早期综合康复治疗对改善中老年脑卒中偏瘫患者运动功能及日常生活能力的临床疗效观察

吴近仪; 吴敏杰; 魏鹏; 雷秀强; 潘宇晓; 吴欢乐

doi:10.16766/j.cnki.issn.1674-4152.002784

早期综合康复治疗对改善中老年脑卒中偏瘫患者运动功能及日常生活能力的临床疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.002784

1.
浙江大学第一附属医院安吉分院安吉县人民医院康复医学科, 浙江湖州 321300
2.
浙江宁波宁海中医院，浙江宁波 315699
3.
宁波市第一医院重建外科, 浙江宁波 315010
4.
杭州市临安区第一人民医院骨科, 浙江杭州 311399

基金项目:

浙江省医药卫生科技计划项目 2019KY569

浙江省宁波市自然科学基金项目 2019A610250

详细信息

作者简介:
吴近仪, E-mail: genetics2008@163.com

中图分类号: R743.3 R493
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- PDF下载量: 7
- 被引次数: 0
出版历程
- 收稿日期: 2022-07-11
- 网络出版日期: 2023-02-07

Clinical effect of early comprehensive rehabilitation therapy on improving the motor functions and activities of daily living in middle-aged and elderly stroke patients with hemiplegia

1.
Department of Rehabilitation Medicine, Anji Branch, the First Affiliated Hospital of Zhejiang University, Huzhou, Zhejiang 321300, China

摘要

摘要: 目的探讨早期综合康复治疗对改善老年脑卒中偏瘫患者日常生活能力的有效方法。方法回顾性收集2018年12月—2020年3月收治的首发脑卒中患者在安吉县人民医院神经科治疗后转至康复科的71例恢复期偏瘫患者作为研究对象。按入院年份分为常规组和综合组；2018—2019年接受常规康复治疗措施的患者纳入常规组(36例), 之后接受综合康复治疗的患者纳入综合组(35例)。综合组采取物理疗法、作业治疗辅以心理康复、认知训练，治疗过程中强化运动和平衡功能训练, 并开展引导式教育。患者的肢体运动功能和日常生活能力(ADL)均分别使用Fugl-Meyer脑卒中偏瘫运动功能积分法(FMA)和Barthel指数(BI)量表评价。结果治疗后常规组FMA和BI评分分别为(44.51±6.60)分和(49.24±13.11)分，综合组分别为(50.28±7.20)分和(59.36±8.74)分，差异有统计学意义(t=3.517、3.837, 均P < 0.001)。2组患者的运动功能和ADL与治疗前相比均有明显改善，而综合组改善更显著(均P < 0.05)。结论综合康复治疗可更有效地改善卒中偏瘫患者的肢体运动功能及ADL, 提高其生活质量。
- 脑卒中 /
- 偏瘫 /
- 老年患者 /
- 综合康复治疗 /
- 日常生活能力 /
- Fugl-Meyer脑卒中偏瘫运动功能积分法 /
- Barthel指数
Abstract: Objective To explore the effective method of early comprehensive rehabilitation treatment for improving the activities of daily living (ADL) of elderly stroke patients with hemiplegia. Methods A total of 71 convalescent hemiplegia patients who were treated in the Neurology Department of Anji People ' s Hospital and transferred to the Rehabilitation Department from December 2018 to March 2020 were retrospectively collected as research subjects. Based on the year of admission, they were divided into conventional and comprehensive groups. The conventional group (36 cases) included patients who received conventional rehabilitation treatment measures from 2018 to 2019, and the comprehensive group comprised those who received comprehensive rehabilitation treatment afterward (35 cases). In the comprehensive group, physical therapy, occupational therapy supplemented by psychological rehabilitation, cognitive training, intensive exercise and balance function training and guided education were carried out. The patients' limb motor function and ADL were evaluated by Fugl-Meyer assessment (FMA) and Barthel index (BI), respectively. Results After treatment, the FMA and BI scores of the conventional group were (44.51±6.60) points and (49.24±13.11) points, respectively, and those of the comprehensive group were (50.28±7.20) points and (59.36±8.74) points, respectively. The differences were statistically significant (t=3.517, 3.837, all P < 0.001). The motor function and ADL of the two groups improved significantly compared with those before treatment, and the improvement of the comprehensive group was more significant (all P < 0.05). Conclusion Comprehensive rehabilitation therapy can effectively improve the motor function and ADL, and improve the quality of life of stroke patients with hemiplegia.
- Stroke /
- Hemiplegia /
- Elderly patients /
- Comprehensive rehabilitation therapy /
- Activities of daily living /
- Fugl-Meyer assessment /
- Barthel index

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表 1 2组脑卒中患者一般资料比较

Table 1. General information of stroke patients in the 2 groups

组别	例数	性别(例)		年龄(x±s，岁)	病程(x±s，d)	脑血管病变类型
组别	例数	男性	女性	年龄(x±s，岁)	病程(x±s，d)	脑梗死	脑出血
常规组	36	18	18	58.2±8.9	38.5±4.8	21	15
综合组	35	19	16	57.6±9.4	40.2±8.6	20	15
统计量		1.310^a		0.276^b	0.103^b	0.100^a
P值		0.450		0.783	0.306	0.555
注：^a为χ²值, ^b为t值。

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表 2 康复治疗前后2组患者BI和FMA评分(x±s，分)

Table 2. BI and FMA scores of the two groups before and after rehabilitation treatment(x±s, points)

组别	例数	BI评分		FMA评分
组别	例数	康复治疗前	康复治疗后	康复治疗前	康复治疗后
常规组	36	15.18±5.61	49.24±13.11^a	17.68±4.38	44.51±6.60^a
综合组	35	13.38±5.87	59.36±8.74^a	15.34±5.69	50.28±7.20^a
t值		1.316	3.837	1.945	3.517
P值		0.193	< 0.001	0.056	< 0.001
注：与同组康复治疗前比较，^aP < 0.05。

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