早期康复对经静脉溶栓治疗的脑卒中后偏瘫患者运动功能的影响

Effects of early rehabilitation on the motor function of post-stroke hemiplegic patients after intravenous thrombolysis

目的观察早期康复对经静脉溶栓治疗的脑卒中后偏瘫患者运动功能的影响。方法选择经静脉阿替普酶（rtPA）溶栓治疗的脑卒中偏瘫患者36例，按随机数字表法分为早期康复组（病程〈3d）和对照组（病程3～7d），每组18例。2组患者均经静脉rtPA溶栓治疗后行2周的康复治疗。于治疗前、治疗2周后（治疗后）和治疗后第3个月（随访时）分别对2组患者行上、下肢运动功能评分（FMA）和日常生活活动（ADL）评分[改良Barthel指数（MBI）]。结果治疗后和随访时，2组患者上、下肢FMA和MBI评分较组内治疗前均显著提高，差异均有统计学意义（P〈0．05）；且治疗后，早期康复组的下肢FMA和MBI评分分别为（23．33±4．37）分和（56．11±22．27）分，与对照组治疗后的（17．06±4．70）分和（40．00±15．81）分比较，差异均有统计学意义（P〈0．05）。结论早期康复可促进经静脉溶栓治疗的脑卒中后偏瘫患者近期下肢运动功能和ADL能力的恢复。

Objective To observe the effects hemiplegic patients treated with intravenous thrombolysis of early rehabilitation on the motor function of post-stroke Methods Thirty-six post-stroke hemiplegic patients af- ter intravenous thrombolysis with rtPA were recruited in this study. They were randomly divided into the early rehabil- itation group （with the course less than three days） and the control group （with the course between three and seven days） , 18 cases in each group. Both group received a two-week rehabilitation programme. They were assessed using the Fugl-Meyer assessment （FMA） of up extremity, FMA of lower extremity and ADL score （modified Barthel index, MBI） before and after treatment, as well as at the 3rd month after treatment （during the following-up）. Results After treatment and at the following-up, FMA scores of up extremity, FMA scores of lower extremity and MBI scores had improved significantly compared with before treatment in both groups. Furthermore, after treatment, in the early rehabilitation group the average FMA score of lower extremity and MBI score reached （23.33 ± 4.37 ） and （56.11± 22.27） respectively, significantly higher than those of the control group [ （ 17.06± 4.70） and （40.00 ± 15.81 ） re- spectively]. Conclusion Early rehabilitation contributes to short-term recovery of lower extremity motor function and ability in the activities of daily living in post-stroke hemiplegic patients after intravenous thrombolysis.