| BackgroundStroke is one of the major diseases endangering national health of us,also known as cerebrovascular accident.It is a group of cerebrovascular diseases(CVD)with sudden onset and common characteristics of focal neurological deficit.It is also the main clinical type of CVD.Stroke is mainly divided into two types:ischemic stroke and hemorrhagic stroke.Hemorrhagic stroke includes intracerebral hemorrhage(ICH)and subarachnoid hemorrhage(SAH),in which ICH is cerebral parenchymal hemorrhage.The incidence rate,mortality rate,disability rate and recurrence rate of stroke are in high level."The guideline for prevention and treatment of stroke in China(2021 Edition)" mentioned that in 2013,a nationwide multi center 480687 sample survey showed that among all those kinds,cerebral infarction accounted for 77.8%,ICH accounted for 15.8%,and SAH accounted for 4.4%.By 2019,the incidence rate of ischemic stroke was about 1700/10 million,meanwhile the rate in hemorrhagic stroke was 306/10 million.In recent years,the incidence rate of stroke is still rising,but the mortality rate tends to be stable.It is the top reason of death in China.The incidence rate of stroke is more in rural areas than in city.The proportion of patients aged 70 years old in the stroke population in China has been increasing,and the trend of younger age is gradually becoming younger.At present,with the gradual development of medical level and the gradual improvement of medical technology,more and more patients can safely survive the acute stage of stroke and enter the long recovery period and sequelae period.How to improve the prognosis of stroke patients in the recovery period and sequelae period has gradually become a problem that needs to be paid attention to in clinical work.In clinical practice,it is found that there are a large number of patients with low hemoglobin(Hb)level in the recovery stage and sequelae stage of stroke,and low Hb level occurs in different age and gender.At present,studies have shown that Hb level is significantly related to the prognosis of stroke,and low Hb level can significantly reduce the survival time of patients.Low Hb has been proved to be related to the mortality and disability rate of stroke,which is an independent risk factor affecting the prognosis of this kind of disease.At present,most studies are about the improvement of Hb by drug treatment.In terms of drugs,there has been more experience in the use of iron and recombinant human erythropoietin(rhEPO).However,according to some studies,gastrointestinal reactions caused by long-term drug use may increase the physical burden of patients,and the overall benefit of stroke patients has not been studied.Non drug rehabilitation therapy has not been reported on improving the low Hb level of patients with stroke sequelae.At present,studies have shown that aerobic exercise can significantly improve the human Hb level.Based on previous studies,this study observed and analyzed the improvement of rehabilitation therapy on stroke complicated with low Hb level.ObjectiveObserve the correlation of rehabilitation training on low Hb level of elderly stroke patients.MethodsA retrospective analysis was conducted on the relevant data of 111 elderly stroke patients admitted to the Southern District of the Second Hospital of Shandong University from June 2020 to December 2021 with Hb value lower than normal.Blood routine,liver and kidney function as well as Activity of Daily Living(ADL)score were included in the analysis to analyze the improvement of Hb level and the efficacy and safety of rehabilitation therapy.Patients were divided into treatment group(n=55)and control group(n=56)according to whether they had received rehabilitation training or not.The improvement of blood routine indexes and ADL scores of liver and kidney function indexes were compared between the two groups before and after 3 months’ treatment,and the occurrence of adverse events was also recorded during the treatment.Results1.The difference between the treatment group and the control group was not statistically significant in gender,age,nasal feeding,primary disease type,hypertension,diabetes,constipation and other general baseline data(P>0.05).The difference in blood routine,liver and kidney function and ADL scores between the two groups was not significant(P>0.05).2.The correlation between the items of the 2 groups and Hb before treatment:the correlation between the items of the two groups before treatment and Hb was observed.In the comparison with the items of blood routine,it was found that Hb was related to red blood cell(RBC),mean corpuscular hemoglobin(MCH)and mean corpuscular hemoglobin concentration(MCHC)strongly and positively,while Hb was negatively correlated with C reactive protein(CRP).In comparison with various items of liver and kidney function,it was found that Hb was positively correlated with total protein(TP)and albumin(ALB).3.In the blood routine and CRP indexes,after treatment,the RBC and Hb of treatment group were much higher than the control group(P<0.05),and the CRP in the treatment group was much lower than the control group(P<0.05).Among the items of liver and kidney function and ADL score,TP,ALB and prealbumin(PA)in the treatment group were higher than the control group(P<0.05).4.The correlation between rehabilitation treatment and various hematological indexes and ADL scores.In statistical analysis,it was set as code 1 for receiving rehabilitation treatment and code 2 for not receiving rehabilitation treatment.Therefore,the increases of hematological and ADL scores in the rehabilitation treatment group(treatment group)were negative,the decrease were positive,the group without rehabilitation treatment(control group)was vice versa.Results:rehabilitation treatment was positively correlated with the improvement of RBC,Hb,TP,ALB,PA and ADL,and negatively correlated with the value of CRP.5.The linear regression between rehabilitation treatment and Hb showed that there was a linear relationship between receiving rehabilitation treatment and the improvement of Hb level.6.The comparison of diarrhea,recurrent stroke,fracture,pulmonary embolism(PE),oh and deep venous thrombosis(DVT)betw een the treatment group and the control group showed that the number of patients with recurrent stroke in the treatment group was less than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically difference between the two groups in the occurrence of diarrhea,fracture,PE,OH and DVT(P>0.05)ConclusionsAfter 3 months of rehabilitation treatment,Hb level in the treatment group was higher than that in the control group.Therefore,it is speculated that rehabilitation training may have a certain correlation with the improvement of Hb level in the elderly stroke patients,and the safety is good. |
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