老年脑梗死患者不同时机康复治疗对神经功能的影响比较

  目的  探讨老年脑梗死患者不同时机康复治疗的效果及对患者神经功能的影响，为临床康复治疗方案的制定提供参考依据。  方法  将2018年5月—2021年5月龙游县人民医院神经内科收治的180例老年脑梗死患者按随机数字表法分为观察组和对照组，每组90例，2组分别于患者生命体征稳定后2周内和2~4周进行康复治疗，均治疗4周。比较2组NIHSS评分、FMA评分、BI评分、炎性因子水平(白细胞介素-6、肿瘤坏死因子-α、超敏C-反应蛋白)及康复效果。  结果  治疗后，2组患者NIHSS评分均降低(P＜0.05)，且观察组明显低于对照组(7.61±1.87)分vs.(8.95±2.09)分，P＜0.05]；2组患者FMA评分均升高(P＜0.05)，且观察组显著高于对照组(73.06±6.34)分vs.(64.15±4.78)分，P＜0.05]；2组患者BI评分均升高(P＜0.05)，观察组高于对照组(68.35±6.83)分vs.(57.11±7.29)分，P＜0.05]；治疗后，2组患者白细胞介素-6、肿瘤坏死因子-α、超敏C-反应蛋白均降低(均P＜0.05)，且观察组低于对照组(均P＜0.05)；观察组的治疗总有效率(84.44%)高于对照组(71.11%，P＜0.05)。  结论  老年脑梗死患者于生命体征稳定后2周内进行康复治疗可改善神经功能、肢体功能、日常生活活动能力，且可降低炎性因子水平，提高康复效果。 

Effects of rehabilitation treatment at different time points on neurological function in elderly patients with cerebral infarction

  Objective  To explore the effect of rehabilitation treatment at different time points on elderly patients with cerebral infarction and its impact on neurological function, so as to provide reference basis for the formulation of clinical rehabilitation treatment plan.  Methods  A total of 180 elderly patients with cerebral infarction treated in the Department of Neurology of Longyou People's Hospital from May 2018 to May 2021 were randomly divided into the observation group and control group, with 90 cases in each group. The two groups received rehabilitation treatment for 4 weeks within 2 weeks and 2-4 weeks after the patient's vital signs were stable. The National Institutes of Health stroke scale (NIHSS) score, Fugl-Meyer assessment (FMA) score, Barthel Index (BI) score, levels of inflammatory factors (interleukin-6, tumour necrosis factor-α, high-sensitivity C-reactive protein) and rehabilitation effect were observed in the two groups.  Results  The NIHSS score of the two groups decreased significantly after treatment (P < 0.05), with the observation group having a significantly lower score than the control group (7.61±1.87) points vs. (8.95±2.09) points, P < 0.05]. After treatment, the FMA score of the two groups increased significantly (P < 0.05), with the observation group having a significantly higher score than the control group (73.06±6.34) points vs. (64.15±4.78) points, P < 0.05]. The BI scores of the two groups increased significantly after treatment (P < 0.05), with the observation group having a significantly higher score than the control group (68.35±6.83) points vs. (57.11±7.29) points, P < 0.05]. The levels of interleukin-6, tumour necrosis factor-α and high-sensitivity C-reactive protein of the two groups increased significantly after treatment (P < 0.05), and the observation group had lower levels compared with the control group (P < 0.05). The total effective rate of the observation group was 84.44%, which was significantly higher than that in the control group (71.11%, P < 0.05).  Conclusion  Rehabilitation treatment for elderly patients with cerebral infarction within 2 weeks after the stability of vital signs can improve neurological function, limb function and activities of daily living, reduce the level of inflammatory factors, and improve the rehabilitation effect.