脑出血康复治疗介入时间和治疗效果的临床相关性研究

Clinical correlation research on intervention time and therapeutic effect of rehabilitation treatment of cerebral hemorrhage

目的研究不同康复治疗介入时间对老年脑出血患者的临床疗效及功能恢复的影响。方法选择2014年12月~2016年6月我院66例老年脑出血患者,分为早期治疗组,中期治疗组,晚期治疗组各22例,分别为A、B、C组,患者生命体征均已稳定,三组患者康复治疗介入时间分别为：A组于发病后72h内,B组于发病72h至2周内,C组于发病4周后。3组患者均采用相类似的康复治疗方案,其余基础治疗基本相同。采用Gos、ADL、FMA、神经功能缺损程度评定评估患者的功能恢复情况。结果 3组患者病死率、植物状态生存率差异无统计学意义（P〉0.05）;A、B、C组的Gos、FMA评分均呈现依次降低的差异,ADL评分则相反,神经功能缺损程度评分显示A组治疗前后差值最大（P〈0.05）,差异具有统计学意义（P〈0.05）,组间评分比较也具有统计学意义（P〈0.05）。结论康复治疗介入时间不同对老年脑出血患者的预后具有明显的影响,早期介入康复治疗可以明显提高老年患者的运动功能及生活自理能力,疗效显著优于晚期介入康复治疗组。

Objective To investigate the influence of different rehabilitation intervention time to clinical curative effect and functional recovery of elderly patients with cerebral hemorrhage. Methods 66 cases of elderly patients with CH cured in our hospital from Dec. 2014 and Jun. 2016 were selected and divided into threee group A, group B and group C, that were early treatment group, medium treatment group and advanced treatment group with 22 casee in each. The vital signs of the patients were stable. The three groups of patients with rehabilitation therapy intervention time were： group A in the incidence of 72 h, group B in the incidence of 72 h to 2 weeks, group C in the 4 weeks after the onset. The 3 groups of patients were treated with similar rehabilitation programs, and the rest of the basic treatment were the same basic treatment.Their clinical effects were examined by GOS, ADL, FMA and degree of nerve function defect assessment. Results There were no significant difference between 3 groups on the rate of mortality, survival. Scores of GOS, FMA represented in reduce. ADL was totally different, and the degree of nerve function defect score showed there was the biggest difference in Group A（P〈0.05）. Conclusion Rehabilitation intervention has great effects on elderly patents with CH. Early time treatment can improve the movement function in selfcare and life quality. The curative effect is significantly better than that of advanced interventional therapy group