Changes of lower-extremity function and peroneal nerve function at different recovery phase in patients with post-stroke hemiplegia
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摘要: 目的 探讨不同恢复阶段脑卒中后偏瘫患者下肢功能、腓神经功能变化情况。 方法 选取2015年10月—2016年9月浙江省中医院收治的脑卒中后偏瘫患者74例,所有患者均采用常规药物治疗并配合康复训练。分别于恢复1、3、6个月采用简式Fugl-Meyer运动功能评分法评估患者下肢功能,采用肌电图检测腓总神经传导速度评估腓神经功能,并进行比较,同时观察下肢功能、腓总神经传导速度的关系。 结果 不同恢复阶段脑卒中后偏瘫患者下肢Fugl-Meyer运动功能评分差异有统计学意义(F=53.950,P<0.001);不同恢复阶段脑卒中后偏瘫患者患侧腓总神经传导速度差异有统计学意义(F=3.241,P=0.045),健侧腓总神经传导速度差异无统计学意义(F=1.017,P=0.432);恢复1个月、恢复3个月脑卒中后偏瘫患者患侧腓总神经传导速度均明显低于健侧(t=-2.751,P=0.007;t=-2.540,P=0.012),恢复6个月时,脑卒中后偏瘫患者患侧、健侧腓总神经传导速度差异无统计学意义(t=-1.371,P=0.173);随着恢复时间的延长,脑卒中后偏瘫患者下肢Fugl-Meyer运动功能评分逐渐升高,二者呈正相关(r=0.583,P<0.001);随着恢复时间的延长,脑卒中后偏瘫患者腓总神经传导速度逐渐加快,二者呈正相关(r=0.181,P=0.007);脑卒中后偏瘫患者下肢Fugl-Meyer运动功能与腓总神经传导速度呈正相关(r=0.148,P=0.028)。 结论 随着恢复时间的延长,脑卒中后偏瘫患者下肢功能、腓神经功能逐渐改善,下肢功能与腓神经功能密切相关,联合监测下肢功能与腓神经功能有助于对预后效果的评估。Abstract: Objective To investigate the changes of lower-extremity function and peroneal nerve function at different recovery phase in patients with post-stroke hemiplegia. Methods A total of 74 post-stroke hemiplegia patients were selected in our hospital from October,2015 to September,2016.The conventional medical treatment and rehabilitation training were performed in all patients.The lower-extremity function of patients was assessed with the Fugl-Meyer Assessment scaly after 1,3 and 6 months.The peroneal nerve function of patients was assessed by using common peroneal nerves conduction velocity.The difference in the functions after 1,3 and 6 months were compared.The correlation between lower-extremity function and common peroneal nerves conduction velocity was observed. Results Among the three recovery phases,Lower-extremity function had significant difference(F=53.950,P<0.001);peroneal nerve function of affected side had significant difference(F=3.241,P=0.045);peroneal nerve function of uninjured side had no significant difference(F=1.017,P=0.432).After 1 month and 3 months recovery,12 cases were with Grade 1 velopharyngeal function,14 cases with grade 2,and 3 cases with grade 3.The peroneal nerve function of affected side was significantly lower than that of uninjured side(t=-2.751,P=0.007;t=-2.540,P=0.012);After 6 months recovery,there was no significant difference between affected side and uninjured side(t=-1.371,P=0.173).FMA-L score increased with the extension of recovery time,there was a positive correlation(r=0.181,P=0.007);As the extension of recovery time,the common peroneal nerves conduction velocity accelerated,there was a positive correlation (r=0.181,P=0.007).There was a positive correlation between FMA-L score and common peroneal nerves conduction velocity(r=0.148,P=0.028). Conclusion As the extension of recovery time,lower-extremity function and peroneal nerve function can be gradually improved.The lower-extremity function is closely related to peroneal nerve function in patients with post-stroke hemiplegia.The combining monitoring on the lower-extremity function and peroneal nerve function will be helpful to the evaluation of prognosis of patients.
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