中风急性期康复疗法与传统治疗的对比研究

Effects of rehabilitation in patients with acute cerebrovascular disease

目的:研究急性脑血管病患者早期康复治疗的效果。方法:对100例入选患者随机分成康复组50例和对照组50例,并按肌力损害情况进行配对疗效对照。对照组仅药物治疗,康复组在药物治疗基础上早期介入神经促通技术,疗程21天。治疗前后运动功能用简式的FMA,日常生活活动能力(ADL)用改良的Barthel指数进行评价。结果:(1)康复组的运动功能及ADL疗效均较对照组有明显提高(P<0.01);(2)肌力损害在3级以下的患者康复组疗效明显优于对照组,P<0.01;(3)中风病灶在脑叶、基底节、丘脑的康复效果均好,治疗前、后P均<0.01;(4)发病≤7天即介入康复治疗的较7天以上才开始康复者效果好(P<0.01);(5)康复组平均1次医疗费用较对照组减少。结论:急性脑血管病患者要早期开始规范化的康复治疗,才能取得最佳疗效,最大程度地减少中风后的残疾率和残疾程度。

Objective: To study the effects of rehabilitation in patients with acute cerebrovascular disease. Methods: A total of 100 patients with acute cerebrovascular disease were divided into rehabilitation group (50 cases) and control group (50 cases) . Patients of rehabilitation group were divided into 4 subgroup according muscle force. Patients of control group treated with drug. Patients of rehabilitation group treated with neuromuscular facilitation technique except drug treatment. One therapy course was 21 days. Effects were evaluated by Fugl-meyer method and Barthel index. Results: (1) Compared with control group, the exercise function and Barthel index increased (P<0. 01); (2) The therapy effects of rehabilitation patients with muscle force of≤Ⅲ grade were more than those of control group (P<0. 01); (3) The therapy effects of thalamic. lobe of brain, basal ganglion focus were finer (P<0. 01 all); (4) Therapy effects were finer when rehabilitation therapy began within 3 days; (5) Average medical cost of rehabilitation group was decreased than control group. Conclusion: If rehabilitation therapy perform in acute cerebrovascular disease early the therapy effect is best.