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脑活素®在缺血性脑卒中康复中的作用:病例报告。

Role of Cerebrolysin® in Rehabilitation in Ischemic Stroke: A Case Report.

机构信息

Department of Physical Medicine and Rehabilitation, Neurological institute of Thailand, Bangkok, Thailand.

Department of Radiology, Neurological Institute of Thailand, Bangkok, Thailand.

出版信息

Am J Case Rep. 2021 Sep 8;22:e932365. doi: 10.12659/AJCR.932365.

Abstract

BACKGROUND The criterion standard treatments for ischemic stroke patients, starting from systemic thrombolysis and/or undergoing endovascular recanalization therapy to intensive rehabilitation, are the best options available nowadays, but still cannot achieve total recovery. Neuroprotective and neurotrophic agents seem to be promising therapeutic targets in stroke, even in ischemic and/or hemorrhagic stroke, either in the acute stage or to support neuro-recovery in subacute to chronic stages. Therefore, new therapies are needed as adjuvants in the rehabilitation phase for promoting the recovery and monitoring adverse effects of treatment. CASE REPORT We describe a patient with an acute occlusion of the right middle cerebral artery who was treated with recombinant tissue-plasminogen activator (rtPA), underwent mechanical thrombectomy, and was then enrolled in a 1-month rehabilitation program. After the post-stroke recovery plateau, the patient received 10 days of 30 mL intravenous Cerebrolysin® to support further neuro-recovery, together with long-term rehabilitation. We utilized clinical standard assessment tools, including National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), modified Barthel Index (MBI), and function of ambulation, to evaluate the outcome of the patient, together with the adverse events monitoring. After Cerebrolysin® administration, the patient demonstrated improvement in all assessment scores at 1, 3, and 6 months. CONCLUSIONS Postoperative treatment with Cerebrolysin® in our patient with subacute ischemic stroke, after plateau recovery in the rehabilitation phase, together with the standard acute stroke regimen, improved the patient's recovery outcomes. No serious adverse effects were observed.

摘要

背景

目前,缺血性脑卒中患者的标准治疗方法是系统溶栓和/或血管内再通治疗,再加上强化康复治疗,这些都是目前最佳的治疗选择,但仍无法实现完全康复。神经保护和神经营养药物似乎是脑卒中治疗的有前途的治疗靶点,即使是在缺血性和/或出血性脑卒中患者中,无论是在急性期还是在亚急性期至慢性期支持神经恢复,这些药物都具有一定的作用。因此,需要新的治疗方法作为康复阶段的辅助治疗,以促进恢复并监测治疗的不良反应。

病例报告

我们描述了一位患有右侧大脑中动脉急性闭塞的患者,该患者接受了重组组织型纤溶酶原激活剂(rtPA)治疗,进行了机械取栓术,然后入组了为期 1 个月的康复计划。在脑卒中后恢复平台期后,患者接受了 10 天 30ml 静脉注射脑活素以支持进一步的神经恢复,并结合长期康复治疗。我们使用了临床标准评估工具,包括美国国立卫生研究院卒中量表(NIHSS)、改良 Rankin 量表(mRS)、改良巴氏指数(MBI)和步行功能,来评估患者的预后,并监测不良反应。在给予脑活素后,患者在 1、3 和 6 个月时所有评估评分均有所改善。

结论

在康复阶段平台期恢复后,我们对亚急性缺血性脑卒中患者术后使用脑活素联合标准急性脑卒中治疗方案,改善了患者的恢复效果。未观察到严重的不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97e4/8438647/f8ec9475ee87/amjcaserep-22-e932365-g001.jpg

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