脑干海绵状血管瘤术后继发肥大性下橄榄核变性的康复治疗1例报道

doi:10.3969/j.issn.1006-9771.2021.12.016

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (12): 1483-1488.doi: 10.3969/j.issn.1006-9771.2021.12.016

• 临床观察 • 上一篇

脑干海绵状血管瘤术后继发肥大性下橄榄核变性的康复治疗1例报道

王楠,赵卿(),胡启龙,陈晶晶,徐燕,郭新迪

上海市养志康复医院（上海市阳光康复中心）,上海市 201619

收稿日期:2021-09-14 修回日期:2021-11-09 出版日期:2021-12-25 发布日期:2021-12-29
通讯作者: 赵卿 E-mail:qingzhao2010@hotmail.com
作者简介:王楠(1992-),女,汉族,辽宁朝阳市人,硕士研究生,医师,主要研究方向：慢性肌骨系统的中医药防治
基金资助:
1.上海市中医医院第二届中医传承项目(No. 沪中医人[2020]2号);2.上海市"科技创新行动计划"医学创新研究专项(21Y31920305)

Integrative Rehabilitation for Hypertrophic Olivary Degeneration after Operation of Brain Stem Cavernous Malformation: A Case Report

WANG Nan,ZHAO Qing(),HU Qi-long,CHEN Jing-jing,XU Yan,GUO Xin-di

Shanghai Yang Zhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Shanghai 201619, China

Received:2021-09-14 Revised:2021-11-09 Published:2021-12-25 Online:2021-12-29
Contact: ZHAO Qing E-mail:qingzhao2010@hotmail.com
Supported by:
The Second Traditional Chinese Medicine Inheritance Project of Shanghai Hospital of Traditional Chinese Medicine (No. [2020]2);Medical Innovation Research Special Project of Shanghai Science and Technology Innovation Action Plan(21Y31920305)

摘要/Abstract

摘要：

目的总结1例行脑干海绵状血管瘤术后继发肥大性下橄榄核变性(HOD)患者的中西医综合康复治疗经验。方法回顾性分析1例脑干海绵状血管瘤术后继发HOD患者的用药、康复治疗及随访情况。结果本例患者术后3个月开始出现四肢静止性及动作性震颤、构音障碍、腭肌震颤、眼球活动障碍、行走困难等症状,结合患者临床症状及头颅MRI结果可明确诊断为HOD,给予针对性康复训练联合针灸、辨证口服中药综合治疗。治疗后,患者震颤显著减轻,可独立站立、行走,平衡功能改善,日常生活能力提高,口服西药用量减少。结论颅脑手术后可继发神经变性并出现相应症状,采取针对性康复训练联合传统康复方法综合治疗可取得较好的临床效果。

关键词: 脑干海绵状血管瘤, 肥大性下橄榄核变性, 综合康复

Abstract:

Objective To summarize the integrative rehabilitation treatment of traditional Chinese medicine (TCM) and Western medicine in hypertrophic olivary degeneration (HOD) secondary to the operation of brain stem cavernous malformation. Methods The clinical data of medication, rehabilitation and follow-up of a patient with HOD secondary to operation on brain stem cavernous malformation was retrospectively analyzed.Results Three months after operation, limb static and motor tremor, dysarthria, palate spasm, eye movement disorder and walking difficulty appeared. The patient was diagnosed as HOD according to clinical features and brain magnetic resonance imaging (MRI). He was treated with pertinence rehabilitation training combined with TCM including acupuncture and herbs. After integrative rehabilitation, he could stand and walk independently, the tremor was alleviated, the balance function improved, the activities of daily living improved, and the dosage of oral western medicine also decreased.Conclusion After intracranial surgery, secondary neurodegeneration and movement disorder may appear, and it could be improved by integrative rehabilitation treatment of TCM and Western medicine

Key words: brain stem cavernous malformation, hypertrophic olivary degeneration, integrative rehabilitation

中图分类号:

R743.4

王楠,赵卿,胡启龙,陈晶晶,徐燕,郭新迪. 脑干海绵状血管瘤术后继发肥大性下橄榄核变性的康复治疗1例报道[J]. 《中国康复理论与实践》, 2021, 27(12): 1483-1488.

WANG Nan,ZHAO Qing,HU Qi-long,CHEN Jing-jing,XU Yan,GUO Xin-di. Integrative Rehabilitation for Hypertrophic Olivary Degeneration after Operation of Brain Stem Cavernous Malformation: A Case Report[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(12): 1483-1488.

图/表 3

参考文献 22

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口服药物	治疗前	治疗后2年	治疗后4年
多巴丝肼	每次62.5 mg,每天3次
盐酸普萘洛尔	每次30 mg,每天3次	每次30 mg,每天3次	每次30 mg,每天3次
盐酸苯海索	每次2 mg,每天2次	每次1 mg,每天2次	每次1 mg,每天2次
托吡酯	每次50 mg,每天2次	每次50 mg,每天2次
盐酸丁螺环酮	每次10 mg,每天3次	每次10 mg,每天3次	每次10 mg,每天3次
氯硝西泮	每次0.5 mg,每天2次	每次0.5 mg,每天2次	每次0.5 mg,每晚1次

症状	量表	满分	治疗前	治疗后2年	治疗后4年
共济失调	ICARS	100分	78.67±2.08	48.33±0.58	40.00±1.00
震颤	TETRAS	64分	42.00±1.00	27.00±1.00	19.00±1.00
平衡	BBS	100分	37.67±0.58	29.00±0.00	13.33±0.58
日常生活能力	MBI	100分	78.67±2.31	70.00±2.00	62.00±2.00

脑干海绵状血管瘤术后继发肥大性下橄榄核变性的康复治疗1例报道

Integrative Rehabilitation for Hypertrophic Olivary Degeneration after Operation of Brain Stem Cavernous Malformation: A Case Report

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