超早期阶梯式康复训练在急性缺血性脑卒中围溶栓期的应用效果观察.docVIP

超早期阶梯式康复训练在急性缺血性脑卒中围溶栓期的应用效果观察 　　[摘要] 目的 观察超早期阶梯式康复训练在急性缺血性脑卒中（AIS）围溶栓期应用效果。方法 将80例AIS患者随机分为对照组和观察组，每组40例。溶栓后，对照组给予常规康复训练，观察组给予超早期阶梯式康复训练。分别于溶栓后24 h及溶栓后14 d检测患者血清神经生长因子（NGF）、神经元特异性烯醇化酶（NSE）、脑源性神经营养因子（BDNF）水平，行简易智能精神状态量表（MMSE）、简易上肢功能评价量表（STEF）、Fugl-Meyer运动功能量表（FMA）、改良Barthel指数量表（MBI）评分。 结果 溶栓后24 h，两组NGF、BDNF、NSE水平及STEF、FMA、MBI评分比较均无显著差异（P0.05）；溶栓后14 d，观察组较对照NGF、BDNF水平明显升高（P0.05），NSE水平明显降低（P0.05），MMSE、STEF、FMA、MBI评分均明显提高（P0.05）。 结论 超早期康复训练可有效调节NGF、BDNF、NSE表达，加快脑组织重塑，促进AIS患者神经功能、认知功能、肢体运动功能、日常生活能力恢复。 　　[关键词] 急性缺血性脑卒中；围溶栓期；超早期阶梯式康复训练；神经功能损伤 　　[中图分类号] R743.2 [文献标识码] B [文章编号] 1673-9701（2017）31-0078-04 　　[Abstract] Objective To observe the application effect of super-early laddering rehabilitation training on acute ischemic stroke（AIS） during peri-thrombolytic period. Methods 80 patients with AIS were randomly divided into control group and observation group， with 40 cases in each group. After thrombolysis， the control group was given routine rehabilitation training， and the observation group was given super-early laddering rehabilitation training. Serum neurotrophic factor （NGF）， neuron-specific enolase （NSE）， brain-derived neurotrophic factor （BDNF） level， mini mental state examination scale （MMSE）， simple upper limb function evaluation scale （STEF）， Fugl-Meyer motor function scale （FMA）， modified Barthel index scale（MBI） score were detected in the patients 24 h and 14 d after thrombolysis respectively. Results There was no significant difference in NGF， BDNF， NSE levels and STEF， FMA and MBI scores between the two groups after 24 hours of thrombolysis（P0.05）； on the 14th day after thrombolysis， the levels of NGF and BDNF in the observation group were significantly higher than those in the control group （P0.05）. NSE level was significantly decreased（P0.05）. MMSE， STEF， FMA， MBI scores were significantly increased （P0.05）. Conclusion Super-early rehabilitation training can effectively regulate the expression of NGF， BDNF and NSE， speed up brain tissue remodeling， and