中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2005年
29期
176-178
,共3页
王蓓%李慧%徐蓓%时恒屏%曹艳%徐艳
王蓓%李慧%徐蓓%時恆屏%曹豔%徐豔
왕배%리혜%서배%시항병%조염%서염
脑血管意外%康复%情感%日常生活活动
腦血管意外%康複%情感%日常生活活動
뇌혈관의외%강복%정감%일상생활활동
背景:多数急性脑卒中患者在综合性医院诊治,但其中有相当部分的患者在发病早期仅局限于药物治疗.目的:探讨综合性医院早期综合康复治疗对急性脑卒中患者情感及日常生活活动能力的影响,并与未进行康复治疗的患者进行比较.设计:随机对照实验.单位:一所市级医院神经科.对象:选择2002-01/2003-08江苏省连云港市第一人民医院神经科住院入选的首发颈内动脉系统急性脑卒中患者80例,男51例,女29例,年龄(63.42±7.47)岁,随机分为康复组与对照组,每组40例.方法:两组急性期脑卒中患者入院后均给予神经内科常规药物治疗.康复组患者病情稳定后(脑梗死患者在入院后1周内,脑出血患者在入院后2周内)进行康复治疗,包括患肢康复训练(物理治疗或/和作业治疗)、理疗、针灸及心理疏导等.康复训练每天一两次,45 min/次;理疗、针灸等1次/d,20 min/次.对照组患者仅为临床医师查房时口头叮嘱其自行活动,或家属自行帮其活动.两组急性期脑卒中患者治疗前及出院时心理状况评估采用症状自评量表,日常生活活动能力的评定采用Barthel指数(共10项,每项0～15分不等,满分100分,＜60分为不能自理).主要观察指标:两组患者治疗前与其出院时症状自评量表、Barthel指数评分.结果:80例患者全部进入结果分析.①出院时康复组经治疗后症状自评量表各症状因子分均得到了明显的改善(P＜0.05～0.01),对照组经治疗后躯体化、强迫、抑郁、焦虑及精神病性等也有明显的改善(P＜0.05);康复组经治疗后躯体化、强迫、抑郁、焦虑、恐怖及精神病性评分明显低于对照组[(1.55±0.43),(1.80±0.35);(1.48±0.39),(1.68±0.55);(1.54±0.43),(1.83±0.37);(1.32±0.39),(1.56±0.36);(1.46±0.43),(1.66±0.52);(1.12±0.38),(1.35±0.35),(t=2.11～2.24,P＜0.05)].②两组患者治疗后Barthel指数均有提高(P＜0.05～0.01),康复组明显高于对照组[(73.24±4.64),(52.44±2.86),(P＜0.05)].结论:进行康复治疗和未进行康复患者治疗后症状自评量表中各症状因子分、Barthel指数均有所改善,进行康复治疗患者改善尤为突出.说明早期综合康复治疗在急性脑卒中患者情感及日常生活活动能力方面影响起到了积极的作用.
揹景:多數急性腦卒中患者在綜閤性醫院診治,但其中有相噹部分的患者在髮病早期僅跼限于藥物治療.目的:探討綜閤性醫院早期綜閤康複治療對急性腦卒中患者情感及日常生活活動能力的影響,併與未進行康複治療的患者進行比較.設計:隨機對照實驗.單位:一所市級醫院神經科.對象:選擇2002-01/2003-08江囌省連雲港市第一人民醫院神經科住院入選的首髮頸內動脈繫統急性腦卒中患者80例,男51例,女29例,年齡(63.42±7.47)歲,隨機分為康複組與對照組,每組40例.方法:兩組急性期腦卒中患者入院後均給予神經內科常規藥物治療.康複組患者病情穩定後(腦梗死患者在入院後1週內,腦齣血患者在入院後2週內)進行康複治療,包括患肢康複訓練(物理治療或/和作業治療)、理療、針灸及心理疏導等.康複訓練每天一兩次,45 min/次;理療、針灸等1次/d,20 min/次.對照組患者僅為臨床醫師查房時口頭叮囑其自行活動,或傢屬自行幫其活動.兩組急性期腦卒中患者治療前及齣院時心理狀況評估採用癥狀自評量錶,日常生活活動能力的評定採用Barthel指數(共10項,每項0～15分不等,滿分100分,＜60分為不能自理).主要觀察指標:兩組患者治療前與其齣院時癥狀自評量錶、Barthel指數評分.結果:80例患者全部進入結果分析.①齣院時康複組經治療後癥狀自評量錶各癥狀因子分均得到瞭明顯的改善(P＜0.05～0.01),對照組經治療後軀體化、彊迫、抑鬱、焦慮及精神病性等也有明顯的改善(P＜0.05);康複組經治療後軀體化、彊迫、抑鬱、焦慮、恐怖及精神病性評分明顯低于對照組[(1.55±0.43),(1.80±0.35);(1.48±0.39),(1.68±0.55);(1.54±0.43),(1.83±0.37);(1.32±0.39),(1.56±0.36);(1.46±0.43),(1.66±0.52);(1.12±0.38),(1.35±0.35),(t=2.11～2.24,P＜0.05)].②兩組患者治療後Barthel指數均有提高(P＜0.05～0.01),康複組明顯高于對照組[(73.24±4.64),(52.44±2.86),(P＜0.05)].結論:進行康複治療和未進行康複患者治療後癥狀自評量錶中各癥狀因子分、Barthel指數均有所改善,進行康複治療患者改善尤為突齣.說明早期綜閤康複治療在急性腦卒中患者情感及日常生活活動能力方麵影響起到瞭積極的作用.
