脑梗死短期住院患者康复效益研究

The functional outcome for the treatment of acute phase rehabilitation in patients with cerebral embolic stroke

目的:应用功能独立性评价量表(FIM)探讨脑梗死短期住院患者康复效益。方法:本研究为随机对照研究。选择65例脑梗死患者,随机分为康复治疗组和对照组,两组药物治疗基本相同。治疗组每天进行以Bobath法为主的康复训练,对照组只进行关节活动度训练和物理因子治疗,两组患者均采用FIM量表进行测量,将两组患者入院、出院值,住院期间获得值,以及康复效益进行配对分析。结果:①两组患者入院、出院时功能独立检查运动分、认知分、总分无显著性差异(P>0.05),康复组、对照组住院期间功能独立检查改变均有显著性差异(P<0.05),两组患者FIM改变值比较仅运动项有显著性差异(P<0.05)。②两组患者住院效率分别为:0.43分/天和0.37分/天,两者相比无显著性差异(P>0.05)。结论:脑梗死短期住院患者进行早期康复治疗只能提高FIM中的“运动项”得分,但在提高患者整体ADL功能上并无积极意义,强调住院时间过短并不利于脑梗死患者康复效益的提高。

Objective:To investigate the functional outcome of early positive rehabilitation applied to cerebral embolic stroke patients. Method: A randomized trial was performed to assess the early positive rehabilitation in 65 subjects after stroke. All 38 subjects were randomly assigned to receive positive treatment as compared with 27 subjects randomly assigned to receive normal treatment. The criteria of patients selection was based on the National Conference of Cerebral Vascular Diseases in 1995.The drug treatment in two groups was almost the same. The positive treatment group was treated with Bobath′s method for physical therapy.The normal treatment group received ROM exercise and simple physical therapy. Functional Independence Measure(FIM) was used to measure 65 cerebral embolic stroke patients. Admission FIM, discharge FIM, FIM gain, FIM efficiency, length of stay(LOS)were compared.Result:①There were no differences in admission FIM-cognition, FIM-motor and FIM-total scores, discharge FIM, FIM gain and lose between the two groups. However, two groups were significant different in discharge scores compared with admission FIM , also the FIM-motor gain(P<0.05). ②The FIM efficiency was 0.43/d and 0.37/d for rehabilitation group and control group. However, there were no significant differences noted between the two groups(P>0.05).Conclusion:In positive rehabilitation, the patients could improve their function. However, there was no high and reasonable efficiency in ADL. Author′s address Sir Run Run Shaw Hospital, Hangzhou, 310016