巴氯酚直肠给药配合综合康复对脑卒中恢复期偏瘫痉挛状态的干预效应

The intervention effect of rectal administration of Baclofen combined with comprehensive rehabilitation on the spastic state in the recovery period of stroke

目的探讨改善脑卒中恢复期偏瘫痉挛状态更为有效的方法。方法 100例研究对象在实施神经内科常规治疗以及病情和生命体征稳定的情况下,采用巴氯酚直肠给药(即保留灌肠)+综合康复措施治疗肌痉挛状态。用药第1天剂量为15 mg/次,然后每天增加5～10 mg,灌肠14 d为1个疗程,连续治疗3个疗程。综合康复措施具体内容包括良肢位的摆放、保持关节的活动度、缓解身体运动控制点周围痉挛、肌肉痉挛的静态牵拉、被动运动与按摩。治疗前和治疗后32 d进行疗效评定。结果治疗后32 d与治疗前比较,患者的肌张力改善情况有差异(P<0.01),提示治疗后的肌张力明显改善,逐渐恢复正常;ADL评分结果比较差异显著(P<0.01),提示治疗后32 d患者日常活动能力明显提高。结论对脑卒中患者偏瘫痉挛采用巴氯芬直肠给药配合综合康复训练有利于脑卒中患者的神经康复,改善预后。

Objective To explore more effective ways to improve hemiplegia spasticity of stroke in the recovery period. Methods 100 subjects were given Baclofen rectal administration （retention enema） ＋ comprehensive rehabilitation measures in the treatment of muscle spasticity on the basis of the implementation of the conventional treatment of neurology and sta- ble conditions and physical signs. The dose was once 15 mg in the first day, then with an increase of 5-10 mg per day, the enema of 14 d was a course of treatment, for three courses. The comprehensive rehabilitation measures included good limb placed to maintain joint mobility, ease of body movement to control the static stretch around the cramps, muscle spasms, passive movement and massage. The effects were evaluated before treatment and after treatment of 32 d. Results 32 d after treatment compared with before treatment, the patient＇s muscle tone to improve the situation had a significant difference （P 〈 0.01）. Muscle tone after treatment showed significant improvement, and gradually returned to normal; the results of the ADL score also had a significant difference （P 〈 0.01）, and prompt patients after treatment of 32 d, the activities of daily living improved significantly. Conclusion Rectal administration of Baclofen with comprehensive rehabilitation training is helpful for the neurological rehabilitation of stroke patients and can improve the prognosis of stroke patients with hemiplegia spasm.