绷带加压联合中药熏蒸缓解脑卒中偏瘫肢体肿胀效果观察
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摘要
目的探讨绷带加压联合中药熏蒸缓解脑卒中偏瘫患者肢体肿胀的效果。方法将60例存在肢体肿胀的脑卒中恢复期偏瘫患者随机分为对照组和观察组各30例。在常规治疗和护理的基础上,对照组行中药熏蒸疗法,观察组行中药熏蒸联合绷带加压治疗,10d为1个疗程,共干预2个疗程。比较两组治疗前后患肢Fugl-Meyer运动功能评分、治疗效果、静息和活动时疼痛评分(VAS)以及患肢肿胀值。结果干预后观察组治疗效果显著优于对照组,Fugl-Meyer运动功能评分显著高于对照组,VAS评分和肿胀值显著低于对照组(P<0.05,P<0.01)。结论绷带加压联合中药熏蒸较单一熏蒸更有助于减轻脑卒中偏瘫患者患肢肿胀和疼痛,促进肢体功能恢复。
Objective To study the effect of manual compression with elastic bandages combining Chinese herbal fumigation on treatment of limb swelling in patients with hemiplegic stroke.Methods A total of 60 patients presenting with limb swelling complicated by hemiplegia following stroke were randomly divided into two groups of 30.The control group was given Chinese herbal fumigation on the basis of conventional treatment and nursing,while their counterparts in the intervention group additionally received manual compression with elastic bandages for two 10-day treatment cycles.Limb function rated by the Fugl-Meyer Motor Scale,therapeutic effect,pain at rest and during exercise evaluated by the Visual Analog Scale(VAS),and the severity of swelling were compared between the two groups before and after the intervention.Results The intervention group had higher therapeutic effect,better Fugl-Meyer motor functioning,lower VAS score and milder swelling compared with the control group after the intervention(P<0.05,P<0.01).Conclusion In patients with hemiplegia following stroke,combination therapy with manual compression by use of elastic bandages and Chinese herbal fumigation may be more effective than fumigation alone in alleviating limb swelling and pain.
Objective To study the effect of manual compression with elastic bandages combining Chinese herbal fumigation on treatment of limb swelling in patients with hemiplegic stroke.Methods A total of 60 patients presenting with limb swelling complicated by hemiplegia following stroke were randomly divided into two groups of 30.The control group was given Chinese herbal fumigation on the basis of conventional treatment and nursing,while their counterparts in the intervention group additionally received manual compression with elastic bandages for two 10-day treatment cycles.Limb function rated by the Fugl-Meyer Motor Scale,therapeutic effect,pain at rest and during exercise evaluated by the Visual Analog Scale(VAS),and the severity of swelling were compared between the two groups before and after the intervention.Results The intervention group had higher therapeutic effect,better Fugl-Meyer motor functioning,lower VAS score and milder swelling compared with the control group after the intervention(P<0.05,P<0.01).Conclusion In patients with hemiplegia following stroke,combination therapy with manual compression by use of elastic bandages and Chinese herbal fumigation may be more effective than fumigation alone in alleviating limb swelling and pain.
引文
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[20]Jacobs D G,Piotrowski J J,Hoppensteadt D A,et al.Hemodynamic and fibrinolytic consequences of intermittent pneumatic compression:preliminary results[J].J Trauma,1996,40(5):710-717.
[2]Langhorne P,Stott D J,Robertson L,et al.Medical complications after stroke:a multicenter study[J].Stroke,2000,31(6):1223-1229.
[3]Pertoldi S,Di Benedetto P.Shoulder-hand syndrome after stroke.A complex regional pain syndrome[J].Eur Med Phys,2005,41(4):283-292.
[4]李艳芳.温热疗法联合肢体运动治疗急性脑卒中患者肢体肿胀[J].护理学杂志,2007,22(11):75-76.
[5]孙玉勤,杨洁.全髋/全膝关节置换术后患者应用足底动静脉脉冲系统减轻患肢肿胀的效果观察[J].护理学报,2009,15(8):59-61.
[6]Platz T,Pinkowski C,van Wijck F,et al.Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test,Action Research Arm Test and Box and Block Test:a multicentre study[J].Clin Rehabil,2005,19(4):404-411.
[7]张红运,杜菲.针刺结合坐位训练治疗脑瘫患儿坐位功能异常的临床研究[J].针刺研究,2013,38(5):403-407.
[8]曹卉娟,邢建民,刘建平.视觉模拟评分法在症状类结局评价测量中的应用[J].中医杂志,2009,50(7):600-602.
[9]真启云,费文勇,杨文婷.四肢骨折患者肢体肿胀的护理干预[J].护理学杂志,2016,31(12):17-19.
[10]隋鹏,姜晓芳.消肿汤熏洗结合气压治疗卒中偏瘫后患肢水肿的疗效观察[J].临床合理用药,2017,10(4):54-55.
[11]严斌泓,冯嘉依,顾亚萍,等.中药熏蒸在预防脑卒中恢复期患者下肢深静脉血栓中的应用[J].解放军护理杂志,2017,34(2):65-68.
[12]桑德春,杨晋.脑血管病后肩手综合征康复治疗的探讨[J].中国康复医学杂志,2003,18(10):604-605.
[13]王元姣,娄玲娣,付金英,等.马铃薯湿敷治疗脑卒中偏瘫手肿胀32例[J].中国中医药科技,2011,18(1):75-76.
[14]李若和,周建丽,计静,等.消肿汤熏洗结合气压治疗卒中偏瘫后患肢水肿的疗效观察[J].浙江中医杂志,2013,48(4):251-252.
[15]刘翾.药熨法治疗中风后偏瘫肢体肿胀及肢体活动能力的护理体会[J].中医外治杂志,2016,25(2):48-49.
[16]王晓旸,李庆利,鲍远程.补阳还五汤治疗中风病恢复期临床观察[J].中医药临床杂志,2010,7(6):994-995.
[17]吕红姣,崔丽笙.针刺联合中药熏蒸治疗脑卒中后肩手综合征的效果观察[J].护理与康复,2013,12(7):696-698.
[18]Urayama H,Tanaka K,Fukui D,et al.Increasing circulation in the lower limb under general anesthesia using the A-V impulse system[J].Angiology,2003,54(6):691-694.
[19]傅丽琴,姚惠萍,徐东平,等.动静脉脉冲泵对危重患者上肢静脉回流障碍作用的临床研究[J].护理学报,2014,21(12):31-33.
[20]Jacobs D G,Piotrowski J J,Hoppensteadt D A,et al.Hemodynamic and fibrinolytic consequences of intermittent pneumatic compression:preliminary results[J].J Trauma,1996,40(5):710-717.