【摘要】 目的 探讨早期康复训练联合分级分期管理对脑卒中偏瘫患者神经功能、生活质量及并发症的影响。方法 将206例脑卒中后偏瘫患者按照密封信封法随机分为两组,各103例,两组均给予早期康复训练,观察组联合分级分期管理进行干预,观察3个月。干预前后采用神经功能缺损量表评定两组患者的神经功能缺损状况,肌张力评分评定痉挛程度,简化运动功能FuglMeyer量表评定肢体运动能力,日常生活活动能力评定量表评定日常生活活动能力,脑卒中专用生活质量量表评定生活质量,比较两组并发症发生情况。结果 干预后两组神经功能缺损量表及肌张力评分均较干预前显著降低(P<0.01),简化运动功能Fugl-Meyer量表及日常生活活动能力评定量表评分均较干预前显著升高(P<0.01),观察组较对照组变化更显著(P<0.01)。干预后两组脑卒中专用生活质量量表各项评分均较干预前显著升高(P<0.05或0.01),观察组体能、家庭角色、语言功能、活动能力、情绪、个性、自理能力、社会角色、上肢功能及总分较对照组升高更显著(P<0.01)。观察组便秘、排便费力、腹痛腹胀及压疮发生率均显著低于对照组(P<0.01)。结论 早期康复训练联合分级分期管理能有效促进脑卒中偏瘫患者神经功能恢复,改善痉挛状况,提高肢体运动能力和日常生活能力,降低并发症发生率,值得推广应用。更多还原

【Abstract】 Objective To analyze the effects of early rehabilitation training combined with hierarchical management on neurological function,quality of life and complications in patients with stroke and hemiplegia.Methods A total of 206 patients with hemiplegia after stroke were randomly divided into two groups,103 patients each.Both groups were given early rehabilitation training,and the observation group intervened with hierarchical management.Before and after the intervention,NIHSS was used to assess the neurological deficit status of the two groups.Muscle tone score was used to assess the degree of spasticity,FMA was used to assess the physical activity of the limbs,ADL was used to assess the activity of daily living,and SS-QOL was used to assess the quality of life.Compare the occurrence of complications between the two groups.Results After intervention,the NIHSS and muscle tone scores of the two groups were significantly lower than before intervention(P<0.01), and the FMA and ADL scores were significantly higher than before intervention(P<0.01).The observation group changed more significantly than the control group(P<0.01).After intervention,the SS-QOL scores of the two groups were significantly higher than before intervention(P<0.05 or 0.01),the observation group’s physical fitness,family role,language function,activity ability,emotion,personality,self-care ability,social role,upper limb function and total score were more significantly increased than the control group(P<0.01).The incidence of constipation laborious defecation,abdominal pain,bloating and pressure ulcers in the observation group were significantly lower thanthose in the control group(P<0.01).Conclusions Early rehabilitation training combined with hierarchical management can effectively promote the recovery of neurological function in stroke hemiplegic patients,improve spasticity,improve limb motor ability and daily living ability,and reduce the incidence of complications,which is worthy of popularization and application.更多还原