배경:다수급성뇌졸중환자재종합성의원진치,단기중유상당부분적환자재발병조기부국한우약물치료.목적:탐토종합성의원조기종합강복치료대급성뇌졸중환자정감급일상생활활동능력적영향,병여미진행강복치료적환자진행비교.설계:수궤대조실험.단위:일소시급의원신경과.대상:선택2002-01/2003-08강소성련운항시제일인민의원신경과주원입선적수발경내동맥계통급성뇌졸중환자80례,남51례,녀29례,년령(63.42±7.47)세,수궤분위강복조여대조조,매조40례.방법:량조급성기뇌졸중환자입원후균급여신경내과상규약물치료.강복조환자병정은정후(뇌경사환자재입원후1주내,뇌출혈환자재입원후2주내)진행강복치료,포괄환지강복훈련(물리치료혹/화작업치료)、리료、침구급심리소도등.강복훈련매천일량차,45 min/차;리료、침구등1차/d,20 min/차.대조조환자부위림상의사사방시구두정촉기자행활동,혹가속자행방기활동.량조급성기뇌졸중환자치료전급출원시심리상황평고채용증상자평량표,일상생활활동능력적평정채용Barthel지수(공10항,매항0～15분불등,만분100분,＜60분위불능자리).주요관찰지표:량조환자치료전여기출원시증상자평량표、Barthel지수평분.결과:80례환자전부진입결과분석.①출원시강복조경치료후증상자평량표각증상인자분균득도료명현적개선(P＜0.05～0.01),대조조경치료후구체화、강박、억욱、초필급정신병성등야유명현적개선(P＜0.05);강복조경치료후구체화、강박、억욱、초필、공포급정신병성평분명현저우대조조[(1.55±0.43),(1.80±0.35);(1.48±0.39),(1.68±0.55);(1.54±0.43),(1.83±0.37);(1.32±0.39),(1.56±0.36);(1.46±0.43),(1.66±0.52);(1.12±0.38),(1.35±0.35),(t=2.11～2.24,P＜0.05)].②량조환자치료후Barthel지수균유제고(P＜0.05～0.01),강복조명현고우대조조[(73.24±4.64),(52.44±2.86),(P＜0.05)].결론:진행강복치료화미진행강복환자치료후증상자평량표중각증상인자분、Barthel지수균유소개선,진행강복치료환자개선우위돌출.설명조기종합강복치료재급성뇌졸중환자정감급일상생활활동능력방면영향기도료적겁적작용.
BACKGROUND: Patients with acute stroke mostly receive treatment in the integrative hospital, but quite a large part of them were treated only with medication during the earlier stage.OBJECTIVE: To probe the influence of earlier integrative rehabilitations on emotions and daily life capability of patients with acute stroke with the outcomes compared with those unexposed to rehabilitative treatment.DESIGN: Randomized controlled study.SETTING: Neurological Department of a municipal Hospital.PARTICIPANTS: Eighty patients who received treatment due to the first onset of acute stroke of internal carotid system were selected from the Neurological Department of the First People's Hospital of Lianyungang City, Jiangshu Province between January 2002 and August 2003. Totally 51 males and 29 females aged (63.42±7.47) years were randomly divided into rehabilitation control group with 40 cases each.METHODS: Patients of the two groups received routine neurological medication in the hospital. When stroke was controlled, patients in the rehabilitative group (including patients with cerebral infarction who were hospitalized for less than 1 week and patients with cerebral hemorrhage who were hospitalized for less than 2 weeks) were subjected to rehabilitative treatment, including rehabilitative training of insulted limbs (physical treatment and/or exercise therapy), physical therapy, acupuncture and psychological consultation. Rehabilitative treatment was given 1-2 times a day and 45 minutes for each time. Physical therapy and acupuncture were given once a day and 20 minutes for each time. In contrast, patients in the control group were only asked in the doctor's round to do exercise themselves or with the assistance of others. Psychological states of all the patients were assessed with Symptom Self Rating Scale before treatment and discharge and daily life capability was also assessed with Barthel index (totally 10 items with scores of 0-15, full mark was 100, and patients who scored for ＜ 60were considered of self-incapability).MAIN OUTCOME MEASURES: Scores for symptom checklist (SCL)and Barthel index of the two groups before treatment and when patients were discharged.Scores for each symptom factors in SCL were significantly improved in the rehabilitation group when patients were discharged from the hospital (P ＜ 0.05-0.01), and somatization, obsessive-compulsive, depression, anxiety and psychoticism, etc. were also obviously improved in the control group (P ＜ 0.05); moreover scores for somatization, obsessive-compulsive,depression, anxiety phobic anxiety and psychoticism in the rehabilitation group after treatment were significantly lower than those in the control group [(1.55±0.43), (1.80±0.35); (1.48±0.39), (1.68±0.55); (1.54±0.43),(1.83±0.37); (1.32±0.39), (1.56±0.36); (1.46±0.43), (1.66±0.52); (1.12±0.38),creased aftertreatment (P ＜ 0.05-0.01), but those of the rehabilitation group were significantly higher than those of the control group [(73.24±4.64),(52.44±2.86), P ＜ 0.05].CONCLUSION:Scores for symptomatic factors in SCL and Barthel indexes were improved after treatment, especially in patients who received rehabilitative treatment, suggesting that earlier integrative rehabilitative treatment may play active influence on the emotions and daily life capability of patients following acute stroke.
