不同介入时机康复对脑出血患者手功能和日常生活活动能力的影响  

Effects of Different Intervention Opportunities of Rehabilitation on Recovery of Hand Function and Activities of Daily Living in Patients with Intracerebral Hemorrhage

作　　者：陶峰[1,2,3] 何嫱[1,3] 张备[1,3] 白玉龙[1,2,3,4] 吴毅[1,3,4] 胡永善[1,3,4] 

机构地区：[1]复旦大学附属华山医院康复医学科,上海市200040 [2]复旦大学附属金山医院康复医学科,上海市201508 [3]复旦大学上海医学院康复与运动医学系,上海市200032 [4]复旦大学附属华山医院永和分院康复医学科,上海市200436

出　　处：《中国康复理论与实践》2012年第6期501-504,共4页Chinese Journal of Rehabilitation Theory and Practice

基　　金：上海市卫生局课题(2009局级250);上海市闸北区卫生局课题(2008重点05)

摘　　要：目的研究不同介入时机康复对脑出血患者手功能及日常生活活动能力(ADL)恢复的影响。方法对2005年6月～2011年6月入住康复病房的108例脑出血患者进行回顾性分析,入选时收集每位患者病史,记录患者的一般情况(性别、年龄、病因、发病时间、出血部位、入院时间、出院时间等),并根据康复介入时机分成:早期、中期、晚期和后遗症期康复组。出入院时评估患者手部Brunnstrom分级和改良Barthel指数(MBI)评分。结果早期和中期康复组康复治疗后手部Brunnstrom分级明显进步(P<0.01),晚期和后遗症期康复组疗效不明显(P>0.05);但4组康复治疗后MBI评分均有明显改善(P<0.01);康复介入时机越早的组,手部Brunnstrom分级和MBI评分增加值越大。结论康复治疗可不同程度地促进手功能和ADL改善,早期康复治疗介入效果更明显。Objective To explore the effects of intervention of rehabilitation at different opportunities on recovery of hand function and activities of daily living（ADL） in patients with intracerebral hemorrhage（ICH）.Methods A retrospective study was conducted.108 patients with ICH admitted to rehabilitation ward between June 2005 and June 2011 were divided into 4 groups according to the time of rehabilitation intervention.Demographic and clinical data were collected.The hand function and ADL were evaluated with Brunnstrom assessment and modified Barthel Index（MBI） at admission and before discharge.Results The hand function of patients in early and intermediate stages significantly improved（P0.01） while the patients in later and sequelae stages did not improve（P0.05）.The MBI of all groups increased after rehabilitation intervention（P0.05）.The earlier rehabilitation intervention was applied,the greater the improvement of Brunnstrom assessment and MBI were.Conclusion Rehabilitation intervention can facilitate the recovery of hand function and ADL of patients with ICH in different stages.Early intervention is more effective.

关 键 词：脑出血 康复 手功能 日常生活活动能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]