作者：吕喆，王耀辉，杨欢，张重阳，陈洁，张琳琳，冯伟

单位：

河北省秦皇岛市第一医院急诊科

Units：

Emergency Department, First Hospital of Qinhuangdao, Qinhuangdao 066000. China

关键词：

脑梗死; 溶栓药; 重组组织型纤溶酶原激活物; 脑电仿生电刺激; 康复;

Keywords：

Brain infarction; Thrombolytic drugs; Recombinant tissue plasminogen activator; Electroencephalograph bionic electrical stimulation; Rehabilitation

CLC：

R 743.33

DOI：

10.12114/j.issn.1008-5971.2023.00.011

Funds：

秦皇岛市科技计划自筹经费项目（201805A159）

摘要：

目的 分析脑电仿生电刺激对急性脑梗死（ACI）患者重组组织型纤溶酶原激活物（rt-PA）溶栓治疗后康复效果的影响。方法 选取2018年12月至2020年12月秦皇岛市第一医院急诊科重症监护室收治的ACI患者70例作为研究对象。采用随机数字表法将患者分为观察组与对照组，各35例。两组患者均于rt-PA溶栓治疗后进行常规干预及康复训练，观察组在上述基础上开展脑电仿生电刺激干预。比较两组入院时（干预前）及干预后2周简易智力状态检查量表（MMSE）、美国国立卫生研究院卒中量表（NIHSS）、改良Barthel指数（MBI）评定量表、Fugl-Meyer运动功能评估量表（FMA）评分，血流动力学指标[大脑前动脉（ACA）、大脑中动脉（MCA）、基底动脉（BA）、椎动脉（VA）平均血流速度]，局部脑氧饱和度（rSO2）及预后。结果 干预后，对照组、观察组MMSE、MBI评定量表、FMA评分分别高于本组干预前，NIHSS评分分别低于本组干预前，且观察组MMSE、MBI评定量表、FMA评分高于对照组，NIHSS评分低于对照组（P<0.05）。干预后，对照组、观察组ACA、MCA、BA、VA平均血流速度分别快于本组干预前，rSO2分别高于本组干预前，且观察组ACA、MCA、BA、VA平均血流速度快于对照组，rSO2高于对照组（P<0.05）。观察组预后优于对照组（P<0.05）。结论 脑电仿生电刺激可有效改善ACI患者rt-PA溶栓治疗后认知、神经、运动功能和日常生活活动能力及脑血流动力学、脑组织供氧状态，同时可改善患者预后。

Abstract：

Objective To analyze the effect of electroencephalograph bionic electrical stimulation on rehabilitation of patients with acute cerebral infarction (ACI) after thrombolytic therapy with recombinant tissue plasminogen activator (rt PA) . Methods Seventy ACI patients admitted to the Intensive Care Unit of the Emergency Department of First Hospital of Qinhuangdao from December 2018 to December 2020 were selected as the research objects. Random number table method was used to divide the patients into observation group and control group, 35 cases in each group. Both groups received routine intervention and rehabilitation training after thrombolytic therapy with rt-PA, and the observation group received electroencephalograph bionic electrical stimulation intervention on the basis of the above. The score of Mini-mental State Examination (MMSE) , National Institute of Health Stroke Scale (NIHSS) , modified Barthel Index (MBI) Rating Scale and Fugl Meyer Motor Function Assessment (FMA) , hemodynamic indexes [mean blood flow velocity of anterior cerebral artery (ACA) , middle cerebral artery (MCA) , basilar artery (BA) , vertebral artery (VA) ] and regional cerebral oxygen saturation (rSO 2) on admission (before intervention) and 2 weeks after intervention, and prognosis were compared between the two groups. Results After intervention, the MMSE, MBI Rating Scale and FMA scores of the control group and the observation group were higher than those before intervention, the NIHSS score was lower than that before intervention respectively, and the MMSE, MBI Rating Scale and FMA scores of observation group were higher than those of control group, the NIHSS score was lower than that of control group ( P < 0.05) . After intervention, the mean blood flow velocity of ACA, MCA, BA and VA in control group and observation group was faster than that before intervention, rSO2 was higher than that before intervention respectively, and the mean blood flow velocity of ACA, MCA, BA and VA in observation group was faster than that in control group, rSO2 was higher than that in control group ( P < 0.05) . The prognosis of observation group was better than that of control group (P < 0.05) . Conclusion Electroencephalograph bionic electrical stimulation can effectively improve the cognitive, neurological and motor functions, activities of daily living, cerebral hemodynamics and oxygen supply status of the brain tissue in ACI patients after rt-PA thrombolytic therapy, and improve the prognosis of the patients.

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