阶段性抗阻训练联合综合康复护理在脑卒中后肩手综合征中的应用效果  

Effect of staged resistance training combined with comprehensive rehabilitation nursing in shoulder-hand syndrome after stroke

作　　者：管华[1] 杨蓓[1] 徐晨婕[1] 朱才溢 张梦如 GUAN Hua;YANG Bei;XU Chenjie;ZHU Caiyi;ZHANG Mengru(Pain Ward of Anesthesiology Department,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing First Hospital,Nanjing,Jiangsu,210006)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院麻醉科疼痛病房,江苏南京210006

出　　处：《实用临床医药杂志》2022年第11期81-86,共6页Journal of Clinical Medicine in Practice

基　　金：江苏省南京市卫生局重点项目(ZKX18033)。

摘　　要：目的探讨阶段性抗阻训练联合综合康复护理在脑卒中后肩手综合征中的应用效果。方法选取180例脑卒中后肩手综合征患者为干预对象,随机分为观察组和对照组,每组90例。对照组给予综合康复护理干预,观察组给予阶段性抗阻训练联合综合康复护理。比较2组症状评分、肩关节主动活动度、等速肌力、Fugl-Meyer运动功能评估表(FMA)评分、血液流变学指标水平、生活质量和护理满意度。结果干预后,观察组患者的肩手综合征评估量表(SHSS)评分(自主神经、运动及总分)、血液流变学指标[血浆黏度(PV)、全血黏度(WBV)、血小板聚集率(PAgT)、纤维蛋白原(Fib)]水平均低于对照组,差异有统计学意义(P<0.05);观察组肩关节主动活动度(前屈、后伸、内旋、外展、内收、外旋等)、肩手等速肌力、FMA评分、生活质量综合评定问卷(GQOLI-74)评分高于对照组,差异有统计学意义(P<0.05)。观察组护理总满意度率为92.22%,高于对照组的78.89%,差异有统计学意义(P<0.05)。结论阶段性抗阻训练联合综合康复护理在脑卒中后肩手综合征中应用效果良好,可改善患者各项症状和生活质量,促进肩、手关节功能恢复,降低机体血液黏度,提高患者护理满意度。Objective To explore the application effect of phased resistance training combined with comprehensive rehabilitation nursing in shoulder-hand syndrome after stroke. Methods A total of 180 patients with shoulder-hand syndrome after stroke were selected as intervention objects, and randomly divided into observation group and control group, with 90 cases in each group. The control group was given comprehensive rehabilitation nursing intervention, and the observation group was given phased resistance training combined with comprehensive rehabilitation nursing. Symptom score, shoulder active range of motion, isokinetic muscle strength, Fugl-Meyer Assessment Scale(FMA) score, hemorheology index level, quality of life and nursing satisfaction were compared between the two groups. Results After the intervention, Shoulder Hand Syndrome Assessment Scale(SHSS) score(sensory, autonomic nervous system, motor and total score), hemodynamic indexes[plasma viscosity(PV), whole blood viscosity(WBV), platelet aggregation rate(PAgT) and fibrinogen(Fib)] levels in the observation group were significantly lower than those of the control group(P<0.05). Shoulder joint total active motion(flexion, extension, pronation, abduction, adduction and pronation), the isokinetic muscle strength of shoulder and hand, FMA score and General Quality of Life Inventory-74(GQOLI-74) score in the observation group were significantly higher than those in the control group(P<0.05). The total satisfaction rate of nursing in the observation group was 92.22%,which was significantly higher than 78. 89% in the control group(P < 0. 05). Conclusion The application effect of phased resistance training combined with comprehensive rehabilitation nursing in shoulder-hand syndrome after stroke is good,which can improve the symptoms and quality of life of patients,promote the recovery of shoulder-hand joint function,reduce blood viscosity and improve patients’ nursing satisfaction.

关 键 词：脑卒中 肩手综合征 综合康复护理 阶段性抗阻训练 肩关节主动活动度 血液流变学 生活质量 

分 类 号：R743[医药卫生—神经病学与精神病学] R473.6[医药卫生—临床医学]