早期不同强度肢体功能锻炼对脑出血患者康复的影响

Influences of early intensified limb function exercise of different intensity on rehabilitation of cerebral hemorrhage patients

目的：分析早期不同强度肢体功能锻炼对脑出血患者康复效果的影响。方法采用便利抽样法选取2012年5月—2014年5月收治的100例危重脑出血患者作为研究对象，按照随机数表法分为对照组和观察组，每组各50例；对照组采用被动锻炼方式进行肢体功能锻炼，观察组采用主动锻炼为主的早期高强度肢体功能锻炼进行护理，比较两组患者锻炼前和锻炼后7，14 d 的机体组成成分、体质量、人血白蛋白、免疫学水平，比较两组患者锻炼过程中出现的并发症。结果观察组患者锻炼7，14 d后肌肉总量和骨骼肌水平高于对照组，差异有统计学意义（P ＜0．05），体脂肪、躯干和四肢水分评分低于对照组，差异有统计学意义（P ＜0．05）；观察组锻炼7，14 d 后 CD4／CD8水平、人血白蛋白水平均高于对照组，差异有统计学意义（P ＜0．05）。观察组16％的患者出现肩周炎、4％的患者出现肩关节半脱位、14％的患者出现肩手综合征、40％的患者出现关节挛缩，对照组中有88％的患者出现肩周炎、18％的患者出现肩关节半脱位、46％的患者有肩手综合征，全部患者均有关节挛缩，观察组的并发症发生率低于对照组，差异有统计学意义（P ＜0．05）。结论早期强度肢体功能锻炼能够减少脑出血患者术后并发症，改善机体健康水平，提高患者免疫功能，促进患者康复。

Objective To analyze the influences of early intensified limb function exercise of different intensity on rehabilitation of cerebral hemorrhage patients.Methods A total of 1 00 critically ill patients with cerebral hemorrhage,admitted from May 201 2 to May 201 4,were selected by convenience sampling and were divided according to random number table method into control group and observation group,each with 50 cases. In the control group,patients did the limb function exercise passively,while in the observation group,patients did the early high intensified limb function exercise mainly in an active way.Body composition,body mass, serum albumin,immunology level were compared in patients of the two groups before the exercise at 7 d after the exercise and 1 4 d after the exercise.Complications happened during the exercise were also compared among patients of the two groups.Results 7 d and 1 4 d after the exercise,muscle amount and skeletal muscle level of patients in the observation group were higher than that of the control group （P 〈0.05）,while body fat,trunk and four-limb moisture scores were lower than that of the control group（P 〈0.05）.After 7 d and 1 4 d exercise, CD4 /CD8 levels and serum albumin level in the observation group were higher than that of the control group （P 〈0.05）.In the observation group,1 6% of the patients had shoulder periarthritis,4% with subluxation in shoulder joints,1 4% having shoulder-hand syndrome,and 40% acquiring joint contracture,while in the control group,the numbers were 88%,1 8%,46% and 1 00% respectively.Occurrence of complications in the observation group was lower than that in the control group （P 〈0.05 ）.Conclusions Early high intensified limb function exercise can reduce postoperative complications of cerebral hemorrhage patients,improve body health level and immune function,and promote rehabilitation of patients.