重症双侧延髓内侧梗死康复治疗病例报告1例并文献复习OACSTPCD

Background Bilateral medial medullary infarction(BMMI),also known as"heart-shaped infarction",has a low incidence in clinical practice,but its special anatomical location leads to high disability and mortality.Objective To explore the clinical efficacy of early,comprehensive,and full-course rehabilitation training for patients with severe BMMI.Methods Early,comprehensive and full-course rehabilitation training was carried out for a patient with severe BMMI,including phonation and swallowing training,respiratory training,trunk and limb movement training,etc.The patient's follow-up time was four months.The National Institute of Health Stroke Scale(NIHSS),Activity of Daily Living Scale(Modified Barthel),Modified Rankin Score(MRS),and diaphragmatic ultrasound evaluation were performed.Results The patient with severe BMMI benefited greatly from rehabilitation,with a 15-point reduction in the NIHSS score,a 68-point improvement in the Modified Barthel score,and a 3-point reduction in the MRS score.Diaphragm ultrasound suggested that the diaphragm thickening ratio increased from 20%to 68%,and diaphragm mobility increased from 21.6 mm to 28.8 mm.As of the follow-up date,the patient was able to sit independently and stand with little assistance.Conclusion Early,comprehensive,and full-course rehabilitation may have a positive effect on the prognosis of patients with severe BMMI.