膝关节0~30°运动控制训练治疗基底核区脑出血患者术后偏瘫的疗效观察  

Observation on the therapeutic effect of knee joint 0-30°motion control training in the treatment of hemiplegia after basal ganglia cerebral hemorrhage surgery

作　　者：丁小丽 朱灿 刘学春 吴颖鹏 周斌 Ding Xiaoli;Zhu Can;Liu Xuechun;Wu Yingpeng;Zhou Bin(Department of Rehabilitation,901 Hospital of Joint Logistics Support Force,Hefei,Anhui 230031,China;Department of Emergency,901 Hospital of Joint Logistics Support Force,Hefei,Anhui 230031,China)

机构地区：[1]联勤保障部队901医院康复科,安徽合肥230031 [2]联勤保障部队901医院急诊科,安徽合肥230031

出　　处：《中国微侵袭神经外科杂志》2023年第12期127-130,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：安徽省重点研究与开发计划项目(编号:2022e07020029)

摘　　要：目的探讨膝关节0~30°运动控制训练对基底核区脑出血术后偏瘫患者功能改善的临床疗效。方法回顾性分析82例基底核区脑出血术后偏瘫患者病例资料,其中34例为常规组,给予常规电针、体能训练、起立床及行走等整体训练,未接受膝关节运动控制训练。48例除常规治疗外,均接受膝关节运动控制训练,其中接受膝关节0~30°运动控制性训练患者22例,归为治疗组;接受膝关节0~15°运动控制性训练患者26例,归为对照组。经3个月治疗后,采用Fugl-Meyer评测法(FMA)评估下肢平衡能力、步幅及步速变化情况,并根据结果评定下肢步行能力。治疗后6个月采用改良Rankin量表(mRS)分级法评定远期疗效。结果治疗组和对照组患者治疗3个月后下肢运动功能、左右步幅差以及步速差均优于常规组,但相较于对照组,治疗组改善更明显,差异具有统计学意义(P<0.05)。治疗组和对照组治疗6个月后mRS评分均优于常规组,并且治疗组结果优于对照组,差异具有统计学意义(P<0.05)。结论膝关节0~30°运动控制训练可有效改善基底核区脑出血偏瘫患者下肢运动及平衡能力,从而提高其日常生活自理能力,改善预后,值得临床推广。Objective To investigate the clinical efficacy of knee joint 0-30°motion control training in improving functional outcomes among patients with hemiplegia following basal ganglia cerebral hemorrhage surgery.Methods A retrospective analysis was conducted on the medical records of 82 patients with hemiplegia after basal ganglia cerebral hemorrhage surgery.Among them,34 patients were assigned to the conventional group,receiving routine electroacupuncture,physical training,standing bed therapy,and ambulation,without knee joint motion control training.The remaining 48 patients received knee joint motion control training in addition to conventional treatment.Specifically,22 patients underwent knee joint 0-30°motion control training and were categorized as the treatment group,while 26 patients underwent knee joint 0-15°motion control training and were categorized as the control group.After 3 months of treatment,the Fugl-Meyer Assessment(FMA)was used to evaluate changes in lower limb balance,stride length,and gait speed,and the lower limb walking ability was assessed accordingly.At 6 months post-treatment,the modified Rankin Scale(mRS)was employed to assess long-term outcomes.Results Both the treatment and control groups demonstrated superior improvements in lower limb motor function,left-right stride length difference,and gait speed compared to the conventional group after 3 months of treatment.However,the treatment group showed more significant improvements than the control group,with statistically significant differences(P<0.05).At 6 months post-treatment,both groups had better mRS scores than the conventional group,and the treatment group outperformed the control group,with statistically significant differences(P<0.05).Conclusions Knee joint 0-30°motion control training can effectively enhance lower limb motor function and balance in patients with hemiplegia secondary to basal ganglia cerebral hemorrhage,thereby improving their daily living abilities and prognosis.This approach is worthy of clinical promotion.

关 键 词：脑出血 基底核区 膝关节运动控制训练 偏瘫 Fugl-Meyer四肢运动功能评分 

分 类 号：R743[医药卫生—神经病学与精神病学]