简易日常生活功能训练在急性脑梗死偏瘫患者中的应用
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摘要
目的探讨简易日常生活功能训练在急性脑梗死偏瘫患者中的应用效果。方法选取2015年7月—2016年7月收治的急性脑梗死偏瘫患者82例作为对照组,选取2016年8月—2017年8月收治的急性脑梗死偏瘫患者82例作为观察组。康复治疗期间,对照组实施常规护理,观察组在对照组基础上增加简易日常生活功能锻炼。对比2组干预前后肢体功能、肌痉挛程度变化,评价观察组患者对简易日常生活功能训练的依从性。结果干预后,2组美国国立卫生研究院卒中量表(NIHSS)评分降低、Barthel指数量表(BI)评分升高、起立-行走计时测试(TUGT)时间缩短、握力提升,且观察组指标改善幅度优于对照组,差异有统计学意义(P<0.05)。干预2个月后,观察组肌痉挛程度轻于对照组。观察组患者简易日常生活功能训练执行良好,仅有7(8.54%)例患者经劝说后仍抗拒训练。结论简易日常生活功能训练应用于急性脑梗死偏瘫患者,可有效改善其肢体功能,减轻肌痉挛程度,提高依从性。
Objective To investigate the effect of function training of daily living on the rehabilitation in acute cerebral infarction(ACI) patients with?hemiplegia. Methods Totally 164 ACI patients with hemiplegia were assigned to the control group(n=82) and the observation group(n=82) according to the sequence of hospital admission. Patients of both two groups received comprehensive treatment and routine care, and those in the control group were given function training of daily living. The functional rehabilitation and level of muscle spasm were assessed before and after interventions. The patient compliance with function training in the observation group was evaluated. Results In both two groups, there was a decrease in National Institutes of Health Stroke Scale(NIHSS) score, an increase in Barthel Index(BI), a decrease in Timed up and Go Test(TUGT) and an increase in hand-gripping strength test after the intervention. Patients in the observation group achieved a better outcome of functional rehabilitation compared with those in the control group(P<0.05). Patients in the observation group had a lower level of muscle spasm compared with those in the control group. The function training of daily living was well tolerated, only 7(8.54%) patients failed to continue training. Conclusion The function training of daily living is effective to improve the rehabilitation and treatment compliance in ACI patients with hemiplegia.
Objective To investigate the effect of function training of daily living on the rehabilitation in acute cerebral infarction(ACI) patients with?hemiplegia. Methods Totally 164 ACI patients with hemiplegia were assigned to the control group(n=82) and the observation group(n=82) according to the sequence of hospital admission. Patients of both two groups received comprehensive treatment and routine care, and those in the control group were given function training of daily living. The functional rehabilitation and level of muscle spasm were assessed before and after interventions. The patient compliance with function training in the observation group was evaluated. Results In both two groups, there was a decrease in National Institutes of Health Stroke Scale(NIHSS) score, an increase in Barthel Index(BI), a decrease in Timed up and Go Test(TUGT) and an increase in hand-gripping strength test after the intervention. Patients in the observation group achieved a better outcome of functional rehabilitation compared with those in the control group(P<0.05). Patients in the observation group had a lower level of muscle spasm compared with those in the control group. The function training of daily living was well tolerated, only 7(8.54%) patients failed to continue training. Conclusion The function training of daily living is effective to improve the rehabilitation and treatment compliance in ACI patients with hemiplegia.
引文
[1] ONO H, NISHIJIMA Y, OHTA S, et al. Hydrogen Gas Inhalation Treatment in Acute Cerebral Infarction: A Randomized Controlled Clinical Study on Safety and Neuroprotection[J]. J Stroke Cerebrovasc Dis, 2017, 26(11): 2587-2594.
[2] 乐趣, 屈云. 脑卒中后偏瘫侧手部运动功能康复技术进展[J]. 中国康复医学杂志, 2012, 27(11): 1084-1086.
[3] LING H M, TAO T, XU J, et al. Effects of repetitive transcranial magnetic stimulation on upper limb motor function in patients with stroke:a meta analysis[J]. Zhonghua Yi Xue Za Zhi, 2017, 97(47): 3739-3745.
[4] 范云霞, 符晓艳, 王羚入, 等. 脑梗死偏瘫患者早期康复护理干预效果评价[J]. 解放军医药杂志, 2014, 26(11): 106-109.
[5] 程秀梅, 王维利, 谢伦芳. PDCA循环在初发脑梗死患者出院后行为管理中的应用效果[J]. 中国实用护理杂志, 2017, 33(10): 739-743.
[6] 金红斌, 陈雪丹, 蒋雪红, 等. 脑梗死二级预防患者服药信念及其影响因素研究[J]. 中国护理管理, 2015, 15(8): 913-916.
[7] SHI L, CAO HM, LI Y, et al. Electroacupuncture improves neurovascular unit reconstruction by promoting collateral circulation and angiogenesis[J]. Neural Regen Res, 2017, 12(12): 2000-2006.
