不同手术治疗时间窗与脑出血患者肢体运动功能恢复的关系

Correlations between various time windows of surgery and the recovery of limb motor function in patients with cerebral hemorrhage

目的:探讨不同手术治疗时间窗对脑出血患者早期运动功能恢复效果,并分析其作用机制。方法:选择出血量在30～50mL以内的大脑基底核区脑出血86例,按微创手术清除颅内血肿的时间分为超早期(6h内)、早期(6～12h)和迟早期(13～24h)3组,采用统一的康复治疗方法,观察术后康复治疗4周后Fugl-Meyer(FMA)和Barthel(MBI)指数评分变化。结果:超早期术后康复治疗组FMA评分为(53.2±11.4)分,MBI评分为(56.3±14.6)分,较早期组犤FMA(37.9±10.4)分,MBI(40.5±12.9)分犦和迟早期手术组犤FMA(33.5±9.6)分,MBI(34.4±12.1)分犦明显提高,相异有显著性意义(P<0.05)。结论:超早期手术后康复治疗在早期改善肢体运动功能和生活自理能力方面明显优于早期和迟早期手术。

AIM:To explore the effect of various time windows of operation on the early re habilitation of motor function in patients with cerebral hemorrhage,and to analy ze its mechanism. METHODS:Totally 86 patients with hemorrhage of basal nuclei with the volume of 30-50 mL were randomly divided into ultra-early(within 6 hours),early(6-12 h ours) and tardy-early(13-24 hours) groups according to the time of micro-inva sive surgical evacuation of intracranial hematoma. The changes in the scores of Fugl-Meyer assessment(FMA) and modified Barthel index(MBI) after 4 weeks of re covery treatment were observed. RESULTS:The FMA and MBI scores in the ultra-early group were 53.2±11.4 and 5 6.3±14.6 respectively,significantly higher than those in the early group(FMA:37 .9±10.4,MBI: 40.5±12.9) and tardy-early group(FMA:33.5±9.6,MBI:34.4±12.1). CONCLUSION:Ultra-early operation combined with recovery treatment can achieve markedly better improvement in limb motor function and self-dependence ability than the early and tardy-early operations.