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自发性脑出血患者康复结局影响因素的回顾性分析。

A Retrospective Analysis of Factors Impacting Rehabilitation Outcomes in Patients With Spontaneous Intracerebral Hemorrhage.

机构信息

From the Department of Neurorehabilitation, Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Center, Beijing, China.

出版信息

Am J Phys Med Rehabil. 2020 Nov;99(11):1004-1011. doi: 10.1097/PHM.0000000000001459.

DOI:10.1097/PHM.0000000000001459
PMID:32371627
Abstract

OBJECTIVE

This study aimed to identify the factors associated with motor and activities of daily living recovery after 4-wk rehabilitation in patients with intracerebral hemorrhage.

DESIGN

Eight hundred ten eligible patients were enrolled and engaged in 4-wk rehabilitation. Fugl-Meyer score and Modified Barthel Index were used to measure the motor and activities of daily living function. Multivariate linear regressions were used to investigate the effect of the 23 preexisting conditions in intracerebral hemorrhage patients (eg, scales of functional abilities, spasticity, cognition, and mental disorders) on efficacy outcomes after 4-wk rehabilitation.

RESULTS

The results indicated the following: (1) young age, absence of diabetes mellitus, right hemiplegia, early rehabilitation, elbow spasticity, and higher cognitive and motor function were significantly associated with better prognosis after 4-wk rehabilitation; (2) patients who started rehabilitation within 120 days of stroke onset had significantly better outcomes; (3) activities of daily living function could be further improved for those patients wherein the time since stroke onset was more than 121 days; and (4) improving cognitive function may improve functional ability after rehabilitation in patients with intracerebral hemorrhage.

CONCLUSIONS

The results could enable clinicians to predict the intracerebral hemorrhage rehabilitation outcome and achieve the maximum favorable outcome to facilitate personal independence.

摘要

目的

本研究旨在确定与脑出血患者 4 周康复后运动和日常生活活动恢复相关的因素。

设计

纳入 810 名符合条件的患者并进行 4 周康复。采用 Fugl-Meyer 评分和改良巴氏指数评估运动和日常生活活动功能。采用多元线性回归分析 23 种脑出血患者(如功能能力量表、痉挛、认知和精神障碍)对 4 周康复后疗效的影响。

结果

结果表明:(1)年龄较小、无糖尿病、右侧偏瘫、早期康复、肘痉挛、认知和运动功能较高与 4 周康复后预后较好显著相关;(2)发病后 120 天内开始康复的患者预后显著更好;(3)发病后时间超过 121 天的患者日常生活活动功能可进一步改善;(4)改善认知功能可能会改善脑出血患者康复后的功能能力。

结论

这些结果可以帮助临床医生预测脑出血康复的结果,并实现最大的有利结果,以促进个人独立。

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