老年脑出血患者康复介入时间不同对功能恢复影响的对照研究

Effects of early or late rehabilitative intervention on functional recovery of elder patients with intracerebral hemorrhage

目的探讨康复介入时间不同对老年脑出血患者功能恢复的影响。方法选择66例老年脑出血患者,分为早期康复组和晚期康复组各33例。早期康复组在患者生命体征稳定,神经系统体征不再进展后48h￣7d开始康复。晚期康复组在发病后3￣4周开始康复。两组均采用以Bobath为主的运动疗法进行康复训练。用Fugl-Meyer运动功能评定法(FMA)评定患者的运动功能,用修订的Barthel指数(MBI)评定患者的日常生活能力,用脑卒中患者临床神经功能缺损程度评分标准(ND)评定患者的病情严重程度。结果治疗前FMA、MBI和ND两组差异无显著性意义,治疗1个月后两组均较治疗前有明显改善,早期康复组比晚期康复组改善程度更大。结论康复介入时间的不同对老年脑出血患者的功能恢复有一定的影响,无论早期或晚期康复介入均能明显改善老年脑出血患者的运动功能和日常生活能力,早期康复介入的疗效优于晚期。

Objective To investigate the effects of early or late rehabilitative training on the motor function and activity of daily living （ADL） of eider patients with intracerebral hemorrhage. Methods Totally 66 eider patients with intracerebral hemorrhage were randomly divided into 2 groups （n=33）： early rehabilitation group that began the training 48 h-7 d after the stabilities of vital signs and nervous system signs and late rehabilitation group that started 3-4 weeks after onset, The training was based on Bobath＇s method. Fugl-Meyer Motor Assessment Scale （FMA）, modified Barthel index（MBI） and neurological deficit evaluation （ND） were used to assess the motor function, ADL and prognosis respectively. Results The scores of the FMA, MBI, ND demonstrated there were no significant differences between the 2 groups before treatment, but the scores were improved 1 month after treatment in both of the 2 groups, and much more significantly in early rehabilitation group. Conclusion Both early and late rehabilitative interventions can facilitate the motor function and ADL recovery of elder patients with intracerebral hemorrhage, and early intervention is better.