早期综合康复锻炼对急性脑卒中患者临床疗效的影响  

Effect of early comprehensive rehabilitation on clinical efficacy of patients with acute stroke

作　　者：刘琴[1] 娄继友[2] 

机构地区：[1]商丘市第一人民医院神经内科,476100 [2]商丘市第一人民医院康复科,476100

出　　处：《中华神经医学杂志》2015年第5期497-500,共4页Chinese Journal of Neuromedicine

摘　　要：目的 探讨早期综合康复锻炼对急性脑卒中患者临床疗效的影响.方法 选取商丘市第一人民医院神经内科自2012年8月至2014年8月收治的116例急性脑卒中患者,依据患者意愿分为康复组和对照组,每组58例,其中康复组在接受常规治疗的同时行早期综合康复治疗,对照组则代之以未经专业指导进行自我锻炼.对2组患者在治疗前及治疗后第7、14、28天采用美国国立卫生院卒中量表评分（NIHSS）评定患者神经功能缺损程度,采用Fugl-Meyer法（FMA）评定瘫痪肢体运动功能,采用Barthel指数（BI）评定患者生活自理能力,同时评定疗效及观察并发症发生情况.结果 康复组NIHSS评分、FMA评分、BI指数在治疗后第14、28天和对照组相比较差异均有统计学差异（P＜0.05）.治疗后第28天,康复组临床疗效明显好于对照组（平均秩次分别为50.23、61.87）,差异有统计学意义（Z=-1.991,P=0.046）;同时肩关节半脱位、肩手综合征、足下垂、肌肉萎缩、褥疮、下肢静脉血栓形成、关节挛缩等并发症发生比例较对照组明显降低,差异有统计学意义（P＜0.05）.结论 急性脑卒中患者给予早期综合康复锻炼能明显促进神经功能的恢复,减少并发症,降低致残率,提高生存质量.Objective To investigate the effect of early comprehensive rehabilitation on clinical efficacy in patients with acute stroke.Methods One hundred and sixteen patients with acute stroke,admitted to our hospital from August 2012 to August 2014,were randomly divided into treatment group and control group （n=58）.Both groups were treated with conventional approach;furthermore,patients in the treatment group conducted the early comprehensive rehabilitation,while those in the control group self-exercised without any professional directions.Neurologic impairment was evaluated by National Institutes of Health Stroke Scale （NIHSS）,motor function of the paralytic limbs was evaluated by Fugl-Meyer assessment （FMA） and self-care ability of daily living of the patients was evaluated by Barthel index （BI） before treatment and 7,14 and 28 days after treatment;the complications of the patients were observed.Results NIHSS scores,FMA scores,and BI of the treatment group were significantly different as compared with those in the control group 14 and 28 days after treatment （P〈0.05）;the treatment effect in the treatment group was obviously improved as compared with that in the control group 28 d after treatment （mean rank：50.23 and 61.87）.The incidence of most commonly encountered complications （glenohumeral subluxation,shoulder-hand syndrome,foot drop,amyotrophy,bedsore,thrombus of lower extremity veins and joint contracture） of the treatment group was significantly lower than that in the control group （P〈0.05）.Conclusion Early comprehensive rehabilitation during the treatment of acute stroke can greatly promote the neurological recovery and markedly reduce the complications;early comprehensive rehabilitation can significantly improve the life quality of the patients.

关 键 词：早期康复锻炼 急性脑卒中 临床疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]