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关键词： Cognition   Ethanol   Event-related potentials   Mental disorders   Schizophrenia   乙醇   事件相关电位   精神分裂症   精神障碍   认知   Cognition   Ethanol   Event-related potentials   Mental disorders   P300   Schizophrenia   Language of Keywords: English   Chinese  

摘要： Objective To understand the difference of event related potential(ERP)detection results before and after treatment between the patients with schizophrenia and alcohol caused mental disorders. Methods Thirty-two inpatients with schizophrenia and 32 inpatients with alcohol caused mental disorders(in accordance with international claasification of diseases-10 diagnostic criteria)in this hospital from January 2015 to September 2016 conducted the ERP detection before medication *** the ERP changes before and after treatment were compared between the patients with schizophrenia and patients with alcohol caused mental *** The detection values at forehead and top electrodes in each ERP lead before treatment had no statistical difference between the patients with schizophrenia and patients with alcohol caused mental disorders(P>0.05).The mismatch negativity(MMN)latent period delay and grade distribution in the patients with schizophrenia had no statistical difference between before and after treatment(P>0.05), while the cognitive formation latent period delay and grade distribution had statistical difference between before and after treatment(P<0.05);which in the patients with alcohol caused mental disorders had statistically significant difference between before and after treatment(P<0.05).Conclusion The cognitive formation in the patient with schizophrenia is significantly improved after treatment, but the unhealthy emotions have no obvious improvement. The unhealthy emotions and cognitive formation after treatment in the patients with alcohol caused mental disorders are *** alcohol caused mental disorders and schizophrenia may be different in the aspects of unhealthy emotions and psychotic symptoms cause and effect. [ABSTRACT FROM AUTHOR]

关键词： 整体护理   躁狂症   依从性   满意度  

摘要： 目的观察整体护理对躁狂症治疗依从性的影响。方法选取我院收治的40例躁狂症患者,根据护理方式不同分为2组,对照组20例实施一般护理,观察组20例实施整体护理,对比2组护理效果。结果观察组治疗依从性良好率、护理满意度均显著高于对照组,差异有统计学意义(P<0.05)。结论对躁狂症患者实施整体护理干预,可显著提高患者整体治疗依从性及护理满意度,有利于患者早日康复。

关键词： 老年股骨骨折   疼痛   创伤后应激障碍   自我效能护理  

摘要： 目的观察自我效能护理对老年股骨骨折患者术后疼痛及创伤后应激障碍(posttraumatic stress disorder,PTSD)的影响。方法选取120例老年股骨骨折患者,按随机数表法分为观察组和对照组,各60例。观察组给予自我效能护理,对照组行常规护理。于术前(T_0)及术后1 d(T_1)、3 d(T_2)、7 d(T_3)时应用McGill疼痛问卷-2(SF-MPQ-2)评估2组患者疼痛情况,PTSD自评量表(PTSD-SS)比较T_3时PTSD表现,一般自我效能感量表(GSES)评估自我效能,改良Barthel指数评定量表(MBI)评估日常活动能力。结果 T_1～T_3时,2组患者SF-MPQ-2评分[T_1:观察组(6.12±1.11)分,对照组(7.63±1.32)分;T_2:观察组(3.57±0.66)分,对照组(4.73±0.83)分;T_3:观察组(2.23±0.42)分,对照组(2.64±0.51)分],均较T_0时逐渐降低[T_0:观察组(8.14±1.45)分,对照组(8.15±1.47)分],且观察组降低幅度大于对照组,差异有统计学意义(P<0.05)。T_3时,观察组患者PTSD-SS主观感受、反复重现体验、回避症状、警觉性增高和社会功能受损评分[(1.55±0.22)、(9.72±1.43)、(10.32±2.31)、(8.47±1.36)、(2.25±0.41)]分,均低于对照组[(2.42±0.37)、(12.47±2.11)、(14.38±2.96)、(10.65±2.11)、(3.06±0.48)]分;观察组患者GSES、MBI评分(31.95±5.68)分、(74.22±12.43)分,均高于对照组(26.38±4.36)分、(66.72±11.84)分,差异有统计学意义(P<0.01)。结论自我效能护理可改善老年股骨骨折术后疼痛情况,减轻PTSD表现,提高患者自我效能和日常活动能力,促进患者尽快恢复,有利于患者病情转归。

