星状神经节阻滞联合认知训练治疗脑卒中后认知障碍

Effect of stellate ganglion block combined with cognitive training on cognitive impairment following stroke

目的:观察星状神经节阻滞(SGB)结合计算机辅助认知训练(CACR)对脑卒中后认知功能障碍的改善效果。方法:脑卒中后认知功能障碍的患者60例,按随机数字表法分为2组各30例,2组患者均给予常规对症处理及CACR,观察组在此基础上加用SGB治疗。治疗前后对2组患者采用简易精神状态检查(MMSE)、神经行为认知状态检查量表(NCSE)和改良的Barthel指数(MBI)进行功能评定,并利用经颅多普勒超声(TCD)检测其左侧椎动脉(LVA)、右侧椎动脉(RVA)和大脑中动脉(MCA)的平均流速(Vm)。结果:治疗1个月后,2组MMSE、NCSE及MBI评分均较治疗前明显提高(P<0.01),且观察组更高于对照组(P<0.05);2组LVA、RVA及MCA的Vm治疗后均明显低于治疗前(P<0.01),且观察组更低于对照组(P<0.05)。结论:SGB结合CACR可改善脑循环提高脑血流量,促使脑卒中患者的认知功能及ADL能力恢复,具有较好临床应用价值。

Objective：To explore the effects of stellate ganglion block （SGB） combined with computer assisted training on cognitive impairment following stroke.Methods：Sixty cases of cognition dysfunction after stroke were randomly divided into control group and observation group （n=30 each）.The patients in both groups received basic symptomatic treatment and computer assisted cognitive rehabilitation （CACR）.Simultaneously,the SGB was adopted to treat the patients in observation group.They were assessed with Mini Mental State Examination （MMSE）,Neuro logical and Cognitive Status Examination （NCSE） and Modified Barthel Index （MBI） and LVA and RVA Vm and MCA Vm by trans-cranial Doppler （TCD） methods before and after training.Results：After 30-day treatment,the MMSE,NCSE and MBI scores in both two groups were significantly higher than those before treatment （P＜0.01）,and the scores in observation group were significantly higher than in control group （P＜0.05）.The LVA and RVA Vm and MCA Vm scores in both two groups were significantly lower than those before treatment （P＜0.01）,and the scores in observation group were significantly lower than in control group （P＜0.05）.Conclusion：CACR combined with SGB may significantly improve cerebral blood circulation and promote the recovery of cognitive function and ADL of the patients with stroke.