丁苯酞联合高压氧治疗脑卒中后认知障碍的疗效观察

Effects of butylphthalide combined with hyperbaric oxygen therapy on post-stroke cognitive impairment

目的观察丁苯酞联合高压氧治疗急性缺血性脑卒中后认知障碍(PSCI)的临床效果。方法选取2019年12月至2020年11月在睢宁县人医院治疗的发病72 h内PSCI患者90例,采用随机数字表法分为对照组45例、观察组45例,对照组采用常规治疗,观察组在常规治疗基础上给予丁苯酞联合高压氧治疗,比较两组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)、日常活动能力(ADL)评分。结果治疗前,两组NIHSS、MoCA、ADL评分差异均无统计学意义(均P>0.05)。治疗后14 d、1个月,观察组NIHSS评分分别为(4.02±2.18)分、(3.21±2.03)分,均低于对照组的(5.21±2.24)分、(4.62±2.68)分,两组差异均有统计学意义(t=2.55、2.81,均P<0.05);治疗后1个月、3个月,观察组MoCA评分分别为(19.79±5.67)分、(23.69±2.67)分,均高于对照组的(16.88±5.12)分、(19.74±2.29)分,ADL评分分别为(54.85±5.69)分、(74.38±4.98)分,均高于对照组的(46.78±6.24)分、(63.21±5.84)分,差异均有统计学意义(t=2.56、7.53、6.41、9.76,均P<0.05)。结论丁苯酞联合高压氧治疗急性缺血性PSCI效果确切,能够减轻患者神经功能缺损,改善患者的认知功能,提高患者的日常生活能力。

Objective To investigate the clinical efficacy of butylphthalide combined with hyperbaric oxygen therapy on post-stroke cognitive impairment in patients with acute ischemic stroke.Methods A total of 90 patients with post-stroke cognitive impairment who were hospitalized within 72 hours of onset in Suining County People's Hospital from December 2019 to November 2020 were included in this study.They were randomly divided into a control group and an observation group(n=45/group).The control group was given conventional treatment and the observation group was given butylphthalide combined with hyperbaric oxygen therapy in addition to conventional treatment.The National Institutes of Health Stroke Scale score,Montreal Cognitive Assessment score,and Activities of Daily Living score were compared between the two groups before and after treatment.Results Before treatment,there were no significant differences in the National Institutes of Health Stroke Scale score,Montreal Cognitive Assessment score,and Activities of Daily Living score between the two groups(all P>0.05).At 14 days and 1 month after surgery,the National Institutes of Health Stroke Scale scores in the observation group were(4.02±2.18)points and(3.21±2.03)points,which were significantly lower than(5.21±2.24)points and(4.62±2.68)points in the control group(t=2.55,2.81,both P<0.05).At 1 and 3 months after treatment,the Montreal Cognitive Assessment score in the observation group were(19.79±5.67)points and(23.69±2.67)points,which were significantly higher than(16.88±5.12)points and(19.74±2.29)points in the control group(t=2.56,7.53,both P<0.05).At 1 and 3 months after treatment,Activities of Daily Living scores in the observation group were(54.85±5.69)points and(74.38±4.98)points,which were significantly higher than(46.78±6.24)points and(63.21±5.24)points in the control group(t=6.41,9.76,both P<0.05).Conclusion Butylphthalide combined with hyperbaric oxygen therapy for the treatment of post-stroke cognitive impairment in patients with acute ischemic stroke can alleviate neurologic deficits,and improve cognitive function and the ability of daily life.