急性缺血性脑卒中偏瘫患者的早期个体化综合康复方案临床观察

Clinical observation of early individualized comprehensive rehabilitation program for patients with acute ischemic stroke and hemiplegia

目的:研究急性缺血性脑卒中(AIS)偏瘫患者的早期个体化综合康复方案。方法:连续选择2016年1月-2017年1月入我院诊断AIS偏瘫患者共100例,发病时间≤7天,随机将其分为对照组和观察组各50例,对照组采用常规药物和康复治疗,观察组采用个体化综合康复方案,疗程为2周,随访6个月;比较2组治疗前后以及随访1个月、3个月和6个月的神经功能缺损(NIHSS评分)和日常生活能力(ADL评分),治疗后和随访6个月的临床效果以及生活质量(SF-36评分)。结果:2组治疗后NIHSS评分较前降低,随访1个月、3个月和6个月可进一步降低,且观察组明显小于对照组,差异有统计学意义(P<0.05)。2组治疗后ADL评分较前增加,随访1个月、3个月和6个月可进一步升高,且观察组明显高于对照组,差异有统计学意义(P<0.05)。观察组治疗后和随访6个月的临床效果均明显优于对照组,生活质量评分均明显高于对照组,差异有统计学意义(P<0.05)。结论:早期个体化综合康复方案可以明显改善AIS偏瘫患者的临床预后,有较好的应用价值。

Objective:To study effects of early individualized comprehensive rehabilitation program for patients with acute ischemic stroke(AIS)and hemiplegia.Methods:A total of 100 consecutives as AIS with hemiplegia of onset time≤7days from January 2016 to January 2017 were enrolled and divided randomly into control and observation groups,each of 50 cases;they in control group received common medical and rehabilitation treatments,and they in observation group adopted individualized comprehensive rehabilitation program,the course was 2 weeks,then 6.0 months follow-up;then to compare differences of nerve function defect NIHSS score and activity of daily living ADL score before and after treatment,one month,three months and six months after follow-up;clinical effect and quality of life SF-36 score after treatment and six months during follow-up.Results:The NIHSS scores after treatment in the two groups were both lower than before,and they were gradually less as time extended,what's more,they in observation group were significantly lower than control group(P<0.05).They were contrary to ADL scores in the two groups(P<0.05).Furtherly,the clinical efficacy after treatment and six months follow-up in observation group were better than control group,and the same to SF-36 scores(P<0.05).Conclusion:It could greatly improve clinical prognosis with early individualized comprehensive rehabilitation program for AIS patients with hemiplegia.