【摘要】 目的:探索规范的三级康复治疗对于脑卒中偏瘫患者综合功能的影响。方法:本研究采用大样本、多中心、前瞻性的随机对照研究方法。各分中心患者在脑梗死和脑出血两个层次上区组随机化分成康复组和对照组,康复组688例,对照组677例,共计1365例,康复组患者予以规范的三级康复治疗,对照组不给予规范的三级康复治疗,但神经内科常规诊疗同康复组,分别于入选时、发病后第1个月末、第3个月末和第6个月末采用功能综合评定量表进行评测。结果:入选时脑梗死组、脑出血组患者综合功能分布情况康复组和对照组不存在明显差异,但是入选后各阶段两组之间存在明显的差异。患者入选后不论是脑梗死康复组、脑出血康复组、总体康复组患者综合功能测评积分明显优于对照组(P<0.01)。康复组患者入选后各阶段的综合功能改善值明显优于对照组(P<0.01)。6个月随访治疗后,脑梗死康复组、脑出血康复组和康复组总体患者的综合功能分别改善了42.78分、50.85分和44.98分,而对照组分别改善了26.94分、32.20分和28.33分。即和对照组相比,脑梗死康复组则多改善15.84分,脑出血康复组多改善18.65分,康复组总体上多改善16.65分。结论:规范三级康复治疗对于脑卒中偏瘫患者各阶段综合功能的提高具有明显的促进作用。更多还原

【Abstract】 Objective:To investigate the effect of standardized tertiary rehabilitation(STR) on the comprehensive (motor & cognitive) functions in 1365 patients with cerebral stroke accompanied by hemiplegia.Method:1365 subjects whose vital signs stabilized in the past week were enrolled sequentially from 22 hospitals. They were classified into two groups of cerebral infarction and cerebral hemorrhage while being enrolled,and then randomly subdivided into two groups of test and control,the former was composed of 688 cases,and the latter,677. Those in the test group were administered STR program in addition to routine interventions of neurological medicine,while those in the control group were only given the routine ones. All patients were assessed with the scale of Functional Comprehensive Assessment(FCA) at the enrollment time, and the end of the 1st,3rd and 6th month after stroke,respectively. Result:At the entering time there was no significant difference between test group and control group in the distribution of FCA scores. At each post-stroke checking point,however,the differences in the distribution of FCA scores between test group and control group were significant. At each of the following post-stroke checkpoints,however,the FCA scores in cerebral infarction or cerebral hemorrhage test group,or in the whole test group were higher than those in the control(P<0.01). At the end of the 6th month,the FCA scores elevated 42.78,50.85 and 44.98 points in test groups respectively,while in control groups elevated 26.94,32.20 and 28.33 points correspondingly. In other words,comparing to the control group,the FCA scores in test group elevated 15.84,18.65 and 16.65 points additionally. Conclusion:Standardized tertiary rehabilitation could significantly improve the comprehensive(motor & cognitive) functions of stroke patients with hemiplegia.更多还原