规范三级康复治疗配合心理干预对脑卒中肩手综合征患者负性情绪、上肢运动功能恢复及生活质量的影响
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摘要
目的:探究规范三级康复治疗配合心理干预对脑卒中肩手综合征(SHS)患者负性情绪、上肢运动功能恢复及生活质量的影响。方法:将2016年4月-2018年4月我院收治的130例SHS患者随机分为观察组与对照组,各65例。对照组给予常规康复治疗,并配合心理干预。观察组在对照组基础上联合规范三级康复治疗。比较两组临床疗效及干预前后的焦虑自评量表(SAS)、抑郁自评量表(SDS)、Fugl-Meyer量表(FMA)、日常生活活动能力(ADL)、世界卫生组织生活质量简表(WHOQOL-BREF)评分。结果:观察组临床疗效总有效率96.92%(63/65)显著高于对照组86.15%(56/65),差异有统计学意义(χ~2=4.866,P<0.05);干预后观察组SAS、SDS评分显著低于对照组,差异有统计学意义(t=-2.907,-2.739;P<0.05);干预后观察组FMA、ADL评分及WHO QOL-BREF评分均显著高于对照组,差异有统计学意义(t=5.039,6.354,2.313,2.360,2.796,2.568,2.391;P<0.05)。结论:规范三级康复治疗配合心理干预对SHS患者上肢运动功能的恢复具重要作用,可显著提高治疗效果及患者生活质量,降低脑卒中后致残率。
Objective:To explore the effects of standardized three-stage rehabilitation therapy combined with psychological intervention on negative emotions,recovery of upper limb motor function and quality of life in patients with stroke and shoulder-hand syndrome(SHS).Methods:A total of 130 cases of SHS patients admitted to our hospital from April 2016 to April 2018 were randomly divided into observation group and control group with 65 cases in each group.Control group was given conventional rehabilitation combined with psychological intervention.On the basis of the control group,the observation group jointly standardized three stage rehabilitation therapy.The clinical efficacy,and the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),Fugl-Meyer Assessment(FMA),activities of daily living(ADL),and WHO Quality of Life-BREF(WHOQOL-BREF)before and after intervention were compared between the two groups.Results:The total effective rate of clinical efficacy in observation group was significantly higher than that in control group[96.92%(63/65)vs 86.15%(56/65)](χ~2=4.866,P<0.05).After intervention,the scores of SAS and SDS in observation group were significantly lower than those in control group(t=-2.907,-2.739;P<0.05).After intervention,the scores of FMA,ADL and WHOQOL-BREF in observation group were significantly higher than those in control group(t=5.039,6.354,2.313,2.360,2.796,2.568,2.391,P<0.05).Conclusion:Standardized three-stage rehabilitation therapy combined with psychological intervention plays an important role in the recovery of upper limb motor function in patients with SHS,and it can significantly improve the treatment effects and quality of life,and reduce the disability rate after stroke.
Objective:To explore the effects of standardized three-stage rehabilitation therapy combined with psychological intervention on negative emotions,recovery of upper limb motor function and quality of life in patients with stroke and shoulder-hand syndrome(SHS).Methods:A total of 130 cases of SHS patients admitted to our hospital from April 2016 to April 2018 were randomly divided into observation group and control group with 65 cases in each group.Control group was given conventional rehabilitation combined with psychological intervention.On the basis of the control group,the observation group jointly standardized three stage rehabilitation therapy.The clinical efficacy,and the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),Fugl-Meyer Assessment(FMA),activities of daily living(ADL),and WHO Quality of Life-BREF(WHOQOL-BREF)before and after intervention were compared between the two groups.Results:The total effective rate of clinical efficacy in observation group was significantly higher than that in control group[96.92%(63/65)vs 86.15%(56/65)](χ~2=4.866,P<0.05).After intervention,the scores of SAS and SDS in observation group were significantly lower than those in control group(t=-2.907,-2.739;P<0.05).After intervention,the scores of FMA,ADL and WHOQOL-BREF in observation group were significantly higher than those in control group(t=5.039,6.354,2.313,2.360,2.796,2.568,2.391,P<0.05).Conclusion:Standardized three-stage rehabilitation therapy combined with psychological intervention plays an important role in the recovery of upper limb motor function in patients with SHS,and it can significantly improve the treatment effects and quality of life,and reduce the disability rate after stroke.
