探讨康复治疗介入时机对脑卒中患者预后的影响

Discussion on effect of intervention timing of rehabilitation therapy on the prognosis of stroke patients

目的探讨康复治疗介入时机对脑卒中患者预后的影响。方法 100例脑卒中患者,采取随机分组法分为对照组和观察组,每组50例。两组患者入院后均给予血液循环改善、脑水肿解除及脑组织保护治疗,待患者生命体征稳定、意识清晰后,观察组患者增加康复治疗,对照组不增加治疗方法。比较两组患者临床疗效及治疗前后美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer评分法(FAM)、改良Barthel指数评定量表(MBI)评分。结果对照组显效21例(42.00%),有效18例(36.00%),无效11例(22.00%),总有效39例(78.00%);观察组显效37例(74.00%),有效11例(22.00%),无效2例(4.00%),总有效48例(96.00%)。观察组总有效率明显高于对照组,差异具有统计学意义(χ2=7.162, P<0.05)。对照组治疗前NIHSS评分为(8.62±5.12)分、FAM上肢评分为(17.52±13.22)分、下肢评分为(16.73±6.31)分、MBI评分为(46.24±20.22)分,治疗后NIHSS评分为(7.31±4.72)分、FAM上肢评分为(21.63±15.62)分、下肢评分为(21.41±16.35)分、MBI评分为(65.51±20.14)分;观察组治疗前NIHSS评分为(8.94±3.32)分、FAM上肢评分为(16.78±11.35)分、下肢评分为(16.82±5.43)分、MBI评分为(47.51±16.44)分,治疗后NIHSS评分为(5.62±2.28)分、FAM上肢评分为(27.93±12.41)分、下肢评分为(27.36±5.77)分、MBI评分为(75.07±18.20)分。治疗前,两组患者NIHSS、FAM、MBI评分对比,差异均无统计学意义(P>0.05);治疗后,观察组NIHSS、FAM、MBI评分均显著优于对照组,差异均具有统计学意义(P<0.05)。结论在脑卒中患者诊治时,结合早期康复治疗能有效提升临床疗效,改善患者运动功能及神经功能,促进患者恢复。

Objective To discuss the effect of intervention timing of rehabilitation therapy on the prognosis of stroke patients. Methods A total of 100 stroke patients were divided by random grouping method into control group and observation group, with 50 cases in each group. After admission, both groups received blood circulation improvement, brain edema relief and brain tissue protection treatment. After the patient’s vital signs were stable and the consciousness was clear, the observation group received rehabilitation treatment, and the control group received no other treatment. Comparison were made on clinical efficacy, National Institutes of Health Stroke Scale(NIHSS), Fugl-Meyer assessment(FAM), and modified Barthel index rating scale(MBI) scores before and after treatment in two groups. Results The control group had 21 excellent cases(42.00%), 18 effective cases(36.00%), 11 ineffective cases(22.00%) and 39 total effective cases(78.00%). The control group had 37 excellent cases(74.00%), 11 effective cases(22.00%), 2 ineffective cases(4.00%) and 48 total effective cases(96.00%). The observation group had obviously higher total effective rate than the control group, and the difference was statistically significant(χ2=7.162, P<0.05). Before treatment, the control group had NIHSS score as(8.62± 5.12) points, FAM upper limb score as(17.52±13.22) points, lower limb score as(16.73±6.31) points and MBI score as(46.24±20.22) points, which were(7.31±4.72),(21.63±15.62),(21.41±16.35) and(65.51± 20.14) points after treatment. Before treatment, the observation group had NIHSS score as(8.94±3.32) points, FAM upper limb score as(16.78±11.35) points, lower limb score as(16.82±5.43)points and MBI score as(47.51±16.44) points, which were(5.62±2.28),(27.93±12.41),(27.36±5.77) and(75.07±18.20) points after treatment. Before treatment, both groups had no statistically significant difference in NIHSS, FAM and MBI score(P>0.05). After treatment, the observation group had obviously better NIHSS, FAM and MBI score than the control group, and the difference was statistically significant(P<0.05). Conclusion In the diagnosis and treatment of stroke patients, combining with early rehabilitation treatment can effectively improve clinical efficacy, improve motor function and nerve function, and promote patient recovery.