关键词： Acupuncture Therapy   Point, Baihui (GV 20)   Point, Neiguan (PC 6)   Point, Shenmen (HT 7)   Point, Taichong (LR 3)   Stress Disorders, Post-traumatic   Electrophysiology   Rats  

摘要： Objective: To observe the effects of acupuncture on the characteristics of neuro-electrophysiological activity in hippocampal CAI and CA3 areas of rats with post-traumatic stress disorder (PTSD). Methods: Fifty Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group, a grasping group, a Western medicine group and an acupuncture group, with 10 rats in each group. Except for the blank group, rats in the other 4 groups all received the combined stress modeling method. Rats in the Western medicine group were intragastrically administrated with paroxetine hydrochloride, those in the acupuncture group received acupuncture intervention, those in the grasping group received grasping fixation, and those in the model group and the blank group did not receive any in terve ntions. After 14 d of in terve ntion, the interspike in terval (ISI) and power spectral den sities (PSD) were an a lyzed and mapped by in vivo multiple channels to record the neuron clusters discharge in the hippocampal CAI and CA3 areas. Results: Compared with the blank group, ISI was proIonged in the CAI and CA3 areas of the model group and the grasping group, and the concentrated PSD distribution area moved down (Pv0.05 or P<0.01). Compared with the grasping group, the ISI of the CAI and CA3 areas in the Western medicine group and the acupuncture group was shortened, and the concentrated PSD distribution area moved up (P<0.05 or P<0.01). The ISI and PSD distributions in the CAI and CA3 areas of the acupuncture group were not statistically different from those in the Western medicine group (both P>0.05). Conclusion: Both acupuncture and paroxetine hydrochloride can significantly regulate the neuro-electrophysiology activity of hippocampal CAI and CA3 areas in PTSD rats, which may be one of the mechanisms of acupuncture intervention to promote PTSD recovery.

关键词： 精神发育迟滞   精神障碍   康复护理   日常生活能力   满意度  

摘要： 目的探讨综合康复护理对精神发育迟滞伴精神障碍患者临床效果的影响。方法在本院2013年2月～2017年5月收治的精神发育迟滞伴精神障碍患者中选取46例,将其随机分为对照组和实验组2组,每组23例。对照组行常规护理,观察组在此基础上提供综合康复护理,干预后对比2组护理效果。结果护理后,2组患者的日常生活能力评分均有所提高,且观察组高于对照组;观察组患者护理总有效率为95.60%,高于对照组的60.87%;观察组患者家属满意度评分为(95.25±3.28)分,高于对照组的(62.52±5.69)分,以上差异均有统计学意义(P<0.05)。结论对精神发育迟滞伴精神障碍患者加强治疗与护理,效果显著,值得推广。

关键词： 正念   PTSD   侵入反刍   社会支持  

摘要： 目的:考察正念对创伤后应激障碍(PTSD)的影响,并检验侵入反刍和社会支持在其中的中介作用。方法:本研究采用正念注意觉知量表(MAAS)、社会认可度量表(SAQ)、事件影响量表(IES-R)和事件相关反刍量表(ERRI)对298名南京市红十字救援的工作人员进行调查。结果:相关分析显示,正念、PTSD、侵入反刍及社会支持之间两两显著相关。路径分析表明,正念可以直接负向预测PTSD,也可以通过侵入反刍和社会支持的中介负向预测PTSD。结论:正念有助于缓解PTSD症状,正念可以通过减少个体的侵入反刍,使个体感知更多的社会支持,从而缓解PTSD症状。

关键词： 创伤后应激障碍   酒精使用障碍   心理咨询   治疗建议  

摘要： 本文目的是通过报道病例诊疗全过程,呈现创伤后应激障碍(PTSD)合并酒精使用障碍的临床诊疗思路及治疗方案。咨客,男性,55岁。12岁时目睹母亲自杀的全过程,随后出现恐惧、孤独、失眠、回避谈论创伤相关话题、反复出现与创伤相关的梦境、易激惹、疼痛及酗酒等一系列情绪、认知、躯体及行为改变,并持续至今。社会功能明显受损,近1年和妻子离婚后症状加重而前来咨询。经过本次咨询,被诊断为PTSD合并酒精使用障碍。建议采用生物-心理-社会的综合干预方法,鼓励咨客进行规律运动,使用选择性5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRI)及第二代抗精神病药物改善情绪、缓解疼痛;心理治疗方面,推荐延迟暴露疗法和认知调整;社会资源方面,在症状缓解后,鼓励咨客积极寻找工作,创造挽回其前妻的可能性。

