缺血性脑卒中患者不同时间开始康复训练的临床研究

A clinical study of rehabilitation training beginning at different times for patients with ischemic stroke

目的对比研究康复治疗在不同时间节点干预缺血性脑卒中患者的疗效和预后。方法 87例患者随机分为2 d康复训练组和14 d康复训练组,嘱病人及家属都须按要求进行训练。在入组时及发病3个月后分别评估严重不良事件数,按简化Fugl-Meyer运动功能评价量表、NIHSS评分量表、Barthel指数评定量表、汉密尔顿抑郁量表进行评分。结果治疗前两组患者NIHSS、Fugl-Meyer运动功能、Barthel指数评定量表、汉密尔顿抑郁量表等评分值差异无统计学意义(P>0.05),发病3个月后2 d组上述评分分别为(9.72±5.37)、(65.21±13.27)、(76.87±12.68)、(29.06±11.48),14 d组分别为(12.14±2.76)、(52.67±14.28)、(62.85±11.69)、(34.23±5.43),2 d组比14 d组有明显改善(P<0.05)。结论对于缺血性脑卒中患者,更早的康复治疗,增加了患者的肢体运动功能、日常生活能力,使患者受益,减轻了患者的抑郁程度。

Objective To study the clinical effects of rehabilitation therapy and the prognosis on patients with ischemic stroke in different periods. Methods 87 patients were randomly divided into two-day rehabilitation training group and fourteen-day rehabilitation training group. The patients were trained as requested and their data were collected and analyzed at the beginning and 3 months after onset. Results There were no significant differences in the scores of NIHSS,Fugl-Meyer motor function,Barthel index and Hamilton Depression scale between the two groups（ P〉0. 05）. After 3 months of treatment,the above scores were（ 9. 72 ± 5. 37）,（ 65. 21 ± 13. 27）,（ 76. 87± 12. 68）,and（ 29. 06 ± 11. 48） in the two-day rehabilitation training group,and（ 12. 14 ± 2. 76）,（ 52. 67 ±14. 28）,（ 62. 85 ± 11. 69）,and（ 34. 23 ± 5. 43） in the fourteen-day rehabilitation training group. The clinical effect of the two-day rehabilitation training group was better than that of the fourteen-day rehabilitation training group（ P〈0. 05）. Conclusion Earlier rehabilitation therapy improves the limb motor function and self-care ability for daily life,and reduces the symptoms of depression in the patients with ischemic stroke.