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目的探讨不同恢复阶段脑卒中后偏瘫患者下肢功能、腓神经功能变化情况。方法选取2015年10月—2016年9月浙江省中医院收治的脑卒中后偏瘫患者74例,所有患者均采用常规药物治疗并配合康复训练。分别于恢复1、3、6个月采用简式Fugl-Meyer运动功能评分法评估患者下肢功能,采用肌电图检测腓总神经传导速度评估腓神经功能,并进行比较,同时观察下肢功能、腓总神经传导速度的关系。结果不同恢复阶段脑卒中后偏瘫患者下肢Fugl-Meyer运动功能评分差异有统计学意义(F=53.950,P<0.001);不同恢复阶段脑卒中后偏瘫患者患侧腓总神经传导速度差异有统计学意义(F=3.241,P=0.045),健侧腓总神经传导速度差异无统计学意义(F=1.017,P=0.432);恢复1个月、恢复3个月脑卒中后偏瘫患者患侧腓总神经传导速度均明显低于健侧(t=-2.751,P=0.007;t=-2.540,P=0.012),恢复6个月时,脑卒中后偏瘫患者患侧、健侧腓总神经传导速度差异无统计学意义(t=-1.371,P=0.173);随着恢复时间的延长,脑卒中后偏瘫患者下肢Fugl-Meyer运动功能评分逐渐升高,二者呈正相关(r=0.583,P<0.001);随着恢复时间的延长,脑卒中后偏瘫患者腓总神经传导速度逐渐加快,二者呈正相关(r=0.181,P=0.007);脑卒中后偏瘫患者下肢Fugl-Meyer运动功能与腓总神经传导速度呈正相关(r=0.148,P=0.028)。结论随着恢复时间的延长,脑卒中后偏瘫患者下肢功能、腓神经功能逐渐改善,下肢功能与腓神经功能密切相关,联合监测下肢功能与腓神经功能有助于对预后效果的评估。
Objective To investigate the changes of lower limb function and peroneal nerve function in patients with hemiplegia after stroke at different recovery stages. Methods Totally 74 patients with post-stroke hemiplegia who were treated in Zhejiang Provincial Hospital of Traditional Chinese Medicine from October 2015 to September 2016 were selected. All the patients were treated with routine medication and rehabilitation training. The function of lower limbs of the patients was assessed by the simple Fugl-Meyer motor function score at 1, 3, and 6 months after resuscitation. Peroneal nerve function was evaluated by EMT, and the function of lower limbs, The relationship between total nerve conduction velocity. Results There were significant differences in motor function scores of Fugl-Meyer between lower limbs in patients with post-stroke hemiplegia at different stages of recovery (F = 53.950, P <0.001). There were statistically significant differences in the speed of ipsilateral common peroneal nerve conduction among patients with post-stroke hemiplegia (F = 3.241, P = 0.045). There was no significant difference in the conduction velocity of the contralateral common peroneal fibrosis between the two groups (F = 1.017, P = 0.432) The total nerve conduction velocity was significantly lower than that of the contralateral (t = -2.751, P = 0.007; t = -2.540, P = 0.012). At 6 months after recovery, the ipsilateral and contralateral common fibular nerve conduction (T = -1.371, P = 0.173). With the prolongation of recovery time, Fugl-Meyer motor function scores of lower extremities increased gradually in stroke patients with hemiplegia after stroke, the two were positively correlated (r = 0.583, P <0.001). With the prolongation of recovery time, the common peroneal nerve conduction velocity gradually increased in post-stroke patients with hemiplegia (r = 0.181, P = 0.007). The motor function of Fugl-Meyer in patients with hemiplegia post stroke Common peroneal nerve conduction velocity was positively correlated (r = 0.148, P = 0.028). Conclusions With the prolongation of recovery time, lower extremity function and peroneal nerve function of hemiplegic patients after stroke gradually improve. The function of lower limbs is closely related to the function of the peroneal nerve. Joint monitoring of lower limb function and peroneal nerve function is helpful to evaluate the prognosis.