康复训练、溶栓和神经保护剂治疗对急性脑梗死患者运动功能的影响

Therapeutic effect of thrombolysis, neuroprotective agents and rehabilitation training on motor function in acute cerebral infarction patients

目的 探讨康复训练、溶栓和神经保护剂联合治疗对急性脑梗死患者运动功能的影响。方法 对 12 0例急性脑梗死患者采用Seldinger法经股动脉插管、闭塞动脉内直接注入 5 0～ 10 0万u尿激酶并同时分别加用神经保护剂 (硫酸镁、GM1 和 2 1 -氨基酸类固醇 )和常规治疗 ,应用神经保护剂的各组均接受运动疗法、作业疗法及电疗等综合康复治疗方法。治疗前、后 3个月进行运动功能评价。结果 与对照组比较 ,综合康复治疗组患者Barthel指数 (BI)、运动功能Fugl -Meyer评分显著提高 (分别P <0 .0 1) ,且疗效高低顺次为GM1 组 >2 1 -氨基酸类固醇组 >硫酸镁组。结论 早期康复训练联合神经保护剂治疗能够显著降低急性脑梗死患者的功能障碍 ,提高溶栓治疗的临床疗效。

Objective To investigate the effects of the combined use of rehabilitation training,thrombolysis and neuroprotective agents on motor function in acute cerebral infarction patients. MethodsAdministration of early intra-arterial thrombolysis was applied in 120 patients with acute cerebral infarction (ACI). A dosage of 50×104 to 106 IU Urokinase(UK), was perfused selectively and directly to the blocked arteries and confirmed by use of Seidinger's method and cerebral angiography. The patients were then randomly divided into neuroprotective agents[magnesium sulfate,ganglioside-1(GM 1),21-amino acid steroid] treatment group(group A) and control group(n=30,respectively). The former was treated further with received rehabilitation training, including electric stimulation therapy and regular physical therapy,while the later was not. The motor function was evaluated before and 3-month after the treatment. ResultsThe Barthel index and Fugl-Meyer scores in group A improved significantly than those in the control group, respectively (P<0.01).The effective rank from the high to the low is GM 1,21-amino acid steroid and magnesium sulfate. ConclusionEarly rehabilitation training combined with neuroprotective agents for ACI could significant recover the motor function and promote early intra-arterial thrombolysis.