良肢位摆放对瘫痪患者肌力恢复影响的前瞻性随机对照研究

A Prospective Study of Randomized Controlled Design on the Effect of Good Limb Placement Nursing on the Recovery of Muscle Strength in Paralysis Patients

目的评价良肢位摆放对瘫痪肢体功能恢复的作用及影响因素。方法选择2018年10月-2019年10月我科住院的肢体瘫痪患者,采用随机数表法分为对照组41例和实验组40例。对照组按常规摆放,实验组从入院当天开始用良肢位摆放对瘫痪肢体进行护理,记录入院当天、1周及出院时的肌力积分值,比较各组入院1周、2周及出院时肌力积分差值变化。结果实验组入院治疗后1周、2周时肌力积分差值均高于对照组,但差异无统计学意义(P>0.05);实验组出院时肌力积分差值高于对照组(P<0.05);实验组女性、>75岁及住院天数>15 d以上的患者肌力积分差值高于对照组(P<0.05);多因素Logistic回归分析显示,实验组住院天数和年龄是肌力积分差值的影响因素(P<0.05)。结论良肢位摆放护理可提高肢体瘫痪患者肌力恢复能力,但临床应用时要考虑疗程、年龄的影响因素。

Objective To evaluate the effect of good limb placement on function recovery of paralyzed limbs.Methods Patients with limb paralysis admitted to our department from October 2018 to October 2019 were randomly divided into control group(41 cases)and experimental group(40 cases).The control group was nursed with traditional functional position,and the experimental group began to care for the good limb placement from the day of admission,the muscle strength integral scores were recorded at the day of admission,1 week and 2 weeks safter admission,at discharge,and compared the difference between 1 week,2 weeks and discharge of each group.Results The difference of muscle strength scores in the experimental group at 1 and 2 weeks after admission was higher than that in the control group,but the difference was not statistically significant(P>0.05).The difference of muscle strength score at discharge in the experimental group was higher than that in the control group(P<0.05).The difference in muscle strength scores of women,patients over 75 years old and patients over 15 days of hospitalization in the experimental group were higher than that in the control group(P<0.05).Multivariate Logistic regression analysis showed that the length of hospital stay and age were the influencing factors of muscle strength score difference in the experimental group(P<0.05).Conclusion Good limb position nursing can improve the muscle strength recovery ability of patients with limb paralysis,but the influencing factors of treatment course and age should be considered in clinical application.