下肢康复机器人辅助步态训练对亚急性期缺血性脑卒中偏瘫并卒中后神经源性膀胱患者的影响研究  

Impact of Gait Training Assisted by Lower Limb Rehabilitation Robot on Subacute Ischemic Stroke Patients Complicated with Hemiplegia and Post-stroke Neurogenic Bladder

作　　者：纪亮[1] 朱湘君 徐景[1] 祈伟[1] 胡丹丹[1] JI Liang;ZHU Xiangjun;XU Jing;QI Wei;HU Dandan(Department of Neurology,Dean Hospital of Changzhou,Changzhou 213000,China;Changzhou Social Welfare Institute,Changzhou 213000,China)

机构地区：[1]江苏省常州市德安医院神经内科,213000 [2]江苏省常州市福利院,213000

出　　处：《实用心脑肺血管病杂志》2020年第6期74-79,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨下肢康复机器人辅助步态训练对亚急性期缺血性脑卒中偏瘫并卒中后神经源性膀胱(PSNB)患者的影响。方法选取2018年1月—2019年8月常州市德安医院神经内科收治的亚急性期缺血性脑卒中偏瘫并PSNB患者70例,采用随机数字表法分为对照组和观察组,每组35例。对照组患者给予常规治疗及常规康复训练,观察组患者在对照组基础上进行下肢康复机器人辅助步态训练。比较两组患者治疗前及治疗2个月后步态、Fugl-Meyer运动功能评定量表(FMA)下肢评分及尿流动力学指标〔包括最大膀胱容量(MCC)、残余尿量、最大尿流率(Qmax)及排尿压力(Pvoi)〕,两组不同年龄患者治疗前及治疗2个月后尿流动力学指标。结果两组患者治疗前步频、步速、患侧步长及FMA下肢评分比较,差异无统计学意义(P>0.05);观察组患者治疗2个月后步频和步速快于对照组,患侧步长长于对照组,FMA下肢评分高于对照组(P<0.05)。两组患者治疗前MCC、残余尿量、Qmax、Pvoi比较,差异无统计学意义(P>0.05);治疗2个月后观察组患者MCC和Pvoi大于对照组,残余尿量少于对照组,Qmax快于对照组(P<0.05)。亚组分析结果显示,两组≥65岁患者治疗前MCC、残余尿量、Qmax、Pvoi及治疗2个月后Qmax比较,差异无统计学意义(P>0.05),而治疗2个月后观察组≥65岁患者MCC和Pvoi大于对照组,残余尿量少于对照组(P<0.05);两组<65岁患者治疗前MCC、残余尿量、Qmax、Pvoi比较,差异无统计学意义(P>0.05),而治疗2个月后观察组<65岁患者MCC和Pvoi大于对照组,残余尿量少于对照组,Qmax快于对照组(P<0.05)。结论下肢康复机器人辅助步态训练能有效改善亚急性期缺血性脑卒中偏瘫并PSNB患者步行能力、下肢运动功能及膀胱功能,减轻排尿障碍。Objective To investigate the impact of gait training assisted by lower limb rehabilitation robot on subacute ischemic stroke patients complicated with hemiplegia and post-stroke neurogenic bladder(PSNB).Methods From January 2018 to August 2019,a total of 70 subacute ischemic stroke patients complicated with hemiplegia and PSNB were selected in the Department of Neurology,Dean Hospital of Changzhou,and they were divided into control group and observation group according to random number table method,with 35 cases in each group.Patients in control group received routine treatment and rehabilitation training,while patients in observation group received gait training assisted by lower limb rehabilitation robot based on that of control group.Gait,FMA lower extremity score and urodynamic index〔including the maximum cystic capacity(MCC),residual urine volume,the maximum urine flow rate(Qmax)and voiding pressure(Qvoi)〕were compared between the two groups before treatment and 2 months after treatment,moreover urodynamic index was compared in patients with different ages between the two groups before treatment and 2 months after treatment.Results There was no statistically significant difference in step frequency,step speed,step length of the affected side and FMA lower extremity score between the two groups before treatment(P>0.05);step frequency and step speed in observation group were statistically significantly faster than those in control group 2 months after treatment,step length of the affected side in observation group was statistically significantly longer than that in control group,while FMA lower extremity score in observation group was statistically significantly higher than that in control group(P<0.05).There was no statistically significant difference in MCC,residual urine volume,Qmax or Qvoi between the two groups before treatment(P>0.05);MCC and Qvoi in observation group were statistically significantly larger than those in control group 2 months after treatment,residual urine volume in observation grou

关 键 词：卒中 偏瘫 卒中后神经源性膀胱 下肢康复机器人 步态训练 膀胱功能 

分 类 号：R743[医药卫生—神经病学与精神病学]