规范三级康复治疗中不同时期卒中患者运动功能改善规律的分析  

Analysis of the Law of Motor Function's Amelioration in Stroke Patients at Different Stages of Standardized Three-Stage Rehabilitation Program

作　　者：朱玉连[1] 胡永善[1] 吴毅[1] 姜从玉[1] 孙莉敏[1] 范文可[1] 谢臻[1] 沈莉[1] 朱秉[1] 白玉龙[1] 李放[1] 

机构地区：[1]复旦大学附属华山医院运动医学与康复科,上海200040

出　　处：《中国运动医学杂志》2004年第4期377-380,408,共5页Chinese Journal of Sports Medicine

基　　金：国家科技部"十五"攻关课题"脑血管病三级康复治疗方案"的研究 (课题编号 :2 0 0 1BA70 3B2 1)

摘　　要：目的 :探索规范的三级康复治疗后 ,卒中偏瘫患者运动功能的改善规律。方法 :卒中 5 2例患者在脑梗塞和脑出血两个层次上随机分为康复组和对照组 ,康复组给予规范的三级康复治疗 ,对照组则不给于规范的三级康复治疗 ,但常规内科治疗同治疗组。分别于入选时 ,发病后第 1个月月末、第 3个月月末和第 6个月月末采用功能综合评定量表进行运动相评分。结果 :康复组在入选后各阶段的评分明显高于对照组 (P <0 .0 0 1) ,康复组各阶段运动功能评分积分差值明显高于对照组 (P <0 .0 5 )。对患者各阶段运动功能进行自身前后对比 ,发现康复组患者各阶段运动功能积分之间存在显著差异 (P <0 .0 1) ,对照组除第 3个月月末和第 6个月月末的运动功能积分间不存在明显差别 ,其余均存在明显差别 (P <0 0 5 )。另外 ,从患者康复各阶段运动功能变化上可以看出 ,康复组在各阶段的积分明显高于对照组 ,且积分在各阶段的增长趋势明显快于对照组。结论 :规范三级康复治疗早期能够加速患者的恢复进程 ,后期康复治疗仍有利于患者运动功能的改善 ,但是速度变慢 ,然而相对于对照组功能恢复仍然较为明显。Objective To explore the law of motor function's amelioration in stroke patients with hemiplegia after the treatment of standardized three-stage rehabilitation program. Methods All 52 patients with primary cerebral infarction or primary cerebral hemorrhage were respectively divided into treated group and controlled group randomly. Patients in the treated group participated in standardized three-stage rehabilitation program, while those in the controlled group received only routine internal medicine treatments same as the treated group and without standardized three-stage rehabilitation. All patients were assessed with the motor evaluation scale of Functional Comprehensive Assessment (FCA) at the begining of rehabilitation (V0), the end of 1st month (V1), 3rd month (V2) and 6th month (V3) after stroke. Results The scores at V1,V2 and V3 of the treated group were higher than that of the controlled group(P<0.001). The differences of V0,V1 and V2 from V3,and of V0 and V1 from V2,and V0 from V1 in the treated group were greater than that in the controlled group(P<0.05). The individual motor function improved stage by stage significantly in the treated group(P<0.01). Except for the scores between the end of 3rd and 6th month, significant differences in motor function were also found at other stage in the controlled group(P<0.05). In addition, the scores of the treated group were higher than that of the controlled group, and the slope of the inereasing in treated group was greater than that in the controlled group. Conclusion Standardized three-stage rehabilitation program could accelerate the recovery of cerebral patients in the early stage, and it could improve the patient's motor function in the later stage. Though the speed of improving in treated group was somewhat slow in the later stage, it was still significant as compared with that in controlled group.

关 键 词：三级康复 运动功能 偏瘫 脑卒中 脑血管病 

分 类 号：R49[医药卫生—康复医学]