[8] 杨瑛, 赵李克, 赵晓辉, 等. 医务社会工作者对急性期脑梗死患者的作用[J]. 上海护理, 2016, 16(3): 67-68.
[9] 严伟, 霍文璟, 姚波, 等. 电针联合运动疗法治疗脑梗死后肌痉挛的疗效观察[J]. 中华物理医学与康复杂志, 2010, 32(2): 139-141.
[10] 徐立, 王群, 张笑平, 等. 急性脑梗死患者静脉溶栓院内时间延误的护理干预及效果评价[J]. 中国护理管理, 2017, 17(2): 257-260.
[11] YEO S, JANG S, LEE J. Central post-stroke pain due to injury of the spinothalamic tract in patients with cerebral infarction: a diffusion tensor tractography imaging study[J]. Neural Regeneration Research, 2017, 12(12): 2021.
[12] 胡平, 周莎莎. 老年脑梗死康复治疗患者角色强化对创伤后成长的影响[J]. 中国实用护理杂志, 2017, 33(12): 900-903.
[13] 韩柳, 田润溪, 姜雨婷, 等. 基于文献的我国脑梗死中医护理研究现状分析[J]. 护理学杂志, 2016, 31(19): 40-43.
[14] 吴颉言, 赵康仁, 徐平. 早期康复治疗对急性脑梗死患者运动、肌痉挛及生活活动能力的影响[J]. 中国临床神经科学, 2009, 17(5): 526-529.
[15] 李秀霞, 卢双顺, 安雅臣, 等. 脑梗死血管性认知障碍患者的注意力训练[J]. 护理学杂志, 2016, 31(11): 8-10.
[16] 王晶晶, 曾玉萍, 余珂. 早期康复护理干预对脑梗死后肢体偏瘫患者运动功能恢复的影响[J]. 华西医学, 2015, 30(7): 1312-1314.
[2] 乐趣, 屈云. 脑卒中后偏瘫侧手部运动功能康复技术进展[J]. 中国康复医学杂志, 2012, 27(11): 1084-1086.
[3] LING H M, TAO T, XU J, et al. Effects of repetitive transcranial magnetic stimulation on upper limb motor function in patients with stroke:a meta analysis[J]. Zhonghua Yi Xue Za Zhi, 2017, 97(47): 3739-3745.
[4] 范云霞, 符晓艳, 王羚入, 等. 脑梗死偏瘫患者早期康复护理干预效果评价[J]. 解放军医药杂志, 2014, 26(11): 106-109.
[5] 程秀梅, 王维利, 谢伦芳. PDCA循环在初发脑梗死患者出院后行为管理中的应用效果[J]. 中国实用护理杂志, 2017, 33(10): 739-743.
[6] 金红斌, 陈雪丹, 蒋雪红, 等. 脑梗死二级预防患者服药信念及其影响因素研究[J]. 中国护理管理, 2015, 15(8): 913-916.
[7] SHI L, CAO HM, LI Y, et al. Electroacupuncture improves neurovascular unit reconstruction by promoting collateral circulation and angiogenesis[J]. Neural Regen Res, 2017, 12(12): 2000-2006.
[8] 杨瑛, 赵李克, 赵晓辉, 等. 医务社会工作者对急性期脑梗死患者的作用[J]. 上海护理, 2016, 16(3): 67-68.
[9] 严伟, 霍文璟, 姚波, 等. 电针联合运动疗法治疗脑梗死后肌痉挛的疗效观察[J]. 中华物理医学与康复杂志, 2010, 32(2): 139-141.
[10] 徐立, 王群, 张笑平, 等. 急性脑梗死患者静脉溶栓院内时间延误的护理干预及效果评价[J]. 中国护理管理, 2017, 17(2): 257-260.
[11] YEO S, JANG S, LEE J. Central post-stroke pain due to injury of the spinothalamic tract in patients with cerebral infarction: a diffusion tensor tractography imaging study[J]. Neural Regeneration Research, 2017, 12(12): 2021.
[12] 胡平, 周莎莎. 老年脑梗死康复治疗患者角色强化对创伤后成长的影响[J]. 中国实用护理杂志, 2017, 33(12): 900-903.
[13] 韩柳, 田润溪, 姜雨婷, 等. 基于文献的我国脑梗死中医护理研究现状分析[J]. 护理学杂志, 2016, 31(19): 40-43.
[14] 吴颉言, 赵康仁, 徐平. 早期康复治疗对急性脑梗死患者运动、肌痉挛及生活活动能力的影响[J]. 中国临床神经科学, 2009, 17(5): 526-529.
[15] 李秀霞, 卢双顺, 安雅臣, 等. 脑梗死血管性认知障碍患者的注意力训练[J]. 护理学杂志, 2016, 31(11): 8-10.
[16] 王晶晶, 曾玉萍, 余珂. 早期康复护理干预对脑梗死后肢体偏瘫患者运动功能恢复的影响[J]. 华西医学, 2015, 30(7): 1312-1314.