早期康复干预对脑出血偏瘫患者肢体功能恢复的影响

Effects of early rehabilitation intervention nursing on limb function recovery in patients with hemiplegia due to cerebral hemorrhage

目的分析早期康复干预护理对脑出血偏瘫患者肢体功能恢复的影响。方法回顾性选取2018年8月至2018年12月收治的脑出血偏瘫患者60例为研究对象,依据护理方法将其分为试验组和对照组,每组30例。对照组仅予以常规护理,试验组在此基础上采用早期康复干预护理持续至出院,对比2组临床疗效及干预前后Fugl-Meyer运动功能评分(Fugl-Meyer assessment,FMA)、美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分、Brunnstrom肌张力分级、日常生活活动能力量表(activities of daily living,ADL)评分及并发症发生率。结果试验组干预总有效率93.33%明显高于对照组73.33%(P=0.038);试验组干预2周、干预4周、干预后1个月FMA评分高于对照组(P=0.021;P=0.029;P<0.001),而NIHSS评分低于对照组(P=0.018;P=0.004;P<0.001);试验组干预4周上肢与下肢Brunnstrom肌张力分级均高于对照组(P=0.032、0.037);试验组干预2周、干预4周、干预后1个月ADL评分高于对照组(P<0.05;P=0.003;P<0.001);试验组干预后褥疮、下肢深静脉血栓发生率低于对照组(P=0.028、0.038)。结论早期康复干预对脑出血偏瘫患者效果较好,能促进其肢体功能与神经功能、肌张力恢复,积极有效改善其生活质量,同时减少并发症风险,值得在临床推广实践。

Objective To investigate the effects of early rehabilitation intervention nursing on limb function recovery in patients with hemiplegia due to cerebral hemorrhage.Methods A total of 60 patients with hemiplegia due to cerebral hemorrhage who were admitted and treated in our hospital from August 2018 to December 2018 were enrolled in the study,who were divided into experimental group and control group according to different nursing methods,with 30 cases in each group.The patients control group were treated by routine nursing,however,the patients in experimental group,on the basis of control group,were treated by early rehabilitation intervention nursing till discharging from hospital.The clinical curative effects,the scores of Fugl-Meyer Motor Function Assessment(FMA)and National Institutes of Health Stroke Scale(NIHSS),Brunnstrom muscle tension grading,activity of daily living(ADL)score and incidence rate of complication were observed and compared between the two groups.Results The total effective rate in experimental group was significantly higher than that in control group(93.33%vs 73.33%,P<0.05).At 2 weeks,4 weeks and 1 month after intervention,the FMA scores in experimental group were significantly higher than those in control group(P<0.05 or P<0.01),however,the NIHSS scores in experimental group were significantly lower than those in control group(P<0.05 or P<0.01).At 4 weeks after intervention,the muscle tension grading of upper limbs and lower limbs in experimental group was significantly higher than that in control group(P<0.01).At 2 weeks,4 weeks and 1 month after intervention,the ADL scores in experimental group were significantly higher than those in control group(P<0.05 or P<0.01),In addition the incidence rates of bedsore and deep venous thrombosis after intervention in experimental group were significantly lower than those in control group(P<0.05).Conclusion The effects of early rehabilitation intervention are relatively better in treatment of hemiplegia due to cerebral hemorrhage,which can promote recovery of limb function,nerve function and muscle tension of patients,and can effectively improve the life quality of patients and reduce risk of complications.Therefor,it is worthy of application and promotion in clinical practice.