冠脉介入患者焦虑的原因及对策研究

焦虑是冠脉介入患者常见的应激反应,焦虑引起的各种病理和生理改变会影响患者手术的顺利实施及疗效。本文基于应激理论,从认知因素、人格特征、应对策略、社会支持等方面入手,试图全面系统地探讨冠脉介入患者焦虑的成因和降低患者焦虑的对策,以期对临床心理干预提供理论依据和具体方法。     

亚临床甲状腺功能减退与冠状动脉粥样硬化性心脏病

对冠心病高危因素积极地预防及治疗,可降低冠心病的患病率和病死率。已经得到公认的临床甲状腺功能减退通过引起代谢及血流动力学紊乱而参与了冠状动脉粥样硬化的发生与发展。目前,国内外许多临床研究显示亚临床甲状腺功能减退通过多种途径参与冠心病的发生和发展,是冠心病的重要危险因素之一。     

冠心病的外科治疗

首例成功的冠状动脉旁路移植术(CABG)手术完成于1960年,随着体外循环技术的成熟,CABG手术得以不断发展.20世纪90年代,以非体外循环下冠脉旁路移植术(OPCAB)为代表的微创冠脉搭桥手术逐渐应用于临床.并取得满意的临床效果.尽管冠脉介入技术(PCI)以其创伤小的优点在冠心病的治疗方面蓬勃发展,但是CABG在远期通畅性方面仍然占据优势地位,因此CABG仍然是冠心病治疗的效果确定的一种方法.     

非ST段抬高急性冠脉综合征药物治疗规范化分析

回顾性分析我院收治的129例非ST段抬高急性冠脉综合征患者的临床资料.对比在非ST段抬高急性冠脉综合征诊治上与最新指南的差距,找出改进措施.结果表明我院的临床实践与最新指南存在较大差距,在强化抗栓,调脂治疗,β受体阻滞剂及血管紧张素转换酶抑制剂类药物使用上均有待提高.今后应采取更加积极的措施,规范用药,以达到更好的预后和转归效果.     

冠脉介入患者焦虑的原因及对策研究

焦虑是冠脉介入患者常见的应激反应,焦虑引起的各种病理和生理改变会影响患者手术的顺利实施及疗效.本文基于应激理论,从认知因素、人格特征、应对策略、社会支持等方面入手,试图全面系统地探讨冠脉介入患者焦虑的成因和降低患者焦虑的对策.以期对临床心理干预提供理论依据和具体方法.     

Effects of morphine hydrochloride on social encounters between male mice

The effects of a single injection of morphine hydrochloride (0.3, 0.6, or 1.25 mg/kg) or physiological saline (0.9% NaCI) on the agonistic behaviour elicited by isolation in male mice were examined. Individually housed mice were exposed to anosmic “standard opponents” 30 minutes after drug administration, and the encounters were videotaped and evaluated using an ethologically based analysis. Morphine (at 0.6 and 1.25 mg/kg) significantly and dose-dependently decreased time spent in offensive (“threat” and “attack”) and “digging” behaviours but markedly increased “non-social exploration” without a significant increase of “immobility.” The lowest dose was completely ineffective in producing changes in any of the behaviours studied. It is concluded that these results present a specific ethopharmacological profile characterized by suppression of aggressive behaviour, increase in non-social explotation, and no evident impairment of motor activity. © 1993 Wiley-Liss, Inc.     

Caregiving styles and anxiety among couples: coping versus not coping with cardiac illness

Background and Objectives: partners’ caregiving efforts are not always beneficial to both recipient and provider. Bowlby’s conceptualization of caregiving style as a stable predisposition may clarify such caregiving effects. The relationship between caregiving style (compulsive and sensitive) and anxiety among couples coping with cardiac illness and a matching control group not coping with cardiac illness were assessed. We hypothesized that one’s compulsive caregiving would associate positively, and one’s sensitive caregiving would associate negatively, with one’s and one’s partner’s anxiety across contexts (cardiac and non-cardiac) and gender. Design: A comparative design of 131 couples with a diagnosis of husbands’ acute cardiac syndrome and 68 matched couples in the community was applied. Methods: The Adult Caregiving Questionnaire and the Brief Symptoms Inventory were administered. Results: Structural equation modeling revealed that one’s compulsive caregiving was positively associated with one’s anxiety, across most contexts. Multi-group analyses revealed that the associations between one’s compulsive caregiving and one’s partner’s anxiety levels differed depending on gender and context. Conclusions: The distress which emerges in an individual who takes on a caregiving role and in his/her partner seems to result not only from the demands of the concrete caregiving situation but also from one’s and one’s partner’s developmental history.     

ALI/ARDS患者糖皮质激素的治疗效果和时机

急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)是临床各科经常遇到的急症,其发病机制主要是中性粒细胞向炎症部位的移动,释放出大量的炎性介质和细胞因子,引起肺泡毛细血管膜通透性增高,弥漫性肺损伤和蛋白性肺泡水肿液聚集等病理生理改变。临床表现为呼吸困难、呼吸窘迫、顽固的低氧血症,虽然使用机械通气和呼气末正压通气(PEEP)后,其病死率有所下降,但仍然维持在50%左右。就糖皮质激素的作用机制,对不同原因引起的ALI/ARDS治疗效果,使用时机作一综述,期望对ALI/ARDS治疗过程中糖皮质激素的使用予以规范。     

急性肺损伤与急性呼吸窘迫综合征的诊断与治疗策略

急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）是多个危险因素直接或间接引起肺部损伤的连续病理过程,以表现低氧血症为特征,ARDS是ALI严重末期的表现。低流量、呼气末正压（PEEP）保护性通气的措施可明显改善氧和,减轻机械通气肺损伤,降低病死率,明显优于传统通气方式。     

急性应激对工作记忆的影响受工作记忆负荷调节:来自电生理的证据

急性应激如何影响工作记忆还不清楚。采用电影片断诱发被试的急性应激或中性状态后,让其完成数字N-back任务并同时记录脑电。结果发现,低负荷工作记忆诱发的P3显著大于高负荷工作记忆;在0-back任务中,急性应激组诱发的P3显著大于控制组;而在2-back任务中,这种差异不显著。这些结果表明急性应激对工作记忆的影响受工作记忆负荷调节,支持了双竞争理论模型。