CAJ | 학술논문

目的：观察依达拉奉联合早期康复治疗缺血性脑卒中的临床效果。方法收集324例缺血性脑卒中患者，均为首次发病，均接受常规药物治疗；按数字表法随机分为观察组（依达拉奉联合早期康复干预）和对照组（早期康复干预），每组162例，观察组在患者发病48 h 内开始接受规范化康复治疗并静脉应用依达拉奉，对照组在发病2周后开始接受规范康复治疗；两组患者均在开始康复治疗时、疗程满4周、12周各进行一次 NIHSS、MMSE 评分。结果两组患者入院时 NIHSS、MMSE 评分差异无统计学意义（P ＞0．05），康复治疗开始时评分对照组优于观察组[NIHSS：（14．8±5．3）分比（16．1±5．1）分，MMSE：（15．9±6．3）分比（14．2±6．2）分]，差异有统计学意义（PNIHSS ＝0．049，PMMSE ＝0．041）。病程满4周、12周进行第2次评分[NIHSS：（10．1±6．3）分比（8.2±5．7）分，MMSE：（17．7±5．5）分比（20．9±5．9）分]和第3次评分[NIHSS：（6．6±4．9）分比（4．7±3．6）分，MMSE：（21．0±4．8）分比（24．6±4．9）分]，观察组均明显优于对照组，差异均有统计学意义（P4周NIHSS ＝0．036，P4周MMSE ＝0．035；P12周NIHSS ＝0．006，P12周MMSE ＝0．003）。结论依达拉奉联合早期康复治疗可明显改善缺血性脑卒中患者的预后。
목적：관찰의체랍봉연합조기강복치료결혈성뇌졸중적림상효과。방법수집324례결혈성뇌졸중환자，균위수차발병，균접수상규약물치료；안수자표법수궤분위관찰조（의체랍봉연합조기강복간예）화대조조（조기강복간예），매조162례，관찰조재환자발병48 h 내개시접수규범화강복치료병정맥응용의체랍봉，대조조재발병2주후개시접수규범강복치료；량조환자균재개시강복치료시、료정만4주、12주각진행일차 NIHSS、MMSE 평분。결과량조환자입원시 NIHSS、MMSE 평분차이무통계학의의（P ＞0．05），강복치료개시시평분대조조우우관찰조[NIHSS：（14．8±5．3）분비（16．1±5．1）분，MMSE：（15．9±6．3）분비（14．2±6．2）분]，차이유통계학의의（PNIHSS ＝0．049，PMMSE ＝0．041）。병정만4주、12주진행제2차평분[NIHSS：（10．1±6．3）분비（8.2±5．7）분，MMSE：（17．7±5．5）분비（20．9±5．9）분]화제3차평분[NIHSS：（6．6±4．9）분비（4．7±3．6）분，MMSE：（21．0±4．8）분비（24．6±4．9）분]，관찰조균명현우우대조조，차이균유통계학의의（P4주NIHSS ＝0．036，P4주MMSE ＝0．035；P12주NIHSS ＝0．006，P12주MMSE ＝0．003）。결론의체랍봉연합조기강복치료가명현개선결혈성뇌졸중환자적예후。
Objective To explore the effect of the joint edaravone in early rehabilitation on the prognosis of patients with ischemic stroke.Methods The general branch of Kailuan group of patients with ischemic stroke who were conformed to the 1995 national conference on the 4th cerebrovascular diagnostic criteria with head CT or MRI imaging diagnosis,were collected from January 2012 to December 2014.A total of 324 cases were the first onset,who had been treated with conventional drugs,and were randomly divided into the observation group(edaravone associated with early rehabilitation)and the control group(early rehabilitation)with 162 cases in each group.Patients of the observation group were given venous application of edaravone and received the standardized rehabilitation treatment within 48 hours.The control group were given standard rebabilitation therapy at 2 weeks after attacked.NIHSS and MMSE scores of the two groups of patients were evaluated at the beginning of the rehabilitation course,4 weeks and 12 weeks of the treatments.Results There were no statistically significant difference and the clinial manifestations of the lesion site between the two groups of patients on admission.At the beginning of the rehabilitation,the NIHSS and MMSE score of control group were statistically significant different from that of observation group [NIHSS:(14.8 ±5.3)vs.(16.1 ±5.1),PNIHSS =0.049;MMSE:(15.9 ±6.3)vs.(14.2 ±6.2),PMMSE =0.041].The sec-ond and third evaluation were respectively conducted at 4 weeks[NIHSS:(10.1 ±6.3)vs.(8.2 ±5.7),MMSE:(17.7 ±5.5)vs.(20.9 ±5.9)]and 12 weeks[NIHSS:(6.6 ±4.9)vs.(4.7 ±3.6),MMSE:(21.0 ±4.8)vs. (24.6 ±4.9)].The results of the observation group were significantly better than the control group(P4W NIHSS =0.036,P4W MMSE =0.035;P12W NIHSS =0.006,P12W MMSE =0.003),and the differences were statistically significant. Conclusion Edaravone associated with early rehabilitation can obviously improve the prognosis of patients with ischemic stroke.