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目的研究大脑中动脉卒中患者的功能预后。方法将83名患者依据损伤部位分为大脑中动脉主干组、深穿支组和皮层支组,分别应用Barthel指数、Brunnstrom分级、步行能力评价患者康复治疗前、后的日常生活活动(ADL)能力、运动功能、步行能力状况。应用方差分析、卡方检验、秩和检验对变量进行统计学分析。结果治疗前,3组患者在日常生活活动(ADL)能力、运动功能、步行能力3个方面的差异有显著性意义(P<0.05),其中主干组3个评价指标均最低,皮层支组均最高,但皮层支组与深穿支组比较,差异无统计学意义(P>0.05),治疗后3组的3个评价指标的差异仍有统计学意义(P<0.05),皮层支组评价指标最高,与深穿支组比较,差异无统计学意义(P>0.05),而深穿支组与主干组比较,差异有统计学意义(P<0.05),主干组评价指标最低。3组患者治疗前、后的差异有统计学意义(P<0.05)。结论主干组患者发病早期损害最重,经康复治疗后,可得到一定的改善;深穿支组康复潜力最大,可明显改变预后;皮层支组康复预后最佳。
Objective To study the functional prognosis of middle cerebral artery stroke patients. Methods According to the injury site, 83 patients were divided into middle cerebral artery trunk group, deep penetration group and cortical branch group. The Barthel index, Brunnstrom grade and walking ability were used to evaluate the ability of daily living activities (ADL) before and after rehabilitation , Motor function, walking ability status. The variance analysis, Chi-square test, rank sum test were used to analyze the variables. Results Before treatment, there were significant differences among the three groups in ADL ability, motor function and walking ability (P <0.05), among which the three evaluation indexes of backbone group were the lowest, But there was no significant difference between the three groups (P> 0.05). There was still significant difference in the three evaluation indexes between the three groups after treatment (P <0.05). The evaluation of cortical branch group (P> 0.05). However, there was a significant difference between the deep penetration group and the trunk group (P <0.05), and the lowest in the trunk group. The difference between the three groups before and after treatment was statistically significant (P <0.05). Conclusion The patients in the trunk group had the most severe early stage of disease onset and could be improved after rehabilitation. The rehabilitation potential of the deep-penetration group was the largest, which could significantly change the prognosis. The prognosis of the cortex branch group was the best.