血管内激光照射治疗对脑卒中后亚急性期交叉性小脑神经机能联系不能的临床疗效研究

目的:探讨血管内激光照射治疗(ILIB)对脑卒中后亚急性期交叉性小脑神经机能联系不能(crossed cerebellar diaschisis，CCD)的临床疗效。方法:2019年6月-2021年12月，筛选我院发生急性中风并接受脑SPECT的48名患者作为研究对象，按照脑卒中偏侧性、性别、梗塞等因素匹配为ILIB治疗组(n=24)和常规治疗组(n=24)。使用99mTc-六甲基丙胺肟(99mTc-HMPAO)进行脑SPECT以检测CCD。通过简易精神状态检查(MMSE)、功能性行走类别(FAC)和修正的Barthel指数(MBI)在2个时间点评估功能结果。分析功能恢复以揭示初始和后续评估之间每个临床评分(MMSE、FAC、MBI)的功能增益。结果:根据独立t检验，常规治疗组在初始评估时的MMSE、FAC、MBI评分与ILIB治疗组相比无显著差异(P值分别为0.122、0.106、0.125)；后继评价中，常规治疗组在初始评估时的MMSE、FAC、MBI评分与ILIB治疗组相比亦无显著差异(P值分别为0.123、0.091和0.136)。常规治疗组的FAC恢复更差(P=0.001)，常规治疗组的MMSE和MBI平均功能恢复低于ILIB治疗组，但两组MMSE和MBI恢复的差异无统计学意义(P值分别为0.032和0.036)。结论:血管内激光照射治疗可改善CCD并有利于功能恢复，ILIB对脑卒中后亚急性期CCD具有较好的临床疗效。

Abstract

Objective: Investigating the clinical effect of intravascular laser irradiation (ILIB) on subacute CCD after stroke. Methods: From June 2019 to December 2021, 48 patients who suffered from acute stroke and received brain SPECT in our hospital were selected as the study subjects, and were matched into ILIB treatment group (n=24) and conventional treatment group (n=24) according to stroke laterality, gender, infarction, hemorrhage, and other factors. Brain SPECT was performed with 99mTc-hexamethylpropioxime (99mTc-HMPAO) to detect CCD. The functional results were evaluated at 2 time points by the simple mental state examination (MMSE), functional walking category (FAC) and modified Barthel index (MBI). The functional recovery was analyzed to reveal the functional gain of each clinical score (MMSE, FAC, MBI) between the initial and subsequent evaluations. Results: According to independent T-test, there were no significant differences in MMSE, FAC, MBI, MMSE, FAC, and MBI scores in the conventional treatment group at the initial assessment (P values were 0.122, 0.106, 0.125, 0.123, 0.091, and 0.136, respectively). The recovery of FAC was worse in the conventional treatment group (P=0.001), and the mean functional recovery of MMSE and MBI in the conventional treatment group was lower than that in the ILIB treatment group, but there was no statistically significant difference in the recovery of MMSE and MBI between the two groups (P= 0.032 and 0.036, respectively). Conclusion: Intravascular laser irradiation can improve CCD and facilitate functional recovery. ILIB has a good clinical effect on CCD in the subacute stage after stroke.

参考文献

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王静, 王丽娟, 王明, 赵会娟, 张杏红. 血管内激光照射治疗对脑卒中后亚急性期交叉性小脑神经机能联系不能的临床疗效研究[J]. 应用激光, 2023, 43(6): 0150. Wang Jing, Wang Lijuan, Wang Ming, Zhao Huijuan, Zhang Xinghong. Clinical Effect of Intravascular Laser Irradiation on Subacute Cerebellar Nerve Block After Stroke[J]. APPLIED LASER, 2023, 43(6): 0150.

血管内激光照射治疗对脑卒中后亚急性期交叉性小脑神经机能联系不能的临床疗效研究

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