低频电刺激联合早期康复训练治疗急性脑梗死

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摘 要 目的：探讨双乳突法头部低频电刺激及早期康复训练对急性脑梗死患者神经功能缺损程度及日常生活能力（ADL）恢复的影响。方法：90例急性脑梗死患者，随机分为低频电刺激及早期康复训练组（A组）、低频电刺激组（B组）和对照组（C组），每组30例。A、B两组均采用低频电刺激、常规药物治疗，A组在发病48 h内立即进行早期康复训练，分别观察治疗前后神经功能缺损评分及ADL的变化。结果：三组在治疗前神经功能缺损评分、ADL评分差异均无统计学意义(P

关键词 脑梗死 康复训练 低频电刺激 临床疗效

中图分类号：R743.3 文献标识码：A 文章编号：1006-1533（2012）04-0051-03

Low frequency electric stimulation combined with the early rehabilitation

training for treatment of the patients with acute cerebral infarction

JIN Zhi-ping, LIU Xue-yuan

（1. Xidu Community Health Service Center, Fengxian, Shanghai, 201401；2.Tenth Hospital, Tongji University, Shanghai, 200072）

ABSTRACT Objective: To explore the effect of the early rehabilitation training and low frequency electric stimulation on the neurological dysfunction (ND) scores and ADL scores in the patients with acute cerebral infarction. Method: Ninety cases of acute cerebral infarction were randomly divided into the low frequency electric stimulation with the early rehabilitation training group (A group), low frequency electric stimulation group (B group) and control group (C group) (n=30). The patients of A and B groups were treated with the routine drugs and low frequency electric stimulation treatment, in addition to the patients in the A group were treated with the early rehabilitation training within 48h occurrence. Then the changes of the ND scores at 21d and ADL scores were observed. Result: Here was no significant difference among those three groups before the treatment in ND scores and ADL scores (P>0.05). Compared with B and C groups, the ND scores and ADL scores in A group were remarkably turned for the better at 21d after treatment (P

KEY WORDS cerebral infarction; rehabilitation training; low frequency electric stimulation; clinical curative effect

随着社会人口的老龄化，脑梗死的发病率越来越高，且有很高的致残率，在存活的患者中，仅有10.00％能恢复正常，50.00％以上的患者将遗留有严重的后遗症。近年来国内外研究表明，低频电刺激可以引起局部脑血流量（regional cerebral blood flow, rCBF）增加，减轻缺血性脑损伤，具有明显的神经保护功能[1]。我们在使用双乳突法头部低频电刺激治疗的基础上，对30例急性脑梗死患者进行了早期康复训练，现报告如下。

1 对象与方法

1.1 对象

2011年1月至2011年12月在我中心康复病房及第十人民医院神经内科住院的急性脑梗死患者。纳入标准:诊断符合全国第4届脑血管病会议制订的诊断标准，所有患者均在发病后72 h以内就诊，并经头颅CT、MRI检查，所有患者格拉斯哥昏迷量表评分>8分。排除标准:严重心、肾功能不全者、出血性卒中、短暂性脑缺血发作(TIA)、严重意识障碍、精神障碍、感觉性失语、严重心律失常的患者。符合条件的对象共90人。采用数字表法随机分为3组：低频电刺激联合早期康复训练组（A组）30例，其中男17例，女13例，年龄54～80岁，平均（63.84±8.05）岁；低频电刺激组（B组）30例，其中男18例，女12例，年龄51～82岁，平均（62.23±8.75）岁；对照组（C组）30例，男16例，女14例，年龄52～81岁，平均（62.87±8.36）岁。三组患者发病时间、年龄、文化程度、伴随疾病及神经功能缺损程度无显著性差异（P>0.05）。