male patients, stump pain while wearing the prosthesis subsided to a considerable extent, 1 of the 2 reported an improvement in steadiness of gait. We suggest that stump treatment with botulinum toxin in rehabilitative medicine should be investigated in more detail.     

Neuropsychologic Assessment and Cognitive Rehabilitation in a Patient With Locked-In Syndrome and Left Neglect

Trojano L, Moretta P, Estraneo A, Santoro L. Neuropsychologic assessment and cognitive rehabilitation in a patient with locked-in syndrome and left neglect.We describe a patient affected by severe incomplete locked-in syndrome (LIS) and left neglect caused by a combination of vascular lesions. Our patient's neglect prevented the use of augmentative communication devices based on a computerized eye-tracker system. For this reason, we adapted a visual scanning training for neglect rehabilitation. At the end of the rehabilitative training, the patient had regained full exploration of the monitor and could use the eye-tracker system for communicative purposes. This case report shows that specific rehabilitative approaches can be devised in severely disabled LIS patients with additional brain lesions and specific cognitive defects.     

New facilitation exercise using the vestibulo-ocular reflex for ophthalmoplegia: preliminary report

OBJECTIVE: To study the effect of facilitation exercises using the vestibulo-ocular reflex on ophthalmoplegia due to brainstem injury. DESIGN: A single-baseline design (A-B: A without specific therapy, B with specific therapy) across individual subjects. SETTING: Inpatient rehabilitation facility. SUBJECTS: Eight patients with ophthalmoplegia (total of 15 affected muscles) due to brainstem injury. INTERVENTIONS: Basic rehabilitative treatment that included physical therapy, occupational therapy and/or speech therapy for impairments such as hemiplegia, ataxia or dysarthria was administered for two weeks (control treatment). Then, two facilitation exercise sessions (100 times/day, five days/week for two weeks) were administered in addition to the basic rehabilitative treatment for four weeks to the eight patients with ophthalmoplegia. Ophthalmoplegia was evaluated at study entry and at the end of each two-week session. The goal of the facilitation exercises is to facilitate voluntary eye movement using conjugated eye movements in the direction opposite to passive movements of the head. MAIN MEASURES: To assess ophthalmoplegia we measured the distance between the internal/external corneal margin and the canthus of the affected eye on images recorded on a video tape recorder. RESULTS: After the initial two-week basic rehabilitative treatment, the distance between the corneal margin and canthus decreased slightly. Subsequently, after each of the two facilitation exercise sessions, there were significant reductions in the distance between the corneal margin and canthus compared with that at the beginning of the respective facilitation exercise session. CONCLUSION: Facilitation exercises significantly improved the horizontal movement of eyes with ophthalmoplegia due to brainstem injury.     

早期与晚期康复治疗对脑梗死病人功能恢复影响的对照研究

目的探讨早期与晚期康复治疗对脑梗死病人功能恢复的影响。方法选择216例脑梗死病人,其中早期康复组与晚期康复组各108例。早期康复组在病人生命体征稳定、神经病学体征不再进展2周内开始康复治疗。晚期康复组在发病2周后开始康复治疗。两组均采用Bobath法和运动再学习法进行训练。采用改良巴式指数(MBI)、简式Fugl-Meyer运动评分(FMA)和临床神经功能缺损程度评分进行康复评价。结果临床神经功能缺损程度评分、FMA和MBI入组时两组均无统计学差异(P>0.05),治疗30d后两组均较治疗前明显改善(P<0.001),早期康复组较晚期康复组改善程度更大(P<0.05)。结论早期与晚期康复治疗均可明显促使神经功能恢复,但早期康复组临床疗效明显优于晚期康复组。     

Laparoscopic rectal tumor surgery after administration of a new sclerosing therapy (aluminum potassium sulfate and tannic acid injection) for internal hemorrhoids: A report of three cases

Aluminum potassium sulfate and tannic acid (ALTA) injection is a new sclerosing therapy for internal hemorrhoids that has been gaining widespread use. However, there have been few reports about rectal cancer after ALTA injection. We performed laparoscopic surgery for three patients who had underwent ALTA therapy 6 months or 1 year earlier: (i) a 51‐year‐old man with neuroendocrine tumor; (ii) a 44‐year‐old woman with rectal cancer; and (iii) 77‐year‐old man with rectal cancer. All three patients had sclerosis of the resected rectal wall stump, making transection of the rectum difficult. Histological examination of the specimens also showed an inflammatory reaction and/or fibrosis of the resection stump. Although laparoscopic low anterior resection was planned for all three patients, we had to construct a diverting stoma for two patients and could not perform sphincter‐preserving surgery for the other. We must be well prepared for laparoscopic rectal surgeries after ALTA therapy, and these cases suggest sigmoidoscopy before ALTA therapy should be recommended.     

规范三级康复治疗对缺血性脑卒中患者运动功能的影响

目的：探讨规范三级康复治疗对缺血性脑卒中患者运动功能的影响。方法：164例缺血性脑卒中患者随机分为康复组和对照组，分别在人组时、发病后第1、3和6个月评价患者简化Fugl—Meyer量表（FMA）评分，并进行统计学分析。结果：康复组在人组时FMA总分、上肢FMA和下肢FMA评分与对照组差异无显著性。对照组在入组时、发病后第1、3和6个月时FMA总分逐渐增加，但只有第1个月与入组时比较以及第3个月与第1个月时比较差异有显著性。康复组FMA总分比对照组显著增加，而且在各次评定之间比较差异均有显著性。对照组上肢FMA评分逐步增高，但只有在第3个月时差异有显著性；康复组上肢FMA评分增加幅度在第3个月和6个月时砬著高于对照组，且各次评定之间比较差异均有显著性。对照组下肢FMA评分逐步增高，但只有在第3个月时差异有显著性；康复组下肢FMA评分增加幅度显著高于对照组，且各次评定之间比较差异均有显著性。结论：规范的三级康复治疗对提高缺血性脑卒中患者运动功能具有重要作用。     

The Role of Therapeutic Exercise in the Conflicting and Unstable Shoulder

Abstract

Context: The use of therapeutic exercise and manual therapy in rehabilitation of the unstable and conflicting shoulder (UCS) is widespread. In the literature, there are several electromyographical studies that have analysed the effect of specific physical exercises and clinical trials on the effectiveness of specific rehabilitative protocols. However, it has not been established yet what is the best intervention for these disorders.

Objective: In order to establish general recommendations for the treatment of UCS, we have reviewed the results of some electromyographical studies to identify the best exercises to recruit specifically the shoulder girdle muscles and some clinical trials that have proposed the utilisation of therapeutic exercise and manual therapy for UCS.

Methods: Review of the literature of the last 10 years. We have searched Pedro, Medline and the Cochrane Library for randomised clinical trials, systematic reviews and electromyographical studies on rehabilitative protocols based on therapeutic exercise and manual therapy.

Outcomes: It is common practice for clinicians to consider the involvement of patients with shoulder instability or impingement in a programme of exercises, before proceeding to a surgical intervention. Our analysis of the literature provides evidence of the efficacy of manual therapy associated with therapeutic exercises for decrease in pain, recovery of patient's strength and restoration of abilities.

Conclusions: While the analysed studies are inconclusive, on the basis of the available data, we suggest some general rehabilitative principles for the treatment of the unstable and conflicting shoulder.     

屈指肌腱修复术98例术后康复治疗及护理体会

目的：探讨屈指肌腱修复术后早期行系统治疗及康复护理的方法。方法：对98例屈指肌腱修复后患者在术后2～3d开始康复治疗及护理，包括早期、中期和晚期的运动功能动训练及物理疗法等。结果：98例患者中，85例手功能达到完全及接近完全恢复正常功能，11例手功能恢复到生活能自理状态，3例因伤情复杂恢复较差，需做手功能修正术。结论：屈指肌腱修复术后患者早期开始系统康复治疗及护理，可最大限度地恢复手指屈伸运动功能。     

冠心病病人的康复护理现状

综述了冠心病病人康复护理的有关措施,从康复治疗与护理、康复训练与护理、心理治疗、饮食的康复护理以及健康教育、冠心病危险因素的控制等方面进行探讨与归纳,为促进冠心病病人的健康,提高护理质量提供建设性意见。