早期训练目标干预对偏瘫患儿康复效果的影响

Effect of early training target intervention on rehabilitation effect of patients with hemiplegia

目的观察早期训练目标策略护理干预对偏瘫患儿康复效果的影响。方法选取我院自2012年9月-2014年9月收治的60例偏瘫患儿作为研究对象,随机分为对照组与观察组各30例。对照组仅给予常规康复训练干预,观察组采用早期训练目标策略护理干预,采取自拟依从度问卷评估患儿训练配合度,分别采取GMFM量表、改良Barthel指数量表、Fugl-Meyer运动量表及FAC（功能性步行）量表、Berg平衡量表评估治疗前后2组患儿患肢功能的改善情况,采用QOL生活质量量表评估患儿生活质量的改善情况。结果 ①干预8周及12周后,观察组患儿GMFM评分分别为（40.1±8.9）分、（46.9±11.8）分,与对照组相比,差异均有统计学意义（均P〈0.05）。②干预后,观察组FAC分级、Barthel指数评分及Fugl-Meyer评分分别为（2.9±1.4）级、（86.6±14.3）分和（16.7±3.5）分,与对照组相比,差异均有统计学意义（均P〈0.05）。③干预8、12周后,观察组患儿Berg平衡量表评分分别上升至（46.2±3.4）分、（52.8±5.3）分,与对照组相比,差异均有统计学意义（均P〈0.05）。④干预8、12周后,观察组患儿生活质量评分分别上升至（56.6±3.7）分、（62.1±5.4）分,与对照组相比,差异均有统计学意义（均P〈0.05）。⑤观察组依从率为93.3%,对照组为50.0%,2组患儿治疗依从率对比,差异有统计学意义（P〈0.05）。结论在偏瘫患儿的临床干预中,采用早期训练目标策略护理干预方案,可提高患儿治疗的依从性与积极性,促进其患肢运动功能的恢复,值得临床推广应用。

Objective To observe the effect of early training target nursing intervention on the rehabilitation effect of children with hemiplegia.Methods 60 children with hemiplegia and admitted into the hospital during September 2012 to September 2014 were selected as the research objects and were divided into the control group and the observation group of two groups with 30 cases in each.The control group only received routine rehabilitation training intervention,while the observation group received early training goal strategy nursing intervention.The self designed compliance degree questionnaires were used to evaluate the training degree of adaptability of children.GMFM scale,modified Barthel index scale,Fugl-Meyer motor scale,FAC（functional ambulation）scale and Berg balance scale were used to evaluate the improvement of the diseased limb function in the two groups before and after the treatment.And the QOL scale was used to evaluate the improvement of the quality of life.Results 8weeks and 12 weeks of intervention later,the GMFM scores of the observation group were（40.1±8.9）and（46.9±11.8）.Compared with the control group,the difference was statistically significant（P〈0.05）.After intervention,FAC classification,Barthel score and Fugl-Meyer score of the observation group were（2.9±1.4）level,（86.6±14.3）and（16.7±3.5）.Compared with the control group,the difference was statistically significant（P〈0.05）.After 8weeks and 12 weeks of intervention,Berg balance scale scores of the observation group were increased to（46.2±3.4）and（52.8±5.3）.Compared with the control group,the difference was statistically significant（P〈0.05）.After 8weeks and 12 weeks of intervention,the quality of life scores of the observation group were increased to（56.6±3.7）and（62.1±5.4）.Compared with the control group,the difference was statistically significant（P〈0.05）.The compliance rate of the observation group was 93.3% while of the control group was50.0% and the difference was statistically significant（P〈0.05）.Conclusion In the clinical intervention of children with hemiplegia,early training goal-strategy nursing intervention program can improve the treatment compliance and enthusiasm of children and promote the recovery of limb motor function.