目的探讨脑出血急性期绝对卧床组与早期活动组患者的预后.方法选取2009年8月~2010年1月就诊于包头市中心医院神经内科的符合入选标准的急性幕上脑实质出血患者97例.随机分为绝对卧床组和早期活动组,两组均接受常规脱水,降颅压,对症治疗,同时均接受早期肢体康复,即发病48h内行常规康复治疗.早期活动组在充分风险管理下鼓励早期坐起,早期站立,早期生活自理.绝对卧床组要求绝对卧床2~3周.对2组患者的预后及不良事件进行比较.结果两组欧洲生活质量EuroQ评分有显著差异(F值9.874,P<0.05),修正的Rankin量表评分有显著差异(F值3.575,P<0.05).两组间血肿扩大发生率无显著差别(t=0.023,P>0.05),呼吸系统感染率有显著差异(t=5.425,P<0.05).预后与NIHSS评分及出血量呈负相关,与活动度呈正相关.结论在充分评估风险的前提下,早期活动的幕上脑实质出血患者预后良好,不良事件的发生率并未增加.% Objective Discussion cerebral hemorrhage acute stage absolute bed group and early activity group patient's prognosis. Methods 2009 August to2010 January, The patients from neurological department of Baotou centre hosipital with acute cerebral hemorrhage were randomly divided into absolute bed rest group and early activities group, both groups received conventional dehydration, reducing the intracranial pressure, symptomatic treatment, and underwent early physical rehabilitation, that the incidence of 48 hours expert conventional rehabilitation. Early in the full set of risk management activities to encourage early next sit, stand early, early self-care. Absolute bed rest group requires 2~3 weeks of absolute bed rest. The prognosis of the two groups of patients and adverse events were compared. Results Two groups of European quality of life EuroQ score were significantly different (F 9.874, P<0.05), modified Rankin Scale score were significantly different (F 3.575, P<0.05). The incidence of hematoma enlargement between the two groups no significant difference (t=0.023, P>0.05), respiratory infection rates were significantly different (t=5.425, P<0.05). NIHSS score and outcome of bleeding with a negative correlation, positive correlation with activity. Conclusion On the basis of full risk assessment, the early motion can leads to the good prognosis, the occurrence of adverse events did not increase.
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