下肢强化负重运动训练对脑卒中后偏瘫合并骨折患者术后生活质量及骨钙含量的影响分析  

The influence of intensive exercise training on the quality of life and calcium content of patients with post-stroke hemiplegia and fractures

作　　者：王晓松 贾妍妍 WANG Xiao-song;JIA Yan-yan(Department of Neurology,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China;Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京同仁医院神经内科,北京100176 [2]首都医科大学宣武医院神经外科,北京100050

出　　处：《中国医学前沿杂志（电子版）》2018年第10期86-89,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨下肢强化负重运动训练对脑卒中后偏瘫合并骨折患者术后生活质量及骨钙含量的影响。方法选择2016年11月至2017年11月首都医科大学附属北京同仁医院和首都医科大学宣武医院收治的56例脑卒中后偏瘫合并骨折术后患者为研究对象,采用随机数表法将其分为观察组和对照组,每组各28例。对照组患者给予常规康复治疗,观察组患者在此基础上给予下肢强化负重运动训练。比较两组患者康复治疗前和康复治疗3个月后骨密度相关指标、骨钙代谢相关指标及健康状况调查问卷(medical outcomes study short-form 36,SF-36)评分情况。结果康复治疗3个月后,两组患者骨密度、T值、碱性磷酸酶(alkaline phosphatase,ALP)、骨钙素、维生素D_3水平及SF-36各维度评分均显著高于治疗前(P_均<0.05),Ⅰ型胶原羧基端肽β特殊序列(βisomer of C-terminal telopeptide of typeⅠcollagen,β-CTX)、抗酒石酸盐酸性磷酸酶异构体-5b(artrate-resistant acid phosphatase-5b,TRACP-5b)水平均显著低于治疗前(P_均<0.05);且观察组患者骨密度、T值、ALP、骨钙素、维生素D_3水平及SF-36各维度评分均显著高于对照组(P_均<0.05),β-CTX、TRACP-5b水平均显著低于对照组(P_均<0.05)。结论强化下肢负重训练可以提高脑卒中后偏瘫合并骨折患者术后的生活质量,改善患者的骨质疏松状态。Objective To explore the effects of intensive limb weight-bearing exercise training on quality of life and bone calcium of patients with post-stroke hemiplegia and fractures.Method 56 patients with post-stroke hemiplegia and fractures who underwent surgery in Beijing Tongren Hospital and Xuanwu Hospital from November 2016 to November 2017 were selected as research objects.They were divided into observation group and control group by randomized digital method,28 cases in ecch.Control group patients received conventional rehabilitation therapy,and observation group patients were given lower limb intensive weight-bearing exercise training.The bone mineral density related indicators,bone calcium metabolism related indicators and medical outcomes study short-form 36(SF-36)scores were compared between the two groups before and after rehabilitation.Result After 3 months of rehabilitation therapy,bone mineral density,T value,levels of alkaline phosphatase(ALP),osteocalcin and vitamin D3,SF-36 scores in the two groups were significantly higher than those before rehabilitation therapy(Pall<0.05),the levels ofβisomer of C-terminal telopeptide of typeⅠcollagen(β-CTX)and artrate-resistant acid phosphatase-5b(TRACP-5b)in the two groups were significantly lower than those before rehabilitation therapy(Pall<0.05);bone mineral density,T value,levels of ALP,osteocalcin and vitamin D3,SF-36 scores of observation group were significantly higher than those of control group(Pall<0.05),the levels ofβ-CTX and TRACP-5b of observation group were significantly lower than those of control group(Pall<0.05).Conclusion Strengthening the training of lower limb weight negative weight can improve the quality of life of patients with hemiplegia and fracture after stroke,and improve the osteoporosis state of the patients.

关 键 词：卒中 偏瘫 骨折 强化训练 下肢负重训练 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R687.3[医药卫生—临床医学]