康复治疗时机对脑卒中患者预后的影响

探讨康复治疗介入时机对脑卒中患者预后的影响。方法：选取2012年1月至2013年1月间我院收治的脑卒中患者90例，随机分为观察组与对照组，两组患者入院给予脑卒中常规治疗，包括解除脑水肿、保护脑组织、扩容改善血液循环等治疗，且均自愿接受康复治疗，并能够配合康复医师的康复训练。观察组患者在生命体征平稳、意识清晰后后即进行康复训练治疗，对照组于常规治疗4周后行康复治疗，两组患者于康复训练治疗前、后采用 MBI（ modified barthel index ）进行日常生活活动能力（ ADL）评价、采用 Fugl-Meyer 评定法（ FMA）对运动功能进行评分、美国国立研究院脑卒中评定量表（ NIHSS ）对神经功能缺损进行评价。结果：两组患者康复治疗前MBI、FMA、NIHSS评分比较无统计学差异（ P＞0．05）；治疗后两组患者上述指标较康复治疗前比显著改善，治疗前后比较差异有统计学差异（ P＜0．05）；观察组患者治疗后MBI、FMA、NIHSS评分改善较对照组更为显著，组间比较差异有统计学意义（ P＜0．05）；观察组患者康复治疗后肩-手综合征治疗显效率显著高于对照组（ P＜0．05）。结论：早期训练治疗可促进脑卒中患者神经、运动功能及ADL能力恢复，缓解肩-手综合征症状，对脑卒中患者预后起积极作用。

Effect of Rehabilitation Timing on the Prognosis of Patients with Cerebral Apoplexy

To investigate the effect of rehabilitation intervention timing on the prognosis of patients with cerebral apoplexy .Method：A total of 90 patients with cerebral apoplexy admitted in our hospi-tal from Jan.2012 to Jan.2013 were randomly divided into observation group and control group , two groups of patients were provided with routine treatment of stroke , including relieving cerebral edema , protecting treatment such as brain tissue , improving blood circulation , adopting rehabilitation treatment voluntarily , and following the instructions of rehabilitation physicians .the vital signs were stable and consciousness recovered , while the control group adopted rehabilitation training 4 weeks conventional after toutine treatment .The abili-ty of daily life （ ADL） , motor function score and neurologic deficits were evaluated respectively with modified barthel index （MBI）, Fugl-Meyer analysis（FMA）and NIH stroke scale （NIHSS） before and after treat-ment.Result：Before rehabilitation treatment , there was no statistical difference of MBI , FMA, NIHSS be-tween two groups （ P〉0.05）;the above-mentioned indexes were improved significantly after treatment in two groups, comparison difference before and after treatment was statistically significant （ P〈0.05）;MBI, FMA and NIHSS improved more significantly in observation group after treatment than that in the control （ P〈0.05）;shoulder-hand syndrome in observation group was better relived compared with control group after re -habilitation （ P〈0.05） .Conclusion：Early treatment can promote the recovery of nerve function , motor func-tion and ADL ability , alleviate symptoms of shoulder-hand syndrome , play a positive role in the prognosis of patients with cerebral apoplexy .