脑白质疏松症对脑梗死康复的影响

目的　探讨脑白质疏松症 (LA)对脑梗死康复的影响。方法　 74例脑梗死偏瘫患者根据MRI有否LA分为两组 :脑梗死合并LA组 (A组 ) 36例 ,脑梗死不伴LA组 (B组 ) 38例 ,均采用综合康复治疗 ,治疗前及治疗 8周后评定偏瘫肢体运动功能 ADL能力 步行能力和高级脑机能。结果　康复治疗前长谷川智能评分 ,A组 2 3 .8± 4 .6 ,B组 2 7.3± 4 .8,两组差异有显著性 (P <0 .0 5) ;肢体运动功能 ADL能力和步行能力两组差异均无显著性 (P >0 .0 5)。治疗 8周后A组不能步行从治疗前 75 %下降至治疗后 2 2 % ,独立步行从 0 %提高至 2 5 % ,B组不能步行从 74%下降至 1 3 % ,独立步行从 0 %提高至 40 % ,两组比较差异有显著性 (P <0 .0 5) ;两组偏瘫肢体运动功能较治疗前明显改善 ,均P <0 .0 5 ,但偏瘫肢体运动功能恢复两组差异无显著性 (P >0 .0 5) ;ADL积分A组从 31 .6± 1 0 .7提高至 64 .1± 1 6 .8,B组从 32 .3± 1 1 .4提高至 71 .5± 1 8.3 ,差异有显著性 (P <0 .0 5) ;A组的康复效率 (0 .54± 0 .0 8)明显低于B组 (0 .65± 0 .0 9) ,差异有显著性(P <0 .0 5)。结论　LA能够影响脑梗死患者日常生活能力和步行能力的恢复

Effects of leuko-araiosis on rehabilitation in patients with hemiplegic cerebral infarction

Objective To study the effects of leuko araiosis (LA) on rehabilitation outcome of patients with cerebral infarction. Methods Seventy four patients with hemiplegia following cerebral infarction were divided into two groups according to MRI findings: group A(complicated with LA) and group B(no LA). Both of them received conventional rehabilitation intervention. The evaluation of motor functions, including ADL, walking abilities and higher brain functions were done before and eight weeks after training. Results The higher cerebral functions in group A were significantly lower than that of group B( P <0.05). Motor function recovery in group A was not different from those in group B ( P >0.05). The ADL scores and walking function recovery of patients in group B were obviously superior to those in group A ( P <0.05). Conclusion Hemiplegic cerebral infarction complicated by LA can seriously affect the rehabilitation outcome, especially the walking functions and the abilities of daily life.