综合康复治疗脑卒中后肩手综合征的疗效观察

The effect of integrated rehabilitation treatment in patients with shoulder-hand syndrome after stroke

目的观察综合康复治疗对脑卒中后肩手综合征患者的治疗效果。方法采用综合康复措施治疗56例脑卒中后肩手综合征患者,治疗方法包括正确体位摆放、避免腕屈曲、关节注射、压迫性向心缠绕、冰疗、主动和被动运动、电针、超短波及药物治疗等,治疗时间为4周。治疗前、后采用Fugl-Meyer量表和目测类比评分法(VAS)对患者上肢关节被动运动范围、上肢和腕手关节的运动功能、疼痛及水肿程度进行评定。结果56例患者经过为期4周的综合康复治疗后,其病情均有明显改善,共显效35例(62.5%),有效21例(37.5%);治疗后患侧上肢关节被动运动范围、上肢及腕手关节的运动功能均较治疗前有显著改善(均P<0.05),上肢疼痛和水肿程度亦均较治疗前有明显下降(均P<0.05)。结论综合康复治疗对脑卒中后肩手综合征患者具有较好疗效。

Objective To study the effect of integrated rehabilitation treatment in patients with shoulderhand syndrome after stroke. Methods Fifty-six patients with shoulder-hand syndrome after stroke were treated with integrated rehabilitation intervention. The treatment methods included proper position, avoiding flexion at the wrist, intraarticular injection, compressive centripetal wrapping, ice therapy, active and passive movement, electric acupuncture, ultrashort wave and medicine, et al. The therapeutic course was 4 weeks. The passive range of motion of upper limb, the movement function of upper limb and hand, the degree of pain and edema were assessed with Fugl- Meyer and Visual Analogue Scale（ VAS）. Results After therapy, the state of illness were ameliorated significantly at the end, the superior rate was 62.5% and effective rate was 37.5%. The passive range of motion of upper limb, the movement function of upper limb and hand were improved markedly （ P 〈 0. 05 ） , and the degree of pain and ede- ma were decreased obviously, too. Conclusion Integrated rehabilitation treatment has preferable effect to shoulder- hand syndrome after stroke.