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目的探讨康复护理结合肩周局部药物注射对脑卒中偏瘫肩痛患者上肢功能的影响。方法选取2012年1月-2014年8月该科住院治疗的脑卒中后偏瘫肩痛患者28例为治疗组,回顾性选取2011年1月-2012年4月该科住院治疗的脑卒中后偏瘫肩痛患者30例为对照组。对照组给予常规康复治疗。治疗组在常规康复治疗基础上,给予康复护理措施及肩周局部痛点药物注射。于治疗前、治疗3d、1周、4周时分别采取数字模拟疼痛评分(NRS)、Fugl-Meyer运动功能评分(FMA)、Barthel指数(ADL BI)、汉密尔顿抑郁评定量表(HAMD)对2组患者的上肢功能、ADL能力、情绪进行评定。结果治疗前2组患者在NRS、FMA、MBI、HAMD评分之间比较,差异无统计学意义(P>0.05)。治疗后,2组患者NRS、FMA、MBI、HAMD评分均较治疗前有所改善(P<0.05),且治疗组均优于对照组(P<0.05)。2组患者的肩痛程度NRS积分低于治疗前(P<0.01),且治疗组3天及1周、4周时疼痛改善程度均优于对照组(P<0.05)。结论局部注射结合康复护理对脑卒中偏瘫肩痛患者上肢功能有一定的改善作用。
Objective To investigate the effects of rehabilitation nursing combined with local injection on the function of upper limbs in patients with stroke and hemiplegia shoulder pain. Methods From January 2012 to August 2014, 28 patients with post-stroke hemiplegia and shoulder pain who were hospitalized in this department were selected as the treatment group. The incidence of post-stroke hemiplegia in hospital from January 2011 to April 2012 was retrospectively reviewed. Shoulder pain in 30 patients as control group. The control group was given routine rehabilitation. On the basis of routine rehabilitation treatment, the treatment group was given rehabilitation nursing measures and partial shoulder pain injection. The scores of NRS, FMA, Barthel Index (ADL BI), Hamilton Depression Rating Scale (HAMD) were calculated before treatment, 3 days, 1 week and 4 weeks after treatment. Group of patients with upper limb function, ADL ability, emotional evaluation. Results There was no significant difference in NRS, FMA, MBI and HAMD score between the two groups before treatment (P> 0.05). After treatment, the scores of NRS, FMA, MBI and HAMD in both groups were improved compared with that before treatment (P <0.05), and the treatment group was better than the control group (P <0.05). The NRS scores of shoulder pain in two groups were lower than those before treatment (P <0.01). The improvement of pain at 3 and 1 and 4 weeks in treatment group was better than that in control group (P <0.05). Conclusion Local injection combined with rehabilitation nursing can improve the upper limb function of stroke patients with hemiplegia and shoulder pain.