脑卒中单侧空间忽略的系统综合康复治疗

Comprehensive rehabilitation intervention for stroke patients with unilateral spatial neglect

目的研究脑卒中单侧空间忽略（USN）的康复疗效。方法对245例脑卒中患者进行单侧空间忽略检测，将确诊为USN的86例患者随机分为对照组（n=43例）和观察组（n=43例）。对照组接受常规的临床药物治疗，同时由专业康复治疗师进行以Bobath、Rood技术为主的康复治疗；观察组在上述治疗的基础上，进行针对USN的系统康复治疗。分别对两组患者的运动功能、平衡功能、步行能力、单侧忽略程度、日常生活活动（ADL）能力进行评定。结果两组患者康复治疗8周后，Fugl—Meyer运动功能评分（P〈0．01）、平衡功能评分（P〈0．01）、Holden功能步行分级（P〈0．001）、Barthel指数评分（P〈0．001）、单侧忽略程度（P〈0．01）均有改善，差异有统计学意义。结论进行针对USN的系统康复治疗，可以明显改善脑卒中所致USN患者的运动功能、平衡功能、步行能力、ADL能力和单侧忽略程度。

Objective To observe the effectiveness of comprehensive rehabilitationinterventions on stroke patients with unilateral spatial neglect （USN）. Methods A total of 245 cases of stroke were examined to diagnose USN. Of the 245 patients, 86 cases were diagnosed as being with USN, and divided into a control group （ n = 43 cases） and a treatment group （ n = 43 cases） randomly. The control group was treated with Bobath and Rood techniques in addition to routine clinical medical interventions, while the treatment group was treated with a comprehensive rehabilitation protocol for USN in addition to the same interventions for the control group. Both groups were assessed with regard to motor, balance function, walking performance, and USN severity as well as the activities of daily living （ADL） performance. Results After 8 weeks of treatment, both groups improved, but there showed a significantly statistical difference between the 2 groups in terms of Fugl-Meyer motor function scores （ P 〈 0.01 ） , balance function scores （ P 〈 0.01 ） , Holden walking function classifications （ P 〈 0. 001 ） , Barthel index （ P 〈 0. 001 ） and USN severity scores （ P 〈 0.01 ）. Conclusion Comprehensive USN rehabilitation intervention could improve motor, balance, walking functions and ADL performance and alleviate the USN severity in stroke patients with USN.