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专业康复训练对青年脑卒中患者神经功能恢复的影响

Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients.

作者信息

Li Chao-Jin-Zi, Du Xiao-Xia, Yang Kun, Song Lu-Ping, Li Peng-Kun, Wang Qiang, Sun Rong, Lin Xiao-Ling, Lu Hong-Yu, Zhang Tong

机构信息

School of Rehabilitation Medicine, Capital Medical University, Beijing, China; Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.

Department of Neurology, Xi'an Gaoxin Hospital, Xi'an, Shaanxi Province, China.

出版信息

Neural Regen Res. 2016 Nov;11(11):1766-1772. doi: 10.4103/1673-5374.194746.

Abstract

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke (59.6%) was the primary stroke type found in the young group, while ischemic stroke (60.0%) was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modified Rankin Scale scores were increased at discharge. Six months after discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction (such as friendship) improved. The degree of disability and functional status improved significantly in young stroke patients after professional rehabilitation, but the number of patients who returned to society within 6 months after stroke was still small.

摘要

年轻的中风患者有强烈的重返社会的愿望,但针对他们的康复训练项目、强度和预后的研究却很少。我们分析了2014年2月至2015年5月在中国首都医科大学附属北京康复医院神经康复科住院的中青年/老年中风患者的临床资料。结果显示,出血性中风(59.6%)是年轻组中主要的中风类型,而缺血性中风(60.0%)是中老年组中主要的中风类型。与老年中风患者相比,年轻中风患者的受教育程度和高同型半胱氨酸血症的发生率更高,而高血压、糖尿病和心脏病的发生率更低。年轻组的平均住院时间比中老年组更长。年轻中风患者中观察到的主要危险因素包括高血压、饮酒、吸烟、高脂血症、高同型半胱氨酸血症、糖尿病、中风病史和心脏病。最常接受的康复项目包括物理治疗、职业治疗、言语治疗、针灸。平均康复训练时间为每天2.5小时。出院时Barthel指数和改良Rankin量表评分有所提高。出院6个月后,职业和经济满意度下降,家庭生活满意度没有变化。其他生活满意度(如友谊)有所提高。经过专业康复后,年轻中风患者的残疾程度和功能状态有显著改善,但中风后6个月内重返社会的患者人数仍然很少。

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