良肢位摆放在脑卒中偏瘫患者肢体功能障碍中作用及时间差异的Meta分析  

The effect of normal limb position on extremity dysfunction of stroke survivors with hemiplegia:effect of different lenpths of intervention and a Meta-analysis

作　　者：李晓军[1] 陈锦秀[1] 陈婷玉[1] 

机构地区：[1]福建中医药大学护理学院,福建福州350122

出　　处：《护理学杂志》2015年第21期81-87,共7页

摘　　要：目的评价良肢位摆放对脑卒中偏瘫患者肢体功能障碍发生率的影响,了解干预时间与效果之间的相关性。方法计算机检索Cochrane图书馆、PubMed、万方数据库、中国知网（CNKI）及维普数据库,检索时限均为建库至2015年3月。应用RevMan5.3软件进行Meta分析。结果共纳入9项研究,均为中文文献,Meta分析结果显示,良肢位摆放干预4-6周或3个月以上均可降低脑卒中偏瘫患者肩关节半脱位、肩痛、髋关节外旋、足内翻或足下垂、肌痉挛及关节活动受限的发生率。干预3个月以上时,肩关节半脱位,髋关节外旋及肌痉挛的发生率低于干预4-6周者;而肩痛、足内翻或足下垂和关节活动受限的发生率高于干预4-6周者。结论良肢位摆放能够减少脑卒中偏瘫患者肢体功能障碍发生率,且干预时间与良肢位摆放效果并非完全呈正相关关系。Objective To evaluate the effect of normal limb position on extremity dysfunction of stroke survivors with hemiplegia,and to understand the correlation between length of intervention and the effect.Methods The Cochrane library,PubMed,Wanfang Data,China National Knowledge Infrastructure and VIP Database were searched for the randomized controlled trials（RCTS）testing the effect of normal limb position on extremity dysfunction of stroke survivors with hemiplegia,from the date of establishment of the databases to March 2015.The extracted data were analyzed using RevMan 5.3.Results A total 9trials were discovered.Metaanalysis showed that normal limb positioning of 4to 6weeks or more than 3months both can reduce the incidence rates of shoulder joint subluxation,shoulder pain,extorsion of hit joint,strephenopodia or food drop,myospasm and limited joint mobility in stroke patients with hemiplegia.When the intervention time lasted 4to 6weeks,the incidence rates of shoulder joint subluxation,extorsion of hit joint and myospasm were higher than when the intervention time lasted more than 3months,but the incidence rates of shoulder pain,strephenopodia or food drop and limited joint mobility were lower than the latter.Conclusion Normal limb positioning can reduce the incidence rate of extremity dysfunction in stroke survivors with hemiplegia,and the effect is not positively related to the length of intervention.

关 键 词：脑卒中 偏瘫 肢体功能障碍 良肢位摆放 时间差异 META分析 

分 类 号：R473.5[医药卫生—护理学]