早期动员对接受溶栓或血栓切除术治疗的急性缺血性脑卒中患者的影响:随机对照试验。

Hsiao-Ching Yen, Guan-Shuo Pan, Jiann-Shing Jeng, Wen-Shiang Chen
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引用次数: 0

摘要

背景:脑卒中后 24 至 72 小时内的早期康复(EM)可改善患者的表现和能力。然而,在静脉溶栓(IVT)或机械取栓(MT)后,出血并发症风险的增加影响了早期下床活动的实施。很少有研究对急性缺血性卒中(AIS)静脉溶栓或机械取栓术后的EM进行调查,其对这些患者的影响尚不清楚:方法:我们招募了 122 例首次接受 IVT 或 MT 治疗的缺血性卒中患者:方法:我们招募了 122 例首次 AIS 患者,其中 60 例接受 IVT 治疗,62 例接受 MT 治疗。在每组 IVT 和 MT 患者中,对照组接受标准的早期康复训练,干预组接受 EM 方案训练。训练时间为每天30分钟,每周5天,直至出院:结果:IVT和MT治疗组都显示出了良好的康复效果:结果:随着时间的推移,IVT 治疗组和 MT 治疗组的 FIM 运动能力和 PASS 评分均有所提高;但只有 IVT EM 组在卒中后 1 个月内的 FIM 运动能力明显优于对照组。结论每天干预时间和次数与标准护理方案相同的 EM 方案能有效改善 IVT 后脑卒中患者的功能能力。
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Impact of Early Mobilization on Patients With Acute Ischemic Stroke Treated With Thrombolysis or Thrombectomy: A Randomized Controlled Trial.

Background: Early mobilization (EM) within 24 to 72 hours post-stroke may improve patients' performance and ability. However, after intravenous thrombolysis (IVT) or mechanical thrombectomy (MT), the increased risk of hemorrhagic complications impacts the implementation of early out-of-bed mobilization. Few studies have investigated EM after IVT or MT for acute ischemic stroke (AIS), and its impact in these patients is unknown.

Objective: To investigate the effect of EM on AIS treated with IVT or MT.|.

Methods: We recruited 122 patients with first AIS; 60 patients were treated with IVT, and 62 patients were treated with MT. For each IVT and MT cohort, the control groups received standard early rehabilitation, and the intervention groups received an EM protocol. The training lasted 30 minutes/day, 5 days/week until discharge.

Main outcomes measures: The effectiveness of the interventions was evaluated using the motor domain of the Functional Independence Measure (FIM-motor) and the Postural Assessment Scale for Stroke Patients (PASS) at baseline, 2-week, 4-week, and 3-month post-stroke, the Functional Ambulation Category 2-week post-stroke, and the total length of stay at the stroke center.

Results: Both IVT and MT treatment groups showed improved FIM-motor and PASS scores over time; however, only the IVT EM group had significantly improved FIM-motor performance within 1 month after stroke than the control group. Conclusion. An EM protocol with the same intervention time and session frequency per day as in the standard care protocol was effective in improving the functional ability of stroke patients after IVT.

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