早期高压氧联合康复训练治疗对老年高血压脑出血患者钻孔置管引流术后神经功能恢复及预后的影响

doi:10.3969/j.issn.1671-7171.2019.11.013

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摘要 【目的】探讨早期高压氧联合康复训练治疗对老年高血压脑出血患者钻孔置管引流术后神经功能恢复及预后的影响。【方法】回顾性分析本院收治的210例老年高血压脑出血患者临床资料,两组患者均行钻孔置管引流术,根据康复治疗方法的不同将其分为观察组(早期高压氧联合康复训练治疗)和对照组(康复训练治疗),每组105例。于治疗前、治疗后,采用美国国立卫生研究院卒中量表(NIHSS)、简易智能精神状态检查量表(MMSE)、欧洲卒中评分量表(ESS)、Fugl-Meyer运动功能积分法(FMA)评价患者神经功能及肢体运动,采用生活质量综合评定问卷(GQOLI)评估患者生活质量,采用格拉斯哥预后评分(GOS)评估患者预后。【结果】两组患者治疗后NIHSS评分、ESS评分低于治疗前,MMSE评分、FMA评分高于治疗前,且观察组患者治疗后NIHSS评分、ESS评分低于对照组,MMSE评分、FMA评分高于对照组,差异有统计学意义(P<0.05)。观察组患者躯体功能、心理功能、社会功能及总分高于对照组,差异有统计学意义(P<0.05)。随访6个月,对照组预后良好率为43.81%(46/105)高于观察组的78.10%(82/105),差异有统计学意义(P<0.05)。【结论】老年高血压脑出血患者钻孔置管引流术后,早期进行康复训练及高压氧治疗,可促进神经、肢体运动功能恢复,提高患者生活质量,改善预后,值得临床推广应用。

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关键词 ：颅内出血, 高血压性/外科学, 引流术, 运动疗法

Abstract：【Objective】To explore the effect of early hyperbaric oxygen combined with rehabilitation training on the recovery of neurological function and prognosis in elderly patients with hypertensive cerebral hemorrhage after drilling and drainage. 【Methods】The clinical data of 210 elderly patients with hypertensive intracerebral hemorrhage in our hospital were analyzed retrospectively. The patients in both groups were treated with drilling and drainage. According to the different rehabilitation treatment methods, they were divided into the observation group (early hyperbaric oxygen combined with rehabilitation training) and the control group (rehabilitation training), 105 cases in each group. Before and after treatment, the neurological function and limb movement were assessed by NIHSS, MMSE, ESS, FMA, GQOLI and Glasgow pre-treatment Post score (GOS) was used to evaluate the prognosis. 【Results】After treatment, NIHSS score and ESS score of the two groups were lower than those before treatment, MMSE score and FMA score were higher than those before treatment. After treatment, NIHSS score and ESS score of the observation group were lower than those of the control group, MMSE score and FMA score were higher than those of the control group, the difference was statistically significant (P<0.05). The physical function, psychological function, social function and total score of the observation group were higher than those of the control group, the difference was statistically significant (P<0.05). After 6 months follow-up, the good prognosis rate of the control group was 43.81% (46 / 105) higher than that of the observation group (78.10%) (82 / 105), the difference was statistically significant (P<0.05). 【Conclusion】Early rehabilitation training and hyperbaric oxygen therapy can promote the recovery of motor function of nerves and limbs, improve the quality of life and improve the prognosis of the elderly patients with hypertensive intracerebral hemorrhage.

Key words： Intracranial Hemorrhage, Hypertensive/SU Drainage Exercise Therapy

收稿日期: 2019-07-03

PACS:

R743.2

引用本文:

邵世蓉, 邓天芳, 刘莎莎, 叶锋, 张友玲. 早期高压氧联合康复训练治疗对老年高血压脑出血患者钻孔置管引流术后神经功能恢复及预后的影响[J]. 医学临床研究, 2019, 36(11): 2121-2123.
SHAO Shi-rong, DENG Tian-fang, LIU Sha-sha, et al. Effect of Early Hyperbaric Oxygen Combined with Rehabilitation Training on the Recovery of Neurological Function and Prognosis in Elderly Patients with Hypertensive Cerebral Hemorrhage after Drilling and Drainage. JOURNAL OF CLINICAL RESEARCH, 2019, 36(11): 2121-2123.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.11.013 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I11/2121

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