溶栓联合早期肢体功能锻炼对急性脑梗死患者的康复作用
李 琴 曾凡杰 唐绍辉 唐柚青 罗高权 古 菁 邢然然 姚惠东
中国人民解放军南部战区总医院，广东 广州 510010
通信作者：曾凡杰
【摘要】 目的 探讨溶栓联合早期肢体功能锻炼对急性脑梗死患者神经功能康复的影响。方法 选取 2018-09—2020-09 中国人民解放军南部战区总医院急诊科、脑血管科收治的急性脑梗死患者 96 例为研究对象，所有患者入院后均于 4.5 h 内进行溶栓治疗。按肢体功能锻炼的时间分为观察组和对照组，观察组 54 例患者在溶栓 24 h 内进行肢体功能锻炼，对照组 42 例患者在溶栓治疗 24 h 后再给予肢体康复训练，共治疗 2 周。分别于治疗前、治疗 2 周后及治疗 3 个月后评估患者的肢体运动功能康复及并发症发生情况。结果 治疗前 2 组 Barthel 指数、Fugl-Meyer 量表评分、患肢关节 Ashworth 评分、Rankin 评分和 NIHSS 评分差异均无统计学意义（P＞0.05）。治疗后 2 周及治疗后 3 个月，观察组 Barthel 指数评分均明显高于对照组（t=4.605、4.303，P＜0.05），Fugl-Meyer 评分均明显高于对照组（t=3.371、3.866，P＜0.05），患肢关节Ashworth 评分、Rankin 评分和神经功能缺损评分均明显低于对照组（P＜0.05）。观察组并发症发生率14.29%（7/42），明显低于对照组的3.70%（2/54）（χ 2 =4.987，P=0.025）。结论 对急性脑梗死患者开展溶栓联合早期肢体功能锻炼能够显著改善肢体运动功能，促进神经功能康复，安全性好。
【关键词】 急性脑梗死；溶栓；肢体功能锻炼；神经功能康复；早期
【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1673-5110 （2022） 07-0798-05
DOI：10.12083/SYSJ.220604
Effect of thrombolysis combined with early limb functional exercise on neurological rehabilitation of patients with acute cerebral infarction
LI Qin，ZENG Fanjie，TANG Shaohui，TANG Youqing，LUO Gaoquan，GU Jing，XING Ranran，YAO Huidong
Southern Theater General Hospital of the Chinese People’s Liberation Army，Guangzhou 510010，China
Corresponding author：ZENG Fanjie
【Abstract】 Objective To investigate the effect of thrombolysis combined with early limb functional exercise on neurological rehabilitation in patients with acute cerebral infarction. Methods A total of 96 patients with acute cerebral infarction admitted to the Emergency Department and Cerebrovascular Department of Southern Theater General Hospital from September 2018 to September 2020 were selected as the study subjects. All patients received thrombolytic therapy within 4.5 hours after admission.According to the time of limb function exercise，the patients were divided into observation group and control group. In the observation group，54 patients were given limb function exercise within 24 h of thrombolytic therapy，and in the control group，they were given limb rehabilitation training after 24 h of thrombolytic therapy for a total of 2 weeks. The recovery of limb motor function and complications were evaluated before treatment，2 weeks after treatment and 3 months after treatment. Results Before treatment，there was no significant difference in Barthel index，Fugl-Meyer score，Ashworth score，Rankin score and neurological deficit score between the two groups（P > 0.05）. After 2 weeks and 3 months of treatment，Barthel Index and Fugl-Meyer score of the observation group were significantly higher than those of the control group Fugl-Meyer scores were significantly higher than those of the control group（P < 0.05）. At 2 weeks and 3months after treatment，the Barthel index score of the observation group was significantly higher than that of the control group（t=4.605 and 4.303，P < 0.05），and the Fugl-Meyer score was significantly higher than that of the control group（t=3.371 and 3.866，P < 0.05）. The incidence of complications in the observation group was 14.29%（7/42） significantly lower than that in the control group（3.70%（2/54），χ2 =4.987，P=0.025）. Conclusion For patients with acute cerebral infarction，early thrombolysis combined with early limb functional exercise can significantly improve the limb motor function，promote the recovery of neurological function，with good safety.
【Key words】 Acute cerebral infarction；Thrombolysis；Limb function exercise；Neurological rehabilitation；Early
