早期康复治疗对不同TOAST分型脑梗死患者神经功能的影响

摘要

Objective To clarify the prognostic differences of the early rehabilitation treatment method among different ischemic stroke subtypes.Methods 361 patients with acute ischemic stroke were collected, and were assessed with the Trial of Org 10172 in Acute Stroke Treatment ( TOAST) classification:large-vessel atherothrombotic ( LVA) , cardioembolic ( CE) , small-vessel and la-cunar infarct ( LACI) and Stroke of Other Determined Etiology&Stroke of undetermined cause ( SOD&SUD) .All the patients were di-vided into 2 groups:early rehabilitation group and control group.The prognostic factors were assessed by NIHSS,Barthel Index and Rankin at the 1 month and 6 month after rehabilitation treatment.Results On admission, Barthel Index scores of LACI patients were higher than those of CE patients.6 month after cerebral infarction onset, patients in rehabilitation groups of CE and LVA had higher Barthel Index scores than those in control group.Conclusion We should adopt rehabilitation measures in cerebral ischemic stroke, especially for CE and LVA patients, because proper rehabilitation treatment will result in excellent prognosis for long.%目的：本研究旨在阐述不同急性卒中治疗org10172（Trial of org10172 in Acute Stroke Treatment，TOAST）分型脑梗死患者早期康复治疗的效果及其对神经功能恢复的影响。方法入选脑梗死患者共361例。按TOAST分型：大动脉粥样硬化型（LVA），心源性栓塞型（CE），小动脉闭塞性卒中和腔隙性梗死型（LACI），其它原因及不明原因型（SOD＆SUD）。各亚型患者再分为早期康复治疗组及未干预组，记录患者，治疗1月后及随访6月后的美国国立卫生院卒中神经功能缺损评分量表（ National Institutes of Health Stroke Scale，NIHSS），Barthel Index评分及Rankin评分。结果入院时，腔隙性梗死型患者Barthel Index评分明显高于心源性栓塞型患者。发病6个月后，心源性栓塞型和大动脉粥样硬化型患者康复治疗组Barthel Index评分较未干预组高。结论早期康复治疗可用于脑梗死的治疗，特别是TOAST分型中的心源性栓塞型和大动脉粥样硬化型患者，对远期神经功能的恢复起到良好效果。