功能性电刺激对脑卒中所致偏瘫患者功能独立性和生活质量的影响

目的：研究分析功能性电刺激应用在脑卒中导致偏瘫患者的功能独立性与生活质量的影响。方法从2012年12月—2014年12月本院收治脑卒中所致偏瘫患者中抽取100例，按照随机数字表法将其分为功能性电刺激合并早期康复组50例（观察组）和单纯康复组50例（对照组）。给予对照组患者实施单纯康复治疗，对观察组在实施单纯康复治疗的基础上给予其功能性电刺激临床治疗。在观察组患者的颈部、患侧的上下肢、肩部、面部分别放置2块电极，分别以能引起患者肩上抬、甲状软骨上台、足踝背屈且外翻、面部肌肉抽动、手腕发生背屈等患者机体所能承受电刺激的最上限为准。2组患者实施上述治疗方法，每次治疗20 m in ，每日治疗2次。在治疗的起始阶段，用蒙特利尔认知评估量表（MoCA）对患者的认知功能障碍进行评定，用功能独立性量表评定2组患者在日常生活中的独立能力，同时应用36条目简明健康调查表（S F‐36）对2组患者的生活质量进行评定。结果2组患者在治疗后的躯体功能均优于治疗前；在治疗4周与治疗8周观察组患者的躯体功能显著优于单纯康复的对照组，其差异有统计学意义（P＜0.05）。两组患者在治疗第4周、第8周的躯体疼痛有显著改善；且在治疗4周与治疗8周观察组患者躯体疼痛评分优于单纯康复治疗对照组患者，其差异有统计学意义（P＜0．05）。2组患者在治疗后的独立性认知功能无显著改善作用，差异无统计学意义（P＞0．05）。在治疗4周与治疗8周观察组患者独立性认知功能评分显著优于单纯康复治疗对照组的患者，其差异有统计学意义（P＜0．05）。结论综上所述，RT300‐S功能性电刺激在临床治疗过程中能够影响脑卒中导致偏瘫患者的生存质量、生活水平与功能的独立性，继而提高患者的自理能力，值得临床广泛应用。

Effects of functional electrical stimulation on functional independence and quality of life in patients with hemiplegia caused by stroke

ABSTRACT:Objective To study the effects of functional electrical stimulation on the functional independence and quality of life in patients with hemiplegia after stroke .Methods A total of 100 hemiplegic patients caused by stroke treated during Dec .2012 and Dec .2014 were selected and randomly divided into functional electrical stimula‐tion combined with early rehabilitation group (observation group ,n=50 ) ,and simple rehabilitation group (control group ,n=50) .In the observation group ,two pieces of electrodes were placed on patients' neck ,ipsilateral upper and lower limbs ,shoulder ,and face ,in order to cause patients' shoulder lift ,thyroid lift ,ankle dorsiflexion and eversion , facial muscle twitch ,and wrist dorsiflexion to the maximum level .The treatment lasted for 20 minutes a time ,twice daily .In the initial stage of treatment ,patients' cognitive impairment was evaluated with Montreal cognitive assess‐ment table (MoCA) ,the independence ability was evaluated with functional independence measurement scale ,and patients' quality of life was assessed with 36‐item short form health survey (SF‐36) .Results In both groups the physical function was improved after treatment .In week 4 and 8 ,the physical function of the observation group was significantly better than that of the control group (P<0 .05);the physical pain was relieved in both groups ,and the observation group had lower pain score than the control group (P<0 .05) .There was no significant improvement of independent cognition after treatment and there was no difference between the two groups (P>0 .05) .In week 4 and 8 ,the independent cognition of the observation group was better than that of the control group (P<0 .05) .Con‐clusions RT300‐S functional electrical stimulation in the course of clinical treatment can improve patients ' quality of life ,living standard and functional independence ,and then improve patient self‐care ability .It is worth of wide clinical application .