不同介入时机康复对脑出血患者手功能和日常生活活动能力的影响

Effects of Different Intervention Opportunities of Rehabilitation on Recovery of Hand Function and Activities of Daily Living in Patients with Intracerebral Hemorrhage

目的研究不同介入时机康复对脑出血患者手功能及日常生活活动能力(ADL)恢复的影响。方法对2005年6月～2011年6月入住康复病房的108例脑出血患者进行回顾性分析,入选时收集每位患者病史,记录患者的一般情况(性别、年龄、病因、发病时间、出血部位、入院时间、出院时间等),并根据康复介入时机分成:早期、中期、晚期和后遗症期康复组。出入院时评估患者手部Brunnstrom分级和改良Barthel指数(MBI)评分。结果早期和中期康复组康复治疗后手部Brunnstrom分级明显进步(P<0.01),晚期和后遗症期康复组疗效不明显(P>0.05);但4组康复治疗后MBI评分均有明显改善(P<0.01);康复介入时机越早的组,手部Brunnstrom分级和MBI评分增加值越大。结论康复治疗可不同程度地促进手功能和ADL改善,早期康复治疗介入效果更明显。

Objective To explore the effects of intervention of rehabilitation at different opportunities on recovery of hand function and activities of daily living（ADL） in patients with intracerebral hemorrhage（ICH）.Methods A retrospective study was conducted.108 patients with ICH admitted to rehabilitation ward between June 2005 and June 2011 were divided into 4 groups according to the time of rehabilitation intervention.Demographic and clinical data were collected.The hand function and ADL were evaluated with Brunnstrom assessment and modified Barthel Index（MBI） at admission and before discharge.Results The hand function of patients in early and intermediate stages significantly improved（P0.01） while the patients in later and sequelae stages did not improve（P0.05）.The MBI of all groups increased after rehabilitation intervention（P0.05）.The earlier rehabilitation intervention was applied,the greater the improvement of Brunnstrom assessment and MBI were.Conclusion Rehabilitation intervention can facilitate the recovery of hand function and ADL of patients with ICH in different stages.Early intervention is more effective.