上肢活动操在脑卒中后偏瘫肩痛延续性康复护理中的运用  

Study on upper extremity exercise in rehabilitation nursing for patients with hemiplegic shoulder pain after stroke

作　　者：宦红美[1] 何俊[1] 钱雪 丁渝权 HUAN Hongmei;HE J u n;QIAN Xue;DING Yuquan(Department of Rehabilitation,Changzhou De＋ an Hospital,Changzhou,Jiangsu,213003)

机构地区：[1]江苏省常州市德安医院康复科,江苏常州213003

出　　处：《中西医结合护理（中英文）》2018年第6期25-28,共4页Journal of Clinical Nursing in Practice

基　　金：2016年常州市科技计划项目(2016373)

摘　　要：目的观察上肢活动操在老年脑卒中后偏瘫肩痛患者延续性康复护理中的运用效果。方法选择2017年3月—2018年2月收治的脑卒中后偏瘫肩痛患者42例,根据随机数字表法分为研究组与对照组,各21例。2组患者住院期间均给予常规治疗与护理,针对偏瘫肩痛均采取中药熏蒸治疗,出院前均给予常规出院指导。研究组出院前学习上肢活动操,并要求出院后每天早晚各训练1次,20 min/次。观察2组患者出院前(干预前)及出院12周时(干预后)偏瘫肩痛VAS评分、Fugl-Meyer上肢评分、改良Barthel指数(MBI)变化情况。结果干预后,研究组患者VAS评分低于对照组[(1.05±0.41)vs.(2.06±0.84),t=4.952,P<0.01],而研究组患者Fugl-M eyer上肢评分、M BI评分高于对照组[(47.24±5.52)vs.(42.63±8.26),t=2.127,P<0.05;(78.15±7.62)vs.(62.49±11.73),t=5.130,P<0.01]。结论上肢活动操运用于老年脑卒中后偏瘫肩痛患者出院后延续性康复护理中,可明显改善患者偏瘫肩痛程度,提高患者上肢功能与日常生活自理能力,对促进患者康复有着重要的意义。Objective To investigate the effect of upper extremity exercise in rehabilitation nursing for patients with hemiplegic shoulder pain after stroke. Methods A total of 42 patients with hemiplegic shoulder pain after stroke were randomly divided into the study group and the control group,with 21 cases in each group. Patients of both two groups received routine drug therapy and nursing during hospitalization,and the hemiplegic shoulder pain were treated with Chinese medicine fumigation. Patients of the study group were taught with upper extremity exercise before discharge and were asked to take exercise for 20 minutes,twice a day after discharge. The degree of hemiplegic shoulder pain by Visual Analogue Scale（ VAS）,Fugl-Meyer Assessment（ FMA）Scores and modified Barthel index（ MBI） were observed and compared between two groups.Results After the intervention,the VAS score of patients in the study group was lower than that of patients in the control group（[1. 05 ± 0. 41] vs [2. 06 ± 0. 84],t = 4. 952,P〈0. 01）. The FMA and MBI scores of patients in the study group were significantly higher than those of patients in the control group（[47. 24 ± 5. 52]vs. [42. 63 ± 8. 26],t = 2. 127,P〈0. 05; [78. 15 ± 7. 62]vs. [62. 49 ± 11. 73],t = 5. 130,P〈0. 01）. Conclusion The upper extremity exercise can relieve the hemiplegic shoulder pain of elderly patients after stroke,and improve the upper limb function and self-care ability of daily life.

关 键 词：上肢活动操 脑卒中 偏瘫 肩痛 康复护理 功能训练 中西医结合护理 

分 类 号：R473.3[医药卫生—护理学]