基层脑卒中单元对脑卒中患者的早期干预效果

发布时间：2018-05-16 08:12

本文选题：脑卒中单元 + 脑卒中　；参考：《中国老年学杂志》2016年18期

【摘要】：目的考察基层医院对脑卒中患者早期即开始卒中单元下的康复干预措施的临床效果。方法选择262例急性脑卒中伴不同程度肢体功能障碍的患者作为研究对象,将全部患者按照随机数字表1∶1分成康复组和常规组。患者均经临床内科规范化的用药治疗和急救措施干预及护理后,病情稳定。对观察组施行早期的综合康复训练治疗,具体包括卧床期间的偏瘫侧肢体的被动活动训练和适度的主动助力的活动训练;逐步进行体位转移练习(坐位、立位平衡练习)、行走练习、协调性练习,躯干肌控制练习,球类灵活性练习,生活能力练习等。对两组患者治疗前、治疗后第4周及第3个月的神经功能(NIHSS评分)、肢体功能(Brunnstrom分级)、日常生活能力(Barthel指数)等指标进行评估,并比较两组的差异。结果在治疗后第4周及第3个月不同时点,两组患者NIHSS评分、Brunnstrom分级、Barthel指数比较差异均有统计学意义(F1=10.30、9.45、5.69,均P0.05)。结论基层医院对收诊的急性脑卒中合并肢体偏瘫患者于发病早期即给予卒中单元模式下的康复训练治疗,可显著地改善患者近期的肢体功能,有望最终达到纠正患者的异常运动模式(偏瘫)、恢复其基本的自理能力的终极治疗目标。
[Abstract]:Objective to investigate the clinical effect of rehabilitation intervention under stroke unit in primary hospitals. Methods 262 patients with acute stroke with different degrees of limb dysfunction were selected and divided into rehabilitation group and routine group according to the 1:1 random digital table. The patients were stable after standardized medication, first aid intervention and nursing. The observation group was treated with early comprehensive rehabilitation training, including passive movement training of hemiplegic limbs and moderate active activity training during bed rest. Standing balance exercises, walking exercises, coordination exercises, trunk muscle control exercises, ball game flexibility exercises, life ability exercises, etc. NIHSS score, Brunnstrom grade and Barthel index of limb function were evaluated before treatment, 4 weeks and 3 months after treatment, and the differences between the two groups were compared. Results at 4 weeks and 3 months after treatment, there were significant differences in NIHSS score and Brunnstrom classification and Barthel index between the two groups (P < 0.05). Conclusion patients with acute stroke complicated with limb hemiplegia were treated with rehabilitation training in the early stage of stroke in primary hospital, which can significantly improve the patients' limb function in the near future. It is hoped that the ultimate goal of correcting the abnormal motor pattern (hemiplegia) and restoring the basic self-care ability will be achieved.
【作者单位】：民航总医院神经内科;唐山市工人医院神内一科;
【分类号】：R473.74

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