偏瘫后肩手综合征的临床分析及康复治疗

The clinical analysis and rehabilitation of the shoulder hand syndrome after stroke-hemipleyia

目的探讨偏瘫后肩手综合征发病机制和合理的康复治疗思路。方法脑卒中偏瘫患者38例,随机分为康复组和对照组,每组19例。所有患者均接受整体感知疗效(global perceived effect,GPE)、视觉模拟量表(visual analogscale,VAS)和肩关节被动活动度(ROM)评定。所得资料均采用CHISS软件进行非参数秩和检验或t检验。结果康复组VAS、GPE和ROM改善优于对照组,差异有统计学意义。结论偏瘫后肩关节继发性损伤导致的疼痛和交感神经系统失调可能是RSD形成的关键因素,通过无痛体位和治疗可以缓解疼痛,调节交感神经,综合其他常规理疗,从而打破这种恶性循环,最终达到治疗的目的。

Objective To understand the principles of RSD and discuss the way to deal with it.Methods 38 stroke-hemiplegia patients were departed randomly into rehabilitation group and control group.Everyone were evaluated through global perceived effect（GPE）、visual analog scale（VAS） and ROM scale.The CHISS statistical software had be used.Results The improvement of rehabilitation group is better than the control group statically,and in each group,there are better improvement than before.Conclusion It showed that the vicious circle of events,which includes the shoulder secondary tissue damage pain and abnormal sympathetic nerve system,are maybe the key course inducing RSD.The treatment should be painless and can adjust sympathetic nerve system.