早期综合康复治疗对急性脑卒中患者功能预后的影响

Functional prognosis of early comprehensive rehabilitation applied to the patients with acute stroke

目的 :探讨早期综合康复治疗对急性脑卒中患者功能预后的影响。方法 :12 3例急性脑卒中患者随机分为康复组和对照组 ,康复组在采用常规药物治疗的同时 ,脑梗死患者于病后 3天、脑出血患者于病后 1周 ,在生命体征稳定、病情无进行性加重时即介入综合康复治疗 (包括肢体功能锻炼、理疗、针灸 ) ,采用电话形式进行随访。神经功能缺损用神经功能缺损程度评分标准评分 ,日常生活活动能力 (ADL)用Barthel指数评分。结果 :经治疗 1个月后两组患者神经功能缺损程度明显减少 ,ADL明显提高 ,与入院时比较有显著差异 (P <0 .0 1) ,康复组改善更明显 ,与对照组比较差异有显著性 (P <0 .0 5 )。其疗效持续至 1年 ,两组仍有显著差异。结论 :急性脑卒中患者进行早期综合康复治疗 ,能明显改善患者神经功能缺损及ADL得分 ,有效地提高患者生活自理能力 ,而且有一定的远期效果。

Objective: To investigate the functional prognosis of early comprehensive rehabilitation applied to patients with acute stroke . Method: 123 cases of acute stroke were randomly devided into two groups, rehabilitation group and control group. The patients in the rehabilitation group were treated with early comprehensive rehabilitation (including limb function exercises, physical therapy and acupuncture) besides routine medicine therapy in the third day (in cerebral infarction patients) or one week (in cerebral hemorrhage patients) after onset when physical signs were stable and conditions didn′t deteriorat. The patients were followed up through telephone, evaluated neurologic impairment by Assessment Standard of Neuroligic Function Impairment, evaluated activities of daily living (ADL) by Barthel′s index. Result: Neuroligic function impairment degree was obviously reduced and ADL was greatly improved in both groups after a month′s therapy compared with the admission time ( P <0.01). The improvement in the rehabilitation group was greater than the control group ( P <0.05). Furthermore, the difference had existed for one year. Conclusion: Early comprehensive rehabilitation applied to patients with acute stroke not only can obviously reduce the neurologic impairment, improve the ADL index and self-care ability, but also shows future effect in some degree.