作业训练对脑梗死患者脑血流的影响

The Effects of Occupational Therapy on Cerebral Blood Flow of Patients with Cerebral Infarction

目的:观察作业训练对脑梗死患者大脑中动脉脑血流的影响,探讨脑梗死康复治疗的方法及效果评价。方法:选取医院住院治疗的脑梗死患者127例,按时间先后顺序分为康复组65例和对照组62例,并选择同期体检健康人81例作为健康对照组,康复组和对照规组在入院早期均按脑梗死常规处理,康复组在病情稳定后经康复师评价后采用作业训练康复治疗。康复组和对照组治疗前后均应用经颅超声多普勒(TCD)检测双侧大脑中动脉的平均血流速度(VD)。结果:治疗前康复组和对照组与健康组比较双侧大脑中动脉的血流速度显著降低(P<0.01),康复组与对照组比较双侧大脑中动脉的血流速度无统计学差异(P>0.05);治疗30d后康复组与健康组双侧大脑中动脉的血流速度无统计学差异(P>0.05),康复组较治疗前增加(P<0.01),较对照组明显增加(P<0.01);对照组较治疗前明显增加(P<0.05),但与健康组比较仍降低(P<0.05)。结论:作业训练能够增加脑梗死患者损害区的脑血流量,促进功能恢复,TCD可以作为评价其早期疗效的指标。

Objective:To explore and evaluate the rehabilitation therapies for cerebral infarction by observing the effects of occupational therapy on cerebral blood flow of patients with cerebral infarction.Methods:127inpatients had been divided into the rehabilitation group(RG)with 65cases and the control group(CG)with 62cases.Meanwhile 81healthy volunteers had been chosen as the healthy control group(HG).The patients in RG had been treated with both drug and the occupational therapy,and those in CG with drug only.The average cerebral blood flow(ACF)in bilateral MCA in RG,CG and HG had been examined by TCD.Results:The ACFs in bilateral MCA in RG and CG were slower than that in HG(P<0.01)before treatment.After 30-day treatment,there were no statistical differences in the ACF between RG and HG(P>0.05),the ACF obviously higher in RG after treatment than that in CG(P<0.01)and the ACF in CG obviously higher after treatment but slower than in HG(P<0.05).Conclusion:The occupational therapy can increase ACF of bilateral MCA in patients with cerebral infarction and TCD can be regarded as a marker to evaluate the early curative effects.