自制抗痉挛手套在脑卒中偏瘫患者康复护理中的应用

摘要

目的 探讨自制新型抗痉挛手套在脑卒中偏瘫患者康复护理中的应用效果.方法 制作方便实用的新型抗痉挛手套.选择脑卒中偏瘫康复患者96例,随机分为实验组和对照组,各48例.对照组接受神经内科药物治疗及常规康复护理干预.实验组在对照组基础上每天使用抗痉挛手套23 h,保持肢体的良肢位.在患者入组时,1,2,3个月时使用Ashworth的痉挛分级及Fugl-Meyer运动功能评定,并比较两组效果.结果 入组3月时,实验组患者偏瘫上肢痉挛评分(1.31±0.85)分,对照组(2.33±1.10),实验组改善肌痉挛方面优于对照组,两组比较差异有统计学意义(Z=-4.836,P＞0.05).实验组患者入组后1,2,3个月偏瘫上肢手功能FMA评分分别为(2.78±1.37),(3.13±1.65),(4.98±1.78)分,均优于对照组,两组比较差异均有统计学意义(t值分别为2.2362,2.0822,6.602 7;P ＜0.05).结论 新型抗痉挛手套设计合理,经济实用简便,临床效果满意.%Objective To evaluate the effect of self-made anti-spasm gloves in the nursing of patients with hemiplegia after stroke.Methods Ninety-six patients with hemiplegia after stroke were chosen and randomly divided into two groups,each with 48 cases.The control group received routine medication of department of internal neurology and early rehabilitation nursing intervention (half an hour in the morning and afternoon,respectively).The experimental group received anti-spasm gloves to keep their bodies a good limb position while rehabilitation (23 hours/day) on the basis of the control group.Spasm classification of Ashworth and motor function of Fugl-Meyer (FMA) were assessed at the beginning of intervention and every month until three months after intervention and two groups' effects were compared.Results The results of the two groups in spasm classification were compared.There was scarcely any difference between the two groups at the beginning,and there were still no significant differences one month later (P ＞ 0.05).But after two months,experimental group gave an advantage to the control group (P ＜ 0.05).Three months later,the advantages were even more obvious especially in ameliorating muscle spasm,the spasm classification was (1.31 ± 0.85) in the experimental group,and (2.33 ± 1.10) in the control group,and the difference was statistically significant (Z =-4.836,P ＜ 0.05).The results in motor function of FMA were compared between the two groups.At the beginning,the experimental group was not superior to the control group.But one or two months later,there was significant difference between them (P ＜ 0.05).After three months,the motor function of the patients in the experimental group was obviously improved and better than that in the control group (P ＜ 0.01).The motor function of FMA were respectively (2.78 ± 1.37),(3.13 ± 1.65),(4.98 ± 1.78) in the experimental group after one,two and three months,and were better than the control group,the differences were statistically significant (t =2.2362,2.0822,6.6027,respectively; P ＜ 0.05).Conclusions The new-type anti-spasm gloves are reasonably designed,economical,practical,convenient,and satisfactory rehabilitation effect.