偏瘫患者综合性神经康复治疗的疗效观察

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1、偏瘫患者综合性神经康复治疗的疗效观察【摘要】目的探讨综合性神经康复治疗对偏瘫患者神经功能缺损及抑郁障碍的疗效。方法将62例首发偏瘫伴抑郁症状的患者随机分为治疗组和对照组，每组31例，治疗组给予规范的综合性神经康复治疗，包括运动疗法、心理治疗和神经科常规药物治疗，对照组予神经科常规药物治疗。用脑卒中患者临床神经功能缺损程度评分标准和汉密尔顿抑郁量表(HAMD)，分别于治疗前和治疗后2、4周末对患者进行疗效评定。结果治疗组与对照组脑卒中患者临床神经功能缺损程度评分和HAMD评分在治疗前差异无显著性(P>0.05);治疗2周末治疗组评分

2、低于对照组，但差异无显著性(P>0.05);4周末治疗组评分均低于对照组，差异有显著性(P<0.05)。结论综合性神经康复治疗能显著改善偏瘫患者神经功能缺损，缓解患者的抑郁症状。【关键词】偏瘫;抑郁;神经功能缺损;康复治疗　　Abstract：ObjectiveToprobeintotheeffectofacomprehensiveneurologicalrehabilitationregimenontheneurologicalimpairmentandremissionofdepressioninpatientswith

3、hemiplegia.Methods62casesoftheinitialhemiplegiawithdepressionwererandomizedintotwogroups:thetreatmentgroupandthecontrolgroup(n=31ealch).Thetreatmentgroupunderwentstandardizedintegraltreatmentofneurological7rehabilitation,physicaltherapy,routinepsychologicalandneurologica

4、lmedication;whilethecontrolgrouponlyreceivedroutineneurologicaldrugadministration.PatientswithstrokewereassessedforefficacybyclinicalneurologicalimpairmentscoringcriteriaandtheHamiltonDepressionRatingScale(HAMD),beforetreatmentand2and4weeksaftertreatment,respectively.Res

5、ultsTheclinicalneurologicalimpairmentscoreandtheHAMDscoreshadnodifferencesbetweenthetreatmentgroupandthecontrolgroupbeforethetreatment(P>0.05);and2weeksafterthetreatment,thescoresintreatmentgroupwereslightlylowerthanthoseinthecontrolgroup,butthedifferencehadnostatisti

6、calsignificance(P>0.05);theclinicaldegreeofneurologicalimpairmentsandHAMDscoresofpatientswithstrokeinthetreatmentgroupwerelowerthanthoseinthecontrolgroup,withsignificantstatisticaldifferenceattheendofthe4thweek(P<0.05).ConclusionTheneurologicalrehabilitationtherapy

7、cansignificantlyimprovetheneurologicalimpairmentandrelievethedepressivesymptomsinpatientswithhemiplegia.　　Keywords：hemiplegia;depression;neurologicalimpairment;rehabilitationtherapy7　　已换引起偏瘫的原因很多，脑卒中、脑外伤最为常见，我国每年死于脑卒中者约130万，存活者约75%致残，给家庭和社会带来沉重负担。早期、积极康复治疗，将使80%的患者功能明显改善

8、[1]。多数偏瘫患者出现应激性心理反应，包括情绪反应、行为反应、自我防御反应[2]，不能配合治疗，因此我们应用综合性神经康复治疗改善偏瘫患者的神经功能缺损，缓解抑郁症状，从而促进患者肢体功能康复。　　1对象