早期高压氧联合康复治疗对老年高血压脑出血患者神经功能恢复及预后的影响

发布时间：2018-04-08 14:24

本文选题：高血压脑出血　切入点：高压氧　出处：《中国老年学杂志》2017年08期

【摘要】：目的探讨早期实施高压氧联合康复治疗对老年高血压脑出血(HICH)患者神经功能恢复及预后的影响。方法老年HICH患者300例,随机数字表法分为研究组和治疗组各150例,研究组采用常规治疗联合早期高压氧和康复治疗,治疗组采用常规治疗+早期高压氧方法,采用美国国立卫生研究院卒中量表(NIHSS)、欧洲卒中评分量表(ESS)、简易智能精神状态检查量表(MMSE)评估两组神经及运动功能变化,采用格拉斯哥预后评分(GOS)标准评估治疗情况。采用中文版Nasreddine检查表(MOCA)评价患者的认知功能,按照Fugl-Meyer运动功能评分评估患者的肢体运动情况,采用日常生活活动能力(ADL)量表评价两组日常活动能力。对比分析治疗30 d后神经功能恢复情况,治疗6个月后预后情况。结果治疗30 d后,研究组NIHSS、ESS评分均低于治疗组,MMSE评分高于治疗组(P0.01);治疗6个月后,研究组认知功能、运动功能、日常生活活动能力评分均明显高于治疗组,GOS评分显示研究组预后良好率明显高于治疗组(均P0.01)。结论早期高压氧联合康复治疗具有缓解老年HICH患者昏迷情况,促进患者神经及日常运动功能恢复,改善预后、提高生存质量。
[Abstract]:Objective to investigate the effect of early hyperbaric oxygen combined rehabilitation therapy on neurological function recovery and prognosis in elderly patients with hypertensive intracerebral hemorrhage (HICH).Methods 300 elderly patients with HICH were randomly divided into study group (n = 150) and treatment group (n = 150). The study group was treated with routine therapy combined with early hyperbaric oxygen and rehabilitation, and the treatment group was treated with routine treatment of early hyperbaric oxygen.The changes of neurologic and motor function were evaluated by NIHSS, ESS and MMSE, respectively. Glasgow prognosis scale (GOS) was used to evaluate the treatment status of the two groups.The cognitive function of the patients was evaluated by the Chinese version of the Nasreddine scale, the limb movement of the patients was evaluated according to the Fugl-Meyer motor function score, and the ADL scale was used to evaluate the daily activity ability of the two groups.The recovery of nerve function after 30 days treatment and the prognosis after 6 months treatment were compared and analyzed.Results after 30 days of treatment, the scores of NIHSS ESS in the study group were lower than those in the treatment group, and the scores of MMSE in the study group were higher than those in the treatment group (P 0.01), and after 6 months of treatment, the cognitive function and motor function were higher in the study group.The scores of ADL were significantly higher than that of GOS in the treatment group (P < 0.01), and the prognostic rate of the study group was significantly higher than that of the treatment group (P < 0.01).Conclusion early hyperbaric oxygen combined rehabilitation therapy can relieve the coma in elderly patients with HICH, promote the recovery of nerve and daily motor function, improve the prognosis and improve the quality of life.
【作者单位】：兴义市人民医院神经外科;贵州医科大学附属医院神经外科;
【分类号】：R743.34;R544.1

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