急性脑梗死溶栓患者早期康复疗效观察

Effect of early rehabilitation for acute cerebral infarction patients treated with intravenous thrombolysis

目的:观察急性脑梗死患者进行静脉溶栓后24h内开始早期康复治疗的疗效。方法:静脉溶栓患者113例为观察组,非溶栓治疗的急性脑梗死患者120例为对照组,在入院后24h内予为期2周的康复治疗方案,在治疗前、治疗后2周和3个月随访时评定患肢Fugl-Meyer运动功能(FMA)、患侧上肢肘关节及下肢膝关节改良Ashworth分级、Barthel指数(BI),及3个月随访时进行改良Rankin(MRS)的预后评估。结果:治疗后2周及3个月后随访时,2组的FMA及BI评分较前均持续增高(P<0.05),且2周及3个月时观察组的FMA及BI分值均高于对照组(P<0.05)。观察组在治疗后2周及3个月随访时上肢肘关节及下肢膝关节的改良Ashworth分级比对照组低(P<0.05),MRS分值较对照组低(P<0.05)。结论:急性脑梗死溶栓患者接受早期康复治疗可以获得更好的运动功能改善、肌张力缓解及提高了日常生活活动能力。

Objective：To observe the effect of early rehabilitation for acute cerebral infarction patients treated with intravenous thrombolysis.Methods：One hundred and thirteen patients accepting thrombolysis were recruited as observation group,and 120 patients not given thrombolysis served as control group.Both groups received a two-week rehabilitation program within 24 hafter admission.They were assessed using Fugl-Meyer assessment scale（FMA）,modified Ashworth scale（MAS）,Bathel index of ADL（BI）before and after treatment,as well as at the 3rd month after treatment（during the following-up period）,and they were also assessed by modified Rankin scale（MRS）at the follow-up.Results：After two-week treatment and at the follow-up,the FMA and BI scores in two groups were improved significantly as compared with those pretreatment,more obviously in the observation group than in the control group（P〈0.05）.The MAS scores of elbow joint and knee joint in the observation group were lower than those in the control group（P〈0.05）.The MRS scores in the observation group were lower than in the control group（P〈0.05）.Conclusion：Early rehabilitation contributes to better functional recovery and ability in the activities of daily living for acute cerebral infarction patients treated with intravenous thrombolysis.