规范三级康复治疗促进脑卒中偏瘫患者综合功能康复的临床研究

Clinical study of standardized three stages′rehabilitation program in promoting comprehensive function in stroke patients with hemiplegia

目的:探索规范的三级康复治疗对于脑卒中偏瘫患者综合功能的影响。方法:脑卒中52例患者在脑梗死和脑出血二个层次上区组随机化分成康复组和对照组,康复组给予规范的三级康复治疗,对照组不给予规范的三级康复治疗,但是一般的常规内科治疗同治疗组。结果:康复组在各阶段的评分明显高于对照组(P<0.001),康复组各阶段评分积分的差值明显高于对照组(P<0.001);入组时、1个月、3个月和6个月时康复组患者的综合功能分别相当于正常人的40.01%、59.43%、77.75%和88.04%,而对照组分别为:35.14%、40.45%、51.61%和57.48%,另外,入组时,1个月、3个月和6个月时康复组患者的综合功能分别相当于对照组的116.71%、146.90%、150.65%和153.16%;1个月月末与入选时、3个月月末与入选时和6个月月末与入选时的康复组综合功能积分差值相当于对照组的指数分别是:3.46、2.34和2.18,另外,1个月月末与入选时、3个月月末与入选时和6个月月末与入选时的康复组综合功能积分差值分别高于对照组:14.14分、22.69分和27.45分。结论:规范三级康复治疗对于脑卒中患者各阶段综合功能的提高具有明显的促进作用。

Objective:To explore the effects of standardized three stages′ rehabilitation on the comprehensive function in stroke patients with hemiplegia.Method:All 52 patients of primary cerebral infarction and primary cerebral hemorrhage were divided into treated group and controlled group randomly. Patients in the treated group were given standardized three stages′ rehabilitation,while those in the controlled group were only given normal internal medicine treatments that was the same as the treated group but without standardized three stages′ rehabilitation.Result:The scores of the treated group at every stage were higher than those of the controlled group(P<0.001). The margins between every stage′s scores in the treated group were greater than those in the controlled group(P<0.001).Compared with normal people, the comprehensive function scores of the treated group′s patients were about 40.01%, 59.43%, 77.75% and 88.04% of normal people at the entering time, the end of 1st month, 3rd month and 6th month after stroke differently, but that of the controlled group were about 35.14%, 40.45%, 51.61% and 57.48% of normal people differently. The patients′ comprehensive function of the treated group were about 116.71%,146.90%,150.65% and 153.16% of the controlled group at the entering time, the end of 1st month,3rd month and 6th month after stroke respectively. Compared with the controlled group, the indexes of the margins between the scores of entering time and that of the end of 1st month?3rd month and 6th month in the treated group were 3.46,2.34 and 2.18 respectively. In addition, the margins were higher than the controlled group by 14.14,22.69 and 27.45 marks respectively.Conclusion:Standardized three stages′ rehabilitation can promote stroke patients′ comprehensive function of every stage obviously.Author′s address Dept. of Rehab. Medicine,Huashan Hospital,Fudan University,Shanghai,200040