早期康复治疗对脑卒中后偏瘫患者炎症反应、神经功能、肢体运动功能及生活质量的影响

Effects of Early Rehabilitation Treatment on Inflammatory Reaction,Neurological Function,Limb Motor Function and Quality of Life in Patients with Hemiplegia after Stroke

目的分析早期康复治疗对脑卒中后偏瘫患者炎症反应、神经功能、肢体运动功能及生活质量的影响。方法选取2018年2月—2020年2月我院收治的脑卒中后偏瘫120例,根据康复治疗时间的不同分为早期组和常规组各60例。观察2组治疗前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和C反应蛋白(CRP)],神经功能恢复情况[美国国立卫生研究院卒中量表(NIHSS)评分],日常生活能力(改良Barthel指数量表评分),肢体运动功能(Fugl-Meyer量表评分)及生活质量(生活质量评定量表评分)改善情况。结果治疗后,2组TNF-α、IL-6、CRP水平均低于治疗前,且早期组低于常规组,差异有统计学意义(P<0.05,P<0.01)。治疗后,2组NIHSS评分低于治疗前,改良Barthel指数量表评分高于治疗前,且早期组NIHSS评分降低、改良Barthel指数量表评分升高程度大于常规组,差异有统计学意义(P<0.05,P<0.01)。治疗后2组Fugl-Meyer量表评分随治疗时间的延长逐渐升高,且早期组治疗后1个月、3个月及6个月Fugl-Meyer量表评分均明显高于常规组,差异有统计学意义(P<0.05,P<0.01)。治疗后2组生活质量评定量表躯体功能、认知功能、角色功能、情绪功能、社会功能评分均升高,且早期组上述评分亦高于常规组,差异有统计学意义(P<0.05,P<0.01)。结论早期康复治疗可降低脑卒中后偏瘫患者炎性因子水平,促进神经功能恢复,改善肢体运动功能,提升患者生活质量。

Objective To analyze effects of early rehabilitation on inflammatory reaction,neurological function,limb motor function and quality of life in patients with hemiplegia after stroke.Methods A total of 120 patients with hemiplegia after stroke admitted between February 2018 to February 2020 were selected and divided into early rehabilitation group(early group,n=60)and conventional group(n=60)according to different times of rehabilitation treatment.Improvement conditions of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)],recovery of neurological function[National Institute of Health stroke scale(NIHSS)score],ability of daily living(modified Barthel Index scale scores),limb motor function(Fugl-Meyer scale scores)and quality of life(Short Form 36 questionnaire score)before and after treatment were observed in two groups.Results After treatment,levels of TNF-α,IL-6 and CRP were significantly lower than those before treatment in two groups,and the levels in early group were significantly lower than those in conventional group(P<0.05,P<0.01).After treatment,NIHSS scores were significantly lower,while modified Barthel index scale scores were significantly higher than those before treatment in two groups;the degrees of decrease of NIHSS score and increase of modified Barthel index score in early group were significantly higher than those in conventional group(P<0.05,P<0.01).After treatment,scores of Fugl-Meyer scale were increased with prolongation of therapeutic time in two groups,and the scores of Fugl-Meyer scale after treatment for 1,3 and 6 months in early group were significantly higher than those in conventional group(P<0.05,P<0.01).After treatment,scores of physical function,cognitive function,role function,emotional function and social function in Short Form 36 questionnaire were significantly higher than those before treatment in two groups,and the above indexes in early group were significantly higher than those in conventional group(P<0.05,P<0.01).Conclusion Early rehabilitation may reduce levels of inflammatory factors,promote recovery of neurological function,and improve the limb motion function and quality of life of patients.