关键词： 创伤后应激障碍   电针   酪氨酸羟化酶   杏仁核   脑源性神经营养因子  

摘要： 目的:观察创伤后应激障碍(PTSD)大鼠杏仁核酪氨酸羟化酶(TH)和脑源性神经营养因子(BDNF)的改变,以及电针对它们的影响。方法:采用连续单一刺激(SPS)构建PTSD模型,随机分为PTSD模型组(6只)和电针治疗组(6只),并另设正常对照组(6只)。电针组于造模第2天,给予电针"足三里"穴和"百会"穴,频率为2 Hz,时间30 min,每日1次,连续电针21 d。电针结束后,采用免疫组织化学方法检测各组杏仁核TH及BDNF的表达。结果:与正常对照组比较,PTSD模型组大鼠杏仁核BDNF阳性神经元的数目及强度均减少;与模型组和正常组比较,电针组BDNF强度及数目均增加;TH(纤维长度及数目)强度在PTSD模型组较正常组增高;电针组TH纤维长度及数目较PTSD模型组降低;正常组与电针组比较差异无统计学意义。结论:电针可防止PTSD大鼠杏仁核TH的增加,并防止PTSD大鼠杏仁核BDNF的减少。

关键词： 卵巢囊性类病变   CT诊断   鉴别诊断  

摘要： 目的:探讨卵巢囊性病变的CT诊断与鉴别诊断经验,进一步提高CT诊断卵巢囊性病变的水平。方法:所有患者均采用16排CT扫描机进行检查,检查前8 h流质饮食,嘱咐患者饮水,确保膀胱充盈,检查前30 min灌服2 000 m L的2%的复方泛影葡胺,患者取仰卧位,扫描范围上缘至两侧骼脊连线,下缘至耻骨联合下缘。参数设定120 kV,工作电流150 m A,扫描层厚3 mm,层距3 mm,矩阵512×512,速度2.5 mL/s。结果:150例患者病理诊断:卵巢癌6例,卵泡膜细胞瘤9例,囊性畸胎瘤15例,巧克力囊肿21例,卵巢囊腺瘤30例,卵巢囊肿69例。术前CT诊断卵巢囊性病变144例,诊断符合率96.0%。结论:CT检查是诊断和鉴别诊断卵巢囊性病变的重要检查方式,患者无痛、经济,值得推广。

关键词： 反刍思维   心理弹性   ICU相关记忆   创伤后应激障碍  

摘要： 目的分析反刍思维与心理弹性在肝缺血再灌注损伤患者ICU相关记忆与创伤后应激障碍之间的多重中介效应,从而为肝缺血再灌注损伤患者心理干预提供指导。方法便利抽样选取哈尔滨市某4所和深圳市某2所三级甲等医院ICU于2017年1-12月收治的522例肝缺血再灌注损伤患者为研究对象,调查ICU相关记忆、创伤后应激障碍、反刍思维和心理弹性,分析反刍思维与心理弹性在ICU相关记忆与创伤后应激障碍之间的多重中介效应。结果肝缺血再灌注损伤患者ICU相关记忆、反刍思维、心理弹性、创伤后应激障碍得分分别为(64.18±10.34)、(63.15±8.21)、(62.34±8.41)、(40.74±10.24)分。肝缺血再灌注损伤患者ICU相关记忆、反刍思维和创伤后应激障碍两两间均呈正相关(r=0.777、0.724、0.734,P<0.01),均与心理弹性呈负相关(r=-0.718、-0.722,P<0.01)。心理弹性和反刍思维在ICU相关记忆与创伤后应激障碍之间均单纯存在部分中介效应,中介效应占总效应的29.0%、20.7%。心理弹性——自我效能感在ICU相关记忆与创伤后应激障碍之间存在链式中介作用,效应值为0.36,占总效应的15.6%。结论通过提高ICU肝缺血再灌注损伤患者心理弹性水平,可抑制其反刍思维和ICU相关记忆,减轻其创伤后应激障碍。