摘要
目的:观察设定条件下轻度降低体温72h对脑卒中患者功能预后的影响。方法:选择2001-06/2003-06北京市隆福医院神经内科急性脑卒中患者64例。随机分为治疗组32例,男20例,女12例,缺血性脑卒中26例,出血性脑卒中6例;年龄43～74岁;对照组32例,男23例,女9例;缺血性脑卒中25例,出血性脑卒中7例;年龄45～77岁。两组患者均应用常规药物治疗,并根据残疾状况给予适当的运动康复。治疗组患者给予肌松合剂使患者维持于亚冬眠状态。采用电恒温降温毯使肛温恒定在35.5～36.0℃,维持24～72h;复温采用自然缓慢法,每4～6小时回升1℃。全部患者在入组时及1周后和30d后分别进行爱丁堡-斯堪的纳维亚神经功能缺损评分检查,最高分为45分,最低分为0分,积分越大缺损程度越严重;采用Barthel指数进行日常生活活动评价,共包括10项内容,正常最高分为100分,严重不良最低分为0分。结果:64例患者均进入结果分析。①神经功能缺损评分改良值:治疗1周后治疗组明显高于对照组犤(6.35±4.92)分,(1.21±1.02)分,t=2.864,P<0.01犦。治疗30d后治疗组也明显高于对照组犤(12.85±5.87)分,(9.84±3.94)分,t=2.958,P<0.01犦。②Barthel指数评分:治疗1周后治疗组高于对照组犤(54.28±8.38)分,(49.76±7.31)分,t=2.206,P<0.05犦。治疗30d后治疗组也明显高于对照组犤(86.72±7.94)分,(67.34±8.63)分,t=2.812,P<0.01犦。结论:早期轻度低温可以明显改善神经功能缺损程度,提高日常生活活动能力,并且近期预后较好。
AIM： To observe the effect of the decrease of body temperature gently for 72 hours on the function prognosi in patients with stroke under the setting condition. METHODS： Six-four patients with acute stroke in Department of Neurology of Beijing Longfu Hospital from June 2001 to June 2003. They were divided randomly into 32 cases in treatment group with 20 males and 12 femals, including 26 cerebral arterial thrombosis cases, and 6 hemorrhagic apoplexy aged cases from 43 to 74 years old; Thirty-two cases in control group with 23 mals and 9 femals, including 25 cerebral arterial thrombosis cases, and 7 hemorrhagic apoplexy cases aged from 45 to 77 years old. All the patients in the two groups were treated with routine drugs, and given reasonable sports rehabilitation according to disability situation. The muscle and pine mixture was treated on patients in treatment group to maintain sub-hiberuation behavior. Using electric homeothermia hypothermic blanket anus temperature fixed at 35.5-36.0 ℃ for 24-72 hours; Rewarming was used by natural slowing method and rising 1 ℃ every 4-6 hours. When entered the group, after 1 week and after 30 days all the patients were performed respectively by MESSS, and the highest mark was 45 points and the lowest mark was 0 point. The higher the mark, the more serious the defection; The activities of daily living was evaluated by Barthel index, including 10 contents, and the highest mark was 100 points and the lowest mark that was the most severity was 0 point. RESULTS： Totally 64 patients were involved in the result analysis. ① The improved value of neurologic impairment： It was significantly higher in treatment group than that in control group one week after treatment[（6.35±4.92）, （1.21±1.02）points, （t=2.864,P〈0.01 ）]. It was also significantly higher in treatment group than that in control group 30 days after treatment [（12.85±5.87）, （9.84±3.94）points, （t=2.958,P〈0.01）]. ② The seore of Barthel index： It was higher in treatment group than that in control group one week after treatment [（54.28±8.38）, （49.76±7.31）points,（t=2.206,P〈0.05）] It was also significantly higher in treatment group than that in control group 30 days after treatment [（86.72±7.94）, （67.34±8.63）points, （t=2.812,P〈0.01）]. CONCLUSION： The earlier period gently hypothermia can significantly ameliorate the level of neurologic impairment, improve the ability of activities of daily living, and the prognosis in the near future is preferable.
出处
《中国临床康复》
CSCD
北大核心
2005年第25期4-5,共2页
Chinese Journal of Clinical Rehabilitation