引文
[1]崔燕,申建,韩玉琦,等.早期康复对脑卒中偏瘫合并心理障碍疗效观察[J].中国健康心理学杂志,2014,22(5):674-676
[2]贾红娥,许涛,郭铁成,等.局部振动治疗脑卒中后肩-手综合征的疗效观察[J].中华物理医学与康复杂志,2014,36(12):939-941
[3]王传英,李庆波,李丽,等.悬吊运动疗法联合蜡疗治疗脑卒中后肩-手综合征疗效观察[J].山东中医杂志,2014,33(10):834-836
[4]黄春水,樊文朝,余安胜,等.八邪透刺配合康复训练治疗脑卒中后肩手综合征手肿胀疗效观察[J].中国针灸,2017,37(2):121-124
[5]朱昌娥,余波,张雯,等.肌肉振动治疗配合常规康复对脑卒中后肩-手综合征的临床效果观察[J].中国康复医学杂志,2017,32(8):902-906
[6]刘结梅,黄国志.早期康复治疗对脑卒中肩手综合征及上肢运动功能的影响[J].卒中与神经疾病,2015,22(3):138-140
[7]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257
[8]卫生部医政司.中国康复医学诊疗规范[M].北京:华夏出版社,1998:226-231
[9]唐强,衣标美,陈慧杰,等.针刺结合康复训练在脑卒中后肩手综合征中的应用[J].针灸临床杂志,2013,29(6):89-91
[10]聂春艳,李天竹,孙筱荻,等.自我意念法联合功能训练对脑卒中偏瘫患者的肢体功能康复的影响[J].中国健康心理学杂志,2018,26(2):213-216
[11]李军,张晓路.针刺、推拿联合康复训练对脑卒中后肩手综合征患者肢体运动功能及生活质量的影响[J].现代中西医结合杂志,2016,25(26):2913-2915
[12]朱昌娥,余波,张雯,等.肌肉振动治疗配合常规康复对脑卒中后肩-手综合征的临床效果观察[J].中国康复医学杂志,2017,32(8):902-906
[13]王立童,姜永梅,詹红生,等.关节腔内注射结合针刺和常规康复疗法治疗脑卒中后肩手综合征的临床疗效观察[J].中华物理医学与康复杂志,2016,38(4):304-305
[14]魏海棠,杨珺,刘志霞,等.三级康复体系对脑卒中患者功能障碍恢复的影响[J].中国康复,2014,29(1):8-11
[15]陶玉东,王东雁,周文江,等.针灸穴位注射与康复训练三级治疗方案对脑梗死后肩-手综合征上肢功能及日常生活活动能力的影响[J].中国中西医结合急救杂志,2016,23(5):532-535
[2]贾红娥,许涛,郭铁成,等.局部振动治疗脑卒中后肩-手综合征的疗效观察[J].中华物理医学与康复杂志,2014,36(12):939-941
[3]王传英,李庆波,李丽,等.悬吊运动疗法联合蜡疗治疗脑卒中后肩-手综合征疗效观察[J].山东中医杂志,2014,33(10):834-836
[4]黄春水,樊文朝,余安胜,等.八邪透刺配合康复训练治疗脑卒中后肩手综合征手肿胀疗效观察[J].中国针灸,2017,37(2):121-124
[5]朱昌娥,余波,张雯,等.肌肉振动治疗配合常规康复对脑卒中后肩-手综合征的临床效果观察[J].中国康复医学杂志,2017,32(8):902-906
[6]刘结梅,黄国志.早期康复治疗对脑卒中肩手综合征及上肢运动功能的影响[J].卒中与神经疾病,2015,22(3):138-140
[7]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257
[8]卫生部医政司.中国康复医学诊疗规范[M].北京:华夏出版社,1998:226-231
[9]唐强,衣标美,陈慧杰,等.针刺结合康复训练在脑卒中后肩手综合征中的应用[J].针灸临床杂志,2013,29(6):89-91
[10]聂春艳,李天竹,孙筱荻,等.自我意念法联合功能训练对脑卒中偏瘫患者的肢体功能康复的影响[J].中国健康心理学杂志,2018,26(2):213-216
[11]李军,张晓路.针刺、推拿联合康复训练对脑卒中后肩手综合征患者肢体运动功能及生活质量的影响[J].现代中西医结合杂志,2016,25(26):2913-2915
[12]朱昌娥,余波,张雯,等.肌肉振动治疗配合常规康复对脑卒中后肩-手综合征的临床效果观察[J].中国康复医学杂志,2017,32(8):902-906
[13]王立童,姜永梅,詹红生,等.关节腔内注射结合针刺和常规康复疗法治疗脑卒中后肩手综合征的临床疗效观察[J].中华物理医学与康复杂志,2016,38(4):304-305
[14]魏海棠,杨珺,刘志霞,等.三级康复体系对脑卒中患者功能障碍恢复的影响[J].中国康复,2014,29(1):8-11
[15]陶玉东,王东雁,周文江,等.针灸穴位注射与康复训练三级治疗方案对脑梗死后肩-手综合征上肢功能及日常生活活动能力的影响[J].中国中西医结合急救杂志,2016,23(5):532-535