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目的探讨不同部位急性脑梗死患者康复治疗的效果。方法选择符合条件的142例急性脑梗死患者,按病变部位分为三组,A观察组(一侧皮层单个病灶,24例)、B观察组(一侧基底节单个病灶,24例)、C观察组(一侧脑干单个病灶,24人)。各组内分别设条件对应的A对照组(23例)、B对照组(24例)、C对照组(23例)。各组均有一侧上下肢功能障碍。且肌力≤Ⅲ级。对照组均接受常规的药物治疗,观察组接受常规药物治疗及康复治疗。入院治疗前、治疗后2 w、4 w分别作Fugl-Meyer运动功能评定(FMA)、Fugl-Meyer平衡功能评定(FM-B)、日常生活活动能力(ADL)评定用Barthel指数(MBI)。结果各观察组与对照组相比在治疗后不同时间FMA、FM-B及MBI评分有显著差异(P<0.01)。各观察组内治疗后不同时间FMA、FM-B及MBI评分有显著差异(P<0.05)。各观察组间在治疗前FMA、FM-B及MBI评分无显著差异(P>0.05),治疗后2 w、4 w时上述评分均有显著差异(P<0.05),其中A观察组FMA、FM-B及MBI评分与B观察组及C观察组相比差异显著(P<0.05),而B观察组与C观察组相比上述指标差异无统计学意义(P>0.05)。结论康复治疗可有效地改善患者的预后;持续的康复治疗获益更大;不同部位的急性脑梗死康复治疗的效果可能不同。
Objective To investigate the effect of rehabilitation treatment in patients with acute cerebral infarction in different parts. Methods Forty-two patients with acute cerebral infarction who were eligible were divided into three groups according to the lesion: group A (single cortical lesion on one side, 24 cases), group B (single lesion on one side of the basal ganglia, 24 cases), C Observation group (a single brain stem lesions, 24). A group (23 cases), B control group (24 cases) and C control group (23 cases) were set up in each group. Each group had dysfunction of upper and lower limbs. And muscle strength ≤ Ⅲ level. The control group received routine drug treatment, the observation group received conventional drug treatment and rehabilitation. Fugl-Meyer motor function assessment (FMA), Fugl-Meyer balance function assessment (FM-B), and daily living activity (ADL) assessment Barthel index (MBI) were used before treatment and 2 w and 4 w after treatment. Results The scores of FMA, FM-B and MBI in each observation group at different time after treatment were significantly different (P <0.01) compared with the control group. The scores of FMA, FM-B and MBI at different time points after treatment in each observation group were significantly different (P <0.05). The scores of FMA, FM-B and MBI in each observation group had no significant difference before treatment (P> 0.05), and there was significant difference at 2 and 4 weeks after treatment (P <0.05) FM-B and MBI scores were significantly different from those of B observation group and C observation group (P <0.05), but there was no significant difference between B observation group and C observation group (P> 0.05). Conclusion Rehabilitation can effectively improve the prognosis of patients. Continuous rehabilitation is more beneficial. The effects of rehabilitation on acute cerebral infarction may be different in different sites.