早期电刺激小脑顶核改善急性脑梗死偏瘫患者的运动功能和脑血流量

Early electrostimulation on cerebellar fastigial nucleus improving motor function and cerebral blood flow of patients with hemiplegia induced by acute cerebral infarction

目的:观察早期电刺激小脑顶核对急性脑梗死偏瘫患者运动功能和脑血流量的影响。方法:将96例急性脑梗死患者,按入院先后顺序分为电刺激小脑治疗康复组(48例)和常规治疗对照组(48例)。康复组在常规药物治疗的基础上同时接受电刺激小脑顶核治疗,对照组仅给予常规药物治疗。分别观察其临床疗效,治疗前后神经功能缺损程度恢复情况,两侧大脑前动脉、大脑中动脉刺激前后血流速度变化;所有数据进行统计学处理。结果:治疗组有效率为92%,与对照组44%比较,χ2=23.67,P<0.01;神经功能缺损程度评分:康复组治疗前后比较(27.47±5.14)比(8.98±6.34)分,t=14.57,P<0.01,刺激后康复组与对照组(18.95±10.32)分比较(t=9.47,P<0.01);脑动脉血流量:康复组患侧治疗后明显增加(t=7.06,t=6.59,P<0.01),与对照组比较(t=4.72,5.36,P<0.01);康复组健侧治疗前后比较(t=2.18,2.34,P<0.05)。肢体运动功能评分:康复组治疗前后比较,上肢t=14.76,P<0.01,下肢t=10.24,P<0.01,治疗后康复组与对照组比较上肢t=9.72,P<0.01,下肢t=5.61,P<0.01,两组之间差异具有显著性意义。结论:电刺激小脑顶核治疗可显著改善急性脑梗死患者神经功能缺损症状,促进神经功能及患肢运动功能的恢复。

AIM:To observe the effect of early electrostimulating cerebellar fastigial nu cleus on motor function and cerebral blood flow of the patients with hemiplegia induced by acute cerebral infarction. METHODS:Ninety-six patients with acute cerebral infarction were orderly div ided into rehabilitation group(n=48) and control group(n=48) according to subseq uence of hospitalization.Rehabilitation group was treated with electrostimulatio n on cerebellar fastigial nucleus based on the routine drug treatment.Control gr oup was only treated with the routine drug treatment.The clinical effect and the degree of neurologic impairment and the blood flow of bilateral anterior cerebr al artery and middle cerebral artery were observed before and after treatment.Al l data were selected for statistical analysis. RESULTS:The effective rate in the rehabilitation group was 92% (÷ 2=23.67, P< 0.01).Compared with the rehabilitation group(8.98± 6.34) after treatment, t he scores of neurologic impairment were 27.47± 5.14 in the rehabilitation befor e treatment(t=14.57, P< 0.01),and 18.95± 10.32 in the control group(t=9.47,P< 0.01).Cerebral artery blood flow in the affected side was significantly increase d in the rehabilitation group after treatment as compared with that before trea tment(t=7.06,P< 0.01;t=6.59,P< 0.01).There were significant differences in the c erebral artery blood flow between the rehabilitation group and control group aft er treatment(t=4.72,P< 0.01; t=5.36,P< 0.01),and between the rehabilitation grou p in the unaffected side before and after treatment(t=2.18,P< 0.05; t=2.34,P< 0. 05). Differences were also significant in the scores of motor function of the re habilitation group before and after treatment(upper limb: t=14.76,P< 0.01;lower limb: t=10.24,P< 0.01),and between the rehabilitation group and control group af ter treatment(upper limb: t=9.72,P< 0.01;lower limb:t=5.61,P< 0.01). CONCLUSION:Electrostimulation of cerebellar fastigial nucleus can significant ly improve the neurologic impairment of acute infarction patient, and promote th e recovery of neurologic function and the motor function in the affected limb.