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目的探讨不同发病性质脑卒中患者发病早期的功能损伤特点及其与康复治疗后功能独立性的相关程度。方法将79例住院脑卒中患者分为脑出血组和脑梗死组。治疗前,采用欧洲脑卒中量表(ESS)评定患者神经功能损伤情况,采用改良巴氏指数(MBI)评定患者日常生活活动能力,采用简明精神状态检查量表(MMSE)评定患者认知功能,采用Sheikh法躯干控制测定(Sheikh法)评定患者躯干控制能力,采用Fugl-Meyer平衡量表(FMB)评定患者平衡功能,采用Fugl-Meyer运动量表(FMA)评定患者肢体运动功能。康复治疗1个月后,采用功能独立量表(FIM)对患者功能独立性进行评定。结果组间比较显示,脑出血患者治疗前日常生活活动能力(MBI)、躯干控制能力(Sheikh法)、平衡能力(FMB)以及治疗后功能独立性(FIM)评分均较脑梗死组低(P<0.01)。直线相关分析表明,除脑出血组FMA评分和FIM评分中度相关(P<0.005),脑梗死组MMSE评分和FIM评分低度相关外(P<0.05),2组其余初评指标均与FIM评分高度相关(P<0.001)。多元线性回归分析发现,脑出血组中,MMSE评分、FMB评分、ESS评分为FIM评分有意义的自变量;脑梗死组中,MBI评分、MMSE评分、ESS评分、FMA评分为FIM评分有意义的自变量。结论脑出血患者发病早期,日常生活活动能力、躯干控制能力和平衡能力较脑梗死患者差,经康复治疗后,其功能独立性较脑梗死组差。脑出血患者发病早期的平衡功能、认知功能和神经功能缺损与其治疗后功能独立性依次相关;脑梗死患者发病早期的认知功能、神经功能缺损、日常生活活动能力、肢体运动功能则与其治疗后功能独立性依次相关。
Objective To explore the early onset of functional impairment in stroke patients with different onset and its correlation with functional independence after rehabilitation. Methods 79 cases of hospitalized stroke patients were divided into cerebral hemorrhage group and cerebral infarction group. Before treatment, the neurological impairment was assessed by the European Stroke Scale (ESS). The daily living activity of the patients was assessed by Modified Papanicum Index (MBI). The patients’ cognitive function was evaluated by the Mini-Mental State Examination Scale (MMSE) The Sheikh method was used to assess the trunk control ability of the patients. The Fugl-Meyer balance scale (FMB) was used to assess the balance function of the patients. The motor function of the limbs was assessed by the Fugl-Meyer scale (FMA). One month after rehabilitation, patients were assessed for functional independence using a functional independent test (FIM). Results Comparisons between groups showed that MBI, Sheikh’s method, FMB and FIM scores of patients with cerebral hemorrhage were lower than those before cerebral infarction (P <0.05) <0.01). The linear correlation analysis showed that there was a moderate correlation between FMA score and FIM score (P <0.005), cerebral infarction MMSE score and FIM score (P <0.05) Highly correlated (P <0.001). Multivariate linear regression analysis showed that MMSE score, FMB score and ESS score were significant independent variables of FIM score in cerebral hemorrhage group. MBI score, MMSE score, ESS score and FMA score of cerebral infarction group were significant Argument. Conclusions The early onset of cerebral hemorrhage, daily living activity, trunk control ability and balance ability are worse than those of cerebral infarction. After rehabilitation, the functional independence is worse than that of cerebral infarction group. The early onset of cerebral hemorrhage patients with balance function, cognitive function and neurological deficit and its functional independence after treatment in turn related to; early onset of cerebral infarction in cognitive function, neurological deficit, activities of daily living, limb motor function and its treatment After functional independence in turn related.