脑出血患者早期综合康复治疗效果的临床观察

The Clinical Observation of Effect of Early Comprehensive Rehabilitation in Patients with Acute Cerebral Hemorrhage

目的:观察早期综合康复治疗对急性期脑出血病人功能恢复的影响。方法:将192例急性期脑出血病人随机分为康复组和对照组,两组病人均同时接受常规药物治疗。其中康复组132例,病情稳定48 h后(发病7 d内)即依据病人不同情况分别进行生物反馈训练(电刺激)、肢体功能训练、语言训练等综合个体化的康复治疗。对照组病人60例,仅接受常规康复治疗。治疗前及治疗开始后30、60、90d分别采用美国国立卫生院卒中量表(NIHSS)、改良量表(MRS)、卒中影响量表(SIS)对病人日常生活活动能力(ADL)、残疾程度、生活质量状况进行评定。结果:治疗前康复组和对照组在NIHSS、MRS、SIS评分均差异无统计学意义(P>0.05);治疗30 d后两组ADL、残疾程度、生活质量状况与治疗前比较有显著差异(P<0.01);康复组改善更明显,与对照组比较差异有统计学意义(P<0.01);治疗60、90 d随访,两组仍有显著差异,康复组改善程度明显优于对照组,组间差异有统计学意义(P<0.01)。结论:急性期脑出血病人进行早期综合康复治疗,能显著改善病人日常生活活动能力,降低致残程度,提高病人生活质量。

Objective-To observe the effect of early comprehensive rehabilitation on recovery of patients with acute cerebral l hemorrhage. Methods： 192 patients with acute cerebral hemorrhage were randomly divided into rehabilitation group and control group. Patients were both received conventional drug treatment in two groups. Patients in rehabilitation group were evaluated on their conditions and treated with individualized com- prehensive rehabilitation including electrical stimulation, physical functional training, language training, etc. The rehabilitation group（ 132 cases）shows stable vital signs, stable condition（seven days after onset within）. The con- trol patients（60 cases） received conventional rehabilitation treatment. Instead of evaluation by the U. S. National Institutes of Health Stroke Scale（NIHSS）, modified scale（MRS）, Stroke Impact Scale（SIS）of the patients activ- ities of daily living（ADL）, disability, quality of life assessment of the condition on day 1, day 30, day 60 and day 90. Results： Before treatment, there are no apparent difference（ P 〉 0.05） in the NIHSS, MRS, SIS scores be- tween lhe rehabilitation group and control group. After 30 days treatment, patient conditions such as activities ofdaily living（ADL）, disability, life quality were improved than before（ P 〈 0.01 ）. Rehabilitation group improved more significantly than the control group（P 〈 0.01 ）. Treatment of 60 days, 90 days follow - up, there are signif- icant differences in the two groups. The improvement of rehabilitation group was still significantly better than that of the control group（P 〈 0.01 ）. Concision： The early comprehensive rehabilitation can help the patients with acute cerebral hemorrhage reduce disability;improve activities of daily living;and raise quality of life.