Выраженность речевых и когнитивных нарушений у больных ишемическим инсультом на втором этапе реабилитации на фоне проведенной тромболитической терапии

Abstract

Introduction. The increasing frequency of ischemic stroke and its rejuvenation, leading to extremely unfavorable socio-economic consequences, make us reconsider the traditional technology of treatment and rehabilitation of patients with acute cerebrovascular accident (CVA). Thrombolytic therapy (TLT) today has established itself as the most effective method of treatment of ischemic stroke. Aim. To study the influence of thrombolytic therapy on the recovery of speech and cognitive disorders in patients with ischemic stroke at the second stage of rehabilitation. Materials and Methods. The study involved 68 ischemic stroke patients who were admitted to the second stage of rehabilitation. The patients were divided into two groups: 1st (n = 14) — patients who received thrombolytic therapy; 2nd (n = 54) — patients who received conventional CVA therapy. The assessment of speech disorders was carried out on the basis of the conclusion of the speech therapist. The severity of cognitive deficit was assessed using the BNCE scale (Brief Neuropsychological Cognitive Examination) and on the basis of data obtained during the consultation with a psychologist. The level of satisfaction of patients with their own condition was assessed using the Visual Analogue Scale. Results. The described neurosomatic status of patients with CVA, who underwent TLT, indicates the prevalence of men of retirement age with the presence of hemispheric infarction, which is combined with disorders of both impressive and expressive speech and mild cognitive impairments. In the 1st group of patients, more severe motor and sensory speech disorders were revealed compared to the 2nd group. Conclusion. The presence of more severe speech disorders in the 1st group of patients, on the one hand, is associated with a smaller number of the 1st group (TLT target is 5%; referral of patients with the absence of cognitive, motor and speech disorders to the 3rd stage of rehabilitation, bypassing the second stage), and on the other hand, with the presence of possible hemorrhagic complications against the background of TLT, which dictates the need for closer control over the reperfusion therapy protocols in the acute period of ischemic stroke.