急性脑血管病偏瘫早期康复治疗与脑血流变化关系的研究

The relationship between cerebral blood flow and early rehabilitative intervention for acute cerebrovascular disease

目的探讨加用早期康复治疗手段对急性脑血管病偏瘫的疗效及相关因素的影响。方法对201例急性脑血管病患者随机分为康复组和对照组,康复组早期加用康复手段,通过对康复治疗前后神经功能缺损评分、生活能力指数(ADL)评分及经颅多普勒彩色超声(TCD)脑血流的变化判断疗效。结果康复治疗前后神经功能缺损评分、ADL比较差异有统计学意义(P<0.01),康复治疗对脑血流情况有明显改善,神经功能缺损程度越重,血流速度越低,康复治疗后血流速度上升的幅度也越小。结论急性脑血管病偏瘫早期加用康复治疗较常规治疗效果好,偏瘫恢复程度提高,减轻病残程度,提高生活质量。TCD可以作为测定脑梗死恢复情况的客观指标。

Objections To investigate the therapeutic effect and correlation factor of additional early rehabilitative intervention for hemiplegia caused by acute cerebrovascular diseases. Methods Two hundred and one cases of acute cerebrovascular diseases were randomized into rehabilitation group or control group. The rehabilitation group received early additional rehabilitation therapy. The treatment efficacy was judged by neurological impairment score, activities of daily living score （ADL） and transcranial doppler sonography before and after rehabilitation. Results Statistical significantly differences were found in neurological impairment and ADL scores between the 2 groups （P〈0.01）. Rehabilitative intervention demonstrated markedly improvement on cerebral blood flow. However, a slightly lowered increase in blood flow velocity post-treatment was also seen in those with more severe neurological impairment and slower cerebral blood flow. Conclusion Compared with conventional therapy, early additional rehabilitation for acute cerebrovascular disease resulted in better outcomes, such as improved recovery of hemiplegia, reduced disabilities and good quality of life. Transcranial doppler sonography may be used as an objective measure in assessment of recovery after stroke.