抗痉挛技术对偏瘫患者上肢肌痉挛改善的疗效观察

The effect of anti-spasm skills on hemiplegia patients'spasticity of upper limb

目的:观察应用抗痉挛技术对偏瘫患者上肢肌痉挛改善的疗效。方法:经临床确诊的72例偏瘫患者,患侧上肢屈肌张力均在Ashworth评分1—3级之间。治疗组36例,每天接受以抗痉挛技术为主的康复训练1—2小时,疗程为3个月,抗痉挛技术以Bobath易化技术为主,痉挛严重者配夹板固定,持续牵伸;对照组36例,除常规神经科用药外不做正规康复训练。两组治疗前后分别进行比较,评估方法采用Ashworth评分法。结果:治疗组患者治疗前后肌张力有显著性差异(P<0.05);对照组患者前后肌张力比较无显著性差异(P>0.05);治疗前两组患者的肌张力评分无显著性差异(P>0.05);治疗后两组患者的肌张力评分有显著性差异(P<0.05)。结论:抗痉挛技术在偏瘫患者的康复训练中非常重要,尤其是痉挛出现的早期,效果尤为显著。

Objective:To observe the effect of anti-spasm skills on hemiplegia patients′ spasticity of upper limb. Method:We observed seventy-two hemiplegia subjects with spasticity, their Ashworth′s scales were between one and three scale. They were divided into rehabilitation training group(36 cases) and contrast group(36 cases). The training group received training with anti-spasm skills mainly,1-2 hours per day,for 3 months. Bobath method was one of the main anti-spasm skills.Severe spasmodic upper limbs of those patients had a fixation with splint and continuous stretching. The contrast cases didn′t receive these training.The two groups were evaluated with Ashworth scale before and after the treatment.Result:There was remarkable difference in Ashworth′s scales of the training cases before and after the treatment(P<0.05), while no remarkable difference in the contrast cases(P>05).There was significant difference in Ashworth′s scales between the two groups after the treatment(P<0.05), while no significant difference before the treatment(P>05).Conclusion:The anti-spasm skills in the rehabilitation training is very effective for the patients with hemiplegia spasticity, especially in the early period of spasm.Author′s address Department of Rehabilitation Medicine,the First Affililated Hospital of Nanjing Medical University,Nanjing,210029