FIM量表在初发脑卒中偏瘫患者近期疗效评价中的应用

发布时间：2018-05-08 15:52

本文选题：FIM + 脑卒中　；参考：《河北联合大学》2014年硕士论文

【摘要】：目的通过对初发脑卒中偏瘫患者的随访，测评患者近期功能改善情况及FIM量表与BI、MMSE、FMA量表评分的相关性，探讨影响患者发病一个月、三个月时FIM评分改变的因素，了解FIM量表在初发脑卒中偏瘫患者近期疗效评价中的应用。方法本研究采用前瞻性研究的方法，选取承德市中心医院神经内科2012年10月～2013年9月住院的初发脑卒中偏瘫患者为研究对象，收集患者的一般人口学资料、疾病资料，在患者入院72小时内、发病一个月、三个月时分别对其进行FIM、BI、MMSE、FMA量表评分，分析FIM量表与BI、MMSE、FMA量表评分的相关性，分析患者的功能恢复情况，分析影响患者发病一个月、三个月时FIM评分改变的因素。结果1患者发病一个月、发病三个月较入院时各量表评分均有不同程度的提高，而且发病三个月比发病一个月时提高幅度大。2入院时、发病一个月、发病三个月时，FIM运动评分与BI评分显著相关，相关系数介于0.799～0.897之间；FIM认知评分与MMSE评分显著相关，相关系数介于0.590～0.786之间。FIM评分改变值与BI改变值、MMSE改变值显著相关，相关系数均大于0.506（P＜0.05）。3对影响FIM运动评分改变的因素进行Logistic回归分析，结果显示文化程度、高血压史、年龄影响FIM运动评分的提高，年龄＜60岁、无高血压史、小学及以上文化程度的患者FIM运动评分提高幅度大。4对影响FIM认知评分改变的因素进行Logistic回归分析，结果显示卒中类型、性别、就诊时间、偏瘫侧影响患者FIM认知评分的提高，脑梗死、女性、偏瘫右侧、就诊时间＜13小时的患者FIM认知评分提高幅度大。结论1FIM量表与BI、MMSE具有很好的相关性，是一项有效的评测工具。2患者发病一个月、发病三个月时日常生活活动能力、运动能力、认知能力均有不同程度的提高，发病三个月比发病一个月时提高幅度大。3患者的文化程度、高血压史、年龄影响FIM运动评分的提高，年龄＜60岁、无高血压史、小学及以上文化程度的患者FIM运动评分提高幅度大；患者的卒中类型、性别、就诊时间、偏瘫侧影响FIM认知评分的提高，脑梗死、患者女性、偏瘫右侧、就诊时间＜13小时的患者FIM认知评分提高幅度大。
[Abstract]:Objective to evaluate the recent function improvement of patients with hemiplegic stroke in primary cerebral apoplexy and the correlation between FIM scale and BI, MMSE, FMA scale, and to explore the factors affecting the change of FIM score at one month and three months, and to understand the application of the FIM scale in the short-term efficacy evaluation of patients with primary stroke hemiplegia.
Methods a prospective study was used in this study to select the primary stroke hemiplegia patients in the Department of Neurology of Chengde Central Hospital from October 2012 to September 2013 as the research object. The general demographic data of the patients were collected and the disease data were collected. Within 72 hours of hospitalization, the patients were treated with FIM, BI, MMSE, and F respectively. The MA scale score was used to analyze the correlation between the FIM scale and the BI, MMSE, and FMA scales. The functional recovery of the patients was analyzed, and the factors affecting the change of the FIM score at one month and three months were analyzed.
Results 1 patients had one month of onset and three months of onset were higher than those at admission, and the incidence of FIM movement was significantly correlated with BI score at one month and three months after the onset of the onset of.2. The correlation coefficient was between 0.799 and 0.897; FIM cognitive score. The correlation coefficient was significantly correlated with the MMSE score, the correlation coefficient was between 0.590 and 0.786, the change value of.FIM score and the BI change value, the change value of MMSE were significantly correlated, the correlation coefficient was greater than 0.506 (P < 0.05).3 for the Logistic regression analysis on the factors affecting the change of FIM movement score. The results showed that the degree of literature, the history of hypertension, and the age affecting the FIM exercise score were raised. High, age < 60 years of age, no history of hypertension, the FIM exercise score of the patients with primary and above education was improved by the Logistic regression analysis of the factors affecting the FIM cognitive score changes. The results showed that the type of stroke, sex, the time of the treatment, the improvement of the FIM recognition score in the hemiplegic side, the cerebral infarction, the women, the right side of hemiplegia, and the medical treatment. The FIM cognitive score increased significantly in patients less than 13 hours.
Conclusion the 1FIM scale has a good correlation with BI and MMSE. It is an effective evaluation tool for.2 patients for one month. The daily living ability, exercise ability and cognitive ability are improved in different degrees in three months, and the incidence of hypertension, hypertension, age, and the history of hypertension, the history of hypertension and age shadow are increased in three months after the onset of the disease. The improvement of FIM exercise score, age < 60 years, no history of hypertension, higher FIM exercise score in patients with primary and above education, stroke type, sex, time of treatment, improvement of FIM cognitive score in hemiplegic side, cerebral infarction, female, hemiplegia on the right, FIM cognitive score for patients with time for consultation less than 13 hours A big margin.

【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

【参考文献】