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低频神经肌肉电刺激联合前列地尔对30例急性缺血性脑卒中患者下肢运动功能的影响

2020-08-18黄广为

上海医药 2020年15期

黄广为

摘 要 目的:观察低频神经肌肉电刺激联合前列地尔对急性缺血性脑卒中患者下肢运动功能的影响。方法:双盲选取90例急性缺血性脑卒中并伴有下肢运动功能障碍的患者随机分为3组各30例,其中常规治疗组给予常规康复治疗,低频NMES组给予常规康复治疗+低频NMES治疗,联合治疗组在低频神经肌肉电刺激(neuromuscular electrical stimulation, NMES)组治疗基础上联合前列地尔治疗,分别在治疗前与治疗6周后采用简易下肢Fugl-Meyer量表(FMA)、改良Barthel指数评分(MBI)和Berg平衡量表(BBS)评定患者的下肢运动能力。结果:3组患者的各项指标在治疗前评分差异无统计学意义。治疗6周后,联合治疗组的3项指标评分升高较其他两组疗效更显著(P<0.05)。结论:在常规康复治疗基础上加用低频NMES联合前列地尔可有效改善急性缺血性脑卒中患者的下肢运动功能。

关键词 低频NMES 前列地尔 缺血性脑卒中 下肢运动

中图分类号:R973.2; R743.33 文献标志码:B 文章编号:1006-1533(2020)15-0045-03

Effect of low frequency neuromuscular electrical stimulation combined with alprostadil on lower extremity motor function in 30 patients with acute ischemic stroke

HUANG Guangwei*

(the First Department of Neurology, the Central Hospital of Jiamusi, Heilongjiang Jiamusi 154002, China)

ABSTRACT Objective: To observe the effect of low frequency neuromuscular electrical stimulation combined with alprostadil on motor function of lower limbs in patients with acute ischemic stroke. Methods: Ninety patients with acute ischemic stroke and lower extremity dyskinesia were randomly divided into 3 groups with 30 cases each. The conventional treatment group was treated with conventional rehabilitation therapy, the low-frequency NMES group with conventional rehabilitation therapy plus low-frequency NMES therapy, and the combined treatment group with alprostadil combined with NMES therapy. The lower extremity dyskinesia before treatment and 6 weeks after were evaluated by FMA, MBI and BBS. Results: There were no significant differences among the three groups in the scores before treatment. The rise of the scores was more significant in the combined treatment group than the other two groups 6 weeks after treatment (P<0.05). Conclusion: The combination of lowfrequency NMES and alprostadil can effectively improve the motor function of lower limbs in patients with acute ischemic stroke.

KEY WORDS low-frequency NMES; alprostadil; ischemic stroke; lower extremity motor function

急性缺血性腦卒中属于临床多发病,其致残率居高不下,尤其以下肢运动功能障碍最常见,严重影响患者的身心健康和生活质量,给患者及其家庭造成沉重负担[1-2]。神经肌肉电刺激(neuromuscular electrical stimulation, NMES)是一项应用20~50 Hz低频电流刺激特定肌肉群使其抽搐或者收缩,继而修复肌肉功能的技术。临床研究结果显示采用低频NMES治疗可改善脑卒中患者的肢体功能,降低患者致残率[3-5]。临床上在使用NMES技术治疗的同时配合药物综合治疗的效果鲜有报道,本研究探讨NMES技术联合药物前列地尔综合治疗对急性缺血性脑卒中患者下肢功能的影响,现报告如下。

1 资料与方法

1.1 一般资料

双盲选取2018年2月—2019年5月本院神经内科收治的符合纳入标准的90例急性缺血性脑卒中并伴有下肢功能障碍患者,依据随机数字表法分为常规治疗组、低频NMES组、联合治疗组,每组30人,3组中均无患者脱落。……

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