早期系统化康复护理对脑梗死患者运动及认知功能的影响

背景在国内,脑血管意外后偏瘫患者的早期康复护理是一个薄弱环节,不利于患者肢体和日常生活活动能力(ADL)的恢复.目的探讨早期系统化康复护理对脑梗死患者肢体运动功能、ADL及认知功能的影响.设计病例对照研究.地点和对象实验地点西南医院神经内科.对象2000-01/2002-09收治的50例脑梗死患者,按入院先后顺序分为康复组25例,对照组25例.干预干预者丁宇,陈贞芳,郑绘春,刘晓铃,陈康宁.具体方法康复组在给予常规治疗的同时分别给予正规的系统化康复护理,对照组仅给予神经科常规治疗.分别于系统化康复护理前当天和治疗后6周采用简式Fugl-Meyer评估(FMA)及Barthel指数分别评定肢体运动功能及日常生活能力(ADL),采用简明精神状态检查量表(MMSE)评估认知功能.主要观察指标①FMA评分.②ADL评分.③MMSE评分.结果经6周系统化康复护理后,康复组患者肢体运动功能恢复明显,上、下肢体运动功能评分(上肢35.82±10.28,下肢22.89±6.31)均显著高于对照组(上肢20.13±6.63,下肢16.52±4.10,t=6.413,4.233,P＜0.01);与对照组(28.12±14.65)比较,康复组日常生活能力评分(52.70±18.28)增高显著(t=5.246,P＜0.01);康复组认知功能评分(16.70±8.28)与对照组(13.83±7.23)比较无统计学差异,但康复组定向力及记忆力(8.69±3.31)改善明显优于对照组(5.32±3.10,t=3.716,P＜0.01).结论早期系统化康复护理能显著改善脑梗死患者的肢体运动功能和ADL.

Impacts of earlysystemic rehabilitative nursing on movement and cognitive functions of cerebral infarctpatients

BACKGROUND:Early rehabilitative nursing greatly affects the restorative extents in the activities of daily life(ADL) of cerebral infarct hemiplegia patients.OBJECTIVE: To discuss the impacts of early systemic rehabilitative nursing on the restoration of limbs moversents, ADL and cognitive functions in cerebral infarct patients.DESIGN: A case-control study.SETTINGS and PARTICIPANTS: Settings: Department of Neurology,Southwestern Hospital. Participants: Fifty subjects were allocated into rehabilitation group(25 subjects) and control group(25 subjects) according to order sequences from January 2000 to September 2002.INTERVENTIONS: Interveners: Ding Y, Chen ZF, Zhen HH, Liu XL and Chen KN. Interventions: Normal systemic rehabilitative nmsing was operated in rehabilitation group in addition to routine therapy. And control group was only under routine neurological therapy. Limbs movements and ADL were assessed by mini-Fugl-Meyer(FMA) scale and Barthel index, and the cognitive function was evaluated by MMSE scale before and 6-week after systemic rehabilitative nursing.MAIN OUTCOME MEASURES: FMA score, ADL score, and MMSEscore.RESULTS: After 6-week of systemic rehabilitative nursing, limbs movements of rehabilitation group distinctly restored, and the scores of upper and lower limbs movements were(upper limbs: 35.82 t 10. 28, lower limbs: 22. 89 ±6. 31 ), which were significantly higher than that of control group(upper limbs:20.13±6.63, lowerlimbs: 16.52±4.10, t=6.413, 4.233, P ＜0.01) .ADL scores of rehabilitation group was (13.83 ±7.23), which was significantly higher than that of control group(28.12 ± 14.65, t = 5. 246, P ＜0.01 ) . There was no significance in MMSE scores between rehabilitation group(16.70 ±8.28) and control group(13.83 ±7.23) . However, the iraprovement in orientation and memory of rehabilitation group(8.69 ± 3.31) was significanfly better than that of control group(5.22 ± 3.10, t = 3. 716, P ＜0. 01).CONCLUSION: Early systemic rehabilitative nursing can significantly improve limbs movements and ADL of cerebral infarct patients.