摘要
目的探讨早期康复联合高压氧(HBO)治疗对急诊微创术后高血压脑出血(HICH)患者神经功能恢复及预后的影响。方法回顾性分析2016年6月至2020年1月烟台市烟台山医院和烟台市莱阳中心医院神经内、外科收治的HICH患者121例的临床资料。根据治疗方法分为观察组(n=64)和对照组(n=57)。对照组患者采用急诊微创介入清除颅内血肿后予以早期常规康复治疗及电针刺激治疗,观察组患者在对照组治疗的基础上予以HBO治疗。术后6个月,根据中华医学会神经功能缺损评分标准评定其临床疗效。采用美国国立卫生研究院卒中量表(NIHSS)和简易精神状态检查量表(MMSE)评估2组患者的心理改善情况。采用蒙特利尔认知评估量表(MOCA)评定2组患者的认知功能;采用日常生活活动能力量表(ADL)评价2组患者的生活日常活动能力。采用生活质量评分(SF-36)评价2组患者术后6个月的生活质量。结果术后6个月,观察组患者总有效率(87.5%)明显高于对照组(75.4%),差异有统计学意义(P<0.05)。观察组患者术后6个月NHISS 、MMSE评分与对照组比较差异均有统计学意义(P<0.05)。与治疗前比较,2组患者术后6个月MOCA、ADL评分均显著升高(P<0.05)。观察组患者术后6个月总体健康、活力、生理职能、生理功能、精神健康、情感职能、社会功能、躯体疼痛评分均显著高于对照组(P<0.05)。结论急诊微创术后HBO联合早期康复治疗能促进HICH患者神经细胞功能的恢复,有助于患者恢复生活技能,增强运动功能,从而提高其日常生活能力。
Objective To investigate the effects of early rehabilitation combined with hyperbaric oxygen(HBO)on neurological function recovery and prognosis of patients with hypertensive intracerebral hemorrhage(HICH)after emergency minimally invasive surgery.Methods The clinical data of 121 HICH patients admitted to the departments of neurology and neurosurgery of Yantai Mountain Hospital and Laiyang Central Hospital from June 2016 to January 2020 were retrospectively analyzed and divided into observation group(n=64)and control group(n=57),according to their treatment.The patients in the control group were given early conventional rehabilitation treatment and electrostimulation after removal of intracranial hematoma by emergency minimally invasive intervention,while the patients in the observation group were given HBO treatment on the basis of the treatment in the control group.Six months after operation,the Chinese Medical Association neurological deficit score was used to evaluate the clinical efficacy.The National Institutes of Health stroke scale(NIHSS)and mini&mental state examination(MMSE)were used to evaluate the psychological improvement of the two groups.The Montreal cognitive assessment(MoCA)was used to evaluate the cognitive function of the two groups.The activities of daily living(ADL)scale was used to evaluate the activities of daily living of the two groups.The short form(SF-36)was used to evaluate the quality of life of the two groups six months after operation.Results Six months after operation,the total effective rate of the observation group(87.5%)was higher than that of the control group(75.4%),with statistically significant difference(P<0.05).Six months after operation,the NHISS and MMSE scores in the observation group were significantly different from those in the control group(P<0.05).Compared with those before treatment,the MoCA and ADL scores of both groups were significantly increased six months after operation(P<0.05);and these scores in the observation group were significantly higher than those in the control group(P<0.05).The general health,vitality,physical functioning,role physical,mental health,role emotional,social functioning,and bodily pain scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion Early rehabilitation combined with HBO treatment after emergency minimally invasive surgery can promote the recovery of nerve cell function in patients with HICH,restore their life skills,enhance their motor function,thus improving their activities of daily living.
作者
姜海鹏
张凯
王广斌
石磊
Jiang Haipeng;Zhang Kai;Wang Guangbin;Shi Lei(Pain Clinic,Yantai shan Hospital,Yantai 264000,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2021年第4期445-449,共5页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
基金
烟台市科技计划资助项目(2018ws0021)。
关键词
早期康复治疗
高压氧
急诊微创术
高血压脑出血
神经功能
预后
Early rehabilitation
Hyperbaric oxygen
Emergency minimally invasive surgery
Hypertensive intracerebral hemorrhage
Neurological function
Prognosis
