脑梗塞康复治疗时机的临床观察

Clinical observation of time window of rehabilitation of cerebral infarction

[目的]探讨脑梗塞偏瘫的康复时机,观察康复开始时间与运动功能和日常生活活动能力恢复的关系,证实脑梗塞早期康复的重要性。[方法]将40例50~75岁确诊为脑梗塞的患者随机分为3组,早期康复组（A组,15例）、恢复期康复组（B组,15例）、对照组（C组,10例）。康复效果的评价：运动功能评分采用Fugl-Meyer评定法（FMA）,日常生活活动能力（ADL）评分采用MBI（modified barthel index）评定法,入院时评定1次,康复训练1个月后再进行评定。[结果]3组的FMA、MBI积分与治疗前比较差异无显著性意义（P〉0.05）。经过1个月康复治疗后,A组的FMA积分为48.61±20.39,与康复前的差值为16.15±7.83,A组的MBI积分为69.47±15.10,与康复前的差值为22.29±12.21,均明显高于B、C两组,差异有显著性意义（P〈0.01）。B组FMA积分为50.03±23.60,与康复前的差值为9.59±7.26,B组的MBI积分为64.97±12.11,与康复前的差值为12.67±5.59,各项指标的增值亦高于C组,差异有显著性意义（P〈0.05）。[结论]脑梗塞患者应进行早期康复治疗,可改善肢体运动功能,提高日常生活活动能力。

[Objective]To determine time window of rehabilitation after cerebral infarction and evaluate the effects of time window of rehabilitation on motor function and ADL（activities of daily living）.[Methods] The study was designed in the manner of single-blinded,randomized and controlled trial.Forty patients with cerebral infarction were divided into three groups（early rehabilitation,recovery rehabilitation and control groups）.There was no difference in age,sex and stroke type among these groups.The three groups were assessed by the Fugl-Meyer assessment（FMA） and modified barthel index（MBI） before the treatment and one month later.[Results]The evaluation scores of FMA,MBI demonstrated that there wasn＇t significant difference among the three groups before the treatment（P0.05）,but after the treatment,the FMA score in the early rehabilitation group was 48.61±20.39,the score was gained by 16.15±7.83 from that of pre-treatment.The MBI score was 69.47±15.10 that was increased by 22.29±12.21 from that of pre-treatment.They were significantly higher than those in the control group and the recovery rehabilitation group（P0.01）.The FMA score in the recovery rehabilitation group was 50.03±23.60,which was gained by 9.59±7.26,the FBI score was 64.97±12.11,that was increased by 12.67±5.59.All of them were all higher than those in control group（P0.05）.[Conclusion]The early rehabilitation training is important in improving motor function and ADL significantly.