丁苯酞联合高压氧对急性脑梗死患者认知功能障碍的影响

王顺达1，刘振国2 ，武冬3 ，杨俊生1

（1.陕西省人民医院：1.康复医学科；2.重症医学科；3.急诊内科，陕西 西安，710068）

浏览次数：126次 下载次数：368次

摘要：

目的 探讨丁苯酞联合高压氧对脑梗死后认知功能障碍的治疗效果。方法 抽取我院收治的90例急性脑梗死伴有认知 功能障碍患者，随机分成观察组和对照组，各45例。对照组采用常规治疗，观察组在常规治疗基础上加用丁苯酞联合高压氧 治疗，对比两组治疗前、后MMSE及ADL评分。结果 治疗后，观察组与对照组MMSE量表总分及ADL总分与治疗前比较，明显改善（P<0.05），且观察组明显优于对照组（P<0.05）；两组患者MMSE量表中时间定向、地点定向、语言即刻记忆、注意和计 算、短程记忆以及言语表达评分明显提高，且观察组明显高于对照组（P<0.05）；两组患者ADL 量表中躯体生活能力及工具使 用能力评分均明显降低，且观察组明显低于对照组（P<0.05）。结论 丁苯酞联合高压氧治疗对脑梗死患者认知功能的改善、神经功能的恢复疗效显著。

关键词：丁苯酞；高压氧；急性脑梗死；认知功能障碍

中图分类号：R743.33文献标志码：A文章编号：2096-1413(2017)32-0010-02

Effect of butylphthalide combined with hyperbaric oxygen on cognitive dysfunction in patients

with acute cerebral infarction
WANG Shun-da 1, LIU 在hen-guo 2, WU Dong 3, YANG Jun-sheng 1
(1. Department of Rehabilitation Medicine; 2. ICU; 3. Department of Emergency Internal Medicine,
Shaanxi Provincial People``s Hospital, Xi``an 710068, China)

ABSTRACT: Objective To investigate the therapeutic effect of butylphthalide combined with hyperbaric oxygen on cognitive dysfunction after cerebral infarction. Methods Nighty cases of acute cerebral infarction patients with cognitive dysfunction were selected and divided into observation group and control group, with 45 cases in each group. The control group accepted routine treatment; on this basis, the observation group was treated with butylphthalide combined with hyperbaric oxygen; then the MMSE and ADL scores before and after treatment were compared between the two groups. Results After treatment, the total scores of MMSE and ADL in the two groups significantly improved compared with before treatment (P<0.05), and those in the observation group were significantly superior to the control group (P<0.05). There were significant differences in the time orientation, location orientation, language immediate memory, attention and calculation, short-range memory, and verbal expression scores in the MMSE scale of the two groups (P<0.05), and the scores of the observation group were higher than the control group (P<0.05); the scores of physical capacity and tool use ability of ADL scale in both groups decreased, and those of the observation group were lower than the control group (P<0.05). Conclusion Butylphthalide combined with hyperbaric oxygen therapy has significant effect in the improvement of cognitive function and the recovery of neurological function.
KEYWORDS: butylphthalide; hyperbaric oxygen; acute cerebral infarction; cognitive dysfunction

参考文献：
[1] 康复医学[M].北京:人民卫生出版社,2014:192.
[2] 中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014 [J].中华神经科杂志,2015,48(4):247-248.
[3] 医用高压氧舱管理与应用规范[M].中华医学会高压氧分会,2015:37-41.
[4] SCHEEL P,PULS I,BECKER G,et al.Volume reduction in cerebral blood flow in patients with vascular dementia[J].Lancet,1999,354(9196): 2137.
[5] HU J,WEN Q,WU Y,et al.The effect of butylphthalide on the brain edema, blood-brain barrier of rats after focal cerebral infarction and the expression of Rho A[J].Cell Biochem Biophys,2014,69(2):363-368.
[6] 陈海恋,何超明,庞明武,等.丁苯酞治疗老年急性脑梗死的疗效及对细胞因子和神经功能的影响[J].中华老年心内血管病杂志,2016,18(11):1173-1177.
[7] 赵秀芹,邓春颖,李世英,等.丁苯酞注射液对大鼠局灶性脑缺血再灌注损伤的神经保护作用[J].山东大学学报:医学版,2016,54(4):25-31.
[8] 邵伟波,饶江,阎俊,等.高压氧对血管性痴呆患者认知功能障碍的康复作用探讨[J].疑难病杂志,2002,1(4):217-218.
[9] 姚太俊,代广辉.高压氧对颅脑损伤患者认知功能障碍恢复的影响 [J].中国实用神经疾病杂志,2007,10(3):22-25.