【摘要】：[目的]比較早期康復聯(lián)合丁苯酞注射液與單純應用丁苯酞注射液等藥物治療急性腦梗塞患者肢體功能障礙的療效,對兩組患者治療1周、2周的肢體運動功能、日常生活能力(ADL)進行評價,分析早期康復在丁苯酞注射液治療條件下不同時間的療效及其應用價值。[方法]選取符合納入標準的急性腦梗塞患者70例,均為發(fā)病48h內就診并應用丁苯酞注射液治療,生命體征穩(wěn)定,神經系統(tǒng)癥狀48h無進展。隨機將患者分為康復組35例與對照組35例,康復組患者在入院治療3d內給予早期規(guī)范化物理治療。經實驗過程篩選,實際最終進入統(tǒng)計分析為康復組29例和對照組30例。對比兩組患者入選時、治療1周、治療2周的簡化Fugl-Meyer運動功能評定法(Fugl-Meyer assessment,FMA)和 Barthel 指數(shù)(the Barthel index,BI)評分,分析康復組與對照組在肢體運動功能和日常生活能力的恢復情況。[結果]1.康復組與對照組在入組時FMA評分無統(tǒng)計學差異(P0.05)。在入組時、治療1周、治療2周的評定中,對照組的FMA評分第1周從25.32±5.76升至36.58±6.11,增加約11.26分,第二周從升至42.63±8.09,增加約6.05分,共增加約17.31分,表明對照組經丁苯酞注射液等藥物治療肢體運動功能得到一定恢復�？祻徒MFMA評分在治療1周從27.55±5.94升至41.07±6.47,增加約13.52分,與對照組無統(tǒng)計學差異(P0.05),但在治療第2周從41.07±6.47升至50.48±6.13,增加約9.41分,共增加約22.93分,較對照組具有統(tǒng)計學差異(P0.05);對照組與康復組FMA升高均以第1周較顯著。2康復組和對照組入組時BI評分的差異無統(tǒng)計學意義(P0.05)。在入組時、治療1周、治療2周的評定中,雖然對照組評分也逐漸增高,從19.52±6.10分增加到35.67±7.74分,增加約16.61分,但康復組從20.52±6.03分增加至40.42±7.48分,增約19.90分,增加幅度明顯高于對照組,具有統(tǒng)計學差異(P0.05)�？祻徒M與對照組在各次評定之間比較差異均有統(tǒng)計學意義(P0.05)。[結論]1.早期康復聯(lián)合丁苯酞注射液治療與單純應用丁苯酞注射液藥物治療的急性腦梗塞患者2周療效相比,早期康復治療的患者肢體運動功能恢復較好,能更好的改善日常生活能力。2.丁苯酞注射液治療的急性腦梗塞患者,肢體運動功能的恢復及ADL的改善,治療第1周較治療第2周明顯。3.早期康復聯(lián)合丁苯酞注射液與單純應用丁苯酞注射液藥物治療急性腦梗塞患治療者第1周肢體功能與ADL改善程度無統(tǒng)計學差異的原因有丁苯酞注射液藥物治療的影響和康復治療時間較短。
[Abstract]:[objective] to compare the effects of early rehabilitation combined with butyphthalide injection and butyphthalide injection on limb dysfunction in patients with acute cerebral infarction. Ability of daily living (ADL) was evaluated and the effect of early rehabilitation on butyphthalide injection at different time and its application value were analyzed. [methods] A total of 70 patients with acute cerebral infarction who met the inclusion criteria were selected. All patients were treated with butyphthalide injection within 48 hours after onset of the disease. The vital signs were stable and the neurological symptoms had no progress for 48 hours. The patients were randomly divided into rehabilitation group (n = 35) and control group (n = 35). The results showed that 29 cases in rehabilitation group and 30 cases in control group were involved in the statistical analysis. The scores of simplified Fugl-Meyer motor function assessment (Fugl-Meyer assessment,FMA) and Barthel index (the Barthel index,BI) were compared between the two groups during the first week of treatment and 2 weeks of treatment. The recovery of motor function and ADL in rehabilitation group and control group were analyzed. [result] 1. There was no significant difference in FMA score between rehabilitation group and control group (P0.05). The FMA score of the control group increased from 25.32 鹵5.76 to 36.58 鹵6.11 in the first week, increased by 11.26 points, and increased from 42.63 鹵8.09 to about 6.5 points in the second week. The total increase of 17.31 points indicated that the limb motor function of the control group was recovered after treatment with butyphthalide injection and other drugs. The FMA score of the rehabilitation group increased from 27.55 鹵5.94 to 41.07 鹵6.47 at 1 week, which increased by 13.52 points. There was no significant difference between the rehabilitation group and the control group (P0.05), but at the second week of treatment, the score rose from 41.07 鹵6.47 to 50.48 鹵6.13. Increase about 9.41 points, a total increase of 22.93 points, compared with the control group has statistical difference (P0.05); The increase of FMA in the control group and rehabilitation group was significantly higher than that in the first week. 2 there was no significant difference in BI score between the rehabilitation group and the control group when entering the group (P0.05). The scores of the control group increased gradually from 19.52 鹵6.10 to 35.67 鹵7.74, an increase of 16.61 points in the evaluation of the first week of treatment and 2 weeks of treatment on the first week of treatment and 2 weeks of treatment, and the scores of the control group increased gradually, from 19.52 鹵6.10 to 35.67 鹵7.74, respectively. But in the rehabilitation group, the score increased from 20.52 鹵6.03 to 40.42 鹵7.48, an increase of about 19.90, which was significantly higher than that of the control group (P0.05). There were significant differences between the rehabilitation group and the control group in each evaluation (P0.05). [conclusion] 1. Compared with the patients with acute cerebral infarction treated with butyphthalide injection alone, the early rehabilitation therapy combined with butyphthalide injection had better recovery of limb motor function than that of patients with acute cerebral infarction treated with butyphthalide injection alone for 2 weeks. Can better improve the ability of daily life. 2. The recovery of limb motor function and the improvement of ADL in patients with acute cerebral infarction treated with butyphthalide injection were significantly higher in the first week than in the second week. Early rehabilitation combined with butyphthalide injection and butyphthalide injection alone in the treatment of acute cerebral infarction patients had no significant difference in limb function and ADL improvement in the first week. The time of influence and rehabilitation was shorter.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3

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