不同治疗时间窗中频脉冲电导对急性脑梗死患者肢体功能的影响

Effect of Medium Frequency Pulse Conductance in Different Treatment Time Windows on Limb Function of Patients with Acute Cerebral Infarction

目的:分析不同治疗时间窗中频脉冲电导对急性脑梗死的临床效果及对患者肢体功能的影响。方法:选取2020年1月—2021年12月于赣南医学院第二附属医院住院治疗的明确诊断为急性脑梗死并伴肢体功能障碍的76例患者作为本项目研究对象,均给予中频脉冲电导治疗,根据发病后接受治疗的时间分为三组,分别为A组(n=27,发病后48h内)、B组(n=25,发病后48~72h)、C组(n=25,发病后72 h以上,96 h以内)。观察比较三组神经功能、肢体功能、日常生活能力及血清细胞因子。结果:与治疗前比较,治疗2周后,三组美国国立卫生研究院卒中量表(NIHSS)评分均显著降低,Fugl-Meyer评估表(FMA)、改良Barthel指数(MBI)评分都显著提高(P<0.05)。治疗2周后,A组NIHSS评分、FMA评分、MBI评分均低于B组、C组,B组均低于C组(P<0.05)。治疗2周后,三组脑源性神经生长因子(BDNF)和神经生长因子(NGF)水平均升高,神经元特异性烯醇化酶(NSE)均降低,A组BDNF和NGF均高于B组和C组,B组均高于C组,A组NSE低于B组和C组,B组低于C组,差异均有统计学意义(P<0.05)。结论:中频脉冲电导治疗能有效促进急性脑梗死患者上下肢功能的改善,并且发病后48h内给予该干预的康复治疗效果最理想。

Objective:To analyze the clinical effect of medium frequency pulse conductance in different treatment time windows on acute cerebral infarction and its influence on limb function of patients.Method:A total of 76 patients diagnosed with acute cerebral infarction accompanied with limb dysfunction who were hospitalized in the Second Affiliated Hospital of Gannan Medical College from January 2020 to December 2021 were selected as the research objects of this project.All patients were given medium frequency pulse conductance therapy,and were divided into three groups according to the treatment time after onset,which were respectively group A(n=27,48 h after onset),group B(n=25,48-72 h after onset),group C(n=25,more than 72 h,less than 96 h after onset).Neurological function,limb function,daily living ability and serum cytokines were observed and compared among the three groups.Result:Compared with before treatment,after 2 weeks of treatment,the scores of national institute of health stroke scale(NIHSS)in the three groups were significantly decreased,and the scores of Fugl-Meyer assessment(FMA)and modified Barthel index(MBI)in the three groups were significantly increased(P<0.05).After 2 weeks of treatment,NIHSS scores,FMA scores and MBI scores in group A were lower than those in group B and group C,and those in group B were lower than those in group C(P<0.05).After 2 weeks of treatment,the levels of brain-derived growth factor(BDNF)and nerve growth factor(NGF)in the three groups were increased,and neuron specific enolase(NSE)in the three groups were decreased,BDNF and NGF in group A were higher than those in group B and group C,those in group B were higher than those in group C,NSE in group A was lower than that in group B and group C,and that in group B was lower than that in group C,the differences were statistically significant(P<0.05).Conclusion:Medium frequency pulse conductance therapy can effectively improve the upper and lower limb function of patients with acute cerebral infarction,and the rehabilitation effect of this intervention within 48 h after onset is the best.