手法淋巴引流结合等速肌力训练对脑卒中偏瘫患者下肢肿胀的疗效

目的 探讨应用手法淋巴引流结合等速肌力训练对脑卒中偏瘫患者下肢肿胀程度、股静脉血流速度以及运动功能改善的临床疗效。方法选择接受治疗的68例脑卒中偏瘫伴下肢肿胀患者为研究对象,按照随机数字表法分为对照组和观察组,各34例。对照组接受常规运动疗法,观察组接受手法淋巴引流结合等速肌力训练。于治疗后7、15 d比较患者下肢肿胀程度、股静脉血流平均速度和Fugl-Meyer下肢运动功能（FMA-L）评分。结果（1）与治疗前比较,治疗7 d后和治疗15 d后两组患者的下肢肿胀程度、股静脉血流平均速度、下肢运动功能FMA-L评分均有明显改善（P<0.05）;与对照组相比,观察组效果更为显著（P<0.05）。（2）与治疗7 d后相比,治疗15 d后两组患者的下肢肿胀程度、股静脉血流平均速度、下肢运动功能FMA-L评分均有明显改善（P<0.05）;与对照组比较,观察组改善更为显著（P<0.05）。结论手法淋巴引流结合等速肌力训练可显著减轻脑卒中偏瘫患者下肢肿胀程度、加快股静脉血流平均速度,进而改善其下肢运动功能。

Clinical study of manual lymphatic drainage combined with isokinetic muscle strength training on lower limb swelling in stroke hemiplegic patients

Objective To evaluatethe clinical effect of manual lymphatic drainage combined with isokinetic muscle strength training on the improvement of lower limb swelling, femoral vein blood flow velocity and motor function in stroke hemiplegic patients. Methods Sixty-eight patients with stroke hemiplegia and lower limb swellingwere selected and randomly divided into the control group and the treatment group according to the random number table method. The control group received routine exercise therapy, while the treatment group received manual lymphatic drainage combined with isokinetic muscle strength training. The swelling severity of the lower limbs, the mean femoral venous flow velocity and the Fugl-Meyer lower limb motor function (FMA-L) score were compared 7 days and 15 days after treatment. Results Compared with those before treatment, the lower limb swelling was alleviated in the two groups 7 days and 15 days after treatment, and the effect in the treatment group was more significant than that in the control group (P<0.05). Compared with those before treatment, the average femoral venous blood flow velocities in the two groups were both significantly increased 7 days and 15 days after treatment (P<0.05). Compared with the control group, the improvements in the treatment group were more significant (P<0.05). The FMA-L scores in the two groups were both significantly increased 7 days and 15 days after treatment. Compared with the control group, the FMA-L score in the treatment group was significantly increased (P<0.05). Conclusion Manual lymphatic drainage combined with isokinetic muscle strength training can reduce the lower limb swelling of stroke patients with hemiplegia, and accelerate the mean femoral venous flow velocity, thereby improving their lower limb motor function.