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目的探讨功能康复对脑卒中患者神经功能及日常生活活动能力的影响。选择2015年7月—2017年3月收治的脑卒中患者120例,根据随机数字表法将患者分为观察组与对照组,每组患者60例。两组均给予常规药物治疗脑卒中。对照组给予Bobath疗法进行康复治疗,1次40 min,3次/周。观察组给予Bobath疗法加PNF方法进行康复治疗,1次40 min,3次/周。同时指导患者进行日常生活活动能力训练及肢体功能锻炼。两组均治疗4周。分别于治疗前后评价两组神经功能缺损程度及日常生活活动能力。计量资料比较采用t检验,等级资料用秩和检验,P<0.05为差异有统计学意义。结果两组治疗前NIHSS评分[(40.37±6.60、41.05±6.34)分]比较差异无统计学意义(P>0.05),治疗2、4周两组美国国立卫生院神经功能缺损程度(NIHSS)评分[(32.09±5.52、20.07±3.34)分,(37.09±5.54、34.09±2.07)分]与治疗前比较差异有统计学意义(P<0.05),治疗2、4周两组NIHSS评分比较差异有统计学意义(P<0.05)。两组治疗前Barthel指数(30.07±5.06、31.27±5.54)比较差异无统计学意义(P>0.05),治疗2、4周两组Barthel指数(45.06±5.71、57.34±3.34,36.71±6.02、40.31±5.19)与治疗前比较差异有统计学意义(P<0.05),治疗2、4周两组Barthel指数比较差异有统计学意义(P<0.05)。治疗4周观察组极严重功能缺陷,生活完全需要依赖7例;生活需要很大帮助8例;生活需要帮助23例;生活基本自理21例。对照组极严重功能缺陷,生活完全需要依赖19例;生活需要很大帮助20例;生活需要帮助10例;生活基本自理11例。两组比较差异有统计学意义(P<0.05)。结论功能康复可减轻脑卒中患者神经功能缺损程度,提高其日常生活活动能力。
Objective To investigate the effect of functional rehabilitation on the neurological function and activities of daily living in patients with stroke. 120 patients with stroke were selected from July 2015 to March 2017. According to the random number table, the patients were divided into observation group and control group, with 60 patients in each group. Both groups were given conventional medication for stroke. The control group was given Bobath therapy for rehabilitation, 1 time 40 min, 3 times / week. The observation group was given Bobath therapy plus PNF for rehabilitation, one time 40 min, 3 times / week. At the same time guide patients to conduct activities of daily living and limb function training. Both groups were treated for 4 weeks. The levels of neurological deficit and activities of daily living in both groups were evaluated before and after treatment respectively. Measurement data were compared using t test, rank data using rank sum test, P <0.05 for the difference was statistically significant. Results There was no significant difference in NIHSS scores between the two groups before treatment [(40.37 ± 6.60,41.05 ± 6.34) points] (P> 0.05). NIHSS score [(32.09 ± 5.52, 20.07 ± 3.34) points, (37.09 ± 5.54,34.09 ± 2.07) points] were significantly different from those before treatment (P <0.05). There was significant difference in NIHSS scores between the two groups Statistical significance (P <0.05). The Barthel index (30.07 ± 5.06, 31.27 ± 5.54) before treatment was not significantly different between the two groups (P> 0.05). The Barthel index (45.06 ± 5.71, 57.34 ± 3.34, 36.71 ± 6.02, 40.31 ± 5.19) compared with those before treatment (P <0.05). There was significant difference in Barthel index between the two groups (P <0.05). In the observation group of 4 weeks, the patients in the observation group had extremely serious functional deficiencies, and their lives were totally dependent on 7 patients. Their lives required a great help in 8 patients, they needed help in 23 patients, and 21 patients were living on their own. In the control group, the patients were severely dysfunctional, 19 were dependent on their life, 20 were assisted by life, 10 were assisted by life, and 11 were self-care. The difference between the two groups was statistically significant (P <0.05). Conclusion Functional rehabilitation can reduce the degree of neurological deficits in stroke patients and improve their activities of daily living.