早期康复治疗对急性脑卒中患者吞咽和肢体运动功能的影响

目的探讨早期康复对急性脑卒中患者吞咽、上下肢运动功能及日常生活能力的影响。方法选择急性脑卒中患者96例，随机分为康复组和对照组（每组48例）。用前瞻性研究方法对两组进行比较分析。两组在给予临床药物＋针灸治疗的同时，康复组进行正规的康复训练，对照组进行未经指导的自我锻炼。分别于入选治疗前24h及治疗后4周进行测评。吞咽功能、运动功能、日常生活能力、神经功能缺损分别采用日本洼田咽水试验、Fugl—Meyer运动积分法（FMA）、Barthel指数（BI）、神经功能缺损程度评分标准（1995）进行评定。结果经过4周的治疗，两组吞咽功能、肢体运动功能均有一定程度改善，日常生活能力提高，康复组改善幅度明显高于对照组（P〈0．01或P〈0．05）。结论急性脑卒中患者进行早期康复治疗，能明显改善吞咽功能、肢体运动功能，提高日常生活能力，提高患者的生活质量。

Effect of Early Rehabilitation on Swallowing, Motor Function and Ability of Daily Living of Acute Stroke Patients

Objective To explore the effect of early rehabilitation on swallowing, motor function and ability of daily living (ADL) of patients with acute stroke. Methods Ninety-six patients with acute stroke were radomly divided into two groups equally: Rehabilitation group and control group. The patients in rehabilitation group were treated with routine rehabilitation in combination with the clinical drugs and acupuncture, while those in control group only treated with clinical drugs and acupuncture. The Swallowing test, Fugl-Meyer Assessment, Barthel Index and Neurological Dysfunction Scale were used to assess deglutition function, motor function, ADL and neurological function of the two groups before and after treatment.Results The swallowing, motor function, ADL and neurological function in both groups were all improved after treatment for 4 weeks. However, the improvement in rehabilitation group was significantly superior to that in control group (P<0.01 or P<0.05). Conclusion Early Rehabilitation could improve the swallowing, motor function and ADL of acute stroke patients, and it could improve their quality of life.