《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (07): 816-820.

• 特稿 • 上一篇    下一篇

溶栓治疗对脑梗死患者近期及远期康复预后的影响

屠建莹 1，张京 1，张于刚 2   

  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-07-25 发布日期:2015-07-25

Effects of Thrombolysis on Short- and Long-term Outcome in Patients with Cerebral Infarction

TU Jian-ying1, ZHANG Jing1, ZHANG Yu-gang2   

  1. 1. Neurology Department, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; 2. Rehabilitation Department, Ganjiakou Community Health Service Center, Beijing 100037, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-07-25 Online:2015-07-25

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摘要： 目的 研究急性脑梗死患者溶栓治疗对短期疗效及长期预后的影响。方法 接受溶栓治疗后存在较严重神经功能缺损的患者29例作为观察组；从同期住院的未溶栓脑梗死患者中，选取起病时间及疾病程度尽量相近患者94例为对照组。比较两组患者入院及出院时的美国国立卫生研究院卒中量表(NIHSS)评分、徒手肌力测试(MMT)分级、Brunnstrom 分级、改良 Barthel 指数(MBI)；病后 6个月，采用改良 Rankin量表(mRS)进行评定。结果 除抵院时间外，两组患者入院时的基线资料均无显著性差异。出院前，除对照组 NIHSS 外，两组患者其他评分均较入院时改善(P<0.05)，观察组 NIHSS 评分及 MBI 评分差值优于对照组(P<0.05)。病后 6个月时观察组死亡 1例(1/29)，对照组死亡 10例(10/94)，失访 4例。观察组 mRS评分低于对照组(P<0.05)。结论 脑梗死患者急性期溶栓治疗可以改善早期神经功能及日常生活活动能力，提高远期生存率及功能活动水平。

关键词: 脑梗死, 溶栓, 预后, 神经功能, 日常生活活动能力

Abstract: Objective To study the effects of thrombolysis on short- and long-term outcome in acute cerebral infarction patients. Methods The patients accepted thrombolysis and remained severe neurologic deficits were as observation group (n=29), and the patients without thrombolysis matching the onset time and severity of disease were as control group (n=94). They were assessed with National Institute of Health Stroke Scale (NIHSS), Manual Muscle Test (MMT), Brunnstrom Grade, modified Barthel Index (MBI) when they admitted and discharged, and with modified Rankin Scale (mRS) 6 months later. Results The scores of MMT, MBI and Brunnstrom grade improved in both groups when discharged (P<0.05), except the NIHSS in the control group, and the scores of NIHSS and MBI improved more in the observation group than in the control group (P<0.05). The score of mRS was better in the observation group than in the control group 6 months later (P<0.05). Conclusion Thrombolysis can improve the neurologic function and activities of daily living in the acute stage of cerebral infarction, as well as the long-term outcome of activities.

Key words: cerebral infarction, thrombolysis, outcome, neurologic function, activities of daily living