高压氧治疗不同时期联合躯干控制训练对缺血性脑卒中患者认知及运动康复的效果  

Effect of hyperbaric oxygen therapy combined with trunk control training at different stages on cognitive and motor rehabilitation in patients with ischemic stroke

作　　者：郭正会 杨梦兰 王爱凤[1] 方大钊[1] GUO Zhenghui;YANG Menglan;WANG Aifeng;FANG Dazhao(Neurosurgery Department,the First People's Hospital of Huai'an,Huaian 223300,Jiangsu,China)

机构地区：[1]淮安市第一人民医院神经外科,江苏淮安223300

出　　处：《贵州医科大学学报》2024年第7期1070-1076,共7页Journal of Guizhou Medical University

基　　金：江苏省卫生健康科研项目(HAWJ202005)。

摘　　要：目的探讨高压氧治疗不同时期联合躯干控制训练对缺血性脑卒中患者康复的效果。方法缺血性脑卒中患者116例随机均分为对照组和观察组,两组均接受溶栓治疗,对照组在高压氧干预后行躯干控制训练、观察组在高压氧干预的同时展开躯干控制训练,均治疗4周;于干预前、干预后分别采用简易智力状态检查量表(MMSE)评估患者认知水平,美国国立卫生研究院卒中量表(NIHSS)评估神经缺损情况,Berg平衡量表(BBS)评估平衡能力,Sheikh躯干控制量表(Sheikh)评估躯干控制能力,Fugl-Meyer评定量表(FMA)评估肢体功能,功能独立性评定量表(FIM)评估患者功能独立性;采集患者干预前、干预后外周静脉血5 mL,检测两组患者神经生长因子、神经元特异性烯醇化酶及髓鞘碱性蛋白水平。结果干预后,两组患者MMSE评分均高于干预前、NIHSS评分低于干预前,且观察组MMSE评分高于对照组、NIHSS评分低于对照组(P<0.05);干预后,两组患者BBS、Sheikh评分高于干预前,且观察组高于对照组(P<0.05);干预后,两组FMA、FIM评分高于干预前,且观察组高于对照组(P<0.05);干预后,两组血清神经生长因子高于干预前,神经元特异性烯醇化酶、髓鞘碱性蛋白低于干预前,观察组神经生长因子高于对照组,神经元特异性烯醇化酶、髓鞘碱性蛋白低于对照组(P<0.05)。结论高压氧干预治疗同时进行躯干控制训练,有利于缺血性脑卒中患者认知功能、平衡运动功能的恢复。Objective To explore the effect of hyperbaric oxygen therapy combined with trunk control training at different stages on the rehabilitation of patients with ischemic stroke.Methods A total of 116 patients with ischemic stroke were randomly divided into a control group and an observation group.Both groups received thrombolytic therapy.The control group received trunk control training after hyperbaric oxygen intervention,while the observation group received trunk control training simultaneously with hyperbaric oxygen intervention.Both groups were treated for 4 weeks.Before and after the intervention,the Mini-Mental State Examination(MMSE)was used to evaluate patients'cognitive function,the National Institutes of Health Stroke Scale(NIHSS)was used to assess neurological deficits,the Berg Balance Scale(BBS)was used to evaluate balance ability,the Sheikh Trunk Control Scale(Sheikh)was used to assess trunk control ability,the Fugl-Meyer Assessment Scale(FMA)was used to evaluate limb function,and the Functional Independence Measure(FIM)was used to assess patients'functional independence.Five milliliters of peripheral venous blood were collected before and after the intervention to detect levels of nerve growth factor,neuron-specific enolase,and myelin basic protein in both groups.Results After the intervention,MMSE scores increased and NIHSS scores decreased in both groups compared to pre-intervention levels,with the observation group showing higher MMSE scores and lower NIHSS scores than the control group(P<0.05).Post-intervention BBS and Sheikh scores were higher than pre-intervention scores in both groups,with the observation group scoring higher than the control group(P<0.05).FMA and FIM scores increased after the intervention in both groups,with the observation group scoring higher than the control group(P<0.05).Serum nerve growth factor levels were higher,while neuron-specific enolase and myelin basic protein levels were lower post-intervention compared to pre-intervention in both groups,with the observation group

关 键 词：缺血性脑卒中 高压氧 躯干控制训练 神经损伤 认知功能 

分 类 号：R743.4[医药卫生—神经病学与精神病学]