远端缺血后适应联合早期康复护理对急性缺血性脑卒中的康复效果研究

Effect of remote ischemic post-conditioning combined with early rehabilitation nursing on rehabilitation of acute ischemic stroke

目的:探讨远端缺血后适应(RIPostC)联合早期康复护理对急性缺血性脑卒中的康复效果。方法:选取缺血性脑卒中病人91例为研究对象,随机分成对照组31例、早期康复组30例、联合组30例。对照组采取常规治疗干预+假RIPostC刺激,早期康复组采取早期康复干预,联合组采取RIPostC与早期康复联合干预。比较3组病人干预后14、90 d美国国立卫生研究院卒中量表(NIHSS)得分和Barthel指数(BI)。结果:干预前,3组病人NIHSS得分和BI差异均无统计学意义(P>0.05)。干预后14 d,早期康复组、联合组NIHSS得分均低于干预前(P<0.05和P<0.01),且联合组NIHSS得分均低于对照组和早期康复组(P<0.05);早期康复组、联合组BI均明显高于干预前(P<0.01),且联合组BI明显高于对照组(P<0.01)。干预后90 d,3组NIHSS得分均低于干预前和干预后14 d(P<0.05~P<0.01),且联合组NIHSS得分明显低于对照组和早期康复组(P<0.01),早期康复组NIHSS得分明显低于对照组(P<0.01);3组BI均高于干预前和干预后14 d(P<0.05~P<0.01),且联合组BI明显高于对照组和早期康复组(P<0.01),早期康复组BI明显高于对照组(P<0.01)。结论:RIPostC联合早期康复护理对急性缺血性脑卒中的康复效果显著,联合干预可以在短期内改善病人的神经功能,提升病人日常生活能力。

Objective:To explore the effect of remote ischemic post-conditioning(RIPostC) combined with early rehabilitation nursing on the rehabilitation of acute ischemic stroke.Methods:A total of 91 patients with ischemic stroke were selected and randomly divided into the control group(n=31),early rehabilitation group(n=30) and combination group(n=30).The control group received conventional treatment+sham RIPostC stimulation,the early rehabilitation group received early rehabilitation intervention,and the combination group received the combined intervention of RIPostC and early rehabilitation.The National Institutes of Health stroke scale(NIHSS) score and Barthel index(BI) were compared between the three groups at 14 and 90 days after intervention.Results:Before the intervention,there was no significant difference in NIHSS score and BI among the three groups(P>0.05).At 14 days after intervention,the NIHSS score in the early rehabilitation group and combination group was lower than that before the intervention(P<0.05 and P<0.01),and the NIHSS score in the combination group was lower than that in the control group and early rehabilitation group(P<0.05);the BI in early rehabilitation group and combination group was significantly higher than that before intervention(P<0.01),and the BI in the combination group was significantly higher than that in the control group(P<0.01).At 90 days after intervention,the NIHSS score in the three groups was lower than that before the intervention and 14 days after the intervention(P<0.05 to P<0.01),the NIHSS score in the combination group was significantly lower than that in the control group and early rehabilitation group(P<0.01),and the NIHSS score in the early rehabilitation group was significantly lower than that in the control group(P<0.01);the BI in the three groups was higher than that before intervention and 14 days after intervention(P<0.05 to P<0.01),the BI in the combination group was significantly higher than that in the control group and early rehabilitation group(P<0.01),and the BI in the early rehabilitation group was significantly higher than that in the control group(P<0.01).Conclusions:RIPostC combined with early rehabilitation nursing has a significant effect on the rehabilitation of acute ischemic stroke.Combined intervention can improve the patients′ neurological function and daily living ability in a short time.