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日常生活活动能力指导对老年脑卒中患者康复疗效的影响(1)
http://www.100md.com 2010年6月25日 黄春丽,雷 迈,汪家钰,蓝杏妮
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     [摘要] 目的:探讨日常生活活动能力(ADL)指导对老年脑卒中患者康复疗效的影响。方法:将60例老年脑卒中恢复期患者随机分为临床护理组(对照组)和康复指导组,对照组给予康复科常规治疗和临床护理,康复指导组给予康复科常规治疗及临床护理和ADL指导。采用Barthel指数及Fugl-Meyer运动功能评定对患者进行护理前后评分。结果:指导前两组ADL及运动功能评分比较无显著性差异(P>0.05)。ADL指导后康复指导组ADL及运动功能评分较指导前显著提高(P<0.01),对照组ADL及运动功能评分较指导前明显提高(P<0.05)。ADL指导后康复指导组ADL及运动功能评分高于对照组(P<0.05)。结论:老年脑卒中患者康复治疗中加强ADL指导,有利于提高患者运动功能和ADL。

    [关键词] 日常生活活动能力;老年;脑卒中;康复疗效

    [中图分类号] R743.3[文献标识码]A [文章编号]1673-7210(2010)06(c)-029-02

    Effect of rehabilitation with guidance of ADL on the elderly poststroke

    HUANG Chunli, LEI Mai, WANG Jiayu, LAN Xingni

    (Rehabilitation Medicine Department of Jiangbin Hospital, Nanning 530021, China)

    [Abstract] Objective: To observe the effect of rehabilitation with guidance of activity of daily living (ADL) on the elderly poststroke. Methods: 60 patients with stroke were divided into the control group and rehabilitation group. All patients in two groups were given regular rehabilitative treatment, but the patients in the rehabilitation group were given guidance of ADL. The Barthel index (BI) and Fugl-Meyer motor scale (FMMS) were applied to assess patients at the beginning of enrollment and after treatment. Results: Before guidance of ADL and motor function scores in two groups had no significant difference(P>0.05), but after treatment, ADL and motor function scores increased significantly compared with those before treatment in the rehabilitation group and the control group (P<0.01 and P<0.05). The scores of BI and FMMS of patients in the rehabilitation group after treatment increased significantly compared with those in the control group after treatment (P<0.05). Conclusion: Rehabilitation with guidance of ADL could obviously increase motor function and ADL of the elderly stroke patients.

    [Key words] Activity of daily living; Elderly; Stroke; Rehabilitation effect

    脑卒中是老年人的常见病,多发病。近年来,随着脑卒中治疗水平的提高,死亡率有所下降,但其后遗症发生率仍较高,在存活者中,约50%遗留有不同程度的运动功能障碍,影响患者的生活质量[1]。我科护理人员按照康复原理,根据患者疾病的不同情况,为脑卒中患者制订了康复护理计划,进行早期康复护理,取得了较好的效果。为了探讨日常生活活动能力(ADL)指导对老年脑卒中患者康复疗效的影响,我科护理人员于2007年1月~2009年12月对60例老年脑卒中患者进行了ADL指导并进行临床对比研究,现报道如下:

    1 资料与方法

    1.1 一般资料

    本组60例老年脑卒中患者均选自2007年1月~2009年12月我院康复科住院患者,诊断符合全国第四届脑血管病学术会议制订的诊断标准[2],均经临床和头颅CT或MRI检查,确诊为脑出血或脑梗死。用随机抽样法分为康复指导组与对照组,各30例。康复指导组中,男16例,女14例;年龄63~73岁,平均68.5岁;脑梗死19例,脑出血11例。对照组中,男18例,女12例;年龄在62~72岁,平均67.2岁;脑梗死13例,脑出血17例。两组在性别构成比及年龄方面比较无显著性差异(P>0.05),具有可比性 ......

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