老年脑卒中患者功能恢复的影响因素分析

Analysis of the factors affecting the fuctional rehabilitation of senile stroke patients

目的:探讨老年人脑卒中后功能恢复的影响因素。方法:将128例脑卒中患者随机分为康复组50例,对照组78例,再按年龄各组又分高龄组(≥65岁)和低龄组(≤64岁)。康复组加用Bobath手法按摩瘫痪肢体及被动运动手段。评估者实施盲法。结果:康复组和对照组的高、低龄组在治疗30d、半年后与治疗前相应项目评分比较均差异有显著性意义(P<0.05)。在治疗30d后高龄组的康复组Fugl-Meyer下肢评分(21.13±10.17)分与治疗前(15.32±8.22)分比较有统计学意义(P<0.05),对照组则无此改变,治疗前为(14.36±9.81)分,30d后为(16.97±9.74)分(P>0.05),但半年后其神经功能缺损评分则与康复前比较无统计学意义(P>0.05)。结论:是否采用康复手段可影响65岁以上脑卒中患者的康复过程,结果表明高龄脑卒中患者应尽早采用康复手段,对其下肢的运动功能和神经缺损改善有益。

AIM:To discuss the factors which affect the functional rehabilitatation of old patients with stroke. METHODS:A total of 128 patients were randomized into rehabilitation group(n=50) and control group(n=78).According to the age the two groups were subdivided into the group of ≥65 years and the group of ≤64 years respectively.Manual massage was performed on the paralytic limbs in the rehabilitation groups,which was combined with passive exercise. It was a blind experiment for the experimenter in charge of evaluation. RESULTS:Thirty days and half a year after treatment,there were significant differences in the corresponding scoring of the rehabilitation and control groups as compared with before treatment(P< 0.05).For the patients aged ≥65 years in the rehabilitation group, the scores of Fugl Meyer assessment on lower limbs at 30 days(21.13±10.17) after treatment significantly differed from those before treatment(15.32±8.22)(P< 0.05).However, there was no significant difference in the control group between before(14.36±9.81) and after treatment(16.97±9.74)(P >0.05), while half a year after rehabilitation, the scores of neurological impairment insignificantly changed as compared with those before rehabilitation(P >0.05). CONCLUSION:The results of the present study indicate that the rehabilitation therapy should be performed in the elderly patients with stroke as early as possible,which is helpful for the improvement of motor function and neurological impairment of lower limbs.