应用功能综合评定量表评估早期康复对脑卒中患者功能结局的影响

Effects of early rehabilitation on the functional outcomes of stroke patients estimated with functional comprehensive assessment

目的:应用功能综合评定量表(functionalcomprehensiveassessment,FCA)在脑卒中患者入院(发病3周内)时和在病后6个月分别进行评估,研究早期康复对脑卒中患者功能结局的影响。方法:2001-11-27/2003-08-15在安徽医科大学附属医院神经内科连续入院,年龄在40～80岁的脑梗死或脑出血患者,病程不超过3周,共计80例。根据入院时间把所有符合研究要求的脑卒中患者按随机分组表入组,所有患者都接受传统的神经内科治疗。80例患者被随机分配到康复组和对照组,康复组除接收神经科治疗外,还需接收物理治疗和作业治疗,以及语言等治疗,每个患者都接受FCA量表评估。结果:76例患者完成研究,4例脱落。一般资料显示年龄、脑梗死和脑出血比例、性别等在治疗前,康复组与对照组差异无显著性意义(P>0.05)。应用wilcoxon秩和检验把FCA总分分为≤40,41～60,61～80,>80,治疗前两组比较差异无显著性意义,但治疗后康复组FCA总分为≤40,41～60,61～80,>80的分别为3,7,9,20例,对照组分别为6,10,16,5例,两者比较差异有显著性意义(P=0.011)。结论:早期康复能够改善脑卒中患者的日常生活能力、运动功能。

AIM: Functional comprehensive assessment (FCA) was used to measure function of stroke patients (in three week after stroke) at admission and six months after stroke and study the influence of early rehabilitation intervention on functional outcomes of stroke patients. METHODS: Totally 80 patients with hemorrhagic and cerebral infarction aged between 40 and 80 consecutively admitted in the Department of Neurology and Rehabilitation, First Affiliated hospital of Anhui Medical University between December 2001 and August 2003 were chosen. The course was no more than three weeks.Eighty patients were randomly divided into two groups: control group and rehabilitation group. Traditional neurology therapies were given to all patients. The rehabilitation group received physical and occupational therapy. In addition, the service of speech pathology was used. The functional status of each patient was assessed at both admission and six months later using FCA instrument. RESULTS: Totally 76 patients finished the study and 4 cases were missed. General data indicated there was no significant difference between the two groups before treatment(P >0.05) in ages, cerebral infarction, proportion of cerebral hemorrhage and sex. FCA total mark was divided into 4 levels:≤40, 41-60, 61-80, >80 using Wilcoxon rank test. There were no significant differences between the two groups before treatment . However, after treatment, total FCA scores were ≤40 (3 cases), 41-60 (7 cases), 61-80 (9 cases), >80 (20 cases) in the rehabilitation group and < 40 (6 cases), 41-60 (10 cases), 61-80 (16 cases), >80 (5 cases) in the control group. There was significant difference between the two groups(P= 0.011). CONCLUSION: Early rehabilitation intervention can obviously improve daily life ability and motor function of stroke patients.