急性重症脑卒中患者早期床旁康复训练对神经功能恢复的影响

Effect of early bedside rehabilitation training on neurological function recovery in patients with acute severe stroke

目的探讨在急性重症脑卒中救治期间加强早期床旁康复训练的效果及价值。方法选取2015年4月~2018年5月石河子市人民医院救治的300例急性重症脑卒中患者,双盲法分为2组,对照组(n=150)进行常规治疗,观察组(n=150)再加施早期床旁康复训练干预,比较治疗前后两组神经、运动功能及生活活动能力等改善效果,并统计治疗期间两组并发症发生情况。结果治疗后7 d、14 d,与对照组比较,观察组Fugl-Meyer运动功能评价量表(FMA)评分显著更高,神经功能缺损评分(NIHSS)显著更低,差异有统计学意义(t=8.816、15.190、6.592、7.683,P<0.05);治疗后15 d、30 d,观察组简易精神状态量表(MMSE)、Barthel指数(MBI)评分均显著高于对照组,差异有统计学意义(t=4.187、9.112、6.771、11.385,P<0.05);治疗后6个月,观察组GQOL-74量表各项评分均显著高于对照组,差异有统计学意义(P<0.05)。观察组组治疗期间肺部感染、关节挛缩、肩手综合征、肩关节脱位及压疮等并发生率显著低于对照组,差异有统计学意义(P<0.05)。结论在急性重症脑卒中患者救治期间加强早期床旁康复训练干预,可使患者神经、认知、运动功能获得更大程度,有助于提高患者生活活动能力,改善其生活质量,并降低并发症的发生风险。

Objective To explore the effect and value of strengthening early bedside rehabilitation training during the treatment of acute severe stroke.Methods:300 patients with acute severe stroke treated in our hospital from April 2015 to May 2018 were selected and divided into two groups.The control group(n=150)received routine treatment,and the observation group(n=150)received early bedside rehabilitation training intervention.The improvement of patients'nerve,motor function and activities of life were compared.Complicaitons during the treatment were recorded.Results:On the 7th and 14th day after treatment,compared with the control group,the FMA score of the observation group was significantly higher and the NIHSS score was significantly lower(t=8.816,15.190,6.592,7.683,P<0.05).On the 15th and 30th day after treatment,MMSE and MBI scores in the observation group were significantly higher than those in the control group(t=4.187,9.112,6.771,11.385,P<0.05).Six months after treatment,the scores of GQOL-74 in the observation group were significantly higher than those in the control group(P<0.05).Compared with the control group,the observation group had significantly lower incidence of pulmonary infection,arthrocontracture,shoulder and Hand Syndrome,dislocation of shoulder joint and pressure sores(all P<0.05).Conclusion Strengthening the intervention of early bedside rehabilitation training during the treatment of patients with acute severe stroke can improve the neurological,cognitive and motor functions of patients,and help to improve their ability of living and improving their quality of life,as well as lower the incidence of complications.