不同康复介入时机对脑梗塞偏瘫患者运动功能及日常生活活动能力改善作用的评估

发布时间：2018-07-10 13:27

本文选题：脑梗塞 + 偏瘫　；参考：《福建医科大学》2014年硕士论文

【摘要】：目的：探讨脑梗塞急性期与恢复期康复介入治疗对脑梗塞偏瘫患者运动功能及日常生活活动能力改善作用的比较。方法：收集2012年12月-2014年2月在我院神经内科及康复医学科住院病例60例，其中急性期康复组（A组，32例），恢复康复组（B组，28例）。两组患者均接受脑梗塞患者的常规治疗，包括控制脑水肿、营养神经、改善循环、抗血小板、调节脂代谢、调控血压等。A组患者在发病后14d内即接受康复介入治疗， B组患者在发病后14d-30d后接受康复介入治疗。分别于康复治疗前、康复治疗后2周、康复治疗后4周对患者康复效果进行评价。康复效果的评价应用简化Fugl-Meyer运动功能评定法、改良Barthel指数评定法分别评估脑梗死急性期与恢复期康复介入治疗对脑梗塞偏瘫患者运动功能及日常生活活动能力的影响。将获取的数据进行整理输入SPSS建立数据库，，运用统计软件SPSS19.0进行分析。结果： 1．两组患者运动功能的比较 A组患者康复治疗前、康复治疗后2周、康复治疗后4周的运动功能评分分别为23.84±4.57、55.72±9.89、78.47±7.11；B组患者康复治疗前、康复治疗后2周、康复治疗后4周的运动功能评分分别为22.96±3.41、45.43±6.70、64.07±6.07。与B组相比，A组康复治疗后2周及康复治疗后4周运动功能评分明显增高，差异具有统计学意义（P㩳0.01）；A组和B组康复治疗前运动功能评分没有统计学差异（P0.05）。 2.两组患者日常生活活动能力的比较 A组患者康复治疗前、康复治疗后2周、康复治疗后4周的Barthel指数分别为4.25±1.41、11.06±1.34、14.97±2.01；B组患者康复治疗前、康复治疗后2周、康复治疗后4周后的Barthel指数分别为4.50±1.26、9.57±2.12、12.39±2.06。与B组相比，A组康复治疗后2周及康复治疗后4周日常生活活动能力评分明显增高，差异具有统计学意义（P㩳0.01）；A组和B组康复治疗前日常生活活动能力评分没有统计学差异（P0.05）。结论：脑梗塞急性期与恢复期康复介入治疗均可明显促进脑梗塞偏瘫患者运动功能和日常生活活动能力的恢复，但急性期进行康复的临床疗效更为明显。
[Abstract]:Objective: to investigate the effects of rehabilitation intervention therapy in acute and convalescent stage of cerebral infarction on the improvement of motor function and activities of daily living in patients with cerebral infarction hemiplegia. Methods: from December 2012 to February 2014, 60 cases of neurology and rehabilitation in our hospital were collected, including 32 cases in acute stage rehabilitation group (group A) and 28 cases in recovery group (group B). Both groups received routine treatment in patients with cerebral infarction, including brain edema control, nutritional nerves, improved circulation, anti-platelet, regulation of lipid metabolism, Patients in group A received rehabilitation interventional therapy within 14 days after onset, while patients in group B received rehabilitation intervention therapy after 14d-30d. The rehabilitation effect was evaluated before, 2 weeks and 4 weeks after rehabilitation respectively. The effect of rehabilitation was evaluated by the simplified Fugl-Meyer motor function evaluation method and the modified Barthel index evaluation method. The effects of rehabilitation interventional therapy on motor function and activities of daily living in patients with cerebral infarction hemiplegia were evaluated respectively in acute and convalescent stage of cerebral infarction. The acquired data was collected and input into SPSS to establish the database, and the statistical software SPSS 19.0 was used to analyze the data. Results: 1. The motor function scores of patients in group A before rehabilitation, 2 weeks after rehabilitation and 4 weeks after rehabilitation were 23.84 卤4.57 卤55.72 卤9.89 and 78.47 卤7.11B, respectively. The motor function scores at 2 weeks after rehabilitation and 4 weeks after rehabilitation were 22.96 卤3.41 卤45.43 卤6.70 卤64.07 卤6.07 respectively. Compared with group B, motor function scores in group A were significantly higher than those in group B (P0.01). There was no significant difference in motor function score between group A and group B before rehabilitation (P0.05). Comparison of activities of daily living in group A: before rehabilitation, 2 weeks after rehabilitation, and 4 weeks after rehabilitation, the Barthel index of patients in group A was 4.25 卤1.41 卤11.06 卤1.34 卤14.97 卤2.01g before and 2 weeks after rehabilitation, respectively. The Barthel index was 4.50 卤1.269.57 卤2.12 卤12.39 卤2.06 after 4 weeks of rehabilitation respectively. Compared with group B, the scores of ADL in group A were significantly higher than those in group B (P0.01). There was no significant difference in scores of ADL between group A and group B before rehabilitation (P0.05). Conclusion: rehabilitation interventional therapy in acute and convalescent stage of cerebral infarction can obviously promote the recovery of motor function and activity of daily living in patients with cerebral infarction hemiplegia, but the clinical effect of rehabilitation in acute stage is more obvious.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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