本文選題：早期康復(fù) + 早期活動(dòng)��； 參考：《河南科技大學(xué)》2017年碩士論文

【摘要】：目的:系統(tǒng)評(píng)價(jià)早期康復(fù)對(duì)蛛網(wǎng)膜下腔出血(subarachnoid hemorrhage,SAH)的有效性和安全性。方法:計(jì)算機(jī)檢索The Cochrane Library(Issue 2,2016)、EMbase、Pubmed、CNKI、VIP、萬(wàn)方數(shù)據(jù)庫(kù)和CBM,系統(tǒng)收集關(guān)于早期康復(fù)對(duì)SAH的隨機(jī)對(duì)照試驗(yàn)(RCT)和隊(duì)列研究(Cohort Study),檢索時(shí)限均設(shè)置為從建庫(kù)到2016年10月。由2位評(píng)價(jià)員按照納入和排除標(biāo)準(zhǔn)獨(dú)立篩選文獻(xiàn)、提取資料和評(píng)價(jià)納入研究的方法學(xué)質(zhì)量,采用Re Vman5.3軟件進(jìn)行Meta分析。結(jié)果:最終納入3個(gè)研究,共335例患者,早期康復(fù)組175例(試驗(yàn)組),未早期康復(fù)組(對(duì)照組)160例。Meta分析顯示:與對(duì)照組相比,試驗(yàn)組在治療期末癥狀性血管痙攣的發(fā)生率明顯降低(RR=0.47,95%CI=0.31-0.71,P=0.0004);試驗(yàn)組轉(zhuǎn)歸不良的發(fā)生率明顯小于對(duì)照組(RR=0.25,95%CI=0.08-0.75,P=0.01);肺部感染的發(fā)生率(RR=0.44,95%CI=0.23-0.86,P=0.01)明顯降低;腦積水的發(fā)生率無(wú)統(tǒng)計(jì)學(xué)差異(RR=1.08,95%CI=0.39-2.96,P=0.88);且未增加相關(guān)死亡風(fēng)險(xiǎn)(RR=0.43,95%CI=0.07-2.50,P=0.35);肺栓塞(RR=1.08,95%CI=0.39-2.96,P=0.88)和下肢靜脈血栓(RR=0.82,95%CI=0.11-5.93,P=0.84)發(fā)生的風(fēng)險(xiǎn),試驗(yàn)組與對(duì)照組之間無(wú)統(tǒng)計(jì)學(xué)差異。結(jié)論:現(xiàn)有證據(jù)顯示:早期康復(fù)有助于降低SAH患者癥狀性血管痙攣的發(fā)生率,降低肺部感染的發(fā)生率并改善預(yù)后且未增加死亡風(fēng)險(xiǎn)。
[Abstract]:Objective: to evaluate the efficacy and safety of early rehabilitation for subarachnoid hemorrhage. Methods: the Cochrane Library (issue 2n2016) was searched by computer, and the database of CNKIIP, Wanfang database and CBM were searched. The random controlled trial (RCT) and cohort study (Cohort study) of early rehabilitation for SAH were systematically collected. The retrieval time limit was set from the construction of the database to October 2016. According to the inclusion and exclusion criteria, two evaluators independently sifted the literature, extracted the data and evaluated the methodological quality of the study. The Meta-analysis was carried out by re Vman 5.3 software. Results: a total of 335 patients were included in 3 studies, 175 cases in early rehabilitation group (trial group) and 160 cases in non-early rehabilitation group (control group). Meta-analysis showed that: compared with control group, The incidence of symptomatic vasospasm in the trial group was significantly lower than that in the control group at the end of the treatment period (RRN 0.4795 CII 0.31-0.71P0.0004), and the incidence of pulmonary infection (RR0.4495CII 0.23-0.86P0. 01) was significantly lower in the trial group than in the control group (RRR 0.2595CII 0.08-0.75P0. 01). There was no significant difference in the incidence of hydrocephalus (RRN 1.0895 CI 0.39-2.96 P0.88), and there was no increase in the associated risk of death (RRN 0.4395 CI 0.07-2.50 P0.35), pulmonary embolism (RRN 1.0895 CI 0.39-2.96P0.88) and lower extremity venous thrombosis (RRN 0.8295CI 0.11-5.93P 0.84). There was no statistical difference between the trial group and the control group. Conclusion: the available evidence shows that early rehabilitation can reduce the incidence of symptomatic vasospasm, reduce the incidence of pulmonary infection and improve the prognosis without increasing the risk of death in patients with SAH.
【學(xué)位授予單位】：河南科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R743.35

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 張通;;中國(guó)腦卒中康復(fù)治療指南(2011完全版)[J];中國(guó)康復(fù)理論與實(shí)踐;2012年04期

2 王運(yùn)良;謝鵬;;急性缺血性卒中的治療進(jìn)展[J];中國(guó)實(shí)用神經(jīng)疾病雜志;2010年03期

3 崔貴祥;殷翠萍;夏文;項(xiàng)鑫;羅月貝;劉愛(ài)芬;焉傳祝;李義召;;急性卒中臨床處理指南[J];中華腦血管病雜志(電子版);2008年05期

4 張?zhí)煲?劉飛;廖達(dá)光;顏輝;李林勇;劉運(yùn)生;;實(shí)驗(yàn)性蛛網(wǎng)膜下腔出血后柔腦膜纖維化的研究[J];中風(fēng)與神經(jīng)疾病雜志;2008年03期

5 尚翠俠,李強(qiáng),劉珊珊,侯海濤;急性腦卒中患者早期康復(fù)的臨床研究[J];中華物理醫(yī)學(xué)與康復(fù)雜志;2003年10期

6 吳兆蘇,姚崇華,趙冬;我國(guó)人群腦卒中發(fā)病率、死亡率的流行病學(xué)研究[J];中華流行病學(xué)雜志;2003年03期

相關(guān)碩士學(xué)位論文 前2條

1 王俊英;早期規(guī)范康復(fù)訓(xùn)練對(duì)腦卒中患者功能結(jié)局的影響研究[D];山東大學(xué);2009年

2 顏輝;大鼠SAH后柔腦膜的纖維化和CTGF表達(dá)[D];中南大學(xué);2008年

，

本文編號(hào)：2093967