康复介入时间对急性缺血性脑卒中功能恢复的影响

目的了解急性脑卒中患者康复治疗开始时间对功能恢复的影响。方法对两组各35例急性脑卒中患者进行运动功能康复,一组于发病1周内开始康复,称为早康复组;另一组于发病1～3周开始康复,称为晚康复组,两组均接受同样的康复治疗和常规药物治疗。疗效评定,运动功能选择Fulg-Meyer运动功能测评,ADL测评选择FIM方法中反映上下肢功能的亚项,测评分别于入组时(治疗前)和病程28～30 d进行,比较两组患者病程1个月时的功能状态。结果运动功能积分:治疗前两组间差异无统计学意义(P>0.05),治疗后早康复组手、腕、上肢积分显著高于康复组(P<0.05)。ADL积分:治疗前早康复组上、下肢积分均低于晚康复组(上肢P<0.05,下肢P<0.01),治疗后早康复组上肢积分高于晚康复组差异有统计学意义(P<0.01)。结论急性脑卒中偏瘫康复治疗开展的越早运动功能恢复的越快,尽早康复治疗可以加快恢复进程。

The effect of starting time of rehabilitation on functional recovery of patient with ischemic stroke

Objective To observe the effect of starting time of rehabilitation on functional recovery of patient with ischemic stroke.Methods Seventy patients with acute ischemic stroke were randomly divided into two groups.There were 35 cases in the early rehabilitation group with treatment starting between day 2 and day 7 after stroke,and other 35 cases in the late rehabilitation group with treatment starting from 1 week to 3 weeks after stroke.All the patients were given the same clinical treatment and physical therapy.Fugl-Meyer assessment scale（FM） and functional independence measure（FIM） were used to assess the motor function and activity of daily living（ADL）,respectively.The assessment were done before rehabilitation treatment and after 28-30 days for stroke,respectively.Results For the aspect of Fugl-Meyer motor function score,there was no statistical difference between the two group before the treatment（P0.05）,however,the patients in the early rehabilitation group had better scores in hand,wrist or arm function than those in the late rehabilitation group did after the treatment（P0.05）.For the aspect of ADL,FIM score of upper limb and lower limb were both significant lower in early rehabilitation group than those in late rehabilitation group before the treatment（P0.05 for upper limb,lower limb for P0.01）.But the score of early group post-treatment was significantly higher in upper limb than that of late rehabilitation group after the treatment（P0.01）.Conclusion The earlier rehabilitation are started,the faster improvement on functional recovery of patient with ischemic stroke.