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目的观察氟西汀对自发性颅内出血后运动功能恢复的影响。方法 72例自发性颅内出血患者随机分为试验组36例和对照组36例。对照组用常规的降压、扩张脑血管治疗及现有的物理康复疗法;试验组在对照组的基础上口服或者鼻饲氟西汀20 mg·d-1,共90 d。治疗前后,比较2组患者的Fugl-Meyer运动评分(FMMS)、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数及改良Rankin量表(mRS)评分。结果治疗后,试验组FMMS评分为(68.28±9.65)分,Barthel指数为(74.53±7.70)分,对照组的FMMS评分为(54.22±10.53)分,Barthel指数为(60.25±8.43)分,2组差异有统计学意义(P<0.01)。试验组NHISS评分为(6.69±2.62)分,对照组NHISS评分为(9.36±3.28),2组差异有统计学意义(P<0.01)。试验组生活自理患者例数为10例(10/36例,27.78%),对照组生活自理例数为3例(3/36例,8.33%),差异有统计学意义(P<0.05)。试验组药物不良反应包括恶心3例和嗜睡2例,药物不良反应发生率为13.89%(5/36例),对照组无药物不良反应发生。结论氟西汀可促进自发性颅内出血患者运动功能和神经功能的恢复。
Objective To observe the effect of fluoxetine on motor function recovery after spontaneous intracranial hemorrhage. Methods 72 patients with spontaneous intracranial hemorrhage were randomly divided into experimental group 36 cases and control group 36 cases. The control group was treated with routine antihypertensive and dilated cerebrovascular therapy and existing physical rehabilitation therapy. The experimental group was orally or nasally administered fluoxetine 20 mg · d-1 for 90 days on the basis of the control group. Before and after treatment, the Fugl-Meyer Movement Score (FMMS), NIH Stroke Scale (NIHSS) score, Barthel Index and Modified Rankin Scale (mRS) scores were compared between the two groups. Results After treatment, FMMS score was (68.28 ± 9.65) and Barthel index was (74.53 ± 7.70) in control group, FMMS score was (54.22 ± 10.53) and Barthel index was (60.25 ± 8.43) and The difference was statistically significant (P <0.01). The NHISS score was (6.69 ± 2.62) in the experimental group and (9.36 ± 3.28) in the control group, and the difference was statistically significant (P <0.01). There were 10 cases (10/36 cases, 27.78%) in the experimental group and 3 cases (8.36%) in the control group, the difference was statistically significant (P <0.05). Adverse drug reactions in the test group included 3 cases of nausea and 2 cases of drowsiness. The incidence of adverse drug reactions was 13.89% (5/36 cases) in the test group. No adverse drug reactions occurred in the control group. Conclusion Fluoxetine can promote the recovery of motor function and nerve function in patients with spontaneous intracranial hemorrhage.