老年脑梗死患者不同时机康复治疗对神经功能的影响比较

张淑红; 凌迎春; 盛高扬

doi:10.16766/j.cnki.issn.1674-4152.002428

老年脑梗死患者不同时机康复治疗对神经功能的影响比较

doi: 10.16766/j.cnki.issn.1674-4152.002428

1.
龙游县人民医院神经内科，浙江衢州 324400
2.
绍兴市第七人民医院检验科，浙江绍兴 312000

基金项目:

浙江省医药卫生科技计划项目 2022KY1309

详细信息

通讯作者:
凌迎春, E-mail: s951269@163.com

中图分类号: R743.3 R493
计量
- 文章访问数: 122
- HTML全文浏览量: 90
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2021-12-03
- 网络出版日期: 2022-08-20

Effects of rehabilitation treatment at different time points on neurological function in elderly patients with cerebral infarction

1.
Department of Neurology, Longyou People's Hospital, Quzhou, Zhejiang 324400, China

摘要

摘要: 目的探讨老年脑梗死患者不同时机康复治疗的效果及对患者神经功能的影响，为临床康复治疗方案的制定提供参考依据。方法将2018年5月—2021年5月龙游县人民医院神经内科收治的180例老年脑梗死患者按随机数字表法分为观察组和对照组，每组90例，2组分别于患者生命体征稳定后2周内和2~4周进行康复治疗，均治疗4周。比较2组NIHSS评分、FMA评分、BI评分、炎性因子水平(白细胞介素-6、肿瘤坏死因子-α、超敏C-反应蛋白)及康复效果。结果治疗后，2组患者NIHSS评分均降低(P＜0.05)，且观察组明显低于对照组[(7.61±1.87)分vs.(8.95±2.09)分，P＜0.05]；2组患者FMA评分均升高(P＜0.05)，且观察组显著高于对照组[(73.06±6.34)分vs.(64.15±4.78)分，P＜0.05]；2组患者BI评分均升高(P＜0.05)，观察组高于对照组[(68.35±6.83)分vs.(57.11±7.29)分，P＜0.05]；治疗后，2组患者白细胞介素-6、肿瘤坏死因子-α、超敏C-反应蛋白均降低(均P＜0.05)，且观察组低于对照组(均P＜0.05)；观察组的治疗总有效率(84.44%)高于对照组(71.11%，P＜0.05)。结论老年脑梗死患者于生命体征稳定后2周内进行康复治疗可改善神经功能、肢体功能、日常生活活动能力，且可降低炎性因子水平，提高康复效果。
- 老年脑梗死 /
- 不同时机 /
- 康复治疗 /
- 神经功能 /
- 肢体功能 /
- 日常生活活动能力
Abstract: Objective To explore the effect of rehabilitation treatment at different time points on elderly patients with cerebral infarction and its impact on neurological function, so as to provide reference basis for the formulation of clinical rehabilitation treatment plan. Methods A total of 180 elderly patients with cerebral infarction treated in the Department of Neurology of Longyou People's Hospital from May 2018 to May 2021 were randomly divided into the observation group and control group, with 90 cases in each group. The two groups received rehabilitation treatment for 4 weeks within 2 weeks and 2-4 weeks after the patient's vital signs were stable. The National Institutes of Health stroke scale (NIHSS) score, Fugl-Meyer assessment (FMA) score, Barthel Index (BI) score, levels of inflammatory factors (interleukin-6, tumour necrosis factor-α, high-sensitivity C-reactive protein) and rehabilitation effect were observed in the two groups. Results The NIHSS score of the two groups decreased significantly after treatment (P < 0.05), with the observation group having a significantly lower score than the control group [(7.61±1.87) points vs. (8.95±2.09) points, P < 0.05]. After treatment, the FMA score of the two groups increased significantly (P < 0.05), with the observation group having a significantly higher score than the control group [(73.06±6.34) points vs. (64.15±4.78) points, P < 0.05]. The BI scores of the two groups increased significantly after treatment (P < 0.05), with the observation group having a significantly higher score than the control group [(68.35±6.83) points vs. (57.11±7.29) points, P < 0.05]. The levels of interleukin-6, tumour necrosis factor-α and high-sensitivity C-reactive protein of the two groups increased significantly after treatment (P < 0.05), and the observation group had lower levels compared with the control group (P < 0.05). The total effective rate of the observation group was 84.44%, which was significantly higher than that in the control group (71.11%, P < 0.05). Conclusion Rehabilitation treatment for elderly patients with cerebral infarction within 2 weeks after the stability of vital signs can improve neurological function, limb function and activities of daily living, reduce the level of inflammatory factors, and improve the rehabilitation effect.
- Senile cerebral infarction /
- Different timing /
- Rehabilitation treatment /
- Neurological function /
- Limb function /
- Activities of daily living

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表 1 2组脑梗死患者NIHSS评分比较(x±s，分)

Table 1. Comparison of NIHSS scores between two groups of patients with cerebral infarction (x±s, points)

组别	例数	治疗前	治疗后	t值	P值
观察组	90	11.06±2.60	7.61±1.87	10.220	＜0.001
对照组	90	11.13±2.55	8.95±2.09	6.273	＜0.001
t值		0.182	4.533
P值		0.856	＜0.001

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表 2 2组脑梗死患者FMA评分比较(x±s，分)

Table 2. Comparison of FMA scores between two groups of patients with cerebral infarction (x±s, points)

组别	例数	治疗前	治疗后	t值	P值
观察组	90	56.04±3.15	73.06±6.34	22.808	＜0.001
对照组	90	56.01±3.17	64.15±4.78	13.464	＜0.001
t值		0.064	10.646
P值		0.949	＜0.001

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表 3 2组脑梗死患者日常生活活动能力(BI评分) 比较(x±s，分)

Table 3. Comparison of activities of daily living (BI score) between two groups of patients with cerebral infarction (x±s, points)

组别	例数	治疗前	治疗后	t值	P值
观察组	90	42.81±5.96	68.35±6.83	26.729	＜0.001
对照组	90	43.03±5.88	57.11±7.29	14.262	＜0.001
t值		0.249	10.674
P值		0.803	＜0.001

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表 4 2组脑梗死患者炎性因子水平比较(x±s)

Table 4. Comparison of inflammatory factors between two groups of patients with cerebral infarction (x±s)

组别	例数	白细胞介素-6(pg/mL)		肿瘤坏死因子-α(μg/L)		超敏C-反应蛋白(μmol/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	90	192.26±31.05	137.23±26.25^a	70.43±8.23	25.76±6.72^a	7.84±1.67	4.22±1.34^a
对照组	90	190.98±30.84	154.76±29.54^a	70.58±8.31	35.87±7.21^a	7.81±1.65	5.36±1.47^a
t值		0.277	4.208	0.122	9.731	0.121	5.437
P值		0.782	＜0.001	0.903	＜0.001	0.904	＜0.001
注：与治疗前比较，^aP＜0.05。

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表 5 2组脑梗死患者康复效果比较[例(%)]

Table 5. Comparison of rehabilitation effect between two groups of patients with cerebral infarction [cases(%)]

组别	例数	基本痊愈	显著进步	进步	无变化	恶化	死亡	总有效
对照组	90	15(16.67)	24(26.67)	25(27.78)	25(27.78)	1(1.11)	0	64(71.11)
观察组	90	23(25.56)	31(34.44)	22(24.44)	14(15.56)	0	0	76(84.44)
注：2组总有效率比较，χ²=4.629，P=0.031。

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