脑卒中患者瘫痪侧别对功能恢复预后影响的分析

关键词：偏瘫侧  利手  脑卒中  预后

Keywords:hemiplegic side  handedness  stroke  prognosis

摘要：

      摘要 目的：探讨脑卒中患者不同瘫痪侧别对功能预后的影响，为临床康复策略的制订提供理论基础。 方法：脑卒中患者278例，分为两组：利手侧瘫痪组和非利手侧瘫痪组；两组都予以规范的三级康复治疗，分别于入选时、第1个月末、第3个月末和第6个月末进行瘫痪侧肢体功能评定（Brunnstrom分期、Fugl-Meyer评定）和生活功能评定（生存质量评定、日常生活活动能力评定和综合功能评定）。 结果：利手侧瘫痪组和非利手侧瘫痪组患者在各次随访时的瘫痪侧肢体功能无明显差异（P>0.05）；利手侧瘫痪组和非利手侧瘫痪组的患者在各次随访时的生活功能有明显差异（P<0.05），其中非利手侧瘫痪组的患者生活功能更好。 结论：非利手侧瘫痪组的脑卒中患者生活功能的恢复进程和预后要优于利手侧瘫痪组的患者；而非利手侧瘫痪组与利手侧瘫痪组对脑卒中患者瘫痪侧肢体功能的恢复速度和预后无影响。

Abstract:

      Abstract Objective：To explore the influences of different hemiplegic sides on patient′s function outcome，and provide the theoretical foundation for rehabilitation strategy. Method：Two hundred and seventy-eight stroke patients were devided into two groups：handedness side hemiplegia group and non-handedness side hemiplegia group. They were all administered standard tertiary rehabilitation program in addition to routine interventions of neurological medicine, Brunnstrom Assessment（BA），Fugl-Meyer assessment（FMA），quality of life（QOL），activity of daily living（ADL） and functional comprehensive assessment（FCA） were evaluated and analyzed at the recruitment，the end of the 1st，3rd and 6th month separately after stroke. Result：In each follow up interview，there was no significant difference in the distributions of BA and FMA scores between handedness side hemiplegia and non-handedness side hemiplegia. There were significant differences in the distributions of QOL，ADL and FCA scores between handedness side hemiplegia and non-handedness side hemiplegia，those of the latter were better. Conclusion：The living function of non-handedness side hemiplegia patients are better than that of handedness side patients in both recovery speed and prognosis；however，the function of hemiplegic sides are similar in two groups.