音乐节拍按摩法对听神经瘤术后面神经麻痹患者康复治疗依从性的影响

目的探讨音乐节拍按摩法对听神经瘤术后面神经麻痹患者康复治疗依从性的影响，为听神经瘤术后面神经麻痹患者提供简便易学、便于操作的手法按摩方法，提高患者训练的依从性。方法采用前瞻性随机对照的方法，将行乙状窦后入路听神经瘤切除术的92例患者分为观察组45例和对照组47例，两组患者均从术后24h开始进行手法按摩，每日3次，每次15min。对照组仅采用手法按摩，观察组在采用手法按摩时配以音乐节拍。两组患者于术后24h及术后1个月均采用House—Braekmann面神经功能评定法进行面神经麻痹等级评定，采用治疗依从性量表于术后1个月进行依从性评分。结果观察组治疗依从性好者18例，部分依从者22例，依从性差者5例；对照组依从性好者11例；部分依从者20例，依从性差者16例，观察组康复治疗依从性明显高于对照组，两组比较，差异具有统计学意义（x^2=7．5069，P〈0．05）。在面神经麻痹康复治疗效果方面，观察组痊愈12例，显效23例，好转7例，无效3例；对照组痊愈9例，显效14例，好转16例，无效8例，经等级资料两样本比较，观察组疗效优于对照组，差异具有统计学意义（U=2．372，P〈0．05）。结论音乐节拍按摩法可以规范按摩手法，在音乐节拍的引导下使康复训练定时、定量、定位，提高患者治疗的依从性、准确性，确保康复训练效果。

Effect of a novel music rhythm-based massage on the therapeutic compliance of the acoustic neurinoma patients with postoperative facial palsy

Objective To apply simple and easy operative facial paralysis massage methods for acoustic neurinoma patients with postoperative facial paralysis and to improve the training-compliance. Methods 92 patients with postoperative facial paralysis were prospectively and randomly enrolled into 2 groups. Both groups were treated with the massage method （ 15 min per time and 3 times a day） 24 h after operation. Control group （47 patients） was treated with conventional massage method, while the experimental group （45 patients） was treated with the novel music rhythm-based massage method. Facial paralysis grade of patients in both groups was evaluated with House-Brackmann facial nerve function evaluation method one month after operation. The score of compliance were measured by the therapeutic compliance scale form. Results 18 patients in the experimental group had great compliance. 22 patients had partial compliance. 5 patients had poor compliance. However, there were 11, 20 and 16 patients for great, partial and poor compliance respectively in the control group. The therapeutic compliance of the experimental group was significantly higher than that of the control group （ X^2 = 7. 506 9, P 〈 O. 05 ）. In the experimental group, 12 patients were cured; 23 were affected; 7 were improved and 3 were unaffected, these numbers were 9,14,16 and 8 respectively in the control group. The facial paralysis rehabilitation of the experimental group showed significantly better than the control group （ U = 2. 372, P 〈 O. 05）. Concltmions The novel music rhythm-based massage methods offers patients a more effective and comprehensive training method. Music rhythm can regulate massage, make the rehabilitation periodical, quantitative and accurate. It can also improve the adherence, accuracy of the therapy, hence ensure rehabilitation training effect.