早期康复治疗对皮质运动性失语患者脑血流的影响

An effect of cerebral blood flow on Broca aphasia patient of cerebrovascular disease by early rehabilitative intervention

目的探讨早期康复治疗对脑血管病皮质运动性失语（Broca失语）患者脑血流的影响，评价早期康复治疗的效果，寻找评价疗效的指标。方法选择Broca失语患者41例，按人院顺序随机分为康复组（23例）和对照组（18例），并选择37例同期体检的健康人作为健康对照组，康复组在应用药物治疗的基础上联用康复治疗，而治疗组仅应用药物治疗，两组治疗前后和健康对照组都应用经颅多普勒检测左侧大脑中动脉的平均血流速度。结果康复组和对照组治疗后VD[（74，54±12.17）m／s、（61.73±11．37）m／s]较治疗前[（46．36±10，21）m／s、（43．47±9．42）m／s]平均血流速度明显增高[（t=9．17，P〈0．01）；（t=7．62，P〈0，01）]，与健康对照组比较差异无统计学意义（q=2，96，P〉0．05）。康复组与对照组比较．治疗后平均血流速度明显增高（q=3．18，P〈0．05）。结论早期康复治疗可以增加Broca失语患者的脑血流量，经颅多普勒检测可以作为评价其早期疗效的指标。

Objective To observe the effect of cerebral blood flow on Broca aphasia patient of cerebrovascular disease by early rehabilitative intervention, to evaluate the result of early rehabilitative intervention, to ques the marker evaluating early effect. Methods 41 Broca aphasia patients were divided to rehabilitation groups（23 patients） and control groups（ 18 patients） according to the sequence of hospitalization,and meanwhile 37 patients of health exami- nation were chosen as health control groups, the patients of rehabilitation groups were treated with drug and rehabili- tative intervention but the patients of control group were treated only with drug, the average cerebral blood flow of left middle cerebral artery of both groups and health control group was examined with transcranium doppler before and after treatment. Results The average cerebral blood flow of left middle cerebral artery of rehabilitation group and control group was not different before treatment, the rehabilitation group and control group was less than health control group;the average cerebral blood flow of left middle cerebral artery of rehabilitation group and control group was increased obviously after treatment than that before treatment; the average cerebral blood flow of left middle cerebral artery was not different between rehabilitation group and health control group after treatment, it was differ- ent between control group and health control group ; the average cerebral blood flow of left middle cerebral artery was increased obviously on rehabilitation group than that on control group after treatment. Conclusions the early reha- bilitative intervention can increase the average cerebral blood flow of left middle cerebral artery of Broca aphasia patient accelerate the functional restoration;TCD can be regarded as an early marker to evaluate early effect.