康复治疗时机对脑卒中患者预后的影响

摘要

To investigate the effect of rehabilitation intervention timing on the prognosis of patients with cerebral apoplexy .Method:A total of 90 patients with cerebral apoplexy admitted in our hospi-tal from Jan.2012 to Jan.2013 were randomly divided into observation group and control group , two groups of patients were provided with routine treatment of stroke , including relieving cerebral edema , protecting treatment such as brain tissue , improving blood circulation , adopting rehabilitation treatment voluntarily , and following the instructions of rehabilitation physicians .the vital signs were stable and consciousness recovered , while the control group adopted rehabilitation training 4 weeks conventional after toutine treatment .The abili-ty of daily life ( ADL) , motor function score and neurologic deficits were evaluated respectively with modified barthel index (MBI), Fugl-Meyer analysis(FMA)and NIH stroke scale (NIHSS) before and after treat-ment.Result:Before rehabilitation treatment , there was no statistical difference of MBI , FMA, NIHSS be-tween two groups ( P>0.05);the above-mentioned indexes were improved significantly after treatment in two groups, comparison difference before and after treatment was statistically significant ( P<0.05);MBI, FMA and NIHSS improved more significantly in observation group after treatment than that in the control ( P<0.05);shoulder-hand syndrome in observation group was better relived compared with control group after re -habilitation ( P<0.05) .Conclusion:Early treatment can promote the recovery of nerve function , motor func-tion and ADL ability , alleviate symptoms of shoulder-hand syndrome , play a positive role in the prognosis of patients with cerebral apoplexy .%探讨康复治疗介入时机对脑卒中患者预后的影响。方法：选取2012年1月至2013年1月间我院收治的脑卒中患者90例，随机分为观察组与对照组，两组患者入院给予脑卒中常规治疗，包括解除脑水肿、保护脑组织、扩容改善血液循环等治疗，且均自愿接受康复治疗，并能够配合康复医师的康复训练。观察组患者在生命体征平稳、意识清晰后后即进行康复训练治疗，对照组于常规治疗4周后行康复治疗，两组患者于康复训练治疗前、后采用 MBI（ modified barthel index ）进行日常生活活动能力（ ADL）评价、采用 Fugl-Meyer 评定法（ FMA）对运动功能进行评分、美国国立研究院脑卒中评定量表（ NIHSS ）对神经功能缺损进行评价。结果：两组患者康复治疗前MBI、FMA、NIHSS评分比较无统计学差异（ P＞0．05）；治疗后两组患者上述指标较康复治疗前比显著改善，治疗前后比较差异有统计学差异（ P＜0．05）；观察组患者治疗后MBI、FMA、NIHSS评分改善较对照组更为显著，组间比较差异有统计学意义（ P＜0．05）；观察组患者康复治疗后肩-手综合征治疗显效率显著高于对照组（ P＜0．05）。结论：早期训练治疗可促进脑卒中患者神经、运动功能及ADL能力恢复，缓解肩-手综合征症状，对脑卒中患者预后起积极作用。