早期镜像治疗对脑肿瘤术后偏瘫患者上肢运动功能的影响研究  

Research of effects of early mirror therapy on upper limb function in postoperative hemiplegic patients with brain tumor

作　　者：王明磊[1] 王松涛 曹崇威 徐斌斌[1] 张荣 李可钰 夏菁[3] 邵印麟[3] WANG Minglei;WANG Songtao;CAO Chongwei;XU Binbin;ZHANG Rong;LI Keyu;XIA Jing;SHAO Yinlin(Department of Neurosurgery of Putuo District People’s Hospital&Putuo People’s Hospital Affiliated to Tongji University,Shanghai,200060,China;Department of Neurosurgery of Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Department of Rehabilitation Medicine of Putuo District People’s Hospital&Putuo People’s Hospital Affiliated to Tongji University,Shanghai,200060,China)

机构地区：[1]上海市普陀区人民医院&同济大学附属普陀人民医院(筹)神经外科,上海200060 [2]复旦大学附属华山医院神经外科,上海200040 [3]上海市普陀区人民医院&同济大学附属普陀人民医院(筹)康复医学科,上海200060

出　　处：《上海医药》2023年第2期28-30,39,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市卫生健康委员会面上项目(201740067)。

摘　　要：目的 :观察术后早期应用镜像疗法对脑肿瘤术后偏瘫患者上肢运动功能的影响。方法 :收集2018年1月1日至2021年9月30日神经外科脑肿瘤术后偏瘫患者60例,按随机信封法分为常规康复组(对照组)30例和镜像治疗组30例。对照组采用常规康复训练,镜像治疗组在常规康复基础上加用镜像疗法,两组均连续治疗4周。采用上肢Fugl-Meyer运动功能评分量表(U-FMA)评估患者治疗后运动功能的改善程度。结果 :镜像治疗组治疗后2周和4周节点的U-FMA评分分别为(37.10±14.49)分和(53.77±12.31)分,显著优于常规康复组的(42.72±16.39)分和(48.70±15.71)分,组间差异有统计学意义(P <0.05)。镜像治疗组治疗前后的评分差值与同时间点常规康复组的评分差值比较,差异有统计学意义(P <0.05)。结论 :基于镜像神经元理论的动作观察和运动想象疗法适用于脑肿瘤术后偏瘫患者的早期康复治疗,并有较显著的效果,且简单易行和经济,患者接受度高,值得深入研究广泛推广。Objective: To observe the effects of early mirror therapy on upper limb function in postoperative hemiplegic patients with brain tumor. Methods: From January 1, 2018 to August 30, 2021, sixty hemiplegic patients after neurosurgical brain tumor surgery were collected and divided into a routine rehabilitation group(a control group) with 30 cases, and a mirror image treatment group with 30 cases by random envelope method. The control group adopted the conventional rehabilitation, and the mirror image treatment group received the mirror image therapy on the basis of the conventional rehabilitation, both groups were treated continuously for 4 weeks. Fugl meyer motor function rating scale(U-FMA) was used to evaluate the improvement of motor function of the patients after treatment. Results: In the mirror image treatment group, the U-FMA scores at the nodes 2 and 4 weeks after treatment were(37.10±14.49) and(53.77±12.31), respectively, which were significantly better than those in the conventional rehabilitation group(42.72±16.39) and(48.70±15.71), and the difference between groups was statistically significant(P<0.05). There was a statistically significant difference between the score difference of the mirror image treatment group before and after treatment and that of the conventional rehabilitation group at the same time point(P<0.05). Conclusion:Action observation and motion imagination therapy based on mirror neuron theory is applicable to the early rehabilitation of postoperative hemiplegic patients with brain tumor, which has significant effect, is simple and economical, and has high patient acceptance, and it is worthy of in-depth study and extensive promotion.

关 键 词：脑肿瘤 镜像治疗 术后偏瘫 康复 

分 类 号：R74[医药卫生—神经病学与精神病学]