CAJ | 학술논문

目的：观察针刀松解配合多向踝关节矫正器治疗脑卒中患者踝关节挛缩的临床疗效。方法选择2010年2月至2011年11月山东省威海市文登中心医院住院治疗的98例脑卒中踝关节挛缩患者，随机分为观察组与对照组各49例，对照组行常规康复治疗，即良肢位摆放、拮抗肌的力量训练、缓慢而被动地牵伸痉挛肌肉、针灸治疗。观察组在常规康复治疗的基础上，选用针刀松解术后加穿多向踝关节矫正器矫治。评价1个月后，2组患者踝关节活动度、下肢踝关节张力改良的Ashworth 分级（MAS）情况。采用 SPSS 11.0版统计学软件包进行数据分析，下肢踝关节张力 MAS用χ2检验，踝关节活动范围用t 检验，以P<0.05表示差异具有统计学意义。结果观察组患者的踝关节活动范围（19.8±3.7）°明显优于对照组（10.3±2.3）°，组间差异具有统计学意义（t'=15.36，Ρ<0.05）；患侧下肢肌痉挛改良 Ashworth 分级有效率85.7%，明显优于对照组67.3%，差异有统计学意义(χ2＝4.60，P<0.05)。结论针刀松解术后加穿多向踝关节矫正器矫治脑卒中后踝关节挛缩，具有矫正效果好，减轻患者的痛苦，提高其康复的依从性，值得推广应用。
목적：관찰침도송해배합다향과관절교정기치료뇌졸중환자과관절련축적림상료효。방법선택2010년2월지2011년11월산동성위해시문등중심의원주원치료적98례뇌졸중과관절련축환자，수궤분위관찰조여대조조각49례，대조조행상규강복치료，즉량지위파방、길항기적역량훈련、완만이피동지견신경련기육、침구치료。관찰조재상규강복치료적기출상，선용침도송해술후가천다향과관절교정기교치。평개1개월후，2조환자과관절활동도、하지과관절장력개량적Ashworth 분급（MAS）정황。채용 SPSS 11.0판통계학연건포진행수거분석，하지과관절장력 MAS용χ2검험，과관절활동범위용t 검험，이P<0.05표시차이구유통계학의의。결과관찰조환자적과관절활동범위（19.8±3.7）°명현우우대조조（10.3±2.3）°，조간차이구유통계학의의（t'=15.36，Ρ<0.05）；환측하지기경련개량 Ashworth 분급유효솔85.7%，명현우우대조조67.3%，차이유통계학의의(χ2＝4.60，P<0.05)。결론침도송해술후가천다향과관절교정기교치뇌졸중후과관절련축，구유교정효과호，감경환자적통고，제고기강복적의종성，치득추엄응용。
Objective To observe the clinical efficacy of needle knife release with multidirectional ankle brace on ankle joint contracture in patients with cerebral apoplexy. Methods Choose from February 2010 to November 2011, Shandong Province, Weihai Wendeng Central Hospital inpatient treatment of 98 patients with ankle joint contracture after stroke were randomly divided into observation group and control group, 49 patients for each group. Patients in control group were given routine rehabilitation therapy including normal limb position put, antagonist muscle strength training, slow and passively stretching of muscle cramps and acupuncture treatment. Patients in observation group were given needle knife relieve and wear ankle brace treatment on the basis of routine rehabilitation. Values of ankle motion and the modified Ashworth scale (MAS) of ankle joint were evaluated 1 month after treatment in two groups of patients. SPSS statistical software package was used for data analysis. Values of MAS in lower limb ankle were tested with χ 2. The range of ankle motion was detected by t-test. A P-value < 0.05 was considered to be statistically significant. Results Ankle range of motion was significantly better in observation group (19.8±3.7)°than that of control group [(10.3±2.3)°, t' = 15.36, P< 0.05]. Modified Ashworth lower limb spasticity efficiency rating of 85.7% was significantly better than the control group 67.3%, the difference was statistically significant ( χ 2= 4.60,P<0.05). Conclusion Needle knife relieve postoperative plus wear ankle garment orthotics for treatment of ankle joint contracture after stroke shows good clinical result, alleviates suffering, and which is worthy promoting.