重症脑卒中相关性肺炎对神经功能的影响及干预对策

摘要

目的：分析重症脑卒中并发相关性肺炎对神经功能损伤的影响，并探讨功能康复疗法在重症脑卒中并发相关性肺炎治疗中的应用价值。方法：选择重症脑卒中患者92例，将其中32例在院期间未发生肺炎者作为 A 组，60例在院期间发生肺炎者作为 B 组，比较两组入组时及治疗1个月后的国立卫生院卒中量表（NIHSS）评分变化。同时将 B 组随机分为单纯接受药物抗肺炎治疗的 B1组及在药物治疗的基础上联合功能康复疗法治疗的 B2组，每组30例，比较两组治疗前后 NIHSS 评分变化。结果：A 组与 B 组 NIHSS 评分入组时比较，差异无统计学意义（P ＞0.05），接受治疗后1个月，A 组 NIHSS 评分明显低于 B 组（P ＜0.05）。B 组不同分组间发生肺炎时 NIHSS 评分比较，差异无统计学意义（P ＞0.05），经对症治疗2周后，B2组 NIHSS 评分明显低于 B1组（P ＜0.05）。结论：重症脑卒中并发相关性肺炎可影响患者的神经功能，而在此类患者中应用功能康复疗法可有效提高神经功能恢复程度。%Objective:To analyze the impact of severe stroke patients associated pneumonia on neurological damage,and to investigate the therapeutic value associated pneumonia in intensive functional rehabilitation therapy in stroke patients. Meth-ods:Nighty - two cases of severe stroke patients was observed,32 cases in Group A did not outbreak of pneumonia in the hospi-tal,60 cases in Group A outbreak of pneumonia in the hospital. To compare the US national institutes of health stroke scale (NIHSS)score of two group at entering the group and after the treatment of one month. While Group B were randomly divided into only accepting anti - pneumonia drug therapy(group B1)and drug therapy combined with functional rehabilitation thera-py(group B2),30 cases in each group,to compare the change of NIHSS scores before and after treatment. Results:The NIHSS score of Group A and Group B was no significant difference( P > 0. 05)at entering the group,after the treatment of one month,the NIHSS score of Group A was significantly lower than group B(P < 0. 05). The NIHSS score of different groups a-mong group B was no significant difference at outbreak of pneumonia(P > 0. 05),after symptomatic treatment of two weeks af-ter,the NIHSS score of Group B2 was significantly lower than group B1(P < 0. 05). Conclusion:The severe stroke - associated pneumonia an affect nerve function in patients,but functional rehabilitation therapy in such patients can the effectively improve the degree of neurological functional recovery.