脑卒中后认知障碍(PSCI)是脑卒中患者常见的并发症,严重影响患者的生活质量和社会功能。近年来,随着认知储备理论的发展和早期干预理念的普及,PSCI的早期干预模式逐渐成为研究热点。文章综述了PSCI早期干预模式的研究现状与进展,包括干预的理论基础、具体措施及未来发展方向,以期为临床实践和科研提供参考。
Post-stroke cognitive impairment(PSCI)is a common complication among stroke patients.It seriously affects the patients’ quality of life and social functions.In recent years,with the development of the cognitive reserve theory and the popularization of the concept of early intervention,the early intervention model for PSCI has gradually become a research hotspot.This article reviews the current research status and progress of the early intervention model for PSCI,including the theoretical basis of the intervention,specific measures,and future development directions,aiming to provide references for clinical practice and scientific research.
目的 观察ST段抬高型急性心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)中应用不同转运模式的应用疗效。方法 选取我院80例行急诊PCI的STEMI患者,有31例患者的12导联心电图由救护车上的急救人员通过手机微信传输到指定的东莞市大朗医院胸痛中心微信群(远程早期干预组),有49例患者自行来院就诊(传统就诊组),比较两组患者的临床疗效。结果 远程早期干预组患者的D-to-B时间低于传统就诊组(P<0.01),D-to-B达标率高于传统就诊组(P<0.01);远程早期干预组患者住院费用、平均住院天数、住院期间病死率及心力衰竭发生率均低于传统就诊组(P<0.05)。结论 相比较传统就诊模式,远程转运模式能显著提高STEMI患者PCI术的治疗效果,并有效改善其预后情况,临床效益较好,值得实践推广。
早期干预是预防和减少早产儿神经系统损伤的有效措施,可以促进早产儿的正常发育并减轻神经系统伤残的发生,对提高儿童综合素质和家庭幸福都至关重要。在早产儿早期干预过程中存在与医学伦理原则不相适应的方面,如医疗设施不足、医疗措施不当、专业人员不足,早产儿干预预后的不确定性,治疗时机与家长经济及遵医行为之间的冲突,家长知情选择和知情同意不足等,本文结合医学伦理学的观点对0~3岁早产儿在早期干预中存在的问题进行分析并提出相应的建议。
Early intervention is an effective measure to prevent and reduce the nervous system injury in preterm infants,It can promote the normal development of preterm infants and reduce the occurrence of the nervous system disability.It is vital to improve the comprehensive quality of children and family quality of life. In the stage of premature infant intervention,there are some aspects that are incompatible with the medical ethics principle,i.e. inadequate medical facilities,improper medical measures,lack of professionals,premature infants intervention prognosis uncertainty,the conflict between the timing of treatment and the parents' economic and compliance behaviors,parents' informed choice and informed consent. etc. This paper analyzes the problems in early intervention of 0~3 year old preterm infants and puts forward corresponding suggestions according to the viewpoint of medical ethics.
目的 探讨早期干预对早产儿运动水平及技能的影响。方法 2013年3月—2014年3月在惠州市出生的283例有早产背景的高危儿,按照家长意愿分为两组,早产儿干预组143例及早产儿对照组140例。选择同时期出生的145例正常足月新生儿作为正常对照组。早产儿干预组根据评估结果制定干预训练方案,并按照评估—干预—评估的模式调整干预方案,早产儿对照组和正常对照组按健康检查的顺序进行体检并给予相关指导。在月龄3、6、9、12、18月时对三组婴儿行AIMS评估和神经系统相关检查。结果 早产儿干预组的运动发育水平明显高于早产儿对照组(P<0.01),神经系统异常率低于早产儿对照组(P<0.01),而早产儿干预组的神经系统异常率高于正常对照组(P<0.05)。但运动发育水平与正常对照组相比差异无统计学意义(P>0.05)。结论 早期干预能提升早产儿运动发育水平,改善运动技能,减少神经系统异常发生率,提高早产儿生存质量。
目的 观察以湿敷为主的早期综合干预疗法治疗婴幼儿湿疹的效果。方法 按照随机的原则对118例患有湿疹的婴幼儿分为观察组(60例)和对照组(58例)。观察组采取以湿敷为主的早期综合治疗,对照组采取一般家庭干预,两组均跟踪随访,观察湿疹的好转情况,并统计湿疹复发率。结果 观察组60例患者中痊愈38例,占 63.3%;显效20例,占 33.3%;有效2例,占3.3%;无效0例;总有效率100%。痊愈的38例中,随访8周后重新出现湿疹的病例为8例,复发率为21%。对照组58例患者中痊愈20例,占 34.48%;显效14例,占24.14%;有效16例,占27.59%;无效8例,占13.79%;总有效率86.21%。观察组痊愈的38例中,随访8周后重新出现湿疹的病例为8例,复发率为21%。对照组痊愈20例中复发6例,复发率为30%。结论 以湿敷为主的早期综合干预疗法能有效减轻湿疹的症状,可以作为社区治疗婴幼儿湿疹的参考。
Objective To observe the effects of wet compress based early comprehensive intervention therapy in the treatment of infant eczema. Methods 118 cases of infantile eczema within the jurisdiction were randomly divided into observati on group (60 cases)and control group (58 cases). The observation group was given early comprehensive therapy based on wet compress while the control group took general family intervention.Follow-up observations were adopted for both groups to examine the curing of eczema and to collect data for eczema recurrence. Results In the observation group of 60 cases, 38 were cured, accounting for 63.3%; 20 markedly improved (33.3%),2 effective(3.3%) and 0 ineffective; with the total effective rate of 100%.of the 38 cases cured, eczema reappeared in 8 cases after eight weeks of follow-up observation, with the recurrence rate of 21%. In the control group of 58 cases, 20 were cured, accounting for 34.48%; 14markedly improved (24.14%), 16 effective (27.59%),and 8 ineffective (13.79%),with the total effective rate of 86.21%. In the observation group, eczema recurred in 8 of the 38 cured cases after eight weeks of follow-up observation, with the recurrence rate of 21% while in the control group, eczema recurred in 6 cases, with the recurrence rate of 30%. Conclusion Wet compress based early comprehensive intervention therapy can effectively relieve the symptoms of eczema, so it can be effectively used in community treatment of infantile eczema.