颅脑损伤所致半侧空间忽略对偏瘫康复疗效与预后的影响

Effect of Unilateral Spatial Neglect on Rehabilitation of Hemiplegia after Brain Injury

目的探讨颅脑损伤后半侧空间忽略(USN)对偏瘫患者康复疗效及预后的影响。方法选取USN阳性患者35例,USN阴性患者38例。两组患者均由指定专业康复治疗师统一进行以Bobath技术为主的综合康复治疗。在康复治疗前、治疗后1个月、2个月,分别对两组患者的运动功能、平衡功能、步行能力、手功能以及日常生活活动(ADL)进行详细评定。结果治疗后,两组患者的Fugl-Meyer运动功能评分、平衡功能评分、改良Barthel指数(MBI)评分均较治疗前显著提高(P<0.001),但两组间的平衡功能、MBI评分、手功能分级差异有显著性意义(P<0.05),Holden功能步行分级差异有非常高度显著性意义(P<0.001)。结论颅脑损伤所致USN对偏瘫患者的运动功能、平衡功能、步行能力和ADL的恢复均有明显影响。

Objective To investigate the unilateral spatial neglect （USN） on the rehabilitation of hemiplegia after brain injury. Methods 35 patients with USN and 38 patients without USN were selected and divided into two groups （USN group and without USN group）. All patients of two groups accepted integrative treatments mainly with Bobath technique by professional therapists. The function of movement, balance, ambulation, hand and activities of daily living （ADL） were all particularly assessed by simplified Fugl-Meyer movement assessment, Fugl-Meyer balance assessment, Holden functional ambulation classification, hand function classification and Modified Barthel Index （MBI） before treatment and 1 and 2 months after treatment. Results After treatment, the scores of the Fugl-Meyer movement assessment, Fugl-meyer balance assessment and MBI of all patients in two groups significantly improved （P 〈0. 001）. But there was a significant difference between the two groups in scores of balance function, MBI, hand function （all P 〈0.05）, and the Holden functional ambulation classification （ P 〈0. 001）. Conclusion USN induced by brain injury has obviously effects on rehabilitation of motor, balance, ambulation and ADL of hemiplegia.