大脑中动脉卒中患者康复治疗的功能预后

目的 研究大脑中动脉卒中患者的功能预后。方法 将83名患者依据损伤部位分为大脑中动脉主干组、深穿支组和皮层支组，分别应用Barthel指数、Brunnstrom分级、步行能力评价患者康复治疗前、后的日常生活活动（ADL）能力、运动功能、步行能力状况。应用方差分析、卡方检验、秩和检验对变量进行统计学分析。结果 治疗前，3组患者在日常生活活动（ADL）能力、运动功能、步行能力3个方面的差异有显著性意义（P〈0．05），其中主干组3个评价指标均最低，皮层支组均最高，但皮层支组与深穿支组比较，差异无统计学意义（P〉0．05），治疗后3组的3个评价指标的差异仍有统计学意义（P〈0．05），皮层支组评价指标最高，与深穿支组比较，差异无统计学意义（P〉0．05），而深穿支组与主干组比较，差异有统计学意义（P〈0．05），主干组评价指标最低。3组患者治疗前、后的差异有统计学意义（P〈0．05）。结论 主干组患者发病早期损害最重，经康复治疗后，可得到一定的改善；深穿支组康复潜力最大，可明显改变预后；皮层支组康复预后最佳。

The functional prognosis of stroke in the territory of middle cerebral artery

Objective To determine the rehabilitation outcome of patients with stroke caused by middle cerebral artery insult. Methods Eighty-three patients were divided into three groups: cortex insult group, basal ganglia insult group and combined group. Activities of daily living (ADL), motor function and walk were assessed by using the Barthel Index, Brunnstrom Stages and walking assessment. Comparisons of all data were carried out among the groups. Results On admission, there were significant differences among the 3 groups in terms of activities of daily living, motor function and walk. The cortex insult group had the highest scores while the combined group the lowest. A comparison among the 3 groups at discharge demonstrated the same results as those on admission. It was shown that all the groups improved significantly at discharge when compared with admission status, indicating that stroke rehabilitation was effective. Conclusion The motor deficit in the combined group was the most severe, but systematic rehabilitation could make functional improvement in the patient. The basal ganglia insult group has the biggest rehabilitation potential. The cortex insult group has the best